Suicide Attempt by a Corrosive Agent Causing Unusual Outcomes and Complications.

We commonly encounter patients in the emergency department who present after a suicide attempt. The methods can vary and present unique challenges depending on the nature of the attempt. We present an unsuccessful attempt via chemical ingestion that led to severe complications involving the ingestion of drain cleaner with both highly corrosive and caustic properties. The management and presentation are discussed in great detail to further investigate the best treatment plan for both acute and chronic complications.

Management of New Onset Amphetamine-Induced Acute Decompensated Heart Failure in a Young Adult: Case Report.

Amphetamine-induced heart failure is a well-recognized complication of chronic amphetamine abuse. Although the exact mechanisms underlying the development of this condition are not fully understood, it is believed to be due to a combination of direct toxicity to the myocardium, increased sympathetic activity, and oxidative stress. Amphetamine-induced heart failure typically presents with symptoms such as dyspnea, fatigue, and peripheral edema and can lead to significant morbidity and mortality. Diagnosis is based on a combination of clinical and laboratory findings, including echocardiography and cardiac biomarkers. Treatment typically involves cessation of amphetamine use, management of heart failure symptoms, and aggressive medical therapy with agents such as beta-blockers and angiotensin-converting enzyme (ACE) inhibitors. However, the long-term prognosis for patients with amphetamine-induced heart failure remains poor, highlighting the need for increased awareness and prevention efforts surrounding this growing public health concern. In this case, a 21-year-old male presented to the emergency department (ED) with acute-onset decompensated heart failure due to amphetamine abuse.

How I do it: Radical debulking of lower extremity end-stage lymphedema.

Debulking procedures have been a last-resort therapy for end-stage lymphedema for more than a century. Multiple techniques have been described, and the approach as a whole has fallen in and out of favor as providers have tried to maximize quality of life outcomes. We describe our technique for radical debulking of the lower extremity for the treatment of severe end-stage lymphedema.

Supra-Aortic Arterial Injuries Following Central Venous Catheterization Managed with Percutaneous Closure Devices: A Comprehensive Literature Review of Current Evidence.

BACKGROUND: Inadvertent supra-aortic arterial injuries during central venous catheterization can lead to devastating outcomes. These have been traditionally been managed with open repair or covered stent placement; only recently have percutaneous closure been incorporated into the management of these iatrogenic arterial injuries. METHODS: We performed a MEDLINE literature search in the English language, using the PubMed web-based search engine across years 2000 to 2020. This report reviews 34 published case reports and series reporting 71 iatrogenic supra-aortic arterial injuries managed with percutaneous vascular closure devices. RESULTS: In our review, the use of a closure device was successful in 87% of cases, even in some cases involving sheath sizes greater than 8F. The devices used in these situations caused minimal complications and offered a quick means to control bleeding. Thus, percutaneous closure devices are a helpful tool that offers an alternative to more invasive open surgical repair. CONCLUSIONS: Vascular closure devices offer a minimally invasive and effective approach to the treatment of inadvertent supra-aortic arterial injury following CVC.

Management of an Active Oral Bleed Following Dental Implant Therapy Using Lidocaine and Epinephrine Injection in the Presence of an Oral Anticoagulant: A Clinical Report.

Active bleeding in a patient on oral anticoagulants can be difficult to treat. While massive blood loss and hemorrhage are the highest concern, it is the incidental or seemingly benign bleeds that can eventually turn life-threatening. A deeper understanding of locating and controlling slow but constant minor bleeds that are resistant to clotting is important to consider and explore further.