Unilateral cyanosis on tongue as an unusual appearance in emergency department: A case report

Introduction: Unilateral and bilateral tongue cyanosis usually occurs due to the Raynaud syndrome and in the underlying severe types of vasculitis and rheumatology. Case Presentation: The present study was conducted on a 54-year-old woman who referred to the emergency department with complaints of sudden and painless discoloration of the left half of the tongue. The patient had no history of disease other than diabetes controlled with glibenclamide. Clinical examination of the head and neck revealed evidence of unilateral cyanosis in the left half of the tongue without pain, whose discoloration did not improve with warming of the tongue. Conclusion: Cyanosis in the emergency department can be managed appropriately by considering some parameters including history taking, history of cyanosis occurrence, history of cardiopulmonary disease, cold sensitivity and history of rheumatologic diseases, presence or absence of nail clubbing, arterial blood oxygen saturation and arterial blood gas test results. These parameters can be effective in designing a treatment regimen, while differentiating the causes of central from peripheral cyanosis. © 2020 The Author(s). Published by Kerman University of Medical Science

The investigation of valid criteria for hospitalization and discharge in patients with limb cellulitis: A prospective cohort study

Objective: The purpose of this study was to evaluate a valid model for patients� admission or discharge from emergency services to improve the health system and reduce costs. Methods: This study was carried out using a prospective cohort method. The study population was patients with limb cellulitis referring to the emergency department of Peymanieh hospital. In this research, the study participants were separated into two groups based on the duration of hospitalization (hospital stay less than 24 hours or longer than 24 hours), then the patients were again separated into 4 groups based on the classification of the the Clinical Resource Efficiency Support Team (CREST) guideline, which in each of these groups the mean age, gender, and the prevalence of underlying diseases were identified and the final outcome for each group was determined after one week from the visit to the hospital. Results: Peripheral vascular disease, history of injection drug use, immunodeficiency and congenital immune deficiency had a significant relationship with the rate of hospitalization and recurrence. There was a significant relationship between class 1 disease and hospitalization for less than 24 hours, classes 2 and 3, and hospitalization for more than 24 hours (P < 0.001). There was a significant relationship between grade 1 disease and non-recourse, grade 3 and recurrence within one week after initiation of the treatment (P < 0.001). But there was no relationship between grade 2 and grade 4 and the referral of the patient after treatment. Conclusion: Corset Scale is a reliable scale for assessing the severity of the disease to determine the process of cellulite treatment for outpatient or hospitalization. © 2020 The Author(s)

Evaluation of the Living 4 Life project : a youth-led, school-based obesity prevention study

The Living 4 Life study was a youth-led, school-based intervention to reduce obesity in New Zealand. The study design was quasi-experimental, with comparisons made by two cross-sectional samples within schools. Student data were collected at baseline (n = 1634) and at the end of the 3-year intervention (n = 1612). A random-effects mixed model was used to test for changes in primary outcomes (e.g. anthropometry and obesity-related behaviours) between intervention and comparison schools. There were no significant differences in changes in anthropometry or behaviours between intervention and comparison schools. The prevalence of obesity in intervention schools was 32% at baseline and 35% at follow-up and in comparison schools was 29% and 30%, respectively. Within school improvements in obesity-related behaviours were observed in three intervention schools and one comparison school. One intervention school observed several negative changes in student behaviours. In conclusion, there were no significant improvements to anthropometry; this may reflect the intervention&rsquo;s lack of intensity, insufficient duration, or that by adolescence changes in anthropometry and related behaviours are difficult to achieve. School-based obesity prevention interventions that actively involve young people in the design of interventions may result in improvements in student behaviours, but require active support from leaders within their schools.<br /