BRASH Syndrome Case Report and Brief Review

BRASH syndrome is an acronym that stands for bradycardia, renal failure, AV node blocker, shock and hyperkalemia. The syndrome is precipitated by synergism from AV nodal blocking agents and hyperkalemia. The combination of the AV nodal blockade and renal failure leads to a cycle of severe bradycardia and hyperkalemia. We will discuss a case of BRASH syndrome with a 68 year old female who presented with generalized weakness and was found to be hypotensive, bradycardia, in acute renal failure with hyperkalemia likely related to metoprolol and amlodipine use

Stercoral Colitis Leading to Hypotension and IVC Syndrome with Respiratory Failure Following Fecal Disimpaction

Constipation is an extremely common chief complaint in the emergency department, contributing to approximately 700,000 emergency department visits in 2011. Severe constipation can result in stercoral colitis, which in turn can lead to development of ulceration and colonic perforation leading to fatal peritonitis. As a result, prompt recognition and treatment of this condition with bowel cleansing and fecal disimpaction are often recommended. Here, we will discuss a case of a 62-year-old male with a history of schizoaffective disorder who came into the Emergency Department (ED) hypotensive with stercoral colitis secondary to severe constipation. Following bedside fecal disimpaction, the patient developed sudden respiratory failure and required emergent intubation

Case Report: Thyrotoxic Hypokalemic Periodic Paralysis

Thyrotoxic crisis, or thyroid storm, is an acute, life threatening event caused by hyperthyroidism with mortality up to 8-25% that can present with multi-system organ involvement. It is a rare, but well studied complication in the emergency department but can lead to further, less common complications. In this study we will discuss a case of thyrotoxic hypokalemic periodic paralysis. Thyrotoxic hypokalemic periodic paralysis (TPP) most commonly affects Asian men. The key features of the syndrome include acute onset of hypokalemia and paralysis. The hypokalemic aspect of the disorder is secondary to the shift intracellularly by thyroid hormones’ sensitization of Na+/K+-ATPase as opposed to body\u27s depletion of potassium. TPP has an incidence of 2% in patients with thyrotoxicosis of any cause. The paralysis occurs because a large majority of the body’s potassium is located in skeletal muscle. When the potassium moves intracellularly the muscles are unable to contract in their normal fashion

Case Report: Unintentional Edible THC Ingestion (Gummi Worms) in a Child

We report the case of a 4 year male who presented to the ED with what his mother described as unusual fatigue and sleepiness. The mother related that family and friends had some to her house for a holiday gathering and that one of the guests had an accessible and open handbag that contained gummi worm THC. The guest observed the child eating the gummi worms and immediately notified the patient’s mother. Poison control was contacted. The child was observed for 6 hours and left the ED in good condition without any specific treatment needed. Awareness of the potential of unintentional edible cannabis in the pediatric population is important

Education in a warming world: Trends, opportunities and pitfalls for institutes of higher education

Higher education institutes (HEI) face considerable challenges in navigating how to respond to the escalating and intertwined socio-ecological sustainability crises. Many dedicated individuals working in the sector are already driving meaningful action through rigorous research, teaching, knowledge sharing, and public engagement, while there is a growing consensus that sector-wide change is needed to ensure that aspirational declarations and positive individual actions translate into sustainable and transformative change. This article seeks to contribute to such efforts by illustrating a number of trends, examples, and reflections on how third-level educational institutes can act sustainably. We highlight the potential of five strategies HEI could employ to support the creation of a more sustainable future namely, (i) innovative approaches to climate change education; (ii) research agendas for societal transformations; (iii) providing climate change education for professional development; (iv) supporting public intellectuals; and (iv) investing in whole-systems approaches to greening the campus. The insights are the product of an interdisciplinary working group with members from across Europe, Australia, and the UK. These international examples provide insight and a sense of possibility for future application

Education in a warming world: Trends, opportunities and pitfalls for institutes of higher education

Higher education institutes (HEI) face considerable challenges in navigating how to respond to the escalating and intertwined socio-ecological sustainability crises. Many dedicated individuals working in the sector are already driving meaningful action through rigorous research, teaching, knowledge sharing, and public engagement, while there is a growing consensus that sector-wide change is needed to ensure that aspirational declarations and positive individual actions translate into sustainable and transformative change. This article seeks to contribute to such efforts by illustrating a number of trends, examples, and reflections on how third-level educational institutes can act sustainably. We highlight the potential of five strategies HEI could employ to support the creation of a more sustainable future namely, (i) innovative approaches to climate change education; (ii) research agendas for societal transformations; (iii) providing climate change education for professional development; (iv) supporting public intellectuals; and (iv) investing in whole-systems approaches to greening the campus. The insights are the product of an interdisciplinary working group with members from across Europe, Australia, and the UK. These international examples provide insight and a sense of possibility for future application

Tertiary Education in a Warming World

Higher education institutes have a critical role to play in driving the scientific, political, technological, and cultural change needed to avoid the worst-case climate change scenarios, and in advancing the societal adaptive capacities needed to meet the ongoing challenges posed by the ongoing environmental crises.In response to the intensification of the environmental problems, growing numbers of institutes of higher education are declaring climate emergencies and making public commitments to supporting and contributing to the realisation of global environmental and social goals. Further, many dedicated individuals working in the sector are already driving meaningful action through rigorous research, teaching, knowledge sharing, and public engagement. There is a growing consensus that sector-wide change is needed to ensure that aspirational declarations and positive individual actions translate into sustainable and transformative change.To contribute to such efforts the Worldwide Universities Network (WUN) Education in a Warming World Research Consortium is launching the Tertiary Education in a Warming World report.It is intended to be a resource to other academics and policymakers who are also grappling with promoting a robust climate change and sustainability agenda within tertiary education.The report illustrates a number of trends, examples, and reflections on how third-level educational institutes can work towards creating a more sustainable future. Drawing on Tristan McCowan’s framework, we focus on five modalities of third-level institutional operations, to provide an analytical lens to understand better the complex interplay between higher education institutes, societies, and climate change

Tertiary Education in a Warming World

Higher education institutes have a critical role to play in driving the scientific, political, technological, and cultural change needed to avoid the worst-case climate change scenarios, and in advancing the societal adaptive capacities needed to meet the ongoing challenges posed by the ongoing environmental crises.In response to the intensification of the environmental problems, growing numbers of institutes of higher education are declaring climate emergencies and making public commitments to supporting and contributing to the realisation of global environmental and social goals. Further, many dedicated individuals working in the sector are already driving meaningful action through rigorous research, teaching, knowledge sharing, and public engagement. There is a growing consensus that sector-wide change is needed to ensure that aspirational declarations and positive individual actions translate into sustainable and transformative change.To contribute to such efforts the Worldwide Universities Network (WUN) Education in a Warming World Research Consortium is launching the Tertiary Education in a Warming World report.It is intended to be a resource to other academics and policymakers who are also grappling with promoting a robust climate change and sustainability agenda within tertiary education.The report illustrates a number of trends, examples, and reflections on how third-level educational institutes can work towards creating a more sustainable future. Drawing on Tristan McCowan’s framework, we focus on five modalities of third-level institutional operations, to provide an analytical lens to understand better the complex interplay between higher education institutes, societies, and climate change

Public opinion about solar radiation management: A cross-cultural study in 20 countries around the world

Some argue that complementing climate change mitigation measures with solar radiation management (SRM) might prove a last resort to limit global warming to 1.5 °C. To make a socially responsible decision on whether to use SRM, it is important to consider also public opinion, across the globe and particularly in the Global South, which would face the greatest risks from both global warming and SRM. However, most research on public opinion about SRM stems from the Global North. We report findings from the first large-scale, cross-cultural study on the public opinion about SRM among the general public (N = 2,248) and students (N = 4,583) in 20 countries covering all inhabited continents, including five countries from the Global South and five ‘non-WEIRD’ (i.e. not Western, Educated, Industrialised, Rich, and Democratic) countries from the Global North. As public awareness of SRM is usually low, we provided participants with information on SRM, including key arguments in favour of and against SRM that appear in the scientific debate. On average, acceptability of SRM was significantly higher in the Global South than in the ‘non-WEIRD’ Global North, while acceptability in the ‘WEIRD’ Global North was in between. However, we found substantial variation within these clusters, especially in the ‘non-WEIRD’ Global North, suggesting that countries do not form homogenous clusters and should thus be considered individually. Moreover, the average participants’ views, while generally neither strong nor polarised, differed from some expert views in important ways, including that participants perceived SRM as only slightly effective in limiting global warming. Still, our data suggests overall a conditional, reluctant acceptance. That is, while on average, people think SRM would have mostly negative consequences, they may still be willing to tolerate it as a potential last resort to fight global warming, particularly if they think SRM has only minor negative (or even positive) impacts on humans and nature

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]