15 research outputs found
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Acute Jaundice in a Six-year-old: An Unusual Presentation of Atypical Kawasaki Disease
Kawasaki disease (KD) is a rare vasculitis of childhood that is critical to recognize and treat due to associated morbidity and mortality. A six-year-old male presented to our emergency department (ED) afebrile but with reported recent fevers. Exam revealed jaundice and erythematous tongue with papules, and laboratory studies indicated a direct hyperbilirubinemia. Admitted for evaluation, he developed continuous fever, increasing maculopapular rash, and subsequent desquamation of hands and feet. He ultimately met criteria for incomplete KD, was treated with intravenous immunoglobulin, and avoided cardiac complications. This presentation of incomplete KD with hyperbilirubinemia is rare because the patient was afebrile at ED presentation
Recommended from our members
Acute Jaundice in a Six-year-old: An Unusual Presentation of Atypical Kawasaki Disease
Kawasaki disease (KD) is a rare vasculitis of childhood that is critical to recognize and treat due to associated morbidity and mortality. A six-year-old male presented to our emergency department (ED) afebrile but with reported recent fevers. Exam revealed jaundice and erythematous tongue with papules, and laboratory studies indicated a direct hyperbilirubinemia. Admitted for evaluation, he developed continuous fever, increasing maculopapular rash, and subsequent desquamation of hands and feet. He ultimately met criteria for incomplete KD, was treated with intravenous immunoglobulin, and avoided cardiac complications. This presentation of incomplete KD with hyperbilirubinemia is rare because the patient was afebrile at ED presentation
The Inability of Older Adults to Recall Their Drugs and Medical Conditions
Background/Objectives: Previous research has shown that many older adults without known cognitive impairment are unable to recall basic knowledge about their medical history. We sought to determine whether older adult patients in our own clinic population were able to recall their drug regimens and medical conditions from memory.Methods: Patients aged 65 years or older with no known cognitive impairment, dementia, or memory loss who were presenting for routine outpatient follow-up in our medical school neurology and general medicine clinics were recruited. Each patient was asked to recall the number and names of their presently prescribed drugs and their associated medical conditions. Each patient was also administered a Mini-Mental State Examination (MMSE) cognitive screening test (range 0–30).Results: Most patients were unable to recall their drug regimens or their medical conditions. Of 99 patients taking drugs, only 22 % correctly named their drugs from memory, and only 34 % correctly named their medical conditions associated with the drugs. Fewer than half (49 %) correctly recalled the number of drugs they were taking. Poor recall performance was evident even in high-cognitive (MMSE \u3e27) patients.Conclusion: The accuracy of recall memory in older adults regarding their drugs and medical conditions may be poor, which has important implications towards medication reconciliation within meaningful-use doctrine. Clinicians treating older adults should be very cautious before relying on their patients’ memories for accurate recall of their medical conditions, their drug regimens, and even the number of drugs they are taking