CJEM Articles: shock

Displaying 1-2 of 2 results

  • Steroids for patients in septic shock: the results of the CORTICUS trial
    July 2011 13 4
    Alina Toma, Angela Stone, Robert S. Green, Sara Gray

    CLINICAL QUESTION What is the role of steroids in septic shock in the emergency department?
    ARTICLE CHOSEN Sprung CL, Annane D, Keh D, et al; CORTICUS Study Group. Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008;358:111-24.
    STUDY OBJECTIVE To assess the safety and efficacy of low-dose hydrocortisone therapy for patients with septic shock and to compare outcomes based on response to corticotropin testing.

  • Acute presentation of choriocarcinoma: a case study and review of the literature
    March 2002 4 2
    Andrew Worster, Farouk Mookadam, John Opie, Sangita Sharma

    We report an unusual case of a 27-year-old male with an acute presentation of choriocarcinoma. The patient presented with unstable vital signs, severe anemia and a widened arterial pulse pressure following a several day history of testicular pain. He was subsequently diagnosed as having testicular choriocarcinoma with multiple hepatic metastases and large hemorrhagic para-aortic lymph nodes. The widened pulse pressure persisted during fluid resuscitation and correction of both the anemia and hypotension, and only narrowed after the initiation of chemotherapy. A literature review indicates that metastatic testicular choriocarcinoma is a rare but aggressive malignancy that often presents with acute symptoms and signs that cause patients to seek emergency care. We summarize the reported cases of "acute" testicular choriocarcinoma presentation and briefly discuss its relationship to widened arterial pulse pressure.