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Ciro Paolillo

44 articles published Follow:

Abdomen

Clinical diagnosis of gastric ulcer. Does your gastroenerologist perform better?

A 35 yo smokerman presents at morning to the ED. He refers epigastric pain since seven days. The pain worses after eating, he refers nausea without vomit and he denies melena and weight loss. Palpation causes pain in epigastric region, there’s not fever, nor tachicardia, hemoglobin is 13 g/dL. Bedside US evidences a normal…

ByCiro Paolillo11 January 20140Comments

Featured Uncategorized

Sick or not-sick at a glance. Is it reliable?

It’s a busy Monday morning in ED, many ambulance are on the go. There’s been a car crash on the high street - says the nurse – we must free the rooms immediately. There is a full flow now. In a box there is a young man, the doctor observes the patient form the outside,…

ByCiro Paolillo11 October 20130Comments

Bones and joints

Low probability of mandibular fracture? C’mon grit your teeth!

It’s a Saturday busy night, in ED when a 31 yo male comes referring pain in the chin and next to the right ear after a trauma. He was out celebrating his birthday, slipped and fell on to his chin. Vital signs are normal, there aren’t wounds, he denies malocclusion, the palpation of the…

ByCiro Paolillo15 September 20130Comments

Abdomen

Is it a subtle appendicitis? How to make time your friend (part two)

It’s about the end of the night shift, in Observation Unit there’s George a 25 yo male presented the evening before with a mild periumbilical pain since 2 days than localized to the right lower quadrant. He was afebrile with stable vital signs, in the car, arriving to the ED, there was vomit, not diahrrea.…

ByCiro Paolillo11 September 20130Comments

Abdomen

Is it a subtle appendicitis? How to make time your friend

Mr. Smith is a 39 yo man with abdominal pain. He has been visited, few hours ago, by his primary care doctor who sent him to you for a surgeon consult. He refers abdominal pain, fever and nausea since the day before. The pain was previously in the midabdomen, than it migrated to the right…

ByCiro Paolillo11 August 20130Comments

Abdomen

Do you suspect a lower UTI? Urine analysis sometimes is over!

A 30 yo woman comes in ED complaining a burning pain when urinating, hematuria and increased of urinary frequency. She denies abdominal pain, fever, and vaginal discharge, she is not pregnant. On the right there’s the toilette – the nurse indicates – could you pee in this cup? Give me antibiotics – she says…

ByCiro Paolillo11 August 20130Comments

Bones and joints

Sciatica: only pain control, or imaging? Point your big toe to your nose!!!

A 50 y/o friend of yours called for you. He refers low back pain radiating to his left leg from approximately 2 weeks. “help me doc - he says - I have a sciatica, a dog is biting my buttock, can you favor me with an urgent RMN?”. He is very suffering. During the straight…

ByCiro Paolillo11 July 20130Comments

Blood

Is it always necessary to perform an arterial blood gas after a blunt trauma?

A 53 year old man is involved in a motor vehicle crash. He refers a moderate thorax and abdominal pain. No head injury, the helmet is not broken, the patient remembers the accident. Systolic blood pression is 120/80 mmHg, respiratory rate is 24, saturation is 100%, he has abrasions over the torso and right thorax…

ByCiro Paolillo10 June 20130Comments

Chest

PCT and pneumonia: worth it?

A 78 yo woman is brought from an assisted-living facility because of dyspnea and fever. She has an history of dyabetes and heart failure. She is confused, tachipnoic, tachicardic and febrile with rales on the back. Chest X ray shows an infiltrate. PCT value is 1,5 µg/L. Does PCT provide prognostic information concerning mortality…

ByCiro Paolillo11 May 20130Comments

Abdomen

How have you come to the hospital?

It’s just started your night shift, Sara is a young EP, she is going home after an hard day. Hello - she says tired - could you help me? There is a guy with abdominal pain and nausea. I think it could be appendicitis, but there is not fever and not leukocytosis. Have you asked…

ByCiro Paolillo22 April 20130Comments

The Emergency Physician

Ciro Paolillo

Clinical diagnosis of gastric ulcer. Does your gastroenerologist perform better?

Sick or not-sick at a glance. Is it reliable?

Low probability of mandibular fracture? C’mon grit your teeth!

Is it a subtle appendicitis? How to make time your friend (part two)

Is it a subtle appendicitis? How to make time your friend

Do you suspect a lower UTI? Urine analysis sometimes is over!

Sciatica: only pain control, or imaging? Point your big toe to your nose!!!

Is it always necessary to perform an arterial blood gas after a blunt trauma?

PCT and pneumonia: worth it?

How have you come to the hospital?

Septic Arthritis

Septic Arthritis and Arthrocentesis

Is cervical spine X-ray necessary if there is a distracting injury?