scholarly journals Vital Signs Reference Range Indicator

2020 ◽  
Author(s):  
Keyword(s):  
Reference Range ◽  
Vital Signs ◽  
Range Indicator

scholarly journals Adrenal Mass Hemorrhage Clinically Mimicking a Pheochromocytoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A112-A112
Author(s):  
Panadeekarn Panjawatanan ◽  
Muhammad Daniyal ◽  
Juan Jose Delgado Hurtado
Keyword(s):  
Adrenal Mass ◽  
Reference Range ◽  
Case Reports ◽  
Adrenal Adenoma ◽  
Vital Signs ◽  
Healthy Woman ◽  
Reference Ranges ◽  
Mri Findings ◽  
Plasma Metanephrines ◽  
Urine Metanephrines

Abstract Background: A pheochromocytoma is diagnosed clinically using correlation of clinical, imaging, and laboratory studies. We report the case of an adrenal mass hemorrhage that presented with significantly elevated urine metanephrines mimicking a pheochromocytoma. Clinical Case: A 59-year-old healthy woman presented to the ED with chest pain, left flank and upper quadrant pain associated with diaphoresis and palpitations. Vital signs were significant for a pulse of 92 bpm, and a BP of 213/88 mm Hg. Physical exam revealed tenderness to palpation on the left upper quadrant and left costovertebral angle. Laboratory tests were significant for an elevated D-dimer (2,449 ng/mL, reference range 215–499 ng/mL). CT abdomen with IV contrast showed a 3.5 x 2.9 cm round mass abutting the lateral limb of the left adrenal gland with surrounding fat stranding with suspicion of inflammation or hemorrhage. 24-hour urine metanephrines showed elevated metanephrine (7,227 mcg/24hr; reference range <400 mcg/24 hr) and normetanephrine (1,209 mcg/24hr; reference range 900 mcg/24 hr). In the setting of up trending cardiac enzymes and inferior-lateral ST segment depression, a cardiac catheterization was performed which was unrevealing. She was discharged from the hospital and referred to endocrinology. On that visit, ~ 1 month after the patient was admitted to the hospital, plasma metanephrines were ordered which showed mildly elevated plasma metanephrine (0.83 nmol/L; reference range <0.5 nmol/L) and normetanephrine (1.2 nmol/L; reference ranges <0.9 nmol/L). An MRI abdomen with and without contrast revealed a 2.7 x 2.2 x 1.8 cm nodule arising from the lateral limb, with loss of signal on in-phase images suggestive of blood products. Plasma metanephrines and MRI findings ruled out the diagnosis of a pheochromocytoma. Conclusion: To our knowledge, few cases of an adrenal mass hemorrhage clinically mimicking a pheochromocytoma have been reported. Although the inpatient clinical presentation of our patient was consistent with this, the outpatient plasma metanephrines and MRI were not. An adrenal adenoma hemorrhage should be considered as a potential differential diagnosis for elevated metanephrines, which can clinically mimick a pheochromocytoma. References: (1)Sekos K, Short T, Ing SW. Adrenal hemorrhage due to hypercoagulable state mimicking pheochromocytoma. Journal of Clinical and Translational Endocrinology: Case Report. 8. 9–12. 2018.(2)Wordsworth S, Thomas B, Agarwal N, Hoddell K, Davies S. Elevated urinary cathecholamines and adrenal haemorrhage mimicking phaechromocytoma. BMJ Case Reports. 2010.

scholarly journals Reference Range for Vital Signs and Clinical Examinations of Healthy Red Foxes in Captivity

2018 ◽  
Vol 71 (10) ◽  
pp. 581-585
Author(s):  
Minoru YATU ◽  
Mitsuhiro SATO ◽  
Toshihiro ICHIJO ◽  
Hiroshi SATOH ◽  
Shigeru SATO
Keyword(s):  
Reference Range ◽  
Vital Signs ◽  
Red Foxes ◽  
In Captivity

scholarly journals What is the normal range of obstetric shock index in the immediate postpartum period in a low resource setting?

2020 ◽  
Author(s):  
Johnbosco Ifunanya Nwafor ◽  
Chuka Nobert Obi ◽  
Olisah Elvis Onuorah ◽  
Blessing Idzuinya Onwe ◽  
Chukwunenye Chukwu Ibo ◽  
...  
Keyword(s):  
Lower Limit ◽  
Current Literature ◽  
Reference Range ◽  
Vital Signs ◽  
Shock Index ◽  
Normal Range ◽  
Upper Limit ◽  
Resource Setting ◽  
Haemodynamic Changes ◽  
Obstetric Population

Abstract AbstractObjective: To determine the normal range of shock index (SI), blood pressure (BP), mean arterial pressure (MAP) and heart rate (HR) among postpartum women and to compare shock index with the normal range in the current literature.Methods: This is a prospective cohort study evaluating vital signs collected at one hour of delivery in women with normal blood loss delivered in Abakaliki, Nigeria. Results: The median (95% reference range) was 120 (100 - 155.8) for systolic BP, 70 (60 - 94) for diastolic BP, 90 (66.5 - 116.6) for MAP, 82 (65 - 102) for HR, and 0.69 (0.48 - 0.89) for SI. The upper limit of SI of 0.89 in this study did support the current literature suggesting a threshold of 0.9 as upper limit of normal. However, the lower limit of SI of 0.48 in this study corresponds to the lower limit of 0.5 for non-obstetric population. Over half (56%) of the study cohorts maintained shock index values within the normal range (0.5 - 0.7) for non-obstetric population. Conclusion: Although haemodynamic changes of pregnancy widens the range of shock index in obstetric population, 56% of the participants maintained normal shock index within the reference range for non-obstetric population. We recommend that the normal obstetric shock index range of 0.7 - 0.9 in current literature be changed to 0.5 - 0.9 to accommodate this lower threshold.

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