Knowledge of the radiation exposure of radiology examinations was lower in nurses than physicians, but knowledge was poor in both groups. ED physicians and nurses should be educated about radiation exposure and cancer risks associated with various diagnostic radiological methods.

Recurrent hyperammonaemic encephalopathy in a patient with urinary tract infection and urinary retention 一位泌尿道感染和尿瀦留患者的重復性高氨血症性腦病 SH Oh, JH Wee, SP Choi Acute hyperammonaemia is a medical emergency. Most cases are resulted from severely impaired liver function but some cases of non-hepatic causes do occur. In patients with unexplained altered conscious state, immediate measurement of plasma ammonia level is a simple but important step in early diagnosis of hyperammonaemia and prompt reduction of ammonia level to minimise permanent brain damage. We reported a case of recurrent hyperammonaemia and cerebral dysfunction due to urinary tract infection with urinary retention in a patient without underlying liver disease. (Hong Kong j.emerg.med. 2012;19:417-419) 急性高氨血症是一種內科急症。大多數情況下都是由於嚴重肝功能衰退引起，但也有非肝源性的病例發 生。在原因不明的意識障礙患者中，直接測量血氨水平是及早診斷高氨血症，迅速減低血氨含量以及盡 量減少永久性的腦損害的一個簡單而重要的步驟。我們報導了一位因尿瀦留引發泌尿道感染的患者在沒 有潛在肝臟疾病的情況下所出現的重復性高氨血症和腦功能障礙。

In poisoning patients with MDD, physicians in the ED must consider that they have a higher tendency to show suicidal behavior and to have ingested multiple types of drugs.

In conclusion, initial serum levels of procalcitonin might be used as an indicator for aggravation in patients with hepatobiliary tract infection at the emergency department, even though there is hemodynamic stability.