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American Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/30327158/the-effects-of-spinal-immobilization-at-20%C3%A2-on-intracranial-pressure
#1
Selim Özdoğan, Özcan Gökçek, Yavuz Katırcı, Şeref Kerem Çorbacıoğlu, Emine Emektar, Yunsur Çevik
OBJECTIVE: In this study, it was aimed to evaluate whether spinal immobilization at 20°, instead of the traditional 0°, affects intracranial pressure (ICP) via the ultrasonographic (USG) measurement of optic nerve sheath diameter (ONSD). METHODS: 140 healthy, adult, non-smoking volunteers who had no acute or chronic diseases were included this study. Volunteers were randomly divided into two groups; performed spinal immobilization at 0° (Group 1) and at 20° (Group 2)...
October 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30316635/comparison-of-two-glycemic-discharge-goals-in-ed-patients-with-hyperglycemia-a-randomized-trial
#2
Brian E Driver, Lauren R Klein, Jon B Cole, Matthew E Prekker, Erik T Fagerstrom, James R Miner
STUDY OBJECTIVE: Hyperglycemia is commonly encountered in the ED; the importance of glucose reduction in patients well enough to be discharged is unknown. METHODS: We conducted a prospective, randomized trial of ED patients with hyperglycemia with a glucose value 400-600 mg/dL who were discharged from the ED, excluding those with type 1 diabetes mellitus. Patients were randomly assigned to a discharge glucose goal, <350 mg/dL (moderate control) or < 600 mg/dL (loose control)...
October 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30297318/hypertensive-ed-patients-missed-opportunities-for-addressing-hypertension-and-facilitating-outpatient-follow-up
#3
Walter Tyler Winders, Ren Ariizumi, Kimberly Hart, Nancy Elder, Michael Lyons, Christopher Lindsell, Opeolu Adeoye
OBJECTIVES: Hypertension is a leading cause of morbidity and mortality. The emergency department (ED) frequently serves populations with unmet health needs and could have a greater and more systematic role in secondary prevention for hypertension. This study sought to determine, among hypertensive patients discharged from the ED, the frequency that patients 1) received hypertension-specific education, and 2) followed-up with a primary care provider. We secondarily assessed participant beliefs about hypertension...
October 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30318278/serum-cardiac-troponins-as-prognostic-markers-in-patients-with-traumatic-and-non-traumatic-brain-injuries-a-meta-analysis
#4
REVIEW
Ayman El-Menyar, Brijesh Sathian, Bianca M Wahlen, Hassan Al-Thani
OBJECTIVE: The association between brain injury and elevated serum cardiac troponin (cTn) remains poorly understood. We conducted a systematic review and meta-analysis to evaluate whether elevated cTn increases the risk of mortality in patients with traumatic (TBI) or non-traumatic brain injury (NT-BI). METHODS: Cochrane Library, MEDLINE, PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry Platform, and Google scholar databases, and clinicaltrials...
October 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30314903/more-than-meets-the-eye-point-of-care-ultrasound-diagnosis-of-acute-optic-neuritis-in-the-emergency-department
#5
Noa P Yee, Saman Kashani, Thomas Mailhot, Talib Omer
Optic neuritis (ON) is an inflammatory condition that causes demyelination and thickening of the optic nerve leading to acute/subacute vision loss. It is frequently associated with other conditions like multiple sclerosis, but is often misdiagnosed, which can lead to a suboptimal prognosis. Ultrasound is rarely utilized to help make this diagnosis, even though it can easily detect a thickened retrobulbar optic nerve sheath diameter. We describe four cases in which ultrasonographic measurement of the optic nerve sheath diameter aided in the diagnosis of ON...
October 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30293844/emergency-physicians-and-nurses-can-provide-percutaneous-cardiopulmonary-support-in-emergency-departments
#6
LETTER
Chang-Chih Tsai, Chien-Chin Hsu, Kuo-Tai Chen
No abstract text is available yet for this article.
October 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30291034/lemierre-s-syndrome-a-forgotten-complication-of-acute-pharyngitis
#7
LETTER
Lindsey Ouellette, Mariah Barnes, Matthew Flannigan, Erica Tavares, David Whalen, Jeffrey Jones
No abstract text is available yet for this article.
October 1, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30291036/intestinal-pseudo-obstruction-as-the-initial-manifestation-of-systemic-lupus-erythematosus
#8
Fang-Jie Zhang, Juan Zhang, Li-Ping Zhou, Ai-Min Wang, Xiang-Min Li
Small bowel obstruction is common in emergency departments. However, the exact cause of intestinal pseudo-obstruction (IPO) is often misdiagnosed. IPO is considered a severe manifestation of systemic lupus erythematosus (SLE). However, IPO is rare as the initial manifestation of SLE. This paper reports a female patient who presented with IPO as the initial manifestation and was ultimately diagnosed with SLE. The 31-year-old female was definitively diagnosed with SLE after IPO symptoms for 1 month. She then presented multiple organ dysfunction syndrome (MODS) leading to a poor prognosis...
September 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30287130/round-opacity-as-a-presentation-of-pneumocystis-jirovecii-pneumonia-in-an-hiv-infected-patient
#9
Raúl A Jiménez-Castillo, Lucía T Fernández, Raymundo Vera-Pineda, Edgar F Carrizales-Sepúlveda, Gisela García-Arellano, Julio E González-Aguirre
We present the case of a human immunodeficiency virus (HIV)-infected patient who arrived at our emergency department with fever, headache and exertional dyspnea. Throughout their stay, a chest x-ray was taken and a rounded opacity in his left lung was observed. CT images showed same abnormality and also ground glass opacities were seen. Symptoms and images strongly suggested a pulmonary infection due to pneumocystis jirovecii, however a presence of a round lesion should always lead to neoplasia being suspected...
September 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30291035/investigation-of-age-adjusted-d-dimer-using-an-uncommon-assay
#10
Christopher Parks, Richard Bounds, Barbara Davis, Richard Caplan, Tom Laughery, Eli Zeserson
BACKGROUND: Use of an age-adjusted D-dimer for the evaluation of acute pulmonary embolus (PE) has been prospectively validated in the literature and has become a practice recommendation from major medical societies. Most research on this subject involves the most common D-dimer assays reporting in Fibrinogen Equivalent Units (FEU) with a non-age-adjusted manufacturer-recommended cutoff of 500 ng/ml FEU. Limited research to date has evaluated age-adjustment in assays that report in D-Dimer Units (D-DU), which use a manufacturer-recommended cutoff of 230 ng/ml D-DU...
September 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30274764/retrospective-chart-reviews-assessing-delays-in-irb-approval
#11
LETTER
Katherine Collen, Deepthi Datla, Stacey L Gardner, Paul Manus, Kacie Spierling, Jeffrey Jones
No abstract text is available yet for this article.
September 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30293843/advanced-airway-management-in-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#12
REVIEW
Leigh White, Thomas Melhuish, Rhys Holyoak, Thomas Ryan, Hannah Kempton, Ruan Vlok
OBJECTIVES: To assess the difference in survival and neurological outcomes between endotracheal tube (ETT) intubation and supraglottic airway (SGA) devices used during out-of-hospital cardiac arrest (OHCA). METHODS: A systematic search of five databases was performed by two independent reviewers until September 2018. Included studies reported on (1) OHCA or cardiopulmonary resuscitation, and (2) endotracheal intubation versus supraglottic airway device intubation...
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30287129/assessment-of-proadrenomedullin-as-diagnostic-or-prognostic-biomarker-of-acute-appendicitis-in-children-with-acute-abdominal-pain
#13
Niki Oikonomopoulou, Concepción Míguez-Navarro, Arístides Rivas-García, Mercedes García Gamiz, Rosario López-López, Paloma Oliver-Sáez, Bibiana Riaño-Méndez, Tamara Farfan-Orte, Zulema Lobato-Salinas, Júlia Rúbies-Olives, Priscila Llena-Isla, Encarnación María Lancho-Monreal
BACKGROUND: Acute appendicitis (AA) is one of the most frequent surgical pathologies in pediatrics. OBJECTIVES: To investigate the utility of proadrenomedullin (pro-ADM) for the diagnosis of AA. METHODS: Prospective, analytical, observational, and multicenter study conducted in 6 pediatric emergency departments. Children up to 18 years of age with suspected AA were included. Clinical, epidemiological, and analytical data were collected. RESULTS: We studied 285 children with an average age of 9...
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30274763/protamine-sulfate-for-the-reversal-of-enoxaparin-associated-hemorrhage-beyond-12-h
#14
Brian R Lauer, Richard A Nelson, John H Adamski, Joseph Gibbons, Matthew R Janko, Gayathri Ravi, Robert A Barcelona
Clinical practice guidelines recommend protamine sulfate for reversal of enoxaparin associated bleeds dependent on the time from last administration and dose of enoxaparin. We present a case of a hemodynamically unstable patient with an enoxaparin induced abdominal wall hematoma/hemorrhage and the previous enoxaparin administration 21.5 h prior to presentation with a therapeutic anti-Xa assay (0.8 IU/mL) upon assessment in the emergency department. Along with resuscitative efforts, an interdisciplinary team collaborated to administer protamine sulfate 50 mg intravenous once (0...
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30274762/pediatric-hypertonic-saline-use-in-emergency-departments
#15
LETTER
Kian Niknam, Rakesh Mistry, Angela Lumba-Brown
No abstract text is available yet for this article.
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30269998/issues-in-professionalism-confronting-beginning-medical-students-during-a-clerkship-in-emergency-medicine
#16
LETTER
Jeffrey Jones, Rohit Abraham, Matthew Emery, Lindsey Ouellette
No abstract text is available yet for this article.
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30269997/hepatopulmonary-syndrome-attributed-extreme-hypoxemia-and-polycythemia-revealing-liver-cirrhosis-a-case-report
#17
Alexandre Nuzzo, Raphael Dautry, Claire Francoz, Damien Logeart, Bruno Mégarbane
We report an unusual case of severe hepatopulmonary syndrome with previously unrecognized cirrhosis, presenting with acute on chronic dyspnoea, extreme hypoxemia, secondary polycythemia as well as direct identification of arteriovenous communications on computed tomography angiography. Hepatopulmonary syndrome, defined as the combination of hepatopathy, arterial deoxygenation and pulmonary vascular dilatation, is increasingly recognized as a life-threatening complication in advanced liver disease and transplant candidacy...
September 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30269999/prehospital-sepsis-alert-notification-decreases-time-to-initiation-of-cms-sepsis-core-measures
#18
Christopher L Hunter, Salvatore Silvestri, Amanda Stone, Anne Shaughnessy, Stacie Miller, Alexa Rodriguez, Linda Papa
OBJECTIVE: To determine if prehospital identification of sepsis will affect time to Centers for Medicare and Medicaid services (CMS) sepsis core measures and improve clinical outcomes. METHODS: We conducted a retrospective cohort study among septic patients who were identified as "sepsis alerts" in the emergency department (ED). Metrics including time from ED registration to fluid resuscitation, blood cultures, serum lactate draws, and antibiotics administration were compared between those who had pre-arrival notification by EMS versus those that did not...
September 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30266384/experience-with-various-techniques-for-fishhook-removal-in-the-emergency-department
#19
LETTER
Kyle Beasley, Lindsey Ouellette, Colleen Bush, Matthew Emery, Stephanie Wigstadt, Lisa Ambrose, Jeffrey Jones
No abstract text is available yet for this article.
September 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30249381/isolated-superior-mesenteric-artery-dissection-in-the-emergency-department-a-rare-cause-of-abdominal-pain
#20
Ömer Salt, Mustafa Burak Sayhan, Eren Duyar
Acute onset abdominal pain constitutes a significant proportion of emergency department visits, but only a small fraction of these cases are attributable to vascular pathologies (Bauersfeld, 1947 [1]). In this case, report, we present an incidental diagnosis of Spontaneous Isolated Superior Mesenteric Artery Dissection (SISMAD). A 69-year-old man was admitted to the emergency department complaining of fever, loss of appetite, vague epigastric pain, dysuria, and a productive cough for several days. A lower extremity venous Doppler ultrasound was performed, and a deep venous thrombosis (DVT) was identified in the left main femoral vein and in the proximal segment of the superficial vein...
September 20, 2018: American Journal of Emergency Medicine
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