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https://www.readbyqxmd.com/read/29045952/-progress-in-diagnosis-and-management-of-syncope-in-children
#1
W R Xu, Y Liao, H F Jin, Q Y Zhang, C S Tang, J B DU
Syncope is a common emergency of children and adolescents, which has serious influence on the quality of life. Neurally-mediated syncope, including postural tachycardia syndrome, vasovagal syncope, orthostatic hypotension and orthostatic hypertension, is the main cause of syncope in children and adolescents. The main manifestations of neurally-mediated syncope are diverse, such as dizziness, headache, chest tightness, chest pain, pale complexion, fatigue, pre-syncope and syncope. Although the clinical manifestations are similar, each subtype of syncope has its hemodynamic feature and optimal treatment option...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29033296/a-comparison-of-headache-treatment-in-the-emergency-department-prochlorperazine-versus%C3%A2-ketamine
#2
Tony Zitek, Melanie Gates, Christopher Pitotti, Alexandria Bartlett, Jayme Patel, Aryan Rahbar, Wesley Forred, Joseph S Sontgerath, Jill M Clark
STUDY OBJECTIVE: Intravenous subdissociative-dose ketamine has been shown to be effective for pain management, but has not been specifically studied for headaches in the emergency department (ED). For this reason, we designed a study to compare standard treatment (prochlorperazine) with ketamine in patients with benign headaches in the ED. METHODS: This study was a multicenter, double-blind, randomized, controlled trial with a convenience sample of patients presenting to the ED with benign headaches...
October 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29028678/increase-in-medical-emergency-calls-and-calls-for-central-nervous-system-symptoms-during-a-severe-air-pollution-event-january-2013-jinan-city-china
#3
Liangliang Cui, George A Conway, Lan Jin, Jingwen Zhou, Jun Zhang, Xinwei Li, Lei Zhou, Tiantian Li, Ji Zhang
BACKGROUND: In January 2013, a continuous and severe haze event affected one third of the major cities in China, including Jinan. OBJECTIVES: We investigated whether medical emergency calls (for nonaccidental emergencies) and calls for Central Nervous System (CNS) syndromes increased during this episode compared with the previous winter months (January, February, and December) in 2011 and 2012. METHODS: Daily emergency calls were obtained from Jinan Medical Emergency Center...
October 2017: Epidemiology
https://www.readbyqxmd.com/read/29027621/use-of-carboxyhemoglobin-as-a-biomarker-of-environmental-co-exposure-critical-evaluation-of-the-literature
#4
Agnese Veronesi, Valentina Pecoraro, Stefano Zauli, Marta Ottone, Giovanni Leonardi, Paolo Lauriola, Tommaso Trenti
Carbon monoxide (CO) poisoning is the primary cause for access to emergency department (ED) services for more than 50,000 persons in Europe and the USA every year. CO poisoning diagnosis is based on multiple factors and is usually confirmed by high carboxyhemoglobin (COHb) levels in the blood. We conducted a systematic evaluation of literature to investigate the usefulness of COHb as a biomarker of environmental CO exposure. We conducted an electronic search in Medline, Embase, and the Cochrane Library databases...
October 13, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28994605/explicit-diagnostic-criteria-for-transient-ischemic-attacks-to-differentiate-it-from-migraine-with-aura
#5
Elena R Lebedeva, Natalia M Gurary, Denis V Gilev, Anne Francke Christensen, Jes Olesen
Background The diagnosis of transient ischemic attacks is fraught with problems. The inter-observer agreement has repeatedly been shown to be low even in a neurological setting, and the specificity of the diagnosis is modest to low, reflected in a poor separation of transient ischemic attacks and mimics, particularly migraine with aura with its varied symptomatology. In other disease areas, explicit diagnostic criteria have improved sensitivity and specificity of diagnoses. We therefore present novel explicit diagnostic criteria for transient ischemic attacks tested for sensitivity and for specificity against migraine with aura...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28993037/reversible-stress-cardiomyopathy-secondary-to-aneurysmal-subarachnoid-hemorrhage-a-case-report
#6
Konstantinos Lampropoulos, Evangelos Giannoulis, Bazoukis George, Gary Tse, Epameinondas Triantafyllou, Athanasios Triantafyllou
BACKGROUND: Acute cerebral incidents have been correlated with cardiac manifestations. Specifically, subarachnoid hemorrhage has been correlated with a syndrome described as neurogenic stress cardiomyopathy and mimics acute coronary syndrome. CASE REPORT: A 55-year-old woman presented at the Emergency Department of our hospital complaining of vomiting and headache of sudden onset. Computed tomography angiography revealed a ruptured aneurysm at the tip of the basilar artery and the patient underwent a successful complete embolism of the sac of the aneurysm...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28992158/avoidable-emergency-department-visits-a-starting-point
#7
Renee Y Hsia, Matthew Niedzwiecki
Objective: To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits. Design/setting: We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. Participants: We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28991942/confusion-recurs-2-weeks-after-fall
#8
Nick Koneri, Andrew Muck, Bruce D Adams
A 77-year-old woman presented to the emergency department complaining of a headache following a syncopal episode (while standing) earlier that day. She said that she'd lost consciousness for several minutes, and then experienced several minutes of mild confusion that resolved spontaneously. On physical exam, she was oriented to person and place, but not time. She had a contusion in her left occipitoparietal region without extensive bruising or deformity. The patient had normal cardiopulmonary, abdominal, and neurologic exams...
October 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28988739/a-tale-of-black-eschar-in-a-returning-traveller
#9
Elizabeth Liao, David Carr
BACKGROUND: African tick-bite fever is an increasingly common cause for fever in the returning traveller. It needs to be considered in the febrile returning traveller with a characteristic rash: a black eschar. CASE REPORT: We describe a 51-year-old man returning from South Africa who presented to our emergency department with fever, headache, myalgia, and chills. On careful history and skin examination, a black eschar was found on the patient's left lateral shoulder, pointing toward a diagnosis of African tick-bite fever...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987433/cerebral-venous-thrombosis-a-challenging-neurologic-diagnosis
#10
REVIEW
Brit Long, Alex Koyfman, Michael S Runyon
Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987431/spontaneous-intracerebral-hemorrhage
#11
REVIEW
Stephen Alerhand, Cappi Lay
Although commonly arising from poorly controlled hypertension, spontaneous intracerebral hemorrhage may occur secondary to several other etiologies. Clinical presentation to the emergency department ranges from headache with vomiting to coma. In addition to managing the ABCs, the crux of emergency management lies in stopping hematoma expansion and other complications to prevent clinical deterioration. This may be achieved primarily through anticoagulation reversal, blood pressure, empiric management of intracranial pressure, and early neurosurgical consultation for posterior fossa hemorrhage...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987430/subarachnoid-hemorrhage-updates-in-diagnosis-and-management
#12
REVIEW
Brit Long, Alex Koyfman, Michael S Runyon
Subarachnoid hemorrhage (SAH) is a neurologic emergency due to bleeding into the subarachnoid space. Mortality can reach 50%. The clinical presentation is most often in the form of headache, classically defined as maximal at onset and worst of life. The most common cause is traumatic; approximately 80% of nontraumatic SAH are due to aneurysmal rupture, with the remainder from idiopathic peri-mesencephalic hemorrhage or other less common causes. Noncontrast brain computed tomography (CT) performed within 6 hours of symptom onset has sensitivity approaching 100%...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28984712/acute-angle-closure-secondary-to-tubercular-choroidal-granuloma
#13
Sushmita Kaushik, Ramandeep Singh, Atul Arora, Gunjan Joshi, Kusum Sharma, Basavraj Tigari
Acute angle closure is usually thought to be secondary to pupillary block which is relieved by laser iridotomy. Anterior rotation of the ciliary body at the scleral spur following development of an inflammatory cilio-choroidal detachment may result in a presentation of acute angle closure. It is imperative to recognize this condition correctly, because the management is with cycloplegics and anti-inflammatory drugs, which is diametrically opposite to the treatment of primary angle closure. More importantly, it has been reported as a consequence of serious systemic disease such as HIV infection and Vogt Koyanagi Harada(VKH) syndrome...
September 3, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28984431/what-do-we-know-about-alara-is-our-knowledge-sufficient-about-radiation-safety
#14
Ibrahim B Atci, Hakan Yilmaz, Veysel Antar, Nuriye G Ozdemir, Oguz Baran, Sila Sadillioglu, Mehmet Ozel, Okan Turk, Mehmet Yaman, Hakan Topacoglu
BACKGROUND: The aim of this study was to determine the knowledge of neurosurgeons and emergency physicians about ALARA (as low as reasonably achievable) and to gain awareness to them about this topic. METHODS: A multiple-choice survey comprising 17 questions was performed to 30 neurosurgeons and 70 emergency room doctors. RESULTS: Emergency medicine doctors, neurosurgeons, emergency medicine residents, neurosurgery residents and general practitioners participated in the survey...
December 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28982121/short-term-efficacy-and-tolerability-of-venlafaxine-extended-release-in-adults-with-generalized-anxiety-disorder-without-depression-a-meta-analysis
#15
Xinyuan Li, Lijun Zhu, Yingying Su, Shaokuan Fang
BACKGROUND: Although efficacy of venlafaxine extended release (XR) for generalized anxiety disorder (GAD) has been reported in previous analyses in 2002 and 2004, the sample size was rather small and estimate of safety or tolerability was not clear. The present analysis had the advantage of large sample size and provided evidence for tolerability. METHODS: Literature databases were searched, including Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of science and clinical trials...
2017: PloS One
https://www.readbyqxmd.com/read/28975014/the-relative-burden-of-menopausal-and-postmenopausal-symptoms-versus-other-major-conditions-a-retrospective-analysis-of-the-medical-expenditure-panel-survey-data
#16
Annlouise R Assaf, Andrew G Bushmakin, Nina Joyce, Michael J Louie, Michael Flores, Margaret Moffatt
BACKGROUND: The direct costs associated with menopausal and postmenopausal symptoms (hereafter "menopausal symptoms") may include the costs of physician and emergency department visits, medications, laboratory testing, and the management of side effects. However, much remains unknown about the costs related to menopausal symptoms, including how they compare with the costs of other diseases that are common among menopausal women. OBJECTIVE: To compare the economic burden of menopausal symptoms with other select prevalent chronic conditions among a nationally representative sample of US menopausal women aged 45 to 65 years...
September 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28967984/thorough-qt-qtc-evaluation-of-the-cardiac-safety-of-secnidazole-at-therapeutic-and-supratherapeutic-doses-in-healthy-individuals
#17
Borje Darpo, Hongqi Xue, Nikki Adetoro, Barbara G Matthews, Helen S Pentikis
SYM-1219, a novel oral granule formulation of secnidazole, is under development as single-dose treatment for bacterial vaginosis. This 4-way, randomized, crossover study evaluated the effects of SYM-1219 on electrocardiographic (ECG) parameters in 52 healthy subjects. Subjects were administered single doses of SYM-1219, 2 g (proposed therapeutic dose), 6 g (supratherapeutic dose), placebo, and moxifloxacin (positive control). Serial digital 12-lead ECGs were recorded pre- and postdose; blood samples were taken to determine plasma secnidazole concentrations...
October 2, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28948500/blocking-cgrp-in-migraine-patients-a-review-of-pros-and-cons
#18
REVIEW
Marie Deen, Edvige Correnti, Katharina Kamm, Tim Kelderman, Laura Papetti, Eloisa Rubio-Beltrán, Simone Vigneri, Lars Edvinsson, Antoinette Maassen Van Den Brink
Migraine is the most prevalent neurological disorder worldwide and it has immense socioeconomic impact. Currently, preventative treatment options for migraine include drugs developed for diseases other than migraine such as hypertension, depression and epilepsy. During the last decade, however, blocking calcitonin gene-related peptide (CGRP) has emerged as a possible mechanism for prevention of migraine attacks. CGRP has been shown to be released during migraine attacks and it may play a causative role in induction of migraine attacks...
September 25, 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28941874/pneumocephalus-and-seizures-following-epidural-steroid-injection
#19
Joseph Sorber, David Levy, Adam Schwartz
We describe a patient with pneumocephalus following an epidural steroid injection (ESI) who presented with altered mental status, headache, focal neurologic findings and seizures. Pneumocephalus has rarely been described following ESI. A 34-year-old female presented with an altered level of consciousness worsening over approximately 18h following an ESI for lumbar back pain. She had associated headache, right-sided facial twitching and right upper extremity weakness. A brain CT scan revealed pneumocephalus in the right lateral ventricle and quadrigeminal plate cistern...
September 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28937843/emergency-department-visits-for-postpartum-complications
#20
Erin Christine Brousseau, Valery Danilack, Fei Cai, Kristen A Matteson
INTRODUCTION: Most estimates of the prevalence and types of postpartum complications are based on hospital readmissions. However, using hospital readmissions (which occurs in only 1%-2% of postpartum women) is problematic as it fails to include women with postpartum complications assessed in the office or emergency department (ED). We utilized data from a cohort of women evaluated in an ED setting to better characterize complications experienced by women in the postpartum period. MATERIALS AND METHODS: We performed a retrospective analysis of all postpartum visits to the ED at a tertiary care women's hospital over 6 months...
September 22, 2017: Journal of Women's Health
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