Hyun Joo Kim, Jung-Man Lee, Jae-Hyon Bahk
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.019
Published online: September 16 2013
xWe hypothesized that the assisted maintenance of head extension would reduce the frequency of direct contact between the laryngoscope blade and the maxillary incisors during tracheal intubation.
Yalcin Velibey, Yalcin Golcuk, Burcu Golcuk, Deniz Oray, Ozge Duman Atilla, Ayfer Colak, Yusuf Kurtulmus, Ali Rıza Erbay, Abdurrahman Yilmaz, Mehmet Eren
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.033
Published online: September 20 2013
xThe main objective of this study was to determine a predictive cutoff value for plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) that could successfully predict the long-term (4-year) survival of patients with acute heart failure (HF) at the time of admission to the emergency department (ED). To our best knowledge, our study is the first research done to identify a predictive cutoff value for admission NT-proBNP to the prescriptive 4-year survival of patients admitted to ED with acute HF diagnosis.
Rong Liu, Zi-Jing Liang, Xiao-Xing Liao, Chun-Lin Hu, Li Jiang, Gang Dai, Ying-Qing Li, Hong-Yan Wei, Gui-Fu Wu, Xin Li
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.035
Published online: September 23 2013
xTo investigate the therapeutic value of enhanced external counterpulsation (EECP) on recovery of cerebral blood flow following cardiac arrest (CA) and successful resumption of spontaneous circulation (ROSC) by cardiopulmonary resuscitation.
Juan Torres-Macho, Ana B. Mancebo-Plaza, Ana Crespo-Giménez, M. Rosa Sanz de Barros, Carlos Bibiano-Guillén, Raúl Fallos-Martí, Jorge Calderón-Parra, José M. de Miguel-Yanes
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.037
Published online: September 23 2013
xThe objective of this study was to identify clinical factors associated with delayed diagnosis of acute pulmonary embolism (PE) in the emergency department (ED).
Nazire Belgin Akilli, Emine Akinci, Hakan Akilli, Zerrin Defne Dundar, Ramazan Koylu, Mustafa Polat, Basar Cander
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.049
Published online: October 2 2013
xCarbon monoxide (CO) poisoning frequently affects repolarization, resulting in abnormal electrocardiography findings. The goal of this study was to examine the effect of CO poisoning on the novel transmyocardial repolarization parameters T peak–T end (Tp-e), Tp-e dispersion, and Tp-e/QT and the relationship of these parameters to myocardial injury (MI).
Thiago M. Santos, Daniel Franci, Carolina M.G. Coutinho, Diego L. Ribeiro, Marcelo Schweller, José R. Matos-Souza, Marco A. Carvalho-Filho
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.053
Published online: October 11 2013
xLung ultrasound (US) is an excellent tool to assess lung edema in a myriad of different clinical situations. We hypothesized that lung US might also be a good prognostic and management instrument in septic patients, regardless of disease severity.
Xiaoming Guo, Dewen Wang, Zhirui Liu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.054
Published online: October 7 2013
xCrush injury from debris, combined with hypoxia and water and food deprivation (combined crush injury), is common in industrial accidents and events such as earthquakes and terrorist attacks. Whether electrocardiographic changes are associated with combined crush injury is unclear.
Jung Hee Wee, Jeong Ho Park, Seung Pill Choi, Kyu Nam Park
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.061
Published online: October 7 2013
xThe objective of this study is to provide appropriate treatment of patients who showed decreased mentality but did not suffer cardiac arrest (CA) from hanging injury, from reviewing the characteristics and analyzing the outcomes in such patients.
Mary Colleen Bhalla, Brad D. Gable, Jennifer A. Frey, Matthew R. Reichenbach, Scott T. Wilber
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.001
Published online: October 7 2013
xSelf-administered epinephrine is the primary out-of-hospital treatment of anaphylaxis. Intramuscular injection of epinephrine results in higher peak plasma concentration than subcutaneous injection. With the prevalence of obesity, autoinjectors may not have an adequate needle length for intramuscular injection.
John R. Allegra, Barnet Eskin, Sarah Campeas, Bonnie McGuire Wreschner
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.003
Published online: October 16 2013
xMany advances have been made recently in the treatment of congestive heart failure (CHF). We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated.
Maria João Vidigal Ferreira, Maria João Cunha, Anabela Albuquerque, Ana Paula Moreira, Gracinda Costa, João Lima, Mariano Pego
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.004
Published online: October 24 2013
xAcute chest pain is a frequent cause of emergency department (ED) visits. Rest myocardial perfusion imaging (RMPI) during or immediately after an episode of chest pain can provide diagnostic and prognostic information concerning acute coronary syndromes.
Henrik Hedelin, Lars-Åke Goksör, Jon Karlsson, Stina Stjernström
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.005
Published online: October 23 2013
xAn ankle sprain is a common injury, and patients are usually examined with plain radiographs to rule out a fracture despite the fact that only a small minority actually have one.
Cai-Jun Wu, Chun-Sheng Li, Yi Zhang, Jun Yang, Qin Yin, Chen-Chen Hang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.017
Published online: September 16 2013
xThis study aims to characterize postresuscitation myocardial dysfunction in 2 porcine models of cardiac arrest (CA): ventricular fibrillation cardiac arrest (VFCA) and asphyxiation cardiac arrest (ACA).
Theodoros Xanthos, Athanasios Chalkias
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.060
Published online: October 3 2013
xPostresuscitation myocardial stunning is characterized by transient and reversible global myocardial dysfunction after return of spontaneous circulation (ROSC). Although it was initially described in 1988 by Negovsky [1], its pathophysiology has been recently elucidated [2,3]. The etiology of this syndrome is multifactorial, with the key facts contributing to its emergence being the “no-reflow” phenomenon and ischemic contracture [2].
Je Sung You, Sung Phil Chung, Hyun Soo Chung, Hye Sun Lee, Jong Woo Park, Hyun Jong Kim, Shin Ho Lee, Incheol Park, Hahn Shick Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.029
Published online: September 23 2013
xDespite the usefulness of the Cincinnati Prehospital Stroke Scale (CPSS) for rapid recognition of acute stroke, its ability to assess stroke severity is unclear. We investigated the usefulness of CPSS for assessment of stroke severity by comparing CPSS and National Institutes of Health Stroke Scale (NIHSS) scores in patients who were candidates for thrombolytic therapy at hospital admission within 6 hours of symptom onset.
Barak Cohen, Ido Laish, Tal Brosh-Nissimov, Azik Hoffman, Lior H. Katz, Rony Braunstein, Ram Sagi, Goldman Michael
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.031
Published online: September 23 2013
xUrine alkalinization is indicated for various medical conditions. Alkalinization is usually achieved by intravenous administration of alkali substances titrated by repeated urinalyses. Some situations such as mass casualty events might require urine alkalinization by the oral route. We evaluated the efficacy of oral sodium bicarbonate administration for urine alkalinization.
Arturo Montaño, Ilene Staff, Louise D. McCullough, Gil Fortunato
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.032
Published online: September 23 2013
xIntravenous (IV) tissue plasminogen activator (tPA) administration for ischemic stroke between 3 and 4.5 hours after onset was found to be safe and beneficial in the ECASS III trial. However, its use has remained controversial, and its benefit as applied in routine practice at community stroke centers is less well defined.
Chunkui Zhou, Jiang Wu, Hongliang Zhang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.030
Published online: October 14 2013
xZhang et al [1] reported a case with concurrent myasthenia gravis (MG) and Guillain-Barré syndrome (GBS) and reviewed 13 cases that were diagnosed as MG and GBS and published in Pubmed. The coexistence of MG and GBS is rare but interesting. However, we have some concern regarding the diagnosis of the case.
Juan Zhang, Jian Li, Wenli Hu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.034
Published online: September 30 2013
xThe reader's first question concerns whether dysarthria, dysphagia, and respiratory muscle weakness belonged to Guillain-Barré syndrome or myasthenia gravis, or both by the edrophonium test. The patient showed improvement of bilateral ptosis after edrophonium test. Dysarthria, dysphagia, and respiratory muscle weakness were not improved obviously after edrophonium test. So we think that these symptoms may belong to both Guillain-Barré syndrome and myasthenia gravis because the improvement of bulbar and respiratory muscle is difficult to detect.
Hakan Sarlak, Muharrem Akhan, Mustafa Cakar, Omer Kurt, Erol Arslan, Sevket Balta
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.039
Published online: October 14 2013
xWe intentionally read the article “Predective Cutoff Point of Admission N-terminal Pro-B-type Natriuretic Peptide (NT-proBNP) Testing in the Emergency Department (ED) for Prognosis of Patients With Acute Heart Failure” written by Yalcin Golcuk et al [1] with interest. They concluded that elevated NT-proBNP levels upon admission were a strong and independent predictor of all-cause mortality in patients with heart failure (HF) [1].
Nicholas J. Connors, Bryan J Weber, Robert S Hoffman
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.052
Published online: October 3 2013
xWe read with interest the recent article on the use of pralidoxime in acute organophosphorus (OP)–poisoned patients (AOPP) [1]. Clarification of several issues would greatly assist in our ability to determine whether the results presented are valid and broadly applicable. Although not clearly stated, it seems that this retrospective study was a comparison of protocols from 2 intensive care units (ICUs) that care for AOPP. Therefore, it is unclear whether the treated populations are comparable, which makes interpretation of the results challenging.
Donald V. Byars, Sara N. Tsuchitani, Jeff Yates, Barry Knapp
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.056
Published online: September 27 2013
xRapid peripheral venous access for the severely ill or injured patient in the prehospital setting is critical for their proper management. Unfortunately, due to either disease or trauma, vascular collapse may cause intravenous cannulation to be delayed considerably or even impossible. Over the years, the use of intraosseous (IO) access has become the preferred alternative method for obtaining vascular access in the prehospital setting. The National Association of EMS Physicians emphasized this role for IO in the prehospital setting in a position statement in 2007 [1].
Hossein Sanaei-Zadeh
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.009
Published online: October 21 2013
xI read with interest the case presented by Avcı et al [1] published in your journal. The authors present a 28-year-old man who collapsed 5 hours after the consumption of three 250-mL energy drinks (almost 240 mg of caffeine) during a basketball match. Fifteen minutes later, he was brought to the emergency department with ventricular tachycardia (VT) restoring to normal sinus rhythm with cardioversion. His arterial blood gas showed metabolic acidosis, and in the echocardiography, he had anteroseptal and left ventricular hypertrophy.
Getaw Worku Hassen, Hossein Kalantari
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.016
Published online: October 24 2013
xThe use of synthetic or designer drug has increased among youth in the past couple of years, and it is still on the rise. We recently have reported about the associated health complications of these drugs [1] and have tried to raise awareness to the public ( http://www.newsdaily.com/article/d308725ad6c7c6c60b11d2ab4c16c8ac/researchers-warn about- increasing-use-of-designer-drugs ).
Kathryn C. Frankel, Jamie M. Rosini, Brian J. Levine, Mia A. Papas, Neil B. Jasani
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.017
Published online: October 21 2013
xAntibiotics are the most common medications involved in prescribing errors; overdosing and underdosing account for more than half of these errors [1]. Inadequate dosing has the potential to result in patient harm through therapeutic failures. To provide a better clinical approach for health care providers, the Infectious Diseases Society of America published a consensus statement of vancomycin therapeutic guidelines in 2009 [2,3].
Alberto Valbusa, Stella Ingrassia, Gian Marco Rosa, Maria Teresa Infante, Angelo Schenone, Fabrizio Montecucco, Christian Cordano
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.030
Published online: October 25 2013
xCardiac complications in myasthenia gravis (MG) represent a hot topic issue for current research and clinical care of the patients. For instance, a “guilty” association of anti-Kv1.4 antibodies have been recently demonstrated in MG, potentially associated with myocarditis and long-QT syndrome [1]. In addition, during the myasthenic crisis, catecholamine excess might trigger apical ballooning syndrome (ABS) [2]. Although QT interval prolongation is prevalent among patients with ABS and might precede torsade de pointes (TdP), life-threatening arrhythmias remain very rare [2,3].
Selcuk Coskun, Lutfi Soylu, Pınar Koksal Coskun, Murat Bayazıt
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.041
Published online: September 23 2013
xUpper limb acute arterial occlusions are uncommon, and when compared with lower limb occlusions, only a few cases have been reported. Although atrial fibrillation is the most common cause, many conditions may lead to ischemia. In this article, 8 cases of upper limb arterial ischemia due to 4 different etiologies were reported (7 brachial, 1 axillary), and the literature was reviewed.
Li-Yen Huang, Wei-Shiang Lin, Wen-Yu Lin, Cheng-Chung Cheng, Shu-Meng Cheng, Tsung-Neng Tsai
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.007
Published online: September 25 2013
xTorsade de pointes (TdP) is a life-threatening polymorphic ventricular tachycardia that is related to QT prolongation. Although QT prolongation is commonly seen in acute stroke, TdP is rare. We report the case of a 78-year-old woman with ischemic stroke who presented with TdP as the initial manifestation of early neurologic deterioration. We hypothesized that an increase in intracranial pressure may result in neurohormonal activation, QT prolongation, and then myocardial damage, leading to TdP. We highlight that new onset of TdP in a patient with stroke may reflect neurologic deterioration, requiring further evaluation and specific intervention.
Yu-jie Ma, Bo Ning, Wei-hong Cao, Tao Liu, Lei Liu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.012
Published online: August 15 2013
xTherapeutic hypothermia (TH) is becoming a standard of care to mitigate neurologic injury in cardiac arrest survivors. Several cooling methods are available for use in TH. For maintaining a target temperature, intravascular cooling is superior to, more efficacious than, and safer than surface cooling methods. The use of an intravenous cooling catheter is independently associated with a higher odds ratio for survival. However, many techniques use commercially developed equipment that is expensive to purchase and use.
Stephen W Borron, Robert Woolard, Susan Watts
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.013
Published online: September 3 2013
xA 40-year-old man with diabetes and seizure disorder was found at home unresponsive and “very hot to touch” by his father 40 minutes before emergency medical services arrival. His usual medications included topiramate, divalproex sodium, and rosiglitazone/metformin. Paramedics administered oxygen, intravenous fluids, and naloxone. They did not witness or report seizure activity. Upon emergency department arrival, the patient was unresponsive (Glasgow Coma Scale 3), hypotensive (94/50 mm Hg), and tachypneic (32 breaths per minute), with a heart rate of 60 beats per minute and elevated rectal temperature peaking at 43.2°C.
Nadia Bouabdallaoui, Frederic Mouquet, Pierre Vladimir Ennezat
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.023
Published online: September 26 2013
xMyocardial infarction occurring with angiographically normal coronary arteries is rare and often described in young people. This report describes a case of myocardial infarction with normal coronary arteries in a young female patient related to coronary thrombosis complicated by left ventricular apical thrombus in the setting of an unknown and subclinical Graves disease.
Tiago Teodoro, João Ferreira, Ana Franco, Vanessa Almeida, Carlos Casimiro, Miguel Coelho, José M. Ferro, Luísa Albuquerque
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.025
Published online: September 23 2013
xVertebral artery dissection (VAD) may uncommonly present as isolated headache. More rarely, it simulates classical headache syndromes, including migraine. We report a VAD mimicking status migrainosus.
Filip M. Szymanski, Grzegorz Karpinski, Anna E. Platek, Bartosz Puchalski, Krzyszof J. Filipiak
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.026
Published online: September 11 2013
xA 53-year-old woman was hospitalized after out-of-hospital cardiac arrest due to ventricular fibrillation. Initial electrocardioagram showed sinus rhythm of 117 beats per minute, 452 ms QTc interval, ST-segment depression up to 1 mm in V2-V6, and ST-elevation in lead aVR. Patient was treated with primary coronary angioplasty and therapeutic hypothermia, during which QTc interval prolonged up to 616 ms and Osborn wave was seen in lead V4, along with elevation of ST-segment in I, II, III, aVF, V5 and V6; negative T waves in I, II, aVL, aVF, and V2-V6.
Omer Faruk Celik, Haldun Akoglu, Serkan Eroglu, Ozge Onur, Arzu Denizbasi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.036
Published online: September 3 2013
xCardiac syncope can be classified as being either structural or dysrhythmogenic in origin, and it may be the only warning symptom of sudden cardiac death. One of the causes of dysrhythmic sudden cardiac death in young adults with structurally normal hearts is Brugada syndrome. Electrocardiogram (ECG) of Brugada syndrome is characterized by an ST-segment elevation in the right precordial leads. A 23-year-old man was presented to our emergency department (ED) with a history of syncope which has occurred 30 minutes before arrival and lasted for 10 minutes.
Guner Çelik, Erkan Yildirm, Huseyin Narci, Mehmet Özülkü
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.037
Published online: September 12 2013
xBehçet's disease is a multisystemic, potentially life-threatening condition with vascular involvement and thrombotic tendency. The disease course is characterized by exacerbations and remissions. Lower extremity vein thrombosis is the most frequent manifestation of vascular involvement, followed by vena cava thrombosis, pulmonary artery aneurysms, peripheral artery aneurysms, dural sinus thrombosis and abdominal aorta aneurysms. The case in this report was considered worth reporting due to vena cava thrombosis extending from brachiocephalic to jugular vein, accompanying thrombosis of the contralateral brachiocephalic vein and jugular veins as well as simultaneous dural sinus thrombosis, and also benefit from thrombolytic therapy.
Scott Blanchard, Gregory D. Griffin, Erin L. Simon
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.008
Published online: September 16 2013
xAcute compartment syndrome is a time-sensitive diagnosis and surgical emergency because it poses a threat to life and the limbs. It is defined by Matsen et al (Surg Gynecol Obstet. 1978;147(6):943–949) as “a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space.” The most common cause of compartment syndrome is traumatic injury. A variety of other conditions such as vascular injuries, bleeding disorders, thrombosis, fasciitis, gas gangrene, rhabdomyolysis, prolonged limb compression, cellulitis, and nephrotic syndrome may also cause compartment syndrome.
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00742-0
Published in issue: December 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00743-2
Published in issue: December 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00717-1
Published in issue: December 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00718-3
Published in issue: December 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00719-5
Published in issue: December 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00720-1
Published in issue: December 2013
