Evaluation of motor vehicle accident drivers for attention deficit hyperactivity disorder: Hyperactivity and ADHD in traffic accidents Murat Enis Ardıç, Sadiye Yolcu, Önder Tomruk, Burak Gün, Bülent Erdur, Vermi Değerli, Ismet Parlak
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.035
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: May 31 2014
x Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity [1].
Cardiac arrest caused by acute intoxication—insight from a registry David Hörburger, Istepan Kurkciyan, Fritz Sterz, Andres Schober, Mathias Stöckl, Peter Stratil, Thomas Uray, Christoph Testori, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 9 2013
x The aim of the study was to evaluate the epidemiology and outcome after cardiac arrest caused by intoxication.
Antabuse reaction due to occupational exposure—an another road on the map? Subramanian Senthilkumaran, Ritesh G. Menezes, Gade Ravindra, Narendra Nath Jena, Ponniah Thirumalaikolundusubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.022
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 21 2013
x With reference to the case of Bourcier et al [1], we would like to share our experience of disulfiram reaction observed in a painter due to occupational exposure of alcohol containing solvents during his deaddiction period. In fact, he was referred as septic encephalopathy by the factory medical officer.
Disulfiram-like Reaction with Ornidazole Sertac Guler, Halit Aytar, Murat Soyuduru, Hayri Ramadan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.022
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: March 15 2015
x Many drugs, including the antibiotics that are most commonly used in the emergency department (ED), are known to cause disulfiram-like reactions (DLR). These reactions can cause a wide variety of clinical presentations, from simple signs to symptoms of life-threatening conditions. The responsible mechanism for the reaction is aldehyde dehydrogenase inhibited by disulfiram and is the accumulation of acetaldehyde in the serum. As shown DLR is caused by metronidazole, and imidazole derivatives are not recommended to use with alcohol.
Olanzapine in ED patients: differential effects on oxygenation in patients with alcohol intoxication Michael P. Wilson, Nita Chen, Gary M. Vilke, Edward M. Castillo, Kai S. MacDonald, Arpi Minassian
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.013
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: May 25 2012
x Agitation has significant consequences for patients and staff. When verbal techniques fail, expert guidelines recommend the use of second-generation antipsychotics (SGAs). Perhaps out of familiarity with haloperidol and benzodiazepines, emergency department (ED) clinicians often pair SGAs with benzodiazepines as well. Use of SGAs such as olanzapine in alcohol-intoxicated (ETOH+) patients or with benzodiazepines is not well studied and may be associated with vital sign abnormalities.
Spur cell anemia in end-stage liver disease: a zebra! Rushikesh Shah, Arpan Patel, Savio John
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.027
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: January 27 2014
x Anemia in alcoholic liver disease has a broad spectrum of differential diagnosis. One of the esoteric pathology that should be considered is spur cell anemia (SCA) in end-stage liver disease patients. Spur cell anemia is a rare type of hemolytic anemia with a grave prognosis. It closely resembles “Zieve syndrome,” which can present similarly and needs to be differentiated for prognostic and treatment purpose. Although presence of SCA indicates poor prognosis in these patients, it is curable with liver transplant, and therefore, early diagnosis is crucial.
Biochemical issues in emergency medicine: diagnostic and therapeutic considerations of selected toxic presentations Christopher Saeui, Nathan Charlton, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2010.09.032
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: November 15 2010
x Understanding biochemical concepts can assist in the diagnosis and treatment of certain presentations in the emergency department. Knowledge of the biochemistry responsible for certain presentations in the emergency department as well as behind various therapies also provides physicians better insight into the use of specific treatments. This review will focus on the biochemistry of numerous clinical syndromes, including methemoglobinemia, various poisoning presentations, including cyanide, methanol, and ethylene glycol—with an emphasis on the diagnostic and management considerations in these presentations.
Large-event medicine—event characteristics impacting medical need Riley Moore, Kelly Williamson, Mark Sochor, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.018
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: October 25 2010
x Large events have been defined in many ways, from the vague description of a focused gathering of people to the more specific description of an event with at least 1,000 spectators and participants who are gathered at a specific location for a defined period of time. Regardless of the definition applied, the actual medical requirements vary considerably from one event to the next. The ability to predict these medical needs allows for the provision of adequate medical support. Many factors contribute to medical need at a large event, including event type, weather (particularly heat index), the presence of alcohol and / or illicit drugs, the number of participants, event duration, crowd demographics, and venue characteristics.
Acute respiratory distress syndrome and outcomes after near hanging Sahar Mansoor, Majid Afshar, Matthew Barrett, Gordon S. Smith, Erik A. Barr, Matthew E. Lissauer, Michael T. McCurdy, Sarah B. Murthi, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.001
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 9 2014
x The purpose of this study is to assess the case rate of acute respiratory distress syndrome (ARDS) after near hanging and the secondary outcomes of traumatic and/or anoxic brain injury and death. Risk factors for the outcomes were assessed.
Propofol for benzodiazepine-refractory alcohol withdrawal in a non–mechanically ventilated patient Darrel W. Hughes, Elizabeth VanWert, Lauren LePori, Bruce D. Adams
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.044
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: September 27 2013
x Long-term alcohol use confers neurochemical changes in response to alcohol's exogenous inhibitory effects. Downregulation and decreased sensitivity of γ -aminobutyric acid receptors render benzodiazepines less effective at controlling psychomotor agitation. Propofol has been reported to have successfully relieved alcohol withdrawal syndrome (AWS) symptoms in part because of activation of γ -aminobutyric acid channels in combination with antagonism of excitatory amino acids such as N -methyl-d -aspartate.
Cocaine-induced isolated right ventricular infarction Aiman Smer, Mahesh Anantha Narayanan, Toufik Mahfood Haddad, Harish Devineni, Venkata Alla
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.053
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: December 29 2014
x Cocaine use has been associated with several cardiovascular events. However, isolated right ventricular infarction because of cocaine use has never been reported before. We report a case of isolated right ventricular infarction secondary to cocaine use in a young male with no previous coronary artery disease. To our knowledge, this is the first report of cocaine-induced right ventricular infraction.
Alcoholic ketoacidosis coincides with acute Marchiafava-Bignami disease Ming-Hua Chen, Chun-An Cheng
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.021
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: February 10 2012
x Alcoholism is the major cause of electrolyte and acid-base imbalance and nutrition deficiency. Ketoacidosis is one of major advised effect on alcoholism. Marchiafava-Bignami disease, a rare alcohol-related disorder, characterized by altered mental status, seizure, and multifocal central nervous system signs, which results from progressive demyelination and necrosis of corpus callosum. Here, we presented a 53-year-old man presented as decreased conscious level and 4 extremity rigidity on admission.
The association between acute alcohol consumption and discharge against medical advice of injured patients in the ED Joo Jeong, Kyoung Jun Song, Yu Jin Kim, Jin Seong Cho, Ju Ok Park, Seung Chul Lee, Young Sun Ro, James F. Holmes
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.065
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x A paucity of data exists on the prevalence and predictors of discharging injured patients against medical advice from emergency departments. The aim of this study is to investigate the association between acute alcohol use and being discharged against medical advice.
Patterns and correlates of drug-related ED visits: results from a national survey Brian E. Perron, Amy S.B. Bohnert, Sarah E. Monsell, Michael G. Vaughn, Matthew Epperson, Matthew O. Howard
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.044
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: July 14 2010
x Drug treatment can be effective in community-based settings, but drug users tend to underuse these treatment options and instead seek services in emergency departments (EDs) and other acute care settings. The goals of this study were to describe prevalence and correlates of drug-related ED visits.
Comparison of Clinical Characteristics of Intentional vs Accidental Drowning Patients Seon Hee Woo, Jeong Ho Park, Seung Pill Choi, Jung Hee Wee
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.051
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 29 2015
x Drowning may happen by accident or as a method of committing suicide. The aim of this study was to determine some characteristics of drowning patients who committed intentionally.
Mass-gathering medicine: a descriptive analysis of a range of mass-gathering event types Samuel Locoh-Donou, Yan Guofen, Melanie Welcher, Thomas Berry, Robert E. O'Connor, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.016
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: February 28 2013
x To identify and evaluate the volume, nature, and severity of patient presentations encountered by emergency medical services (EMS) at all mass-gathering events held at or near a southeastern US university. In addition, to compare the existing literature base (single mass-gathering event held in large urban population centers) with a broader variety of events varying in crowd size and locations.
Acute myocardial infarction with normal coronary arteries associated with subclinical Graves disease Nadia Bouabdallaoui, Frederic Mouquet, Pierre Vladimir Ennezat
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.023
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: September 26 2013
x Myocardial 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.
Large left upper quadrant mass Amy A. Ernst, Steve J. Weiss, David A. Wachter, Michael D. Stifelman
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.011
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: August 16 2010
x Causes of left upper quadrant (LUQ) masses include spleen, colonic, pancreatic, and renal etiologies. Emergency department (ED) ultrasound can help differentiate the cause. In this article, we present the case of a 53-year-old female attending Emergency Medicine physician diagnosed with a large palpable LUQ mass. The mass was noted after an episode of moderate nausea and mild LUQ, left lower quadrant, and flank pain. The pain and nausea resolved the following day. The mass was palpable about 10 cm below the left costal margin and was thought initially to be the spleen.
Energy drinks overdose and metabolic abnormalities—a double whammy! Subramanian Senthilkumaran, Suresh S. David, Namasivayam Balamurugan, Ponniah Thirumalaikolundusubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.016
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: April 19 2013
x The article by Dikici et al [1] is interesting. There are increasing reports regarding adverse effect of energy drink (ED) in current literature. Energy drink use has been anecdotally linked with seizure, and there is paucity of evidence-based literature in support of this association. This raises a debate whether the risk is negligible or it is underestimated, due to inadequate reporting [2].
Incentives to participate in clinical trials: practical and ethical considerations Steven L. Bernstein, James Feldman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.020
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 28 2015
x Clinical trials often offer incentives to encourage individuals to enroll and to enhance follow-up. The scope and nature of incentives used in emergency department (ED)-based trials are unknown.
