Hyperammonemia in idiopathic epileptic seizure Kensuke Nakamura, Kiyomi Yamane, Kazuaki Shinohara, Kent Doi, Ryota Inokuchi, Takahiro Hiruma, Susumu Nakajima, Eisei Noiri, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.003
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 4 2013
x It is known that patients with convulsion often present hyperammonemia. The elevation of ammonia levels in convulsion is considered to occur along with extensive muscle contractions, but the details remain unclear. In emergency pathologies, such as cardiopulmonary arrest or hemorrhagic shock without muscle contraction, red blood cells are known to produce ammonia through acidosis, leading to hyperammonemia. A similar effect would be considered to be involved in idiopathic epileptic seizure patients as well.
Barriers to outpatient stress testing follow-up for low-risk chest pain patients presenting to an ED chest pain unit Margaret Story, Bradford Reynolds, Meghan Bowser, Hongyan Xu, Matthew Lyon
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.083
The American Journal of Emergency Medicine , Vol. 34 , Issue 5 ,
Published online: January 5 2016
x Outpatient stress testing (OST) after evaluation in the emergency department (ED) is an acceptable evaluation method for patients presenting to the ED with low-risk chest pain (CP). However, not all patients return for OST. Barriers to follow-up evaluation exist and are poorly understood. In this study, we examined the influence of demographic and social characteristics on OST compliance.
Can melatonin improve adaptation to night shift? Mark James, Michael O Tremea, Jeffrey S Jones, Jon R Krohmer
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90129-2
The American Journal of Emergency Medicine , Vol. 16 , Issue 4 ,
Published in issue: July 1998
x This study was undertaken to determine whether melatonin (N -acetyl-5-methoxytryptamine) is effective in helping emergency medical services (EMS) personnel who work rotating night shifts reset their biological clocks and minimize circadian rhythm disruption. A double-blinded, randomized, crossover study was performed using 22 volunteers. Participants were working a span of consecutive night (2300 to 0700 hours) shifts and received either a melatonin capsule (6 mg) or placebo to be taken before each of the consecutive day sleeps.
Nonsuicidal self-injury and suicide attempts among ED patients older than 50 years: comparison of risk factors and ED visit outcomes Namkee G. Choi, Diana M. DiNitto, C. Nathan Marti, Bryan Y. Choi
DOI: http://dx.doi.org/10.1016/j.ajem.2016.02.058
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: February 25 2016
x Although the number of older adults who engage in nonsuicidal self-injury (NSSI) is not insignificant, research on older adults' NSSI is scant. The current study examined the prevalence and characteristics of NSSI compared to suicide attempt (SA) in adults older than 50 years who were seen at Emergency Departments (EDs) and their ED visit outcomes.
Reversible neurological deficits in a chronic alcohol abuser: A case report of Wernicke's encephalopathy Mary-Ellen Guido, William Brady, Daniel DeBehnke
DOI: http://dx.doi.org/10.1016/0735-6757(94)90250-X
The American Journal of Emergency Medicine , Vol. 12 , Issue 2 ,
Published in issue: March 1994
x The abuse of alcohol presents daily challenges for the emergency medicine physician. Wernicke's encephalopathy represents one of the metabolic complications associated with alcoholism. A classic presentation of Wernicke's encephalopathy is reported. The patient presented to the emergency department with the chief complaint of confusion, difficulty ambulating, and visual disturbances. Following administration of intravenous thiamine, the patient's symptoms spontaneously resolved. The pathophysiology, clinical presentation and therapy of this classic disorder are discussed.
Sexual assault in postmenopausal women: epidemiology and patterns of genital injury Jeffrey S. Jones, Linda Rossman, Renae Diegel, Phyllis Van Order, Barbara N. Wynn
DOI: http://dx.doi.org/10.1016/j.ajem.2008.07.010
The American Journal of Emergency Medicine , Vol. 27 , Issue 8 ,
Published in issue: October 2009
x Physical abuse of older women, including reports of sexual assault, has risen rapidly for the last decade. The purpose of this study was to compare a group of postmenopausal victims of sexual assault with younger adult women (18-39 years old) by examining patient demographics, assault characteristics, and patterns of physical injury.
Facial trauma in motor vehicle accidents: Etiological factors Karim B. Nakhgevany, Mark LiBassi, Barbara Esposito
DOI: http://dx.doi.org/10.1016/0735-6757(94)90237-2
The American Journal of Emergency Medicine , Vol. 12 , Issue 2 ,
Published in issue: March 1994
x The effects of seat belts and the use of alcohol and drugs have been studied as etiological factors in facial trauma to occupants of motor vehicle accidents (MVAs). During a 15-month period, 461 patients were admitted to a regional trauma center as a result of injuries sustained in MVAs. Two hundred thirty-seven (51%) of these patients had facial trauma. Facial trauma was the single most common injury in these patients. One hundred eighty-five patients (78%) had major soft tissue injury, and 52 patients (22%) had facial bone fractures.
Editorial Board
DOI: http://dx.doi.org/10.1016/0735-6757(89)90073-9
The American Journal of Emergency Medicine , Vol. 7 , Issue 1 ,
Published in issue: January 1989
Bicycle helmets benefits might be overestimated Dorothy L. Robinson
DOI: http://dx.doi.org/10.1016/j.ajem.2010.02.022
The American Journal of Emergency Medicine , Vol. 28 , Issue 4 ,
Published in issue: May 2010
x We know that alcohol increases the risk of injury. In Maryland, for cyclists with blood alcohol of 80 mg/dL, the increase was 20-fold [1]; and it was 10-fold for cyclists in Finland with blood alcohol of 100 mg/dL [2].
A study on energy drinks and realistic results concordant with daily clinical practice Mustafa Aparci, Omer Uz, Ejder Kardesoglu, Mehmet Uzun
DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.018
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: March 9 2016
x We have read the article of Kozik et al [1] titled “Cardiovascular responses to energy drinks in a healthy population: The C-energy study” with great interest. Authors evaluated the effects of consumption of energy drink with high content of caffeine and additional energetic supplements such as guarana and others on the cardiovascular and electrocardiogram (ECG) parameters in healthy young individuals. Indeed, they reported clinically significant and potentially lethal ECG changes and hemodynamic abnormalities.
Alcoholic beverages: Proof and flammability Christopher H Linden, Jeffrey R Tucker
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90016-X
The American Journal of Emergency Medicine , Vol. 16 , Issue 5 ,
Published in issue: September 1998
Acute isopropanol ingestion: Pharmacokinetic parameters in the infant K.Michael Parker, Thomas A. Lera Jr
DOI: http://dx.doi.org/10.1016/0735-6757(92)90179-2
The American Journal of Emergency Medicine , Vol. 10 , Issue 6 ,
Published in issue: November 1992
x We describe a case of isopropanol intoxication in a 2-month-old infant. The source of isopropanol and both the route and time of ingestion could be clearly identified. Serial measurements of isopropanol and acetone provided data for calculating their respective elimination half-lives. Isopropanol (half-life = 5.8 hr) clearance was similar to values reported for adults; acetone (half-life = 10.8 hr) was eliminated twice as rapidly as in adults.
The effects of clinical case management on hospital service use among ED frequent users Robert L. Okin, Alicia Boccellari, Francisca Azocar, Martha Shumway, Kathy O'Brien, Alan Gelb, Michael Kohn, Phyllis Harding, and others
DOI: http://dx.doi.org/10.1053/ajem.2000.9292
The American Journal of Emergency Medicine , Vol. 18 , Issue 5 ,
Published in issue: September 2000
x This study examined the impact of case management on hospital service use, hospital costs, homelessness, substance abuse, and psychosocial problems in frequent users of a public urban emergency department (ED). Subjects were 53 patients who used the ED five times or more in 12 months. Utilization, cost, and psychosocial variables were compared 12 months before and after the intervention. The median number of ED visits decreased from 15 to 9 (P <.01), median ED costs decreased from $4,124 to $2,195 (P < .01) and median medical inpatient costs decreased from $8,330 to $2,786 (P < .01).
The short-stay emergency observation ward is here to stay Fatimah Lateef, Venkataraman Anantharaman
DOI: http://dx.doi.org/10.1053/ajem.2000.9291
The American Journal of Emergency Medicine , Vol. 18 , Issue 5 ,
Published in issue: September 2000
x The traditional venue for the management of most medical and surgical emergencies has been the in-hospital environment. It is only when patients have been fully evaluated and treated that they are discharged. The increasing cost of hospital stay and burgeoning cost of health care are forcing the medical profession to consider options where illnesses can be managed on a more ambulatory basis. The objective of this study was to assess the volume, characteristics, and disposition of emergency department (ED) patients who were managed in the Short-Stay Emergency Observation Ward (SSEOW).
A life-threatening double gap metabolic acidosis Yu-Tzu Tsao, Wei-Chi Tsai, Shih-Ping Yang
DOI: http://dx.doi.org/10.1016/j.ajem.2007.07.026
The American Journal of Emergency Medicine , Vol. 26 , Issue 3 ,
Published in issue: March 2008
x Double gap metabolic acidosis represents the high anion gap metabolic acidosis combined with raised serum osmolal gap due to retention of unmeasured osmole with accompanied metabolite. We describe a 62-year-old man diagnosed with community-acquired pneumonia undergoing continuous sedation in the context of asynchronous mechanical ventilation. High anion gap metabolic acidosis coupled with high plasma osmolal gap was noted with resultant severe bradyarrhythmia. d -Lactic acidosis and high serum concentration of propylene glycol (PG) eventually established the diagnosis of lorazepam-induced PG intoxication.
Management of acute alcoholic intoxication Antonio Boba
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90105-5
The American Journal of Emergency Medicine , Vol. 17 , Issue 4 ,
Published in issue: July 1999
Underappreciation of sleep disorders as a cause of motor vehicle crashes Barry D. Fuchs, Janet McMaster, Gregory Smull, Joanne Getsy, Basil Chang, Rosemary A. Kozar
DOI: http://dx.doi.org/10.1053/ajem.2001.28328
The American Journal of Emergency Medicine , Vol. 19 , Issue 7 ,
Published in issue: November 2001
x Despite an increased risk of motor vehicle crashes (MVC) in patients with obstructive sleep apnea (OSA), we hypothesized that OSA was not considered in drivers admitted to trauma centers after an injury-producing MVC. A retrospective study on drivers involved in MVCs admitted to a level 1 trauma center was performed, with crash cause determined and the frequency of sleep studies recorded. A questionnaire was also mailed to 240 trauma centers seeking information on evaluation of patients with unexplained causes for MVCs, including screening for OSA.
Adult female with hematemesis—Dieulafoy lesion Mansour Jammal, Boris Khodorkovsky, Mark Raden, Barry Hahn
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.035
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: April 22 2013
x A 40-year-old healthy woman presented to the emergency department with a complaint of intermittent hematemesis, despite the absence of usual factors associated with upper gastrointestinal bleeding (ie, nonsteroidal anti-inflammatory drugs, alcoholism, etc). The patient was diagnosed with a Dieulafoy lesion. This is an uncommon finding, which clinicians must be familiar with and maintain in the differential diagnosis because the consequences of this disease process are grave. It is vital to properly diagnose this condition and be familiar with the treatment.
Blood coagulation and fibrinolysis in trauma patients, with special reference to FPA and FPB β 15–42: Gando S, Tsujinaga H, Takechi S, et al. Jpn J Acute Med 1987;11:221–228
DOI: http://dx.doi.org/10.1016/0735-6757(87)90400-1
The American Journal of Emergency Medicine , Vol. 5 , Issue 5 ,
Published in issue: September 1987
Significance of plateau wave (A wave) in severe head injury : Yokota H, Kobayashi S, Nakazawa S, et al. Jpn J Acute Med 1987;5:337–342
DOI: http://dx.doi.org/10.1016/0735-6757(87)90401-3
The American Journal of Emergency Medicine , Vol. 5 , Issue 5 ,
Published in issue: September 1987
