Interaction of the diabetes mellitus and cardiac diseases on survival outcomes in out-of-hospital cardiac arrest Dayea Beatrice Jang, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Ok Ahn, Seung Sik Hwang, Young Taek Kim, Sung Ok Hong, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.076
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: December 29 2015
x Diabetes mellitus (DM) and cardiac disease (CD) both likely effect out-of-hospital cardiac arrest (OHCA) survival, but the effect of their relationship on survival outcomes is unclear. This study aims to investigate whether the association of DM and OHCA outcomes differ in patients with and without CD.
Possible association between Takotsubo cardiomyopathy, sepsis, and diabetes mellitus: a still open question Fabio Fabbian, Alfredo De Giorgi, Ruana Tiseo, Benedetta Boari, Raffaella Salmi, Fulvia Signani, Beatrice Zucchi, Roberto Manfredini
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.042
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 23 2015
x We appreciated the comments by Dr Madias [1], raising some interesting key points. On one hand, we quite agree that emotional and physical stressors are not strictly separated entities and, in most cases, may overlap as triggering factors of Takotsubo cardiomyopathy (TTC). However, this definition is widely used [2,3]. The association between diabetes mellitus (DM) and TTC has been matter of several investigations. Pelliccia et al [3], evaluating a series of 19 studies (1109 patients), after a contact with corresponding authors, asked to provide additional quantitative details, concluded that patients with TTC have a relevant prevalence of cardiovascular risk factors and associated comorbidities.
Trends in diabetes-related visits to US EDs from 1997 to 2007 Michael D. Menchine, Warren Wiechmann, Anne L. Peters, Sanjay Arora
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.028
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published online: May 13 2011
x The aims of the study were to describe temporal trends in the number, proportion, and per capita use of diabetes-related emergency department (ED) visits and to examine any racial/ethnic disparity in ED use for diabetes-related reasons.
Comparison of coronary calcification of the culprit lesion between diabetic and non-diabetic patients with acute coronary syndrome Dimitrios Barmperis, Konstantina Bouki, Thomas Apostolou, Athanasios Chalkias, Theodoros Xanthos
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.057
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: February 10 2014
x The risk of myocardial infarction or death in diabetic patients is similar to that of patients with a history of heart attack with coronary artery calcification being an independent predictor of mortality [1,2]. Optical coherence tomography (OCT) is one of the most precise tools in the description of the morphology of the culprit lesion, allowing for the in vivo characterization of the atherosclerotic plaques [3,4]. The purpose of this study was to compare the calcification of the culprit lesion between diabetic and non-diabetic patients who present with acute coronary syndrome (ACS).
Using a single cut-off for stress hyperglycemia in myocardial infarction decreases its prognostic value particularly in diabetes Goran P. Koracevic
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.027
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: November 11 2013
x High admission blood glycemia (ABG), that is, stress hyperglycemia (SH), is an important prognostic indicator in a variety of diseases, including acute myocardial infarction (AMI) [1]. Although this has been known for decades [2], there is, to date, no universal consensus about ABG concentration(s) required for SH in AMI patients [1,3-5]. Indeed, it is intrinsically difficult to define SH in patients with diabetes mellitus (DM) because basal glycemia is not known and could vary significantly in this patient population [6].
Clopidogrel resistance in diabetic patient with acute myocardial infarction due to stent thrombosis Matej Samoš, Radoslava Šimonová, Frantisek Kovář, Lukas Duraj, Jana Fedorová, Peter Galajda, Jan Staško, Marian Fedor, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.006
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: January 21 2014
x Stent thrombosis is a morbid complication after percutaneous coronary intervention. Dual antiplatelet therapy significantly reduces stent thrombosis risk and forms currently the basis in acute ST elevation myocardial infarction pharmacologic treatment. The introduction of clopidogrel has made a major advance in the acute coronary syndrome treatment. However, there is growing evidence about failure in antiplatelet response after clopidogrel, which may lead to subsequent risk of future thrombotic events.
Prevalence of diabetes mellitus in patients with sepsis-triggered Takotsubo syndrome John E. Madias
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.041
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 23 2015
x The article by Fabbian et al [1] published on line ahead of print on June 18, 2015 in the journal about the concurrence of infections/sepsis and Takotsubo syndrome (TTS) is of interest from the pathogenetic point of view, that a physical stress like sepsis can trigger TTS, and that male patients afflicted with this combinations have worse in-hospital mortality than do their female counterpart. It is conceivable that we are in error when we think that we can separate physical and emotional stresses, and it is possible to consider an emotional overlay over the physical stress of sepsis, as a trigger of TTS.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint Ronald Maag, Susie Sun, Michael Hannon, Rhian Davies, Peter Alagona, Andrew Foy
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.003
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: February 10 2015
x Cardiac troponin testing is used to aid the diagnosis of myocardial infarction (MI) in the emergency department (ED) for patients who present with a range of symptoms. From a clinical perspective, the distinction between MI due to acute coronary artery thrombosis (type I MI) and other forms of direct and secondary myocardial injury (type II MI) is very important. However, the positive predictive value (PPV) of an elevated troponin for diagnosing type I MI, based on clinical history, has not been described.
Coronary atherosclerosis and adverse outcomes in patients with recent-onset atrial fibrillation and troponin rise Alberto Conti, Elena Angeli, Margherita Scorpiniti, Andrea Alesi, Federica Trausi, Delia Lazzeretti, Luigi Padeletti, Gian Franco Gensini
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.013
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 16 2015
x The relationship between troponin and atrial fibrillation (AF) without acute coronary syndrome is still unclear. We sought to investigate the presence of coronary atherosclerosis and adverse outcomes in patients with AF.
The impact of body mass index on patient survival after therapeutic hypothermia after resuscitation Khadijah Breathett, Nishaki Mehta, Vedat Yildiz, Erik Abel, Ruchika Husa
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.077
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: December 29 2015
x Therapeutic hypothermia improves survival in patients after cardiac arrest, yet the impact of body mass index (BMI) on survival is lesser known. We hypothesized that nonobese patients would have greater survival post–therapeutic hypothermia than obese patients.
Validation of the use of B-type natriuretic peptide point-of-care test platform in preliminary recognition of cardioembolic stroke patients in the ED Zhixin Wu, Mingming Zhao, Mingfeng He, Hongke Zeng, Feng Tan, Kuangyi Li, Shenglong Chen, Qianpeng Han, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.013
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: January 16 2015
x The aim of the study is to validate of the use of plasma B-type natriuretic peptide (BNP) point-of-care test platform in preliminary recognition of cardioembolic stroke patients in the emergency department (ED).
Various admission glucose cut-offs for prognostication and for therapeutic threshold in acute myocardial infarction Goran P. Koracevic
DOI: http://dx.doi.org/10.1016/j.ajem.2014.09.046
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 2 2014
x Glycemia is a crucial laboratory parameter; and from a “therapeutic” point of view, it is essential to avoid/correct both hypoglycemia and hyperglycemia, particularly if they are pronounced. This also holds true for patients with acute myocardial infarction (AMI). Indeed, in addition to general principles, one of the reasons why correction of high/low glycemia is important in AMI comes from precise investigations of prognostic impact of dysglycemia in this diasease.
Catamenial diabetic ketoacidosis—a diagnostic dilemma in ED Nayer Jamshed, Bharatraj Banavaliker, Praveen Aggarwal
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.038
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: October 29 2012
x Diabetic ketoacidosis (DKA) is a frequent medical emergency. The most common precipitating events are absolute or relative deficiency of insulin, infection, and noncompliance with medication. We describe a 32-year-old lady with type 1 diabetes mellitus in whom DKA was precipitated 1 to 2 days before her menstrual periods resulting in repeated admissions to hospital. Menstruation may precipitate DKA. Emergency physicians must keep this in mind if no other precipitating event can be found in a patient with DKA.
Diabetic ketoacidosis as the initial presentation of hyperthyroidism Chao-Yen Huang, Wei-Lung Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.065
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 29 2015
x Abdominal pain is a common chief complaint that encompasses a broad differential diagnosis at emergency department (ED), ranging from general discomfort to life-threatening disease. Abdominal pain induced by a metabolic disorder should also be considered. Diabetic ketoacidosis (DKA) is a common complication of new-onset type 1 diabetes mellitus in young patients. Although DKA that presented to the ED with complaint of abdominal pain is not uncommon, it is precipitated by hyperthyroidism, which is rare and more complicated.
Serum procalcitonin level for the prediction of severity in women with acute pyelonephritis in the ED: value of procalcitonin in acute pyelonephritis Jeong Ho Park, Jung Hee Wee, Seung Pill Choi, Kyu Nam Park
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.012
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 22 2013
x Predicting medical outcomes for acute pyelonephritis (APN) in women is difficult. Delay in diagnosis and treatment often results in rapid progression to circulatory collapse, multiple-organ failure, and death. The aim of this study was to investigate the value of procalcitonin (PCT) level in women with APN at ED.
The pregnant heart: cardiac emergencies during pregnancy Alyson J. McGregor, Rebecca Barron, Karen Rosene-Montella
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.046
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: March 6 2015
x Cardiovascular emergencies in pregnant patients are often considered a rare event; however, heart disease as a cause of maternal mortality is steadily increasing.
Transient ischemic attack (TIA): the initial diagnostic and therapeutic dilemma Peter D. Panagos
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.004
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published online: May 13 2011
x Many patients with transient ischemic attacks (TIA) are at high risk of stroke within the first few days of onset of symptoms. Emergency physicians and primary care physicians need to assess these patients quickly and initiate appropriate secondary stroke prevention strategies. Recent refinements in diagnostic imaging have produced valuable insight into risk stratification of patients with TIA. Clinical data regarding urgent initiation of antiplatelet therapy specifically in this patient population with non-cardioembolic TIA are limited but promising.
Thoracic spine fracture in the course of severe nocturnal hypoglycemia in young patients with type 1 diabetes mellitus—the role of low bone mineral density Liliana Majkowska, Ewa Waliłko, Piotr Molęda, Andrzej Bohatyrewicz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.055
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 6 2014
x Thus far, only a few spine fracture cases related to severe nocturnal hypoglycemia in type 1 diabetes patients have been reported. Due to the relatively young age of these subjects, osteoporosis was not taken into consideration and bone mineral density was not assessed.
A risk stratification model of acute pyelonephritis to indicate hospital admission from the ED Changwoo Kang, Kyuseok Kim, Soo Hoon Lee, Chanjong Park, Joonghee Kim, Jae Hyuk Lee, You Hwan Jo, Joong Eui Rhee, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.048
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: April 29 2013
x There are no guidelines regarding the hospitalization of female patients with acute pyelonephritis (APN); therefore, we performed a retrospective analysis to construct a clinical prediction model for hospital admission.
