A clinical score to obviate the need for cardiac stress testing in patients with acute chest pain and negative troponins Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J. Broullón, Nemesio Álvarez-García, Nicolás Maneiro-Melón, Patricia Pardo-Martinez, Marta Sagastagoitia-Fornie, Dolores Martínez, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.016
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 12 2016
x Although cardiac stress testing may help establish the safety of early discharge in patients with suspected acute coronary syndromes and negative troponins, more cost-effective strategies are necessary. We aimed to develop a clinical prediction rule to safely obviate the need for cardiac stress testing in this setting.
Prevalence and risk factors for central diabetes insipidus in cardiac arrest survivor treated with targeted temperature management Dong Hun Lee, Byung Kook Lee, Kyoung Hwan Song, Yong Hun Jung, Jung Soo Park, Sung Min Lee, Yong Soo Cho, Jin Woong Kim, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2016.04.005
Publication stage: In Press Accepted Manuscript
The American Journal of Emergency Medicine
Published online: April 8 2016
x Central diabetes insipidus (CDI) is a marker of severe brain injury. Here we aimed to investigate the prevalence and risk factors of CDI in cardiac arrest survivors treated with targeted temperature management (TTM).
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.
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.
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
Looking at diabetic ketoacidosis through electrocardiogram window! Soheila Talebi, Farzaneh Ghobadi, Arthur Cacacho, Ola Olatunde, Alicia DeRobertis, Gerald Pekler, Ferdinand Visco, Savi Mushiyev, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.032
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 28 2015
x Initial serum potassium (K
Mucormycosis: what emergency physicians need to know? Brit Long, Alex Koyfman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.037
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published online: August 25 2015
x Mucormycosis is a rare presentation for patients in the emergency department (ED), primarily affecting immunocompromised patients. Multiple forms of infection are present, and with poor prognosis, ED diagnosis and treatment of this deadly condition are necessary.
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.
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.
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.
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.
Is there a potential role for echocardiography in adult patients with CAP? Birdal Yıldırım, Funda Sungur Biteker, Özcan Başaran, Ömer Doğan Alataş, Ethem Acar, Hamdi Sözen, Volkan Doğan, Halil Beydilli, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.036
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: June 18 2015
x The role of echocardiography in adult patients with community-acquired pneumonia (CAP) has not been tested in a clinical trial. The aim of the study was to assess the cardiac changes secondary to CAP by echocardiography and to find out the correlation between echocardiographic findings and the severity of CAP.
Prognosis of Critically Ill Patients in the ED and Value of Perfusion Index Measurement: A Cross-Sectional Study Alten Oskay, Oktay Eray, Selcan Enver Dinç, Alp Giray Aydın, Cenker Eken
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.033
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 24 2015
x Critically ill patients have high mortality and admission rates requiring early recognition and a rapid management. In the present study, we evaluated the prognostic parameters in these patients and the value of perfusion index measurement as a novel tool for accomplishing emergency department (ED) triage.
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.
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.
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).
Clinical features and impact of empirical therapy in cirrhotic adults with community-onset bacteremia Chih-Chia Hsieh, Ching-Chi Lee, Tsung-Yu Chan, Ming-Yuan Hong, Chih-Hsien Chi, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.024
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 28 2014
x The objectives were to investigate the clinical characteristics of community-onset bacteremia in cirrhotic adults visiting the emergency department (ED), as well as the clinical impact of empirical antibiotics on their outcome.
The impact of age on outcomes of elderly ED patients ventilated due to community acquired pneumonia Toru Hifumi, Ippei Jinbo, Ichiro Okada, Nobuaki Kiriu, Hiroshi Kato, Yuichi Koido, Junichi Inoue, Kenya Kawakita, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.046
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 8 2014
x There is no consensus on whether mechanical ventilation should be initiated for advanced age with community-acquired pneumonia (CAP). This study investigated the effects of age on the outcomes of mechanical ventilation in the emergency department (ED) for advanced age with CAP.
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.
Prescriber beware: report of adverse effect of sodium-glucose cotransporter 2 inhibitor use in a patient with contraindication Reginald St Hilaire, Heather Costello
DOI: http://dx.doi.org/10.1016/j.ajem.2014.09.039
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: October 2 2014
x Diabetic ketoacidosis (DKA) is well recognized as an endocrine emergency. Diabetic ketoacidosis more commonly occurs in patients with type I diabetes secondary to the absence of endogenous insulin and their general predilection toward ketone production. Emergency medicine physicians are well trained in the prompt recognition and initiation of appropriate treatment needed to stop the rapidly progressive cycle of acidosis and dehydration before it becomes fatal. Traditionally, diagnostic criteria include hyperglycemia (>
