Surviving a crisis of HIV-associated immune reconstitution syndrome Yu-Tzu Tsao, Shih-Wei Lee, Jin-Chyr Hsu, Feng-Ming Ho, Wei-Jie Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2011.09.003
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: October 28 2011
x The management of life-threatening complications in HIV-associated immune reconstitution syndrome is becoming a challenging scenario in emergency practice, especially in the era of highly active antiretroviral therapy paralleled by increased worldwide incidence of HIV infection. Here, we described a 37-year-old woman with acute hypoxic respiratory failure, acute renal failure, and hypercalcemic crisis as the presenting features of HIV-associated immune reconstitution syndrome. In this patient, the restored granulomatous host response toward isolated pulmonary Mycobacterium avium complex infection led to a near-fatal catastrophe.
Considerations for resuscitation at high altitude in elderly and untrained populations and rescuers Takashi Suto, Shigeru Saito
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.007
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: November 14 2013
x With the development of transportation technologies, elderly people with chronic diseases are increasingly enjoying trekking and tours of nature resorts that include mountain highlands. Because of problems related to circulation, respiration, metabolism, and/or the musculoskeletal system in this population, the impact of high altitude on cardiopulmonary function is increased. Alpine accidents, therefore, tend to be more common in this population, and cases of cardiopulmonary arrest (CPA) at high altitudes seem to be increasing.
Spontaneous spinal epidural hematoma presenting as Brown-Séquard syndrome Jung-In Ko, Taikwan Kim, Cheol Su Jwa, Ji Yeon Jang, Ki Young Jeong, Gil Jun Suh, Taejin Park
DOI: http://dx.doi.org/10.1016/j.ajem.2012.11.018
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 4 2013
x Spontaneous spinal epidural hematoma (SEH) is a rare disease. Furthermore, Brown-Séquard syndrome due to spontaneous SEH has been rarely reported. Early detection of spontaneous SEH is not easy because early symptoms are often atypical and neurologic findings are often absent in the early stage. Early diagnosis and urgent surgical management are needed to prevent permanent neurologic deficits. We report a case of a 30-year-old patient who presented with Brown-Séquard syndrome due to spontaneous SEH.
A primary cardiac sarcoma presenting with superior vena cava obstruction Manish Thakker, Tracey Keteepe-Arachi, Ausami Abbas, Graham Barker, Neil Ruparelia, Gearoid T. Kingston, Timothy J. Parke
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.030
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: January 31 2011
x Superior vena cava (SVC) obstruction leads to a constellation of symptoms and signs that encompass the SVC syndrome. Today, malignancy accounts for 65% of all cases. The most common neoplastic causes are non–small cell lung cancer (50%), small cell lung cancer (25%), lymphoma, and metastasis. Primary cardiac tumors are an extremely rare cause of SVC obstruction. We describe the case of a 48-year-old man who presented with dyspnea, confusion, and facial swelling with cyanosis. The patient developed life-threatening airway obstruction after administration of anxiolytic.
About ultrasound in pneumothorax Andrew Verniquet, Rafid Kakel
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.015
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: June 6 2011
x The interesting case report “the double lung point: an unusual sonographic sign of juvenile spontaneous pneumothorax” by Volpicelli and Audino [1] raises several questions.
ED crowding and the outcomes of out-of-hospital cardiac arrest Jiwon Kang, Joonghee Kim, You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Taeyun Kim, Jungyoup Lee, Ji Eun Hwang, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.002
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 4 2015
x Emergency department (ED) overcrowding is a worldwide problem associated with adverse outcomes. This study was performed to investigate the association between ED overcrowding and the outcomes and quality of cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA).
Timing and appropriateness of initial antibiotic therapy in newly presenting septic patients Antonia L. Vilella, Charles F. Seifert
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.008
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: October 21 2013
x To determine the effectiveness of antibiotic regimens and time to antibiotics in septic patients admitted to an intensive care unit from the emergency department.
Impact of individual characteristics on sonographic IVC diameter and the IVC diameter/aorta diameter index Jianjun Gui, Jiongguang Guo, Fengqiu Nong, Dongxin Jiang, Anding Xu, Fan Yang, Qiaozhu Chen, Youping Lin
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.047
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: June 22 2015
x The inferior vena cava (IVC) parameters, including its diameter and collapsibility index have been evaluated for fluid status for over 30 years, but little is known about the impacts of patient characteristics on IVC parameters. The purpose of this study was to explore the relationships between individual patient characteristics and IVC parameters in healthy Chinese adult volunteers.
Large hiatal hernia at chest radiography in a woman with cardiorespiratory symptoms Daniele Torres, Gaspare Parrinello, Mauro Cardillo, Marina Pomilla, Caterina Trapanese, Bellanca Michele, Umberto Lupo, Caterina Schimmenti, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.009
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration.
Monitoring the response to treatment of acute heart failure patients by ultrasonographic inferior vena cava collapsibility index Özcan Yavaşi, Erden Erol Ünlüer, Kamil Kayayurt, Selim Ekinci, Caner Sağlam, Nebi Sürüm, Mehmet Hicri Köseoğlu, Murat Yeşil
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.046
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: January 6 2014
x Our aim was to determine if N-terminal pro-brain natriuretic peptide (NT-proBNP) or sonographic measurements of inferior vena caval (IVC) diameters and collapsibility index (IVC-CI) have a role in the monitoring of acute heart failure (AHF) therapy.
Spontaneous tension pneumothorax and CO2 narcosis in a near fatal episode of chronic obstructive pulmonary disease exacerbation Walter Spindelboeck, Adrian Moser
DOI: http://dx.doi.org/10.1016/j.ajem.2011.09.015
The American Journal of Emergency Medicine , Vol. 30 , Issue 8 ,
Published online: November 21 2011
x Exacerbation of chronic obstructive pulmonary disease (COPD) is a disease pattern frequently seen in emergency medical services and intensive care units. Usually, exacerbations of COPD are of infectious origin, and an acute vital threat may take several days to develop. Tension pneumothorax in patients with COPD is a rare and often unexpected cause of acute vital threat. To the best of our knowledge, this is a unique case of CO2 narcosis after spontaneous tension pneumothorax in a patient with COPD.
Usefulness of triggering receptor expressed on myeloid cells-1 in differentiating between typical and atypical community-acquired pneumonia Chorng-Kuang How, Sen-Kuang Hou, Hsin-Chin Shih, David Hung-Tsang Yen, Chun-I Huang, Chen-Hsen Lee, Gau-Jun Tang
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.010
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: May 3 2010
x The purpose of this study is to investigate the clinical use of inflammatory marker triggering receptor expressed on myeloid cells (TREM)-1 at admission for differentiating between typical and atypical bacterial community-acquired pneumonia (CAP).
Acute heart failure diagnosis by ultrasound: new achievements and persisting limitations Daniela Catalano, Guglielmo M. Trovato, Marco Sperandeo
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.026
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: December 19 2013
x The article by Anderson et al [1] elegantly addresses the problem of misdiagnosis of acutely decompensated heart failure (ADHF). Their approach is very comprehensive and, in our opinion, is an important advancement of the current evidence in emergency medicine, beyond the existing severe limitations of previous studies using lung ultrasound (LUS). Nonetheless, we can agree only partially with the statements, which are the background of this and similar reports and by which the subsequent statistical analysis is severely biased.
Vomiting is not associated with poor outcomes in pediatric victims of unintentional submersions Kimberley M. Farr, Elizabeth A. Camp, Shabana Yusuf, Rohit P. Shenoi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.055
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 4 2015
x The outcome of submersion victims depends on submersion duration and the availability of timely and effective resuscitation. The prognostic implication of vomiting during resuscitation of submersion victims is unclear. The study sought to determine whether vomiting during resuscitation in children treated for unintentional submersion injuries adversely impacts outcome.
Recurrent idiopathic ventricular fibrillation induced by high fever Kazuhiko Omori, Kei Jitsuiki, Hiromichi Ohsaka, Kentaro Mishima, Kouhei Ishikawa, Mariko Obinata, Yasumasa Oode, Youichi Yanagawa
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.021
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: March 17 2015
x A 75-year-old man became unconscious while taking a bath and drowned. His family found him and called an ambulance, and he was transported to our department. On arrival, his consciousness had improved. The results of his physical examination and an electrocardiogram were negative for abnormalities. After starting to eat, he developed a high fever at greater than 39°C, which was followed by pulseless ventricular tachycardia and ventricular fibrillation (Vf). Immediate coronary angiography showed no remarkable findings.
Clinical assessment of children with first-attack seizures admitted to the ED Chun-Yu Chen, Wen-Chieh Yang, Kang-Hsi Wu, Han-Ping Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.008
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x This study aims to evaluate clinical values and determine the function of a pediatric observation unit (POU) as an alternative to inpatient unit admission for children with newly onset seizures.
The infected heart: ventriculoseptal abscess and intracardiac fistulization Keith Habeeb, Holly Stankewicz, Jennifer Axelband, Scott Melanson
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.053
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: June 29 2015
x Infective endocarditis is a rare but potentially deadly infection of the endocardial layer, which can involve the valves of the heart among other structures. The extraordinarily rare complication seen in this case involves extensive damage manifesting in an aortic root abscess resulting in an abnormal communication between the aorta and the atrium known as an aortocavitary fistula (Eur Heart J 2005;26:288-297; Pediatr Cardiol 2011;32:1057-1059; J Am Coll Cardiol 1991;18:663-667). As the disease progresses, wading through the complex symptoms, which may seem unrelated, represents a key challenge in diagnosis.
Linezolid is a novel and effective treatment for septic pulmonary embolism Maki Yasuda, Ryota Inokuchi, Kazuma Ohshima, Miyuki Yamamoto, Kurato Tokunaga, Tatsuma Fukuda, Kensuke Nakamura
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.035
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: January 6 2015
x Septic pulmonary embolism (SPE) is an uncommon and severe infectious disease that requires early diagnosis and proper antibiotic therapy. We present the case of a healthy 14-year-old girl with a history of atopic dermatitis, who developed SPE caused by Staphylococcus aureus bacteremia. We initially administered intravenous doripenem and vancomycin. Four days after her admission, blood and urine cultures yielded penicillinase nonproducing, methicillin-sensitive S aureus , with a minimum inhibitory concentration less than 0.06 μ g/mL.
Hantavirus infection in North America: a clinical review James Hartline, Chris Mierek, Tristan Knutson, Christopher Kang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.001
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: May 15 2013
x The recent outbreak of hantavirus in Yosemite National Park has attracted national attention, with 10 confirmed cases of hantavirus cardiopulmonary syndrome and thousands of more people exposed. This article will review the epidemiology, presentation, workup, and treatment for this rare but potentially lethal illness. The possibility of infection with hantavirus deserves consideration in patients with severe respiratory symptoms with rodent exposure or rural/wilderness travel. Accurate diagnosis requires a high index of suspicion.
Ketamine-propofol combination (ketofol) vs propofol for procedural sedation and analgesia: systematic review and meta-analysis Mohammad Jalili, Maryam Bahreini, Amin Doosti-Irani, Rasoul Masoomi, Mona Arbab, Hadi Mirfazaelian
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.074
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 28 2015
x This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA).
