Haemophilus influenzae serotype f as a rare cause of septic arthritisPatompong Ungprasert, Kunatum Prasidthrathsint, Nitipong Permpalung, Narat Srivali, Quanhathai Kaewpoowat
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.024
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: May 20 2013
x Non–type B Haemophilus influenzae emerges as a new pathogen in the post H. influenzae serotype b vaccine era. We describe a case of polyarticular septic arthritis caused by H. influenzae serotype f in an adult. The patient was successfully treated with surgical debridement and antibiotic. To the best of our knowledge, this is the fourth reported case of H. influenzae serotype f septic arthritis in adults.
Severe sepsis and septic shock due to Plasmodium vivax infection Athanasios Chalkias, Sotirios Aridas, Drosos E. Karageorgopoulos, Georgios Stratiotis, Dimitra Mystrioti, Athanasios Mallios, Ioannis Nakos, Nikolaos Mpellos, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.011
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 4 2013
x Plasmodium vivax malaria is typically characterized by a mild and benign clinical course. Organ dysfunction is rarely seen, whereas acute lung injury has been found to occur after starting antimalarial treatment. We present an unusual case of severe sepsis and septic shock due to Plasmodium vivax monoinfection.
Appropriateness of epinephrine use in ED patients with anaphylaxis Damian V. Baalmann, John B. Hagan, James T.C. Li, Erik P. Hess, Ronna L. Campbell
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.003
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 8 2015
x Studies have demonstrated low rates of emergency department (ED) epinephrine administration for anaphylaxis patients, suggestive of ED undertreatment of anaphylaxis. Our study assessed the appropriateness of ED epinephrine administration in anaphylaxis management.
Acute vertebrobasilar ischemic stroke due to electric injury Rajendra Singh Jain, Sunil Kumar, Desai Tushar Suresh, Rakesh Agarwal
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.068
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: January 6 2015
x Electrical injuries are most commonly due to household accidents. Various factors determine the severity of electric injury, including type of current, amperage, voltage, tissue resistance, pathway of current, and duration of contact with the body. Various types of neurologic damage due to electrical injury have been described in literature. It may manifest as peripheral nerve injury, spinal cord damage, seizures, cerebellar ataxia, hypoxic encephalopathy, and intracerebral hemorrhage. Acute ischemic stroke is an infrequent complication of electrical injury.
Efficacy of urine alkalinization by oral administration of sodium bicarbonate: a prospective open-label trial Barak Cohen, Ido Laish, Tal Brosh-Nissimov, Azik Hoffman, Lior H. Katz, Rony Braunstein, Ram Sagi, Goldman Michael
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.031
The American Journal of Emergency Medicine , Vol. 31 , Issue 12 ,
Published online: September 23 2013
x Urine alkalinization is indicated for various medical conditions. Alkalinization is usually achieved by intravenous administration of alkali substances titrated by repeated urinalyses. Some situations such as mass casualty events might require urine alkalinization by the oral route. We evaluated the efficacy of oral sodium bicarbonate administration for urine alkalinization.
The accuracy of mainstream end-tidal carbon dioxide levels to predict the severity of chronic obstructive pulmonary disease exacerbations presented to the ED Nurettin Özgür Doğan, Alp Şener, Gül Pamukçu Günaydın, Ferhat İçme, Gülhan Kurtoğlu Çelik, Havva Şahin Kavaklı, Tuğba Atmaca Temrel
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.001
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: January 16 2014
x The end-tidal carbon dioxide (ETCO2 ) measurement was considered as an essential tool for the assessment of several conditions in emergency medicine. However, the diagnostic role of capnography in dyspneic patients still remains unclear. We aimed to analyze the alteration of the ETCO2 levels in chronic obstructive pulmonary disease (COPD) exacerbations and its role in the decision-making process.
Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease Peter McCanny, Kath Bennett, Paul Staunton, Geraldine McMahon
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.011
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: September 12 2011
x The purpose of this study was to investigate the clinical correlation between arterial and venous blood gas (VBG) values in patients presenting to the emergency department (ED) with acute exacerbation of chronic obstructive pulmonary disease.
Proadrenomedullin, a useful tool for risk stratification in high Pneumonia Severity Index score community acquired pneumonia Caroline Courtais, Nils Kuster, Anne-Marie Dupuy, Margit Folschveiller, Riad Jreige, Anne-Sophie Bargnoux, Julie Guiot, Sophie Lefebvre, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2012.07.017
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 24 2012
x The aim of the present study was, first, to evaluate the prognostic value of mid-regional proadrenomedullin (proADM) in emergency department (ED) patients with a diagnosis of community acquired pneumonia (CAP) and, second, to analyze the added value of proADM as a risk stratification tool in comparison with other biomarkers and clinical severity scores. We evaluated proADM, C-reactive protein and procalcitonin, along with the Pneumonia Severity Index (PSI) score in consecutive CAP patients. Ability to predict 30-day mortality was assessed using receiver operating characteristic curve analysis, logistic regression, and reclassification metrics for all patients and for patients with high PSI scores.
Role of inferior vena cava and right ventricular diameter in assessment of volume status: a comparative study: Ultrasound and hypovolemia Suat Zengin, Behcet Al, Sinan Genc, Cuma Yildirim, Süleyman Ercan, Mehmet Dogan, Gokhan Altunbas
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.013
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: April 19 2013
x Ultrasonography has been suggested as a useful noninvasive tool for the detection and follow-up for hypovolemia. Two possible sonographic markers as a surrogate for hypovolemia are the diameters of the inferior vena cava (dIVC) and the right ventricle (dRV). The goal of this study was to evaluate IVC and RV diameters and diameter changes in patients treated for hypovolemia and compare these findings with healthy volunteers.
Medical students do not adversely affect the quality of cardiopulmonary resuscitation for ED patients Xian-Long Zhou, Xiao-Wen Duan, Yan Zhao, Cheng Jiang, Peng Xu, Shan Jiang, Shao-Zhou Ni
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.007
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: December 12 2013
x To investigate the effect of medical student involvement on the quality of actual cardiopulmonary resuscitation (CPR).
Utilizing left ventricular outflow tract velocity changes to predict fluid responsiveness in septic patients: a case report Alan T. Chiem, Elizabeth Turner
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.006
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: November 18 2013
x Toxin-mediated vasodilation in the sepsis syndrome can lead to end-organ dysfunction and shock. Assessing for fluid responsiveness and preload optimization with intravenous fluids is a central tenet in the management of sepsis. Aggressive fluid administration can lead to pulmonary edema and heart failure, whereas premature inotropic or vasopressor support can worsen organ perfusion. Inferior vena cava ultrasonography is commonly used to assess for fluid responsiveness but has multiple limitations.
Predicting tularemia with clinical, laboratory and demographical findings in the ED Derya Yapar, Ali Kemal Erenler, Özlem Terzi, Özlem Akdoğan, Yasemin Ece, Nurcan Baykam
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.034
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 24 2015
x We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED).
A trial of midazolam vs diphenhydramine in prophylaxis of metoclopramide-induced akathisia Bulent Erdur, Pinar Tura, Berrin Aydin, Mert Ozen, Ahmet Ergin, Ismet Parlak, Burhan Kabay
DOI: http://dx.doi.org/10.1016/j.ajem.2010.10.007
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: December 15 2010
x The study aimed to evaluate the effects of midazolam and diphenhydramine for the prevention of metoclopramide-induced akathisia.
Anaphylaxis with intravenous immunoglobulin: a time for introspection Rajendra Singh Jain, Rakesh Agrawal, Sunil Kumar, Pankaj Kumar Gupta
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.019
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: March 15 2015
x As the perplexity of human immune system is disentangled day by day, a wide panoply of diseases is being managed by intravenous immunoglobulin (IVIG) therapy. Intravenous immunoglobulin, a blood-derived product, is used to treat a wide gamut of immunodeficiency disorders and autoimmune diseases. But no drug is free of side effects, and IVIG is also associated with mild and serious adverse reactions including anaphylaxis. The clinicians require an in-depth knowledge regarding the product, side effects, and patient comorbidities while infusing IVIG.
Oxcarbazepine-induced resistant ventricular fibrillation in an apparently healthy young man Ayman El-Menyar, Mazhar Khan, Jassim Al Suwaidi, Esam Eljerjawy, Nidal Asaad
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.008
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: August 16 2010
x We report a 30-year-old man with recurrent loss of consciousness. His resting electrocardiogram revealed Brugada pattern. The patient developed resistant ventricular fibrillation after receiving oral oxcarbazepine. The clinical, echocardiographic, and electrocardiographic features are discussed in brief.
An electrocardiographic sign of tumor invasion of the myocardium Francisco J. Toledano, José Suárez de Lezo, José Segura, Javier Suárez de Lezo, Dolores Mesa
DOI: http://dx.doi.org/10.1016/j.ajem.2011.10.010
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: December 26 2011
x Lung cancer is one of the most common neoplasms associated with cardiac metastasis, and the pericardium is often affected. However, isolated myocardial involvement in these patients is very uncommon. Most tumor invasions into the heart are nonspecific and clinically silent. Myocardial metastasis rarely mimics an acute myocardial infarction. We report a case of a 59-year-old man with a metastatic lung cancer into the myocardium mimicking an acute myocardial infarction.
Incomplete Kawasaki disease Margarita M. Miller, Adam H. Miller
DOI: http://dx.doi.org/10.1016/j.ajem.2013.01.012
The American Journal of Emergency Medicine , Vol. 31 , Issue 5 ,
Published online: March 7 2013
x This is a report of a 4-year-old Hispanic boy who presented with skin changes to the lips and oral cavity, a generalized rash, edema of hands and feet, and peeling of the periungual areas of the fingers as well as to the groin and perianal areas. Fourteen days earlier, his 19-month-old brother was diagnosed and treated for Kawasaki disease. Upon laboratory investigation, our patient was found to have an elevated sedimentation rate, C-reactive protein, and serum γ -glutamyl transferase. Infectious disease and cardiology consultations subsequently diagnosed and treated our patient for incomplete Kawasaki disease.
Improved sepsis bundles in the treatment of septic shock: a prospective clinical study Nian-Fang Lu, Rui-Qiang Zheng, Hua Lin, Jun Shao, Jiang-Quan Yu, De-Gang Yang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.031
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 25 2015
x Sepsis bundles can decrease mortality in patients with severe sepsis or septic shock. However, current methods of measuring pressure, such as central venous pressure, are inadequate. This study investigated the effect of improved sepsis bundles informed by pulse-indicated continuous cardiac output.
Venoarterial extracorporeal membrane oxygenation resuscitation in diabetic ketoacidosis with hypothermic cardiocirculatory instability Lin Ming-hsien, Ko Wen-Je, Shih Shyang-rong, Wang Chih-hsien
DOI: http://dx.doi.org/10.1016/j.ajem.2010.11.003
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: December 27 2010
x Diabetic ketoacidosis with hypothermia is underrecognized, and the mortality rate is high at between 30% and 60%. The cause of hypothermia in diabetic ketoacidosis patients is speculative and has multiple factors. Insulin deficit is the most important factor that leads to a lack of substrate for cellular heat production [4]. Water depletion and low environment temperature may also be contributing factors, especially in patients with a severe diabetic coma. Hypothermia may also aggravate uncontrolled diabetes mellitus and complicate treatment because insulin secretion is impaired and exogenous administered insulin is less effective at low temperatures.
The impact of age and gender on resource utilization and profitability in ED patients seen and released Philip L. Henneman, Brian H. Nathanson, Kara Ribeiro, Hari Balasubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.030
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 1 2014
x To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED).
