Carotid blowout and cerebral gas embolism related to bidirectional carotid-esophageal fistula: a serious complication of esophageal cancer under radiotherapy Kuei-Hong Kuo, Hsu Hung-Lung, Pan Yi-Ju, Chun-Yang Huang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.036
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: July 21 2015
x Carotid-esophageal fistula (CEF) could be a serious complication of esophageal cancer in a patient receiving radiotherapy. We reported a 47-year-old male patient with advanced cervical esophageal cancer under radiotherapy who developed CEF with the presentations of unstable vital signs and disturbances of consciousness. Carotid-esophageal fistula–associated life-threatening conditions of carotid blowout syndrome and cerebral gas embolism were diagnosed after presentation. Subsequently, intramural dissection of esophageal and gastric walls, profound hemoperitoneum, and hypovolemic shock occurred.
A 10-month-old with Lemierre syndrome complicated by purulent pericarditis Rachel W. Root, Tyler W. Barrett, Thomas J. Abramo
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.019
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: July 18 2012
x Lemierre syndrome is a potentially life-threatening septic thrombophlebitis associated with a neck infection. We present a case of a 10-month-old female infant with Lemierre syndrome complicated by thrombotic strokes and purulent pericarditis. A healthy 10-month-old female infant presented to the pediatric emergency department of our tertiary care center complaining of 5 days of fever to 105°F and 1 day of neck stiffness and decreased oral intake. In the pediatric emergency department, she developed septic shock, requiring vasopressor support, endotracheal intubation, and broad-spectrum antibiotics.
Methadone overdose causing acute cerebellitis and multi-organ damage Jessica Rando, Sofia Szari, Gogi Kumar, Hemanth Lingadevaru
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.032
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: June 17 2015
x Methadone is a synthetic opioid that, when taken in supratherapeutic amounts or with accidental ingestion in children, has shown to have adverse effects, especially to the cerebellum [1–5]. Our patient was a 14-year-old male adolescent with no significant past medical history, who presented after being found unresponsive at a friend’s house. Laboratory and imaging investigation revealed acute cardiac damage, acute renal injury, acute liver damage, and cerebellitis. Later, through specialized testing, it was discovered that patient had high levels of methadone in his serum.
Brain computed tomographic scan findings in acute opium overdose patients Farkhondeh Jamshidi, Babak Sadighi, Kamran Aghakhani, Hossein Sanaei-Zadeh, Mohammadali Emamhadi, Nasim Zamani
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.030
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: August 6 2012
x Early radiologic evaluations including noncontrast computed tomographic (CT) scan of the brain have been reported to be useful in the diagnosis and management of the intoxicated patients. Changes in the brain CT scan of the acute opium overdose patients have little been studied to date. This study aimed to evaluate changes of the brain CT scans in the acute opium overdose patients.
Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(11)00448-7
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published in issue: November 2011
Energy drinks overdose and metabolic abnormalities—a double whammy! Subramanian Senthilkumaran, Suresh S. David, Namasivayam Balamurugan, Ponniah Thirumalaikolundusubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.016
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: April 19 2013
x The article by Dikici et al [1] is interesting. There are increasing reports regarding adverse effect of energy drink (ED) in current literature. Energy drink use has been anecdotally linked with seizure, and there is paucity of evidence-based literature in support of this association. This raises a debate whether the risk is negligible or it is underestimated, due to inadequate reporting [2].
Use of an intraosseous device for invasive pressure monitoring in the ED Ralph J. Frascone, Joshua G. Salzman, Eric V. Ernest, Aaron M. Burnett
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.029
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: December 19 2013
x Venous access is essential to providing emergency care for critically ill or injured patients. Obtaining peripheral or central access can be problematic and time consuming. Intraosseous (IO) fluid administration provides similar flow rates and central circulation times compared to central lines, but use of these devices to monitor blood pressure has not been explored. We report a case of successful IO pressure (IOP) monitoring through an IO during the resuscitation of a 31-year-old male. This is the first report of monitoring IOP in a clinical setting and comparing it to traditional measures of central pressure.
Correlation of optic nerve sheath diameter measurements by computed tomography and magnetic resonance imaging Hossein Kalantari, Rajnish Jaiswal, Isaac Bruck, Hussein Matari, Farzaneh Ghobadi, Jeremy Weedon, Getaw Worku Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 19 2013
x Traditionally, intracranial pressure is measured by direct ventriculostomy, which is invasive. Noninvasive measures such as bedside ultrasound and magnetic resonance imaging have been advocated and utilized recently to assess the intracranial pressure. The role of this study is to determine the degree of agreement between measurements of the optic nerve sheath diameter by computed tomography (CT) and magnetic resonance imaging (MRI).
TOC
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00306-3
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published in issue: September 2012
An analysis of ED utilization by adults with intellectual disability Arvind Venkat, Rene B. Pastin, Gajanan G. Hegde, John M. Shea, Jeffrey T. Cook, Carl Culig
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.009
The American Journal of Emergency Medicine , Vol. 29 , Issue 4 ,
Published online: April 26 2010
x We sought to identify factors increasing the odds of ED utilization among intellectually disabled (ID) adults and differentiate their discharge diagnoses from the general adult ED population.
K2 types and their contents: are product disclosures true? Getaw Worku Hassen, Asha A. Roy, Ivan Becerra, Monica Diep, Ioana Scherbakova, Lara DeNonno, Roger Chirurgi, Peter McCorkell, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.037
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: March 19 2015
x There is an ongoing rise in use of synthetic cannabinoids (SC) with various clinical and psychiatric symptoms [1-4]. These products come in different flavors, and the presenting symptoms vary with each type of K2 ranging from agitation, altered mental status, lethargy, paranoid behavior, psychosis, and seizures. K2 is legally marketed and sold as incense and potpourri and is produced with common herbal products mixed with synthetic cannabis [1,5-8]. The SC compounds are sprayed over various herbal plants, some of which also have intrinsic psychotropic effects, and the combination produces different clinical and psychiatric symptoms.
Hazards with ordering troponin in patients with low pretest probability of acute coronary syndrome Soheila Talebi, Rosa Maria Ferra, Sara Tedla, Alicia DeRobertis, Adrian C. Garofoli, Ferdinand Visco, Gerald Pekler, Getaw Worku Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.006
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: June 8 2015
x In clinical practice, we progressively rely on biomarkers, without estimating the pretest probability. There is not enough support for the use of cardiac troponin (cTn) I in the management of noncardiac patients. We studied the rate at which this test was ordered, the prevalence of detection of a positive result in noncardiac patients, and the impact of this incidental finding on clinical management.
Lipid 20% emulsion ameliorates the symptoms of olanzapine toxicity in a 4-year-old Russell K. McAllister, Carrie D. Tutt, Christopher S. Colvin
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.025
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: June 6 2011
x Olanzapine (Zyprexa; Eli Lilly, Indianapolis, IN) is an antipsychotic medication that has been useful in the treatment of psychiatric disorders. In cases of overdose, cardiovascular and neurologic changes are seen. Lipid emulsion has proven successful in relieving the toxicity associated with overdose of lipid-soluble drugs. We present a case report of a 4-year-old child who presented with tachycardia and agitation, followed by somnolence after presumed accidental olanzapine ingestion. Treatment with lipid emulsion resulted in amelioration of the symptoms.
Association of plasma diamine oxidase and intestinal fatty acid–binding protein with severity of disease in patient with heat stroke Lin Zhang, Xiaoming Fan, Zhiyue Zhong, Guoxiong Xu, Jie Shen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.047
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: February 2 2015
x The aim of this study was to describe the role of intestinal fatty acid–binding protein (iFABP) and allergy-related diamine oxidase (DAO) in patients with heat stroke (HS).
Airway compromise in children exposed to single-use laundry detergent pods: a poison center observational case series Paul E. Stromberg, Michele H. Burt, S. Rutherfoord Rose, Kirk L. Cumpston, Michael P. Emswiler, Brandon K. Wills
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.044
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 2 2014
x Single-use laundry detergent pods (LDPs) were introduced to the United States in 2010 but had been available in Europe as early as 2001. Case reports of unintentional exposures noted vomiting, ocular injuries, respiratory depression, and central nervous system depression. We summarize clinical effects from unintentional LDP exposures reported to a single poison center over 15 months.
Ondansetron as an effective antiemetic in the rural, out-of-hospital setting John P. Benner, Jeffrey D. Ferguson, Anthony E. Judkins, Robert E. O'Connor, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.022
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: June 6 2011
x We write to you with the results of our investigation of ondansetron as an acceptable and efficacious antiemetic for the treatment of nausea and vomiting in the rural, out-of-hospital setting. Nausea is a commonly encountered patient complaint in both the out-of-hospital and emergency department (ED) settings [1]. Although a nonspecific symptom, nausea can result from a myriad of both benign and emergent etiologies, ranging from migraine headaches and gastroenteritis to intracranial hemorrhage and acute myocardial infarction.
Answering the myth: use of emergency services on Friday the 13th Bruce M. Lo, Catherine M. Visintainer, Heidi A. Best, Hind A. Beydoun
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.008
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: August 22 2011
x The aim of the study was to evaluate the risk of Friday the 13th on hospital admission rates and emergency department (ED) visits.
Heart rate–corrected QT interval predicts mortality in glyphosate-surfactant herbicide–poisoned patients Yong Hwan Kim, Jun Ho Lee, Chong Kun Hong, Kwang Won Cho, Yong Hwan Park, Yang Weon Kim, Seong Youn Hwang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.025
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: December 23 2013
x Glyphosate-surfactant herbicide is promoted by the manufacturer as having no risks to human health. Glyphosate surfactant has recently been used with increasing frequency in suicide attempts, so clinical toxicologists occasionally encounter cases of severe systemic toxicity. The purpose of this study was to identify the early predictive factors of patients at risk for mortality and the usefulness of the corrected QT interval (QTc interval) for predicting mortality from glyphosate-surfactant intoxication.
Occipital lobe epilepsy presenting as Charles Bonnet syndrome Damaris Brown-Vargas, John J. Cienki
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.008
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: May 25 2012
x Charles Bonnet syndrome describes visual field or acuity loss with complex hallucinations. This typically occurs in the elderly with preexisting visual impairment. We describe a patient who presented to the emergency department with acute hemianopsia and intermittent complex hallucinations. A 57-year-old man was referred for visual field loss and hallucinations. Chief complaint was “seeing little heads of people” and a right-sided visual loss. The patient was alert, oriented, and able to repeat and name and had fluent speech.
The electric Kool-Aid NBOMe test: LC-TOF/MS confirmed 2C-C-NBOMe (25C) intoxication at Burning Man Patil Armenian, Roy R. Gerona
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.047
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: April 28 2014
x Designer drugs are constantly evolving, with the NBOMe derivatives of the 2C class of phenethylamines recently emerging in the US market. Cases of 2C-I-NBOMe toxicity have recently been reported in the literature. No reports to date describe the clinical effects 2C-C-NBOMe toxicity.
