Xiaomin Hou, Chunsheng Li, Wei Gu, Zhijun Guo, Wenpeng Yin, Da Zhang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.020
Published online: June 26 2013
xShenfu injection (SFI), a traditional Chinese formulation, has been confirmed to be protective against brain during ischemia and reperfusion injury. In this exploratory study, we investigated the action of SFI in regulating the inflammatory response and brain edema after cardiopulmonary resuscitation.
Ali Kemal Erenler, Turker Yardan, Ahmet Baydin, Murat Gunay, Ramazan Amanvermez
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.005
Published online: June 27 2013
xThe aim of this study was to investigate the role of serum heart-type fatty acid-binding protein (H-FABP) in the evaluation of patients with carbon monoxide (CO) poisoning.
Zhengdong Kong, Fei Wang, Shizhao Ji, Xiaoming Deng, Zhaofan Xia
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.020
Published online: June 24 2013
xRecently, several studies were conducted to investigate the effect of selenium supplementation in septic patients. However, no consistent conclusion was made. Thus, we aimed to systematically summarize the available randomized controlled trials (RCTs) to evaluate the effect of selenium supplementation on important clinical outcomes in septic patients.
Esther Dahan, Sara Dichtwald, Eyal Amar, Patrick Sorkine, Avi A. Weinbroum
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.030
Published online: June 3 2013
xHeatstroke (HS) is a life-threatening condition, manifested by systemic inflammation and multiorgan failure. Rapid recognition and treatment are life saving. We report a laboratory-oriented characterization of HS by low plasma C-reactive protein (CRP) level and propose its usefulness in distinguishing this type of hyperpyrexia from central nervous system–associated high core temperature.
Hooman Hossein-Nejad, Pooya Payandemehr, Seyed Ali Bashiri, Hamid Hossein-Nejad Nedai
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.032
Published online: July 1 2013
xThe aim of this study was to evaluate the necessity of chest x-ray (CXR) in detecting the endotracheal tube (ETT) misplacement after the intubation.
David M. Schreck, Robert D. Fishberg
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.037
Published online: June 28 2013
xThe cardiac dipolar field is represented by the measured 12-lead electrocardiogram (ECG) and 3-lead vectorcardiogram (VCG). The objective is to derive the 12-lead ECG and 3-lead VCG from 3 measured leads acquired from only 5 electrodes.
Yalcin Golcuk, Burcu Golcuk, Yalcin Velibey, Deniz Oray, Ozge Duman Atilla, Ayfer Colak, Yusuf Kurtulmus, Aydın Yıldırım, Mehmet Eren
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.038
Published online: June 6 2013
xThe main objective of this study was to determine a cutoff level of plasma N-terminal pro–B-type natriuretic peptide (NT-proBNP) that could successfully predict the short- and long-term prognosis of patients with acute heart failure at the time of admission to the emergency department. The results of our study are presented in context with previously published literature. We believe that the present study will be useful and salutary for the progress of literature.
Christer Axelsson, Maria Jimenez Herrera, Martin Fredriksson, Jonny Lindqvist, Johan Herlitz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.002
Published online: June 10 2013
xThe aim of this study is to describe the outcome changes after out-of-hospital cardiac arrest (OHCA) in Gothenburg, Sweden, after introduction of mechanical chest compression (MCC).
Marcus Eng Hock Ong, Ken Goh, Stephanie Fook-Chong, Benjamin Haaland, Khin Lay Wai, Zhi Xiong Koh, Nur Shahidah, Zhiping Lin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.005
Published online: June 12 2013
xWe aimed to develop a risk score incorporating heart rate variability (HRV) and traditional vital signs for the prediction of early mortality and complications in patients during the initial presentation to the emergency department (ED) with chest pain.
Kenton L. Anderson, Katherine Y. Jenq, J. Matthew Fields, Nova L. Panebianco, Anthony J. Dean
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.007
Published online: June 14 2013
xRapid diagnosis (dx) of acutely decompensated heart failure (ADHF) may be challenging in the emergency department (ED). Point-of-care ultrasonography (US) allows rapid determination of cardiac function, intravascular volume status, and presence of pulmonary edema. We test the diagnostic test characteristics of these 3 parameters in making the dx of ADHF among acutely dyspneic patients in the ED.
Shahram Majidi, Farhan Siddiq, Adnan I. Qureshi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.026
Published online: June 27 2013
xThe prevalence and impact of prehospital neurologic deterioration (PhND) in patients with traumatic brain injury (TBI) have not been investigated. We aimed to determine the prevalence of PhND during emergency medical service (EMS) transportation among patients with TBI and its impact on patient's outcome.
David Couret, Sophie de Bourmont, Nicolas Prat, Pierre-Yves Cordier, Jean-Baptiste Soureau, Dominique Lambert, Bertrand Prunet, Pierre Michelet
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.028
Published online: June 27 2013
xChest trauma remains a leading cause of trauma-death. Since lung contusion is one of the most important lesions implicated, the aim of this experimental study was to evaluate the cardiorespiratory consequences of an isolated lung contusion model.
Diego Conde, Juan Pablo Costabel, Florencia Lambardi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.045
Published online: June 28 2013
xChest pain represents between 5% and 10% of annual visits to emergency departments (EDs) and near 25% of hospitalizations. Characterization of chest pain is sometimes difficult, and strategies should focus on preventing inappropriate discharge of patients with acute coronary syndrome. The goal of our study is to compare negative predictive value of the algorithm in the chest pain unit using the fourth-generation troponin T assay (4GTT) vs high-sensitivity troponin T assay (HSTT).
Xiao-wei Liu, Tao Ma, Bo Qu, Yan Ji, Zhi Liu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.019
Published online: May 24 2013
xThe aim of this study is to evaluate the prognostic value of initial arterial lactate level and 12-hour lactate metabolic clearance rate (MCR) in patients with acute paraquat poisoning.
Devin Loewenstein, Christine Stake, Mark Cichon
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.031
Published online: June 3 2013
xThe purpose of this study is to compare fingerstick point-of-care (POC) testing for cardiac troponin I to conventional venipuncture POC testing using the i-STAT device.
ShaoShan Tang, Yao Wang, YiJiao Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.034
Published online: June 26 2013
xThe purpose of this study was to evaluate contrast-enhanced ultrasonography (CEUS) as a modality for diagnosing perforation of the gallbladder (GB) and pericholecystic hepatic abscess.
Daniel K. Nishijima, Kiarash Shahlaie, Korak Sarkar, Nancy Rudisill, James F. Holmes
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.035
Published online: June 6 2013
xThe objective was to compare neurological outcomes at 6 months in older patients with preinjury warfarin or clopidogrel use and mild traumatic intracranial hemorrhage with those without prior use of these medications.
Hiroshi Sekiguchi, Yutaka Kondo, Ichiro Kukita
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.047
Published online: June 17 2013
xThe 2010 American Heart Association (AHA) for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science has changed the basic life support (BLS) sequence from “A-B-C” to “C-A-B.” The AHA explained that this change may shorten the initiation time for chest compressions. In this study, the 2010 AHA guidelines for BLS (2010-BLS) were studied through a simulation program and practiced on a manikin. The time saved in initiating initial chest compressions was calculated, and the significance of the new guidelines was evaluated.
William S. Stewart, Herbert Pettit
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.008
Published online: June 12 2013
xCurrent reversal options for warfarin-related bleeding are limited but include fresh frozen plasma, recombinant factor VIIa, or a prothrombin complex concentrate (PCC). There are little data discussing the use of activated 4-factor PCC for warfarin reversal.
Majdi Massarwi, Galia Gat-Yablonski, Biana Shtaif, Moshe Phillip, Mati Berkovitch
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.020
Published online: June 27 2013
xThe use of protein- and peptide-based drugs in the treatment of disease has significantly increased in recent years. However, their chemical and physical properties make them unsuitable for simple oral delivery.
Jonas P. DeMuro, Susan Simmons, Judy Jax, Scott M. Gianelli
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.027
Published online: June 26 2013
xThe traditional method to identify hemorrhage after trauma has been vital signs–based. More recent attempts have used mathematical prediction models, but these are limited by the need for additional data including a Focused Assessment with Sonography for Trauma exam, or an arterial blood gas. Shock Index (SI) is the mathematical relationship of the heart rate divided by the systolic blood pressure; the cutoff of >0.9 has been associated with bleeding.
Juan Zhang, Shiqin Niu, Yan Wang, Wenli Hu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.029
Published online: June 27 2013
xThe objective of this study was to review all cases in literature in which the clinical manifestations of myasthenia gravis (MG) and Guillain-Barré syndrome (GBS) were presented in the same patient including a new case of our own and identify the clinical characteristics and possible mechanisms of this syndrome.
Bory Kea, Ruwan Gamarallage, Hemamalini Vairamuthu,, Jonathan Fortman, Kevin Lunney, Gregory W. Hendey, Robert M. Rodriguez
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.021
Published online: June 24 2013
xComputed tomography (CT) has been shown to detect more injuries than plain radiography in patients with blunt trauma, but it is unclear whether these injuries are clinically significant.
John F. Kragh Jr., James E. Johnson, Craig K. Henkel, Michael A. Dubick
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.027
Published online: June 27 2013
xJunctional body regions are too proximal for a regular limb tourniquet to fit and include the groin and axillary areas [1,2]. Recently, we described a technique of the use of the Combat Ready Clamp (Combat Medical Systems, Fayetteville, NC) in prehospital hemorrhage control and a cadaver model used in its regulatory approval, but such uses were only in the groin [3-5]. Uncontrolled upper extremity hemorrhage in war is common, disabling, and lethal; recently, we counted 833 US military casualties hospitalized with a junctional wound coded during the current wars.
John F. Kragh Jr., Elizabeth A. Mann-Salinas, Russ S. Kotwal, Kirby R. Gross, Robert T. Gerhardt, Bijan Kheirabadi, Timothy E. Wallum, Michael A. Dubick
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.021
Published online: June 28 2013
xJunctional body regions between the trunk and its appendages, such as the groin, are too proximal for a regular limb tourniquet to fit [1,2]. Not since 1993’s Black Hawk Down has junctional hemorrhage control become such a hot topic in military casualty care [1–7]. In February 2013, the US military’s Task Force Medical Afghanistan requested a fill of a gap in junctional hemorrhage control as an urgent operational need, meaning that junctional hemorrhage control devices should be considered urgently to fill a gap in medical care in war.
Giuseppe Lippi, Paola Avanzini, Rosalia Aloe, Gianfranco Cervellin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.022
Published online: June 26 2013
xThe assessment of cardiospecific troponin, either troponin I (TnI) or T, is a mainstay for diagnosing acute myocardial infarction as well as for detecting a variety of nonischemic myocardial injuries [1]. The finding of highly increased concentrations of cardiospecific troponin(s), exceeding the upper detection limit of the immunoassay, is a rare but challenging occurrence [2]. According to available recommendations [3], sample dilution may be systematically required in this circumstance, for accurate calculation of kinetics and delta variation.
Promporn Suksaranjit, Kunatum Prasidthrathsint, Wonngarm Kittanamongkolchai, Supawat Ratanapo, Narat Srivali, Daych Chongnarungsin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.028
Published online: May 20 2013
xWe thank Huang et al [1] for their interesting article on identification of painless aortic dissection (AD) before thrombolytic treatment for acute ischemic stroke. We would like to emphasize the importance of being vigilant to AD before initiating any contraindicated therapy. We recently had an 84-year-old man with history of atrial fibrillation and transient ischemic attack who presented to the emergency department with acute shortness of breath without chest pain. The symptom contributed to atrial fibrillation with rapid ventricular response.
Shu Zhang, Da Zhu, Zhi Wan, Yu Cao
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.036
Published online: June 6 2013
xHypertrophic cardiomyopathy (HCM) is a heterogeneous cardiac disease with a diverse clinical presentation and course affecting approximately 0.2% of the general population [1-3]. It is associated with some profound complications such as heart failure, malignant cardiac arrhythmia, or even sudden cardiac death [4]. As for the emergency physician, it is of paramount importance to make a rapid and accurate diagnosis in patients with suspected HCM presenting with clinical symptoms [5]. However, the routine cardiovascular screening examinations are neither sensitive nor specific for HCM [5].
Diego Conde, Pablo Elissamburu, Nicolas Lalor, Leandro Rodriguez, Marcelo Trivi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.004
Published online: June 6 2013
xB-type natriuretic peptide (BNP) has been associated with diagnosis and prognosis of acute coronary syndromes, and it was associated in only 1 study, Navarro Estrada et al, with the extension and severe coronary lesions in the acute coronary syndromes without ST elevation (NSTEMI), but the relationship with the extension and severe coronary lesions in patients with an acute coronary syndrome with ST elevation (STEMI) and NSTEMI is not well established [1-5].
Alfredo De Giorgi, Fabio Fabbian, Giulia Piazza, Ambra Faccini, Alessandra Mallozzi Menegatti, Alda Storari, Luigi Grassi, Roberto Manfredini
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.011
Published online: June 17 2013
xSuicide is a complex and tragic event deriving from mental disorders that include ideation, planning, and then attempting suicide [1]. If suicide is the act by which a person willfully obtains a mortal injury, attempted suicide is a potentially self-injurious action with a nonfatal outcome for which there is evidence, either explicit or implicit, that the individual intended to kill himself/herself, but the action did not result in fatal injuries [2]. Interestingly, these 2 entities are also characterized by different times of day of occurrence [3-6].
Murtaza Akhter, Melissa Lamberson
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.012
Published online: June 17 2013
xWe thank Zhong-qun et al [1] for their wonderful article on the elevation of the ST segment in the aVR lead on electrocardiogram (ECG) in a patient with pulmonary embolism (PE). ST elevation in aVR is associated with left main coronary artery (LMCA) obstruction [2-4]. It is also associated with diffuse coronary artery disease [5]. However, as mentioned by the authors, it can also be a marker for PE and/or its prognosis, likely due to right ventricular overload [6,7].
Subramanian Senthilkumaran, Ritesh G. Menezes, Gade Ravindra, Narendra Nath Jena, Ponniah Thirumalaikolundusubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.022
Published online: June 21 2013
xWith reference to the case of Bourcier et al [1], we would like to share our experience of disulfiram reaction observed in a painter due to occupational exposure of alcohol containing solvents during his deaddiction period. In fact, he was referred as septic encephalopathy by the factory medical officer.
Diego Conde, Nicolas Lalor, Leandro Rodriguez, Pablo Elissamburu, Marcelo Trivi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.024
Published online: June 21 2013
xThe management of acute coronary syndromes (ACS), defined as unstable angina, non–ST-elevation myocardial infarction and ST-elevation myocardial infarction (STEMI), has made considerable progress in the past few years. This has been possible due to a number of factors, including procedural advances in coronary reperfusion techniques, a greater proportion of patients receiving timely mechanical reperfusion, newer additions to the pharmacoinvasive armamentarium, and increased adherence to evidence-based therapies, both acutely and at discharge [1].
Leandro Rodriguez, Diego Conde, Nicolas Lalor, Pablo Elissamburu, Marcelo Trivi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.025
Published online: June 17 2013
xThe use of new antiplatelet drugs as prasugrel in patients with acute coronary syndromes (ACS) reduced the incidence of ischemic events. In many cases, the bleeding increases patient morbidity and mortality [1-5].
Nicolas Lalor, Diego Conde, Leandro Rodriguez, Pablo Elissamburu, Marcelo Trivi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.037
Published online: June 26 2013
xThe use of new antiplatelet drugs such as prasugrel in patients with acute coronary syndromes (ACS) reduced the incidence of ischemic events [1-5].
Shu Zhang, Da Zhu, Wan Zhi, Yu Cao
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.038
Published online: June 28 2013
xPoint-of-care (POC) echocardiography performed by specialized trained emergency physician using a miniaturized and portable echocardiographic platform is a newly emerged technique, which could largely facilitate the detection of important emergency cardiovascular pathology such as pericardial effusions, cardiac tamponade, massive pulmonary embolism, heart failure, and compromised cardiac function as well as volume deficit [1]. However, because of unique anatomical feature of the heart and its adjacent structure, in a significant proportion of patients, echocardiography fails to produce diagnostically useful images.
Carlos J. Roldan, Samir M. Haq, Adam H. Miller
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.038
Published online: May 22 2013
xAcute promyelocytic leukemia, a subtype of acute myelogenous leukemia characterized by an abnormal accumulation of immature granulocytes called promyelocytes, is a feared oncologic emergency. Currently, management of acute promyelocytic leukemia with supportive transfusions, to correct underlying coagulopathy, and all-trans retinoic acid, in combination with chemotherapy, can lead to complete remission in 80% to 90% of cases. However, early mortality from pulmonary or intracranial hemorrhage remains high if cases are late presenting or treatment is delayed.
Toru Hifumi, Ichiro Okada, Nobuaki Kiriu, Hiroshi Kato, Junichi Inoue, Yuichi Koido
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.044
Published online: April 29 2013
xLandiolol hydrochloride (LH) has advantages over other β-blockers because it has a shorter half-life (4 minutes) and its effects are titratable. In the acute-phase management of blunt aortic injuries (BAI), aggressive blood pressure management, reduction of heart rate, and decreased contractility with the administration of β-blockers are critical to reduce aortic wall tension. Here we report the first case of the use of LH in the conservative management of BAI. A 41-year-old man riding a motorcycle fell off his vehicle after colliding with a car.
Xiaoyan Xue, Lina Liu, Zhiguo Rao
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.051
Published online: May 22 2013
xDamage control resuscitation (DCR) that addresses all aspects of the lethal triad (ie, acidosis, hypothermia, and coagulopathy) is a resuscitation strategy originally developed for combat casualties and subsequently used for civilian trauma patients. However, its survival benefits in obstetric emergencies have yet to be evaluated. Here, we report successful management of a life-threatening case of postpartum hemorrhagic shock associated with disseminated intravascular coagulation (DIC) with DCR.
Gregory L. Cvetanovich, Brandon Erickson, Bryan D. Haughom, Michael D. Hellman, Jason J. Magnani, Jan P. Szatkowski
DOI: http://dx.doi.org/10.1016/j.ajem.2013.03.053
Published online: May 22 2013
xWe report an unusual case of a patient who sustained a gunshot wound to the left anterior distal thigh. The bullet was initially thought to be extra-articular, although a missed intraarticular injury cannot be ruled out because a saline load test and cross-sectional imaging were not performed. After 14 months, the patient felt a popping sensation and developed increasing knee pain. Imaging revealed migration of the bullet to an intraarticular location in the left knee. Arthroscopic-assisted extraction of the bullet was performed, revealing diffuse deposition of small metallic particles with associated synovitis but no arthritic changes.
Justin Ng, Chirag Barbhaiya, Nagesh Chopra, Tobias Reichlin, Eyal Nof, Thomas Tadros, William G. Stevenson, Roy M. John
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.009
Published online: May 22 2013
xAutomatic external defibrillators (AEDs) in public places are invaluable in resuscitation from sudden cardiac arrest. We report a case of inappropriate AED shock from inadequate sensing of intrinsic rhythm and review the available data on detection criteria in AEDs. The case exemplifies the potential for an inappropriately advised AED shock to set off a cascade of events leading to potentially unnecessary cardiac interventions based on the presumption that a dangerous ventricular arrhythmia had occurred.
Chih-Yu Liang, Jiun-Nong Lin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.010
Published online: May 3 2013
xIschemic stroke is a disease that frequently presents to the emergency department (ED). Diabetes mellitus is a well-known risk factor for stroke. Here, we present a diabetic patient who visited our ED with muscle weakness of unilateral side but who was found to have hyperattenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging at his unilateral basal ganglion, which is frequently found in patients with hyperglycemia-induced chorea-ballismus.
Jiun-Nong Lin, Lin-Li Chang, Chung-Hsu Lai, Hsi-Hsun Lin, Yen-Hsu Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.011
Published online: May 22 2013
xGroup A Streptococcus, also known as Streptococcus pyogenes, is a common gram-positive bacterium that causes a broad spectrum of human infections ranging from uncomplicated pharyngitis and impetigo to life-threatening necrotizing fasciitis, bacteremia, and streptococcal toxic shock syndrome. Although it is rarely encountered in emergency departments, streptococcal toxic shock syndrome usually leads to a catastrophic outcome. Here we present 2 young patients who experienced trivial traumas before admission, which, nevertheless, finally resulted in lethal streptococcal toxic shock syndrome.
Edward T.D. Hoey, Jun K. Teoh, Vijayabhaskar Pakala, Helen Simpson, Richard W. Watkin
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.014
Published online: May 22 2013
xCardiovascular magnetic resonance imaging (MRI) is the reference technique for assessment of structural heart disease including cardiomyopathies and cardiac masses. It has a number of advantages over echocardiography including an unrestricted field of view and excellent soft tissue resolution, which enables accurate identification of myocardial based pathology. We present a case in which cardiovascular MRI was integral to establishing the cause of out-of-hospital cardiac arrest secondary to an intramyocardial metastasis.
Corey Goldberg, Stephen Topp, Christopher Hopkins
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.015
Published online: May 22 2013
xA 42-year-old man presented to a tertiary care emergency department (ED) with a 5-hour history of abdominal pain, nausea, and vomiting. Over the course of several hours, symptoms progressed from nausea and vomiting to dysarthria and facial muscle weakness, ultimately resulting in complete bulbar paralysis requiring intubation and admission to the intensive care unit. The patient had no medical history to suggest a cause. The working differential initially focused on the patient's abdominal pain but quickly broadened to include myasthenia gravis, Miller Fisher variant Guillain-Barré syndrome, botulinum toxicity, and cerebrovascular event.
Julius Z.H. von Martels, Evelien K. Van de Meeberg, Mirjam Holman, Jack J.M. Ligtenberg, Jan C. ter Maaten
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.022
Published online: June 28 2013
xCeftriaxone is a widely prescribed third-generation broad spectrum cephalosporin, often used for treatment of severe bacterial infections in children. It is known that ceftriaxone can cause sonographic biliary abnormalities in children. However, in only a minority of these cases, it will be accompanied with the clinical relevant symptoms and biochemical abnormalities seen in gallbladder disease. Ceftriaxone-associated cholelithiasis has a highly reversible nature and is thus called pseudolithiasis.
Ya-Feng Yu, Hong-Yang Ling, Gen-Sheng Xiao, Peng Sun, Man-Yi Li, Wen-Ying Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.023
Published online: May 22 2013
xEarly-stage subglottic lesions are easily misdiagnosed as bronchial asthma. We report on 4 cases of rare subglottic lesions. Our aim is to provide insights for the accurate diagnosis of subglottic lesions.
Vincenzo Montinaro, Giuliana Loizzo, Anna Zito, Giuseppe Castellano, Loreto Gesualdo
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.024
Published online: May 24 2013
xAngioedema (AE) is related to the activation of the contact phase system—kallikrein and generation of bradykinin. Different types of AE are recognized: hereditary or acquired deficit of the C1 inhibitor, drug-related, or idiopathic. Treatment of idiopathic nonhistaminergic AE (IAE) is difficult because corticosteroids, antihistamine drugs, and adrenalin are inefficacious. We describe a patient with an IAE and an acute attack of facial AE that was successfully treated with the bradykinin receptor antagonist icatibant.
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00424-5
Published in issue: August 2013
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00425-7
Published in issue: August 2013
