Jean-Eudes Bourcier, Julie Paquet, Mickael Seinger, Emeric Gallard, Jean-Philippe Redonnet, Fouad Cheddadi, Didier Garnier, Jean-Marie Bourgeois, Thomas Geeraerts
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.003
Published online: November 4 2013
xThe aim of our study was to assess the potential of bedside lung ultrasound examination by the attending emergency physician in the diagnosis of acute pneumonia.
Murat Saritemur, Mehmet Turkeli, Kamuran Kalkan, İbrahim Halil Tanboga, Enbiya Aksakal
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.011
Published online: November 14 2013
xTo investigate the predictive role of serum uric acid (SUA) levels measured in the emergency department (ED) to monitor contrast-induced nephropathy (CIN) and correlation with severity of nephropathy in patients undergoing primary percutaneous coronary intervention (PCI).
Olan A. Soremekun, Azita Hamedani, Frances S. Shofer, Katie J. O'Conor, James Svenson, Judd E. Hollander
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.020
Published online: November 11 2013
xMost patients at low to intermediate risk for an acute coronary syndrome (ACS) receive a 12- to 24-hour “rule out.” Recently, trials have found that a coronary computed tomographic angiography–based strategy is more efficient. If stress testing were performed within the same time frame as coronary computed tomographic angiography, the 2 strategies would be more similar. We tested the hypothesis that stress testing can safely be performed within several hours of presentation.
Louise Cullen, Jaimi H. Greenslade, Martin Than, Anthony F.T. Brown, Christopher J. Hammett, Arvin Lamanna, Dylan F. Flaws, Kevin Chu, Lindsay F. Fowles, William A. Parsonage
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.021
Published online: November 14 2013
xTo externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays.
Amy J. Pate, Reno Giovonni Terribilini, Farzaneh Ghobadi, Alaleh Azhir, Andre Barber, Julie Marie Pearson, Hossein Kalantari, Getaw W. Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.026
Published online: November 14 2013
xMethicillin-resistant Staphylococcus aureus (MRSA) infections are becoming increasingly prevalent in both community and hospital settings. Certain strains are notorious for causing skin and soft tissue infections in patients with no established risk factors. In this article, we report our findings on the dynamic antibiotic resistance pattern of MRSA and outpatient prescription trend for skin and soft tissue infections within our community.
Violetta Raffay, Athanasios Chalkias, Pavlos Lelovas, Georgios Karlis, Anastasios Koutsovasilis, Apostolos Papalois, Jasna Jevdjic, Zlatko Fiser, Theodoros Xanthos
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.030
Published online: November 14 2013
xCardiac arrest is a daunting medical emergency. The aim of the present study was to assess whether the combination of adrenaline and glucagon would improve initial resuscitation success, 48-hour survival, and neurologic outcome compared with adrenaline alone in a porcine model of ventricular fibrillation.
Tatsuma Fukuda, Naoko Ohashi, Takehiro Matsubara, Kent Doi, Masataka Gunshin, Takeshi Ishii, Yoichi Kitsuta, Susumu Nakajima, Naoki Yahagi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.032
Published online: December 2 2013
xIt is unclear whether the prehospital termination of resuscitation (TOR) rule is applicable in specific situations such as in areas extremely dense with hospitals.
Jae-Hyug Woo, Yong Su Lim, Hyuk Jun Yang, Won Bin Park, Jin Seong Cho, Jin Joo Kim, Sung Youl Hyun, Gun Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.035
Published online: November 22 2013
xThe aim of this study is to investigate risk factors associated with the development of pneumonia during the first 7 days of admission in survivors of cardiac arrest receiving therapeutic hypothermia.
Thomas Chloros, Theodoros Xanthos, Nicoletta Iacovidou, Eleni Bassiakou
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.048
Published online: November 6 2013
xAccording to the 2010 European Resuscitation Council guidelines on cardiopulmonary resuscitation (CPR), one can appreciate that the classic laryngeal mask airway (CLMA) is acceptable as an alternative airway device to endotracheal intubation for airway management in cardiac arrest victims.
Christopher L. Hunter, Salvatore Silvestri, George Ralls, Steven Bright, Linda Papa
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.049
Published online: November 6 2013
xTo determine the ability of prehospital end-tidal carbon dioxide (ETCO2) to predict in-hospital mortality compared to conventional vital signs.
Pierre-Marie Brun, Jacques Bessereau, Hichem Chenaitia, Anne-Lise Pradel, Cecile Deniel, Gilles Garbaye, Regis Melaine, Olivier Bylicki, Christophe Lablanche
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.008
Published online: November 14 2013
xThe concept that ultrasonography could be interesting in the prehospital setting and during the transfer of traumatized patients is not new. Paradoxically, there is a lack of description of routine use of ultrasonography in emergency ambulances. The aim of this study was to compare the feasibility and efficiency of an extended focused assessment sonography for trauma (eFAST) examination performed on-site, during the patient's transfer, or both.
Murat Yesilaras, Ersin Aksay, Ozge Duman Atilla, Mustafa Sever, Onder Kalenderer
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.009
Published online: November 14 2013
xMusculoskeletal ultrasonography is a technique that is becoming more popular in diagnosing injuries of emergency department (ED) patients especially for the diagnosis of fractures. In this study, we determined the reliability of ultrasonography for the diagnosis of fractures of the fifth metatarsal.
Nora V. Becker, Ari B. Friedman
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.002
Published online: November 11 2013
xEmergency department (ED) wait times have continued to worsen despite receiving considerable attention for more than 2 decades and despite the availability of a variety of methods to restructure care in a more streamlined fashion. This article offers an economic framework that abstracts away from the details of operations research to understand the fundamental disincentives to improving wait times. Hospitals that reduce wait times are financially penalized if they must provide more uncompensated care as a result.
Subramanian Senthilkumaran, Namasivayam Balamurugan, Ramachandran Meenakshisundaram, Ponniah Thirumalaikolundusubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.029
Published online: November 21 2013
xWe read the article by Ekinozu et al [1] with great interest. Based on the temporal relationship between ingestion of sildenafil and the onset of chest pain, the authors concluded sildenafil as a cause for acute coronary syndrome, which is not congruent with current evidence [2]. Sildenafil does not reduce the coronary blood flow in either diseased or normal coronary arteries. Indeed, data from animal and human studies undoubtedly have shown that sildenafil increases coronary blood flow during exercise even in coronary arteries, which has critical stenosis, thus, results in an improvement in the epicardial flow and thereby averts the effects of myocardial ischemia [3,4].
İsmail Ekinozu, Yusuf Aslantas, Hakan Tibilli, Yasin Turker, Hakan Ozhan
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.028
Published online: December 16 2013
xWe thank our colleagues for their interest in our manuscript. They claimed our conclusion is a definite statement. Let us except their concerns on age, sex, smoking habit, and hypertension. However, the patient had a Naranjo score of 4/16 indicating a probable cause-and-effect relationship between sildenafil and acute coronary syndrome [1]. Of course, our case does not establish a definite correlation between sildenafil use and myocardial infarction, but cumulative reports showed that there is more than a coincidence.
Yalcin Golcuk, Murat Ozsarac, Burcu Golcuk, Yalcin Velibey, Salahaddin Akcay
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.034
Published online: November 25 2013
xTo the Editor,
B. Armel, K. Berechid, S. Himmich, J. Tadili, A. Kettani, M. Faroudy, A. Azzouzi, A. Benchekroun, R. Abouqal, N. Madani
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.037
Published online: December 9 2013
xAntibiotics are frequently started in emergency departments (EDs). Several studies performed in developed countries evaluated the quality of antibiotic use in these departments [1,2]. No data appraising antimicrobial practice in EDs are available in developing countries. The aims of the study were to evaluate anti-infective treatments initially delivered to patients hospitalized in an ED in Morocco and to define factors impairing the appropriateness of these prescriptions.
Y. Freund, A.L. Philippon, S. Carreira, A. Duguet
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.038
Published online: November 25 2013
xWe read with great interest the report on the randomized crossover trial by Buléon et al [1]. As the authors highlighted, the quality of cardiopulmonary resuscitation (CPR) is a great determinant for cardiac arrest outcome. Their study reports that the use of a CPRmeter is associated with a better quality of chest compression (CC), including rhythm and depth.
Catherine A. Marco, Steven Nelson, Matthew Jolly, Stephanie Ritter, Andrew Rudawsky
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.041
Published online: November 27 2013
xMotor vehicle accidents comprise approximately 1.3% of emergency department (ED) visits annually in the United States [1]. A previous study demonstrated that successful communication with patients regarding reasons for hospital admission was correlated with increased patient satisfaction [2]. Emergency department patients have reported a perceived need for improved communication with health care providers [3]. Another recent study demonstrated that the satisfaction of patients with trauma is improved when health care providers provide both instrumental and attentive care [4].
Diego Conde, Pablo Elissamburu, Nicolas Lalor, Leandro Rodriguez, Marcelo Trivi
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.050
Published online: November 6 2013
xHigh-sensitive troponin T has been associated with diagnosis and prognostic of acute coronary syndromes (ACS), and it was associated in some studies with the extent and severity of coronary lesions in ACS with and without ST elevation, but the relationship of fourth-generation troponin I (4GTI) in this population [1–5] is not well established.
Christopher J. Hogan, Kevin R. Ward, Douglas S. Franzen, Leroy L. Thacker, Champion Sébastien
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.051
Published online: November 6 2013
xDr Hogan and colleagues conducted a prospective observational study evaluating perfused capillary density (PCD) by sidestream darkfield imaging (SDI) in a cohort of patients admitted to the emergency department (ED) for acutely decompensated heart failure (ADHF) [1]. As they acknowledged, the collection of 36 patients over more than 2 years was laborious, despite broad inclusion criteria. Apart from the availability of the SDI device, admission to the ED without prior treatment was a problem. Indeed, we know that early treatment of heart failure is of prognostic value [2].
Ilknur Balta, Sevket Balta, Mustafa Demir, Cengiz Ozturk, Sait Demirkol
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.053
Published online: November 6 2013
xWe read the article “Diffuse thrombosis secondary to Behçet's disease: a case report” by Celik et al with interest [1]. The authors reported a case with diffuse thrombosis extending from vena cava superior to brachiocephalic vein accompanied by dural sinus thrombosis, which was successfully treated with oral anticoagulant and thrombolytic therapy.
Subhash C. Arya, Nirmala Agarwal
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.057
Published online: November 11 2013
xTo the Editor:
Arik Eisenkraft, Daniel Gilburd, Michael Kassirer, Yitshak Kreiss
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.005
Published online: November 11 2013
xOn August 21st, late at night, short movies started to appear in social media platforms. They described a frightening event in Damascus, Syria. The images depicted whole families, including children, lying down seemingly peacefully, while many others arrived to local clinics with muscle tremors, diaphoresis, hypersalivation, miosis, respiratory insufficiency, and seizures. These comprised the unmistaken toxidrome of organophosphate poisoning, and in this case, the nerve agent sarin [1-3].
Pablo Elissamburu, Nicolas Lalor, Leandro Rodriguez, Diego Conde
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.006
Published online: November 11 2013
xB-type natriuretic peptide (BNP) has been associated with diagnosis, prognosis, and infarct size in acute coronary syndrome with ST elevation (STEMI) and without ST elevation (NSTEMI). It was associated with the extension and severe coronary lesions in patients with STEMI and NSTEMI together and in patients with only STEMI, but the relationship with the extension and severe coronary lesions in patients with only NSTEMI is not well established [1-4].
Riccardo Lubrano, Alberto Villani, Corrado Cecchetti, Patrizio Veronelli, Manuela Turbacci, Marco Bonci, Sebastian Cristaldi, Antonio Urbino, Italo Nofroni, Marco Elli
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.020
Published online: November 18 2013
xAs in most families, both parents work; nowadays, children spend a large amount of time in a school environment from early childhood. Critical events sufficient to endanger the child's life can occur at any time and can be related to accidental trauma [1,2] or less frequently to unknown preexisting health conditions, intentional violence, and accidental swallowing of toxic substances or foreign objects [3]. Several studies document that the average school teacher has little knowledge of first-aid principles.
Pablo Elissamburu, Nicolas Lalor, Leandro Rodriguez, Diego Conde
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.023
Published online: November 18 2013
xTroponin I (TnI) and high-sensitive troponin T after acute myocardial infarction have proven useful for estimation of the complex and extension of coronary lesions in acute coronary syndromes, and high-sensitive troponin T has proven useful for estimation of the infarct size in this population too, but the value of TnI for assessment of left ventricular function and infarct size is not well known [1-4].
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.041
Published online: November 13 2013
xIn the article, “Renal infarction secondary to ketamine abuse” in Am J Emerg Med 2013;31:1153, the name of the first author was incorrectly listed. The correct byline is:
Francesco Ruggieri, Marco Cerri, Luigi Beretta
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.047
Published online: September 30 2013
xHere we originally describe the clinical scenario of a young immune-competent patient affected by acute rhomboencephalitis with severe parenchymal edema and acute hydrocephalus who developed sudden life-threatening cardiac derangement. Hemodynamic and perfusion parameters revealed cardiogenic shock, so intensive circulatory support with epinephrine infusion and intra-aortic balloon pump was needed to restore organ perfusion. Transesophageal echocardiographic examination showed severe left ventricular dysfunction (ejection fraction as low as 20%) with wall motion abnormalities resembling a pattern of Takotsubo-inverted cardiomyopathy.
Jui-Yuan Chung, Jiann-Hwa Chen, Henry Chih-Hung Tai, Pai-Hao Huang, Wei-Lung Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.048
Published online: September 30 2013
xLower leg weakness is a common and nonspecific complaint that encompasses a broad differential diagnosis at emergency department, which includes neurologic aspect and a wide range of nonneurologic conditions. Infective endocarditis usually presented with variable symptoms emphasizing constitutional complaints, or complaints that focus on primary cardiac effects or secondary embolic phenomena. Underdiagnosis of the disease can lead to clinical catastrophe and even death. By far, it is rarely considered in the differential diagnosis of lower leg weakness.
David R. Lamborn, Craig Schranz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.050
Published online: October 2 2013
xA 22-year-old morbidly obese, nonpregnant woman presented with left ileofemoral deep vein thrombosis (DVT) presenting as low back pain and bilateral, left greater than right, leg swelling and pain for 2 days. While on heparin, she developed compartment syndrome in her left leg and had evidence of dead muscle tissue at the time of fasciotomy.
Tomohiro Sonoo, Masataka Gunshin, Daisuke Son, Susumu Nakajima, Kiyoshi Kitamura, Naoki Yahagi, Jeffrey G. Wong
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.055
Published online: October 18 2013
xThis case report describes a 21-year-old man with headache who was ultimately diagnosed as having cerebral venous thrombosis (CVT), a rare cause of headache in the emergency department that is sometimes lethal. However, correct diagnosis of CVT is often quite difficult because of a lack of findings in imaging studies. Unenhanced head computed tomography was completely normal in up to 39% of patients diagnosed as having CVT, but a subtle sign known as “Dense Triangle Sign” was found in this case.
Gregory Hall, Craig I. Schranz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.08.057
Published online: October 14 2013
xBenign acute childhood myositis is a rare postviral myositis seen in school-aged children after a common upper respiratory infection (URI), most commonly caused by influenza [J Microbiol Immunol Infect 2004;37:95-98]. Predominantly seen in boys, this condition causes bilateral calf tenderness and pain with ambulation, often presenting as a refusal to bear weight. To avoid activation within the gastroc-soleus complex, the child will frequently compensate with a “Frankenstein gait,” described as a stiff-legged posture with shuffling gait [CMAJ 2009;181:711-713].
Keith Habeeb, Rebecca Jeanmonod
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.002
Published online: October 11 2013
xStercoral perforation is an uncommon cause of large intestinal perforation that is typically the result of chronic constipation. Historically, this disease process has a devastatingly high mortality rate, and recent evidence questions the incidence of the disease, once thought to be scarce. We report the case of an elderly woman presenting with symptoms related to mediastinal and soft tissue air in the neck from dissection of air retroperitoneally from stercoral perforation. She had minimal abdominal complaints and no history of chronic constipation.
Ramazan Buyukkaya, Ömer Aydın, Bahattin Hakyemez, Müfit Parlak
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.020
Published online: November 27 2013
xAir embolism is known to be a complicating factor in several clinical settings, including thoracic, cardiovascular, and neurosurgical operations; central line placement; and penetrating thoracic and cranial trauma. There are, however, only few case descriptions for cardiopulmonary resuscitation massive cerebral air embolism, and the frequency of this supposedly rare complication is unknown. Computed tomography is useful for showing cerebral air embolism. In this report, we present a 16-year-old adolescent girl with cerebrovascular air embolism on computed tomographic examination after a posttraumatic cardiopulmonary resuscitation and discuss the reasonable mechanisms of cerebrovascular air embolism.
Anupam Lal, Manphool Singhal, Navneet Sharma, Ashish Bhalla, Niranjan Khandelwal
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.021
Published online: November 27 2013
xIsolated splenic peliosis is an extremely uncommon condition that can present with atraumatic rupture and potential fatal outcome. We here report 1 such case that developed after a viperine bite in a 21-year-old woman. The case highlights the diagnostic findings on computed tomographic (CT) scan and its potential complications.
Thuy V. Pham, Carina A. Sorenson, Jose V. Nable
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.022
Published online: October 30 2013
xAcquired factor VIII deficiency is a rare disease that has high rates of mortality and morbidity. Although this bleeding disorder has a classic presentation, its infrequency can make it difficult to identify. We present a case report of an elderly woman who came to an emergency department with spontaneous bilateral lower extremity compartment syndrome. Although she presented with tachycardia and hypotension, her only laboratory abnormalities were an elevated activated partial thromboplastin time and anemia.
Jun-Gang Nie, Jian-Zeng Dong
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.023
Published online: October 30 2013
xSpontaneous coronary artery dissection (SCAD) is a very rare but potentially fatal condition, which often causes acute myocardial infarction and sudden cardiac death. Spontaneous coronary artery dissection associated with pseudoaneurysm has been rarely reported mostly managed with coronary artery bypass grafting. We report a female patient with SCAD and pseudoaneurysm who was treated by successful percutaneous coronary intervention.
Jin Young An, Ji Seon Kim, Jin Hong Min, Kyu Hong Han, Jun Ho Kang, Jung Soo Park, Hoon Kim, Suk Woo Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.024
Published online: October 28 2013
xBee sting is one of the most commonly encountered insect bites in the world. Despite the common occurrence of local and systemic allergic reactions, there are few reports of ischemic stroke after bee stings. To the best our knowledge, there have been no reports on involuntary hyperkinetic movement disorders after multiple bee stings. We report the case of a 50-year-old man who developed involuntary movements of the left leg 24 hours after multiple bee stings, and the cause was confirmed to be a right temporal infarction on a diffusion magnetic resonance imaging scan.
Alexander A.N. Maini, Hector Maxwell-Scott, Daniel J.B. Marks
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.027
Published online: October 28 2013
xStanozolol is a popular androgenic anabolic steroid, used by body builders and athletes for physical performance enhancement. There are few data on its potential adverse effects and no documented cases of it causing severe electrolyte imbalance. Here, we report a patient presenting to a tertiary care emergency department with reduced conscious level, profound hypokalemia, and severe metabolic alkalosis, resulting from stanozolol misuse. This is the first such case reported.
Mitsutoshi Kimura, Osamu Kinoshita, Yoshifumi Fujimoto, Arata Murakami, Takahiro Shindo, Koichi Kashiwa, Minoru Ono
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.031
Published online: October 30 2013
xExtracorporeal membrane oxygenation (ECMO) is an effective respiratory and circulatory support in patients in refractory cardiogenic shock or cardiac arrest. Peripheral ECMO sometimes requires left heart drainage; however, few reports state that pulmonary arterial (PA) venting is required during ECMO support. We present a case of a 14-year-old boy who required PA venting during ECMO support after resuscitation from near-drowning in freshwater. A biventricular assist device with an oxygenator implantation was intended on day 1; however, we were unable to proceed because of increasing of pulmonary vascular resistance from the acute lung injury.
Héctor González-Pacheco, Guering Eid-Lidt, Yigal Piña-Reyna, Luis M. Amezcua-Guerra, Natalia Aldana-Sepúlveda, Carlos Martínez-Sánchez
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.032
Published online: October 30 2013
xMost coronary events in young adults are related to atherosclerosis; however, approximately 20% of coronary heart disease in young adults is related to nonatherosclerotic factors such as coronary abnormalities, connective tissue disorders, and autoimmune diseases. Different initial manifestations of systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) have been reported. Myocardial infarction is observed in patients with SLE in all age groups; it appears during the course of the disease; and it is unusual in the APS.
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00871-1
Published in issue: February 2014
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00872-3
Published in issue: February 2014
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00873-5
Published in issue: February 2014
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00874-7
Published in issue: February 2014
