The effect of diclofenac sodium intoxication on the cardiovascular system in rats
Diclofenac sodium (DS) is a widely used nonsteroidal anti-inflammatory drug. Although its high doses are known to cause toxic effects in many tissues including liver and kidney, the effects on the cardiovascular system (CVS) have not been fully elucidated yet. Therefore, this study aimed to investigate the effect of DS on CVS. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 13, 2020 Category: Emergency Medicine Authors: Turgut Dolanbay, Mustafa Makav, Huseyin Fatih Gul, Emin Karakurt Source Type: research

Chronic alcohol use does not protect against COVID-19 infection
Since the beginning of the coronavirus pandemic, there has been a concurrent global rise in misinformation about the prevention and treatment of coronavirus disease (COVID-19). Many of the proposed therapies, such as bathing or ingesting bleach, can result in significant harm with no evidence of clinical efficacy. One of the earliest myths suggested that frequent consumption of concentrated ethanol could kill the COVID-19 virus in the oropharynx, thereby preventing airborne transmission or treating active infection [1-3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 13, 2020 Category: Emergency Medicine Authors: Jacob A. Lebin, Anita Mudan, Alan H.B. Wu Source Type: research

Therapeutical plasma exchange for thrombotic thrombocytopenic purpura in the emergency department: A single center experience
Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening and easily misdiagnosed thrombotic microangiopathy disease. Few studies have reported the use of therapeutic plasma exchange (TPE) for TTP in emergency departments in China. The present study was a retrospective analysis of patients with TTP who were treated with TPE in our emergency intensive care unit (EICU). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 12, 2020 Category: Emergency Medicine Authors: Xiang-Min Li, Xiao-Ye Mo, Guo-Qing Huang, Fang-Jie Zhang Source Type: research

Therapeutical plasma exchange for thrombotic thrombocytopenic purpura in the emergengy department: A single center experience
Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening and easily misdiagnosed thrombotic microangiopathy disease. Few studies have reported the use of therapeutic plasma exchange (TPE) for TTP in emergency departments in China. The present study was a retrospective analysis of patients with TTP who were treated with TPE in our emergency intensive care unit (EICU). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 12, 2020 Category: Emergency Medicine Authors: Xiang-Min Li, Xiao-Ye Mo, Guo-Qing Huang, Fang-Jie Zhang Source Type: research

Syncope in a 14yo female with ventricular tachycardia; an atypical etiology
We present a 14 yo female in extremis with syncope at rest witnessed by her mother, found in ventricular tachycardia by EMS who challenged with IVF hydration and amiodarone. Consecutive adequate fluid challenges and antiarrhythmics in the emergency department failed requiring synchronized cardioversion for stabilization. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 11, 2020 Category: Emergency Medicine Authors: J. Lehman, B.T. Williams Source Type: research

Bacteriology of pediatric breast abscesses beyond the neonatal period
Limited data exist regarding the presentation and bacteriology of nonneonatal pediatric breast abscess. Objective: To determine the bacteriology and characteristic presentation of pediatric breast abscesses in a tertiary care center. Methods: Cross-sectional study of patients age 1  month to 21 years admitted to a pediatric Emergency Department (ED) between 1996 and 2018 with a breast abscess. Patients with pre-existing conditions were excluded. Records were reviewed to determine demographics, history, physical exam findings, wound culture results, imaging and ED dispositi on. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 11, 2020 Category: Emergency Medicine Authors: Eman Ansari, Marvin B. Harper, Assaf Landscahft, Rotem Kimia, Alexander Ozonoff, Amir A. Kimia Source Type: research

Racial and ethnic disparities in hospital observation in Maryland
Hospital observation is a key disposition option from the emergency department (ED) and encompasses up to one third of patients requiring post-ED care. Observation has been associated with higher incidence of catastrophic financial costs and has downstream effects on post-discharge clinical services. Yet little is known about the non-clinical determinants of observation assignment. We sought to evaluate the impact of patient-level demographic factors on observation designation among Maryland patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 11, 2020 Category: Emergency Medicine Authors: Cody Cichowitz, Gideon Loevinsohn, Eili Klein, Elizabeth Colantuoni, Panagis Galiatsatos, Jodi Rennert, Nathan Irvin Source Type: research

CK – What does it stand for?
In a recent edition of the American Journal of Emergency Medicine, Chan et al. describe two cases of weakness and elevated “creatinine kinase” (sic) as the initial presentation of coronavirus disease 2019 (COVID-19) [1]. The reference to “creatinine kinase” in the article title is repeated in the keywords and abstract, although in the main text the enzyme is simply referred to as “CK”. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 11, 2020 Category: Emergency Medicine Authors: Nick Flynn Source Type: research

Naloxone provision to emergency department patients recognized as high-risk for opioid use disorder
Patients with opioid use disorder (OUD) are at increased risk for overdose and death. Clinical practice guidelines and professional organization policy statements recommend providing naloxone to patients at risk for overdose. We sought to characterize fidelity to naloxone practice recommendations in a cohort of Emergency Department (ED) patients in whom opioid use disorder was suspected by the treating physician. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 10, 2020 Category: Emergency Medicine Authors: Bennett H. Lane, Michael S. Lyons, Uwe Stolz, Rachel M. Ancona, Richard J. Ryan, Caroline Freiermuth Source Type: research

MicroRNA-365 expression in the serum of patients with heart failure with reduced ejection fraction after myocardial infarction
MicroRNA-365 (miR-365) is a recently discovered cardiovascular disease cytokine that plays an important role in the inflammatory immune response, interacting with chemotactic macrophages, monocytes, T cells, B cells, and other cells responsible for the immune response. Recent studies have shown that miR-365 plays an important regulatory role in the pathogenesis of heart failure. MiR-365 excites the sympathetic nerves and stimulates AngII expression, induces smooth muscle actin, and promotes the proliferation and differentiation of vascular endothelial cells. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 10, 2020 Category: Emergency Medicine Authors: Hai-Bo Wu, Yun-Can Wang, Wen-Jing Yao, Yue-Tao Xie, Xue-Chao Wang, Rong-Pin Du Source Type: research

Author's reply: Diagnosing covid-19 associated Guillain-Barre syndrome
The acute onset and rapid progression (3  days) of neuropathic symptoms in both Case 1 and 3 is against the presentation of Typical Diabetic sensorimotor polyneuropathy which by definition are chronic in onset and slowly progressive [1]. Uremic polyneuropathy was not considered in Patient 3 as again the onset of Uremic polyneuropathy is insidious and slowly progressive over months unlike our case [2]. Albumino-cytological dissociation present in both cases is also a supporting laboratory feature of Guillain Barre Syndrome [3]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2020 Category: Emergency Medicine Authors: Satyan Nanda, Rahul Handa, Atul Prasad, Rajiv Anand, Dhruv Zutshi Source Type: research

Recurrent stump appendicitis
Acute appendicitis is one of the most common reasons for abdominal surgery. Stump appendicitis, one of the rare complications of appendicitis surgery, is an inflammation that develops in the remaining part of the appendix following surgery and occurs at a rate of 1/50.000 in cases with appendectomy. Although patients manifest the same findings as those with acute appendicitis on physical examination and laboratory tests, the history of previous appendectomy may cause delays in diagnosis.. Complications such as perforation and peritonitis can develop if an early diagnosis cannot be made. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2020 Category: Emergency Medicine Authors: Yavuz Yuksel, Tarkan Ergun, Ebru Torun, Ozkan Ozen Source Type: research

Association of air temperature with pediatric intussusception in northeastern China: A 10-year retrospective study
The aim of this study was to determine whether an association existed between intussusception and air temperature. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2020 Category: Emergency Medicine Authors: Xiao Bing Tang, Dong Yan Hu, Xian Qing Mu, Yu Zuo Bai Source Type: research

Shock index is better than conventional vital signs for assessing higher level of care and mortality in severe sepsis or shock
Conventional vital signs alone have limitations in determining the physiological status. Age-adjusted shock-index (SIPA), a comprehensive physiological variable, defined as the ratio of heart rate (HR) and systolic blood pressure (SBP) may be better at predicting hemodynamic stability and outcome than vital signs. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 9, 2020 Category: Emergency Medicine Authors: Sarika Gupta, Areesha Alam Source Type: research

Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data
This study aimed to investigate the association between presentation by chief complaints and COVID-19 status. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2020 Category: Emergency Medicine Authors: Christopher T. Clifford, Trevor R. Pour, Robert Freeman, David L. Reich, Benjamin S. Glicksberg, Matthew A. Levine, Eyal Klang Source Type: research

Rapidly fatal necrotizing soft tissue infection due to Clostridium sordellii in an injection drug user
We report a case presented with necrotizing soft tissue infection of the right upper extremity caused by C. sordellii in a patient with known use of injected heroin. Despite broad spectrum antibiotics and surgical debridement, the patient's clinical course became rapidly fatal, within 24  h of admission. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2020 Category: Emergency Medicine Authors: Jack Silva, Reynold Henry, Matthieu Strickland, Dandan Wang, Kazuhide Matsushima Source Type: research

Ventricular tachycardia as a consequence of triggered activity
One of the less frequent underlying mechanisms of ventricular tachycardia (VT) is triggered activity. Triggered activity refers to an extrasystole due to a premature depolarization that occurs when the amplitude of an early afterdepolarization or delayed afterdepolarization brings the cardiac membrane to its threshold potential. Hydrochlorothiazide and hydroxyzine can prolong repolarization and QT interval and are associated with early afterdepolarizations. Cyclic AMP-mediated delayed afterdepolarization can occur as a result of catecholaminergic surge. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2020 Category: Emergency Medicine Authors: John Riggins, Taylor Douglas, Ian S. deSouza Source Type: research

Clinical value of procalcitonin in critically ill patients infected by SARS-CoV-2
Background Blood procalcitonin (PCT) levels usually increase during infectious diseases and might be helpful to differentiate bacterial from non-bacterial origin. COVID-19 patients could present co-infections at initial presentation in the Emergency Department and nosocomial infections during stay in the ICU. However, the published literature has not established whether PCT changes could aid in the diagnosis of infectious complication during the COVID-19 pandemic. Methods Retrospective, single-center, cohort study, including COVID-19 patients admitted between March and May 2020. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2020 Category: Emergency Medicine Authors: Pedro Garrido, Pitter Cueto, Conxita Rovira, Elisabeth Garcia, Ana Parra, Raquel Enriquez, Armando Pinos, Manuel Sosa, Anna Hern ández-Aguilera, Immaculada Vallverdú Source Type: research

Difficult intravenous access in the emergency department: Performance and impact of ultrasound-guided IV insertion performed by nurses
Difficult intravenous access (DIVA) is a common problem in Emergency Departments (EDs), yet the prevalence and clinical impact of this condition is poorly understood. Ultrasound-guided peripheral intravenous catheter (USGPIV) insertion is a successful modality for obtaining intravenous (IV) access in patients with DIVA. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 7, 2020 Category: Emergency Medicine Authors: Evan M. Davis, Sarah Feinsmith, Ashley E. Amick, Jordan Sell, Valerie McDonald, Paul Trinquero, Arthur Moore, Victor Gappmeier, Katharine Colton, Andrew Cunningham, William Ford, Joseph Feinglass, Jeffrey H. Barsuk Source Type: research

Factors associated with hospitalization for ischemic stroke and TIA following an emergency department headache visit
Misdiagnosis of cerebrovascular disease among Emergency Department (ED) patients with headache has been reported. We hypothesized that markers of substandard diagnostic processes would be associated with subsequently ischemic cerebrovascular events among patients discharged from the ED with a headache diagnosis even after adjusting for demographic variables and medical history. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Ava L. Liberman, Jenny Lu, Cuiling Wang, Natalie T. Cheng, Khadean Moncrieffe, Richard B. Lipton Source Type: research

Patient/parent administered epinephrine in acute anaphylaxis
Among patients with a known peanut allergy, previous studies suggest low carrying rates of epinephrine auto-injectors (EAIs) and hesitancy to self-administer epinephrine upon anaphylaxis onset. Given the high prescription rates of epinephrine and prevalence of peanut allergies, it is important to identify rates of on-scene EAI use and affecting factors. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Michelle A. Murata, Loren G. Yamamoto Source Type: research

Authors respond MS24789: Hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control
We appreciate the authors' interest and comments regarding the manuscript “Hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control” [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Jessica Nicholson, Quinn Czosnowski, Tara Flack, Peter S. Pang, FACC, Kelsey Billups Source Type: research

Clinical relationship between blood concentration and clinical symptoms in aconitine intoxication
Aconitine is well-known for its potential analgesic, anti-inflammatory, and circulation promoting effects and has been widely used as a folk medicine in South Korea. Owing to its extremely toxic nature and relatively low safety margin, intoxication is sometimes fatal. The toxic compound mainly affects the central nervous system, heart, and muscle, resulting in cardiovascular complications. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: So Young Jeon, Wonjoon Jeong, Jung Soo Park, Yeonho You, Hong Joon Ahn, Dongwoo Kim, Dongeun Park, Hyejin Chang, Seung Whan Kim Source Type: research

Resolution of bronchoconstriction with positive airway pressure after intravenous adenosine
We present a case of a 63-year old female patient who was treated with adenosine and subsequently went into respiratory distress. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Malak Abbas, Justin Verville, Khalil Mroue Source Type: research

Barrier enclosure use during aerosol-generating medical procedures: A scoping review
Barrier enclosure devices were introduced to protect against infectious disease transmission during aerosol generating medical procedures (AGMP). Recent discussion in the medical community has led to new designs and adoption despite limited evidence. A scoping review was conducted to characterize devices being used and their performance. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Courtney Price, Maxim Ben-Yakov, Joseph Choi, Ani Orchanian-Cheff, Davy Tawadrous Tags: Review article Source Type: research

A neonate with metabolic acidosis: A case report of intentional ethylene glycol poisoning
We present a rare case of the intentional poisoning of a neonate. An 8-day old child presented to an academic pediatric emergency department (ED) with respiratory distress and decreased intake. In the ED the patient was stabilized, and workup uncovered an anion gap metabolic acidosis. Blood, urine, and CSF cultures were negative at 48  h and a metabolic screen revealed elevated glycine. Calcium oxalate crystals were later found in the urinalysis, raising concern for ethylene glycol poisoning. The patient's father admitted to mixing antifreeze with the child's formula. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: David Greenky, Tamara Taylor Ball, Brittany Murray Source Type: research

The cases not seen: Patterns of emergency department visits and procedures in the era of COVID-19
Prior data suggest Emergency Department (ED) visits for many emergency conditions decreased during the initial COVID-19 surge. However, the pandemic's impact on the wide range of conditions seen in EDs, and the resources required for treating them, has been less studied. We sought to provide a comprehensive analysis of ED visits and associated resource utilization during the initial COVID-19 surge. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Joshua J. Baugh, Benjamin A. White, Dustin McEvoy, Brian J. Yun, David F.M. Brown, Ali S. Raja, Sayon Dutta Source Type: research

Bed bugs are associated with anemia
The objective was to determine if red blood cell (RBC) and coagulation indices of bed bug –infested emergency department (ED) patients differed from those of noninfested control patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Johnathan M. Sheele, Bobbi S. Pritt, Claudia R. Libertin, Ewa M. Wysokinska Source Type: research

ST segment elevation in COVID-19-related pulmonary embolism
In their retrospective study of pulmonary embolism(PE) in COVID-19 infection Kho et al. made the following points: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Rethinking disaster vulnerabilities
Accurately predicting disasters has been an elusive and complex task for many decades, but anticipating the aftermath of an event can be based on historic precedence and forward thinking [1]. The response challenges, mechanisms of injury and complexities of a specific event type are well documented and can be anticipated based on previous lessons learned [2]. The consequences of a compound disaster, where one event precipitates another, are much harder to anticipate: a terrorism induced derailing of a train carrying volatile chemicals becomes a herculean disaster response. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Derrick Tin, Alexander Hart, Gregory R. Ciottone Source Type: research

The differential diagnosis of ischemic mitral regurgitation
The point is well made by the authors that “the absence of a murmur on cardiac auscultation in patients with cardiac sounding chest pain and severe dyspnea does not exclude mechanical complications of myocardial infarction” [1]. I would add that, in a patient with cardiac sounding chest pain, ST segment elevation(as in e Gala et al) [1], and hypotension(also as in e Gala et al) [1], the presence or absence of a systolic murmur does not exclude a “mechanical” problem such as life-threatening ventricular septal rupture attributable to Takotsubo cardiomyopathy(TTC) or the ST Elevation Myocardial Infarc...
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Oscar M. Jolobe Source Type: research

Inadvertent Methylergonovine administration to a newborn: A case report
Previous case reports describe the inadvertent administration of methylergonovine to newborns resulting in rare, life-threatening events including neonatal death. To our knowledge, no case reports exist detailing inadvertent methylergonovine administration in the emergency medicine literature. A newborn infant presented to the emergency department (ED) at hour five of life following methylergonovine administration with periods of apnea and cyanosis. The infant required intubation, mechanical ventilation, and a seven day neonatal intensive care stay. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Kayla Wilson, Rafael Santiago, Mark Preziosi, Rosemarie Fisher, A. Brad Hall Source Type: research

An unusual presentation and treatment of a hemorrhaging plexiform neurofibroma
Neurofibromatosis type 1 (NF), also known as Von Recklinghausen Disease is an autosomal dominant genetic condition involving the gene coding for the protein neurofibromin. NF has a prevalence of roughly 1 in 3000 live births [1,2]. NF manifests as characteristic cutaneous pigmentation (caf é au lait lesions and freckles in groin and axillary regions), optic gliomas, osseous lesions, and benign peripheral nerve tumors [3]. The diagnosis of NF is made clinically if a patient has more than two disease features [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 5, 2020 Category: Emergency Medicine Authors: Andrew D. Yocum, Dana Bacharach, Erin L. Simon Source Type: research

Comment on: “Hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control”
Management of atrial fibrillation (AF) is a very challenging situation for physicians. In the light of this issue, we read the article by Nicholson et al. about “hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control” [1]. Although this article gives us unique informations, we want to address some points that need more attention. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 4, 2020 Category: Emergency Medicine Authors: Mehmet Ozgeyik, Mufide Okay Ozgeyik Source Type: research

Identifying patients with symptoms suspicious for COVID-19 at elevated risk of adverse events: The COVAS score
Develop and validate a risk score using variables available during an Emergency Department (ED) encounter to predict adverse events among patients with suspected COVID-19. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 4, 2020 Category: Emergency Medicine Authors: Adam L. Sharp, Brian Z. Huang, Benjamin Broder, Matthew Smith, George Yuen, Christopher Subject, Claudia Nau, Beth Creekmur, Sara Tartof, Michael K. Gould Source Type: research

National analysis of COVID-19 and older emergency physicians
Emergency physicians (EPs) have played a critical role in the response to coronavirus disease 2019 (COVID-19). While public health efforts (e.g., statewide stay-at-home orders) had initially flattened the curve [1], COVID-19 spread in the U.S. has once again begun to accelerate. On October 23, 2020, the U.S. reached a new pandemic record of 83,010 daily cases [1], and all signs point toward an impending “second wave” or “third surge.” Given the association between advanced age and COVID-19 severity [2], our objective was to compare the geographic distribution of U.S. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 4, 2020 Category: Emergency Medicine Authors: DavidX. Zheng, Tarun K. Jella, Elie J. Mitri, Carlos A. Camargo Source Type: research

Should age be incorporated into the adult triage algorithm in the emergency department?
To compare resource utilization and mortality between older and younger adult patients with similar ED chief complaints and ESI triage levels. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 4, 2020 Category: Emergency Medicine Authors: Alexander D. Ginsburg, J.E. Silva Lucas Oliveira, Aidan Mullan, Kubwimana Moses Mhayamaguru, Susan Bower, Molly M. Jeffery, Fernanda Bellolio Source Type: research

Is Guillain Barre syndrome truly caused by SARS-CoV-2?
With interest we read the article by Nanda et al. about 4 patients with Guillain Barre syndrome (GBS) suspected to have been caused by an infection with SARS-CoV-2 [1]. It was concluded that these were the first cases with SARS-CoV-2 associated GBS from India and that the frequency of neuro-COVID may have been underestimated so far [1]. We have the following comments and concerns. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 4, 2020 Category: Emergency Medicine Authors: Josef Finsterer, Carla A. Scorza, Fulvio A. Scorza, Ana C. Fiorini Source Type: research

Smartphone evaluation of postero-anterior chest x-rays: An inter-observer study
Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 3, 2020 Category: Emergency Medicine Authors: Mustafa Bo ğan, Hasan Baki Altınsoy, Mehmet Karadağ Source Type: research

Optimal sessions of hyperbaric oxygen therapy in patients with carbon monoxide poisoning: A prospective observational study
Hyperbaric oxygen (HBO) therapy may be a useful treatment to prevent the development of delayed neuropsychiatric sequelae (DNS) in patients with acute carbon monoxide (CO) poisoning. However, there is no clear consensus regarding the optimal number of HBO therapy sessions in patients with CO poisoning. Here, we compared the development of DNS after 3 and  > 3 sessions of HBO therapy in patients with acute CO poisoning. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Sangsoo Han, Sangun Nah, Sungwoo Choi, Gi Woon Kim, Young Hwan Lee Source Type: research

Clinically relevant adverse cardiovascular events in intermediate heart score patients admitted to the hospital following a negative emergency department evaluation
Study objective: To estimate the frequency of clinically relevant adverse cardiac events (CRACE) in patients admitted to the hospital for chest pain with an intermediate HEART score (4, 5, 6), non-diagnostic EKG, and a negative initial troponin. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Rory Spiegel, Mark Sutherland, Robert Brown, Akilesh Honasoge, Michael Witting Source Type: research

Multi-center implementation of automated age-adjusted D-dimer results reduces unnecessary PE imaging
Several previous studies have investigated the clinical utility of age-adjusted D-dimer cutoffs for diagnosing pulmonary embolism (PE). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Jeffrey Dubin, Mary Kathleen Ratay, Matt Wilson, Peter Davis-Allen, Michael Gillam, Joseph Izzo, Kevin Maloy, Jonathan Davis, Munish Goyal Source Type: research

Colposcopic genital findings in female sexual assault victims: Relationship to prior sexual intercourse experience
There is scant literature addressing genital injuries in sexually assaulted women who had no prior sexual intercourse experience at the time of the assault. Prior studies in adolescent patients suggest that young women without prior sexual intercourse suffer more anogenital injuries after assault, in different locations, when compared to those women who have had prior sexual intercourse experience [1,2]. However, clinical evidence and the literature on sexual assault indicate that not all cases of penetration result in perforation of the hymen or subsequent visible genital injuries regardless of sexual intercourse experien...
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Linda Rossman, Stephanie Solis, Lindsey Ouellette, Christian Kolacki, Jeffrey S. Jones Source Type: research

Language preference does not influence stroke patients' symptom recognition or emergency care time metrics
Our objective was to determine whether acute ischemic stroke (AIS) patients' language preference is associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Kori S. Zachrison, Shaw Natsui, Betty M. Luan Erfe, Nicte I. Mejia, Lee H. Schwamm Source Type: research

Linking lactate dehydrogenase to the severity of COVID-19 cannot ignore the employed methodology
We read with interest the paper by Henry et al. [1], who, through a pooled analysis of available studies, supports the evidence that lactate dehydrogenase (LDH) measurements in serum can be a significant predictor of severity and mortality in COVID-19 patients [2]. The link between LDH levels and the COVID-19 severity may reflect both the direct lung injury and more widespread tissue damage [3,4]. This association was analyzed in 9 published studies. Although the information provided by these studies is potentially relevant for guiding patient care and permitting early identification of subjects at high risk of death or of...
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Elena Aloisio, Sara Pasqualetti, Mauro Panteghini Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 1, 2020 Category: Emergency Medicine Source Type: research

Toc
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 1, 2020 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - November 1, 2020 Category: Emergency Medicine Source Type: research

The COVID-19 pandemic: How predictive analysis, artificial intelligence and GIS can be integrated into a clinical command system to improve disaster response and preparedness
Europe's second wave of coronavirus infections has struck well before flu season even started, with intensive care units filling up again. Making matters worse, authorities say, is a widespread case of “COVID-fatigue.” Record high daily infections in several eastern European countries and sharp rebounds in the hard-hit west suggest Europe never really flattened the COVID-19 curve as hoped after springtime lockdowns [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 31, 2020 Category: Emergency Medicine Authors: Attila J. Hertelendy, Krzysztof Goniewicz, Amir Khorram-Manesh Source Type: research

COVID-19 in pregnancy and the puerperium: A review for emergency physicians
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel virus responsible for causing the novel coronavirus disease of 2019 (COVID-19). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - October 31, 2020 Category: Emergency Medicine Authors: Marina N. Boushra, Alex Koyfman, Brit Long Source Type: research