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Total 43 results found since Jan 2013.

Systemic thrombolysis in patients with acute stroke and active cancer: a systematic review and meta-analysis
AbstractCancer patients frequently have concomitant cerebrovascular diseases, which significantly worsen their prognosis. Prospective studies validating intravenous thrombolysis (IVT) safety profile in patients with acute ischemic stroke and active cancer are still lacking. Therefore, we aimed to evaluate IVT ’s efficacy and safety profile in acute ischemic stroke patients with comorbid active cancer. We included in a meta-analysis all relevant published studies, including patients with acute ischemic stroke with or without active cancer and receiving IVT, according to recommendations for IVT treatment for acute ischemic...
Source: Internal and Emergency Medicine - June 19, 2023 Category: Emergency Medicine Source Type: research

A man with left-sided weakness and numbness
Clinical introduction A 63-year-old right-handed man presented for evaluation of left leg stiffness and sensory change. He had a medical history of remote prostate cancer (status post resection in 2011). The patient reported that one week prior, he began noticing left leg stiffness and numbness, as well as left hand weakness and discoordination. He went to see his internist where he had a fall while the physician was testing his gait. He was sent to the emergency room (figure 1). He denied episodes of loss of consciousness, shaking, or headaches. He had no recent weight loss, night sweats, or previous falls. Question What ...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Gheihman, G., Paradis, X. G., ONeal, M. A. Tags: EMJ Image Challenge Source Type: research

Bleeding and thrombotic events in atrial fibrillation patients with cancer: a systematic review and meta-analysis
AbstractAtrial fibrillation (AF) and cancer are frequently coexisting in elderly patients. Pooled metanalytic data on the impact of cancer on clinical outcomes in AF patients are lacking.  We performed a systematic review and meta-regression analysis of clinical studies retrieved from Medline (PubMed) and Cochrane (CENTRAL) databases according to PRISMA guidelines. Bleeding endpoints included any, major, gastrointestinal (GI) bleeding and intracranial haemorrhage (ICH). Cardiovascul ar (CV) endpoints included myocardial infarction (MI), ischemic stroke/systemic embolism (IS/SE), CV and all-cause death. PROSPERO registrati...
Source: Internal and Emergency Medicine - December 8, 2022 Category: Emergency Medicine Source Type: research

Repurposing of Clinically Approved Poly-(ADP-Ribose) Polymerase Inhibitors for the Therapy of Sepsis
Sepsis’ pathogenesis involves multiple mechanisms that lead to a dysregulation of the host's response. Significant efforts have been made in search of interventions that can reverse this situation and increase patient survival. Poly (ADP-polymerase) (PARP) is a constitutive nuclear and mitochondrial enzyme, which functions as a co-activator and co-repressor of gene transcription, thus regulating the production of inflammatory mediators. Several studies have already demonstrated an overactivation of PARP1 in various human pathophysiological conditions and that its inhibition has benefits in regulating intracellular proces...
Source: Shock - November 26, 2021 Category: Emergency Medicine Tags: Review Articles Source Type: research

Emergency Department capacity to initiate thromboprophylaxis in patients with atrial fibrillation and thrombotic risk after discharge: URGFAICS cohort analysis
AbstractAtrial fibrillation (AF) is the most prevalent heart rhythm disorder in the general population. Stroke prevention is one of the leading management objectives in the treatment of AF patients. The variables associated with the non-initiation of thromboprophylaxis in patients with thrombotic risk consulting for an episode of AF in Emergency Departments (ED) were investigated. This was a multipurpose, analytical, non-interventionist, multicenter Spanish study with a prospective 30-day follow-up. All patients  ≥ 18 years of age consulting to the ED for the casual finding of AF in an electrocardiogram (ECG) perfor...
Source: Internal and Emergency Medicine - October 22, 2021 Category: Emergency Medicine Source Type: research

Clinical characteristics and tumor markers in ischemic stroke patients with active cancer
AbstractCancer-associated ischemic stroke (CAS) refers to a hypercoagulation disorder related to malignant tumors, especially adenocarcinoma. Carbohydrate antigen (CA) 125 is a mucinous serum marker that might reflect hypercoagulation status, but the association between CA 125 and CAS is unclear across various types of cancer. The aim of this study was to investigate the associations among tumor markers, coagulation markers, and clinical factors in acute ischemic stroke (AIS) patients with active cancer. Consecutive AIS patients with active cancer (a diagnosis or ongoing active therapy for cancer within 6  months) were pr...
Source: Internal and Emergency Medicine - October 1, 2021 Category: Emergency Medicine Source Type: research

500,000 Americans Now Dead from COVID-19 500,000 Americans Now Dead from COVID-19
The novel coronavirus is now the third leading cause of death in the U.S. -- behind heart disease and cancer, but ahead of accidents, respiratory diseases, stroke, Alzheimer ' s, and the flu.WebMD Health News
Source: Medscape Emergency Medicine Headlines - February 22, 2021 Category: Emergency Medicine Tags: Infectious Diseases News Source Type: news

Epidemiology and factors associated with mortality of thyroid storm in Taiwan: a nationwide population-based study
In conclusion, the 90-day mortality rate of thyroid storm was high and was commonly associated with multiorgan failure and shock. Therefore, clinical physicians should identify thyroid storm and treat it accordi ngly.
Source: Internal and Emergency Medicine - July 15, 2020 Category: Emergency Medicine Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Nearly Half of U.S. Adults have Heart or Blood Vessel Disease
A new report estimates that nearly half of all U.S. adults have some form of heart or blood vessel disease, a medical milestone that's mostly due to recent guidelines that expanded how many people have high blood pressure. The American Heart Association said Thursday that more than 121 million adults had cardiovascular disease in 2016. Taking out those with only high blood pressure leaves 24 million, or 9 percent of adults, who have other forms of disease such as heart failure or clogged arteries. Measuring the burden of diseases shows areas that need to improve, the heart association's chief science and medical officer, D...
Source: JEMS: Journal of Emergency Medical Services News - February 1, 2019 Category: Emergency Medicine Tags: News Patient Care Cardiac & Resuscitation Source Type: news

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Looking Past Dementia Reveals Hidden Life Threats
Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophen...
Source: JEMS Special Topics - August 13, 2018 Category: Emergency Medicine Authors: Joseph K. Mesches, NRP, FP-C Tags: Exclusive Articles Patient Care Source Type: news

Acute aortic occlusion in a patient without risk factors
A 94-year-old female with a history of ischemic stroke, mild right hemiparesis, vascular dementia, breast cancer with right mastectomy, colon cancer resulting in colectomy, hyperlipidemia, and hypertension presented to the emergency department (ED) with bilateral leg pain. Patient had no smoking history, and her medications included Donepezil, Aspirin, Citalopram, Losartan, and Pantoprazole.
Source: The American Journal of Emergency Medicine - March 28, 2018 Category: Emergency Medicine Authors: Trina Stoneham, Erin L. Simon Source Type: research