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Trajectory of Cognitive Decline After Sepsis
OBJECTIVES: Cognitive impairment is an important consequence of sepsis. We sought to determine long-term trajectories of cognitive function after sepsis. DESIGN: Prospective study of the Reasons for Geographic and Racial Differences in Stroke cohort. SETTING: United States. PATIENTS: Twenty-one thousand eight-hundred twenty-three participants greater than or equal to 45 years, mean (sd) age 64.3 (9.2) years at first cognitive assessment, 30.9% men, and 27.1% Black. MEASUREMENTS AND MAIN RESULTS: The main exposure was time-dependent sepsis hospitalization. The primary outcome was global cogni...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Not as Simple as Canker Sores
BY ​NANA P. MATSUMOTO, & DEREK MEEKS, DO​​A 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.​An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the...
Source: JEMS Special Topics - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Columns Cardiac & Resuscitation Special Topics Patient Care Source Type: news