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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
Lung transplant of extrahospitalary donor after cardiac death
The objective of this study is to describe the results of lung transplantation of after cardiac death program, specifically the section regarding lung extraction donation. Twenty potential lung donors were obtained during the study. Most patients were male (19 cases), with a mean age of 42 years (36.5-49.5 years). A total of 33 lungs were donated (18 right and 15 left lungs). Most extractions were multiorganic (19 cases). One liver, 19 kidneys, 2 pancreas, and 19 corneas were obtained from these donors; bone tissue was obtained from all donors. The transplantation was bipulmonary in 13 cases and unipulmonary in 7. Thirty d...
Source: The American Journal of Emergency Medicine - March 5, 2013 Category: Emergency Medicine Authors: Alonso A. Mateos Rodríguez, José Maria Navalpotro Pascual, Francisco del Río Gallegos Tags: Brief Reports Source Type: research
Transient ischemic attack in hereditary hemorrhagic telangiectasia
We describe the case of a 53-year-old woman with a previous history of recurrent epistaxis, admitted to our unit for a transient episode of diplopia and unbalance. Cerebrovascular screening showed the presence of a right to left shunt at saline contrast transcranial Doppler, related to 3 PAVMs detected by subsequent chest computed tomographic scan. Genetic screening evidenced deletion in endoglin gene (ENG), suggesting diagnosis of HHT type 1. Secondary cerebrovascular prevention with antithrombotic therapy was early stopped for the worsening of epistaxis. Neurologic symptoms are common in HHT, and saline contrast transcra...
Source: The American Journal of Emergency Medicine - February 4, 2013 Category: Emergency Medicine Authors: Gino Gialdini, Alberto Chiti, Michelangelo Mancuso, Eva Terni, Nicola Giannini, Giovanni Orlandi Tags: Case Reports Source Type: research
Complete resolution of a solitary pontine abscess in a patient with dental caries
A solitary brainstem abscess is a rare fatal intracranial infection, which can be mistaken for an acute stroke complicated with a systemic infection. Dental caries without abscess formation can be a possible source of infection. Herein, we describe the case of a 59-year-old man with dental caries who presented with a 4-day history of progressive dizziness, double vision, gait ataxia, emesis, and left facial and body numbness. Fever, suboccipital headache, and difficulties in urinating and defecating were noted on admission. Acute brainstem infarction and suspected aspiration pneumonia were then diagnosed. Magnetic resonanc...
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Ming-Hua Chen, Hung-Wen Kao, Chun-An Cheng Tags: Case Reports Source Type: research
Endotoxin adsorption by polymyxin B column or intraaortic balloon pumping use for severe septic cardiomyopathy
Septic patients often have low cardiac output. Some of them present severe cardiac dysfunction such as septic cardiomyopathy. However, no well-known and effective treatment for septic cardiomyopathy exists. The effect of endotoxin adsorption by polymyxin B–immobilized fiber column–direct hemoperfusion (PMX-DHP) and intraaortic balloon pumping (IABP) for septic shock remains uncertain. We experienced 2 very contrastive case reports of severe septic cardiomyopathy. We experienced 2 cases of severe septic cardiomyopathy with refractory shock. Case 1 with colon perforation presented refractory shock 6 hours after PMX-DHP, ...
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Kensuke Nakamura, Kent Doi, Ryota Inokuchi, Tatsuma Fukuda, Takahiro Hiruma, Takeshi Ishii, Susumu Nakajima, Eisei Noiri, Naoki Yahagi Tags: Case Reports Source Type: research
Troponin rise and poor outcome in patients with acute atrial fibrillation: rationale and criteria of selection of patients
The role of new onset atrial fibrillation (AF) as a marker of thromboembolic risk has been demonstrated in the setting of acute myocardial infarction . Thus, someone might inquire the role of acute AF in patients with abnormal troponin not fulfilling criteria of acute myocardial infarction and might question if the minor reported range of troponin I (cTn-I) values in the study population of Conti et al (from 0.15 to 7.0 ng/mL) may not be linked with a secondary ischemic mechanism, likely an imbalance between demand and supply . However, the independent predictive value of abnormal troponin for a composite of stroke, acute ...
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Alberto Conti, Yuri Mariannini, Erica Canuti Tags: Correspondence Source Type: research
Painless aortic dissection: thrombolytic and antithrombotic vigilance
We thank Huang et al 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. Chest x-ray showed increased soft tissue prominence of the aortic arch suspicious ...
Source: The American Journal of Emergency Medicine - May 20, 2013 Category: Emergency Medicine Authors: Promporn Suksaranjit, Kunatum Prasidthrathsint, Wonngarm Kittanamongkolchai, Supawat Ratanapo, Narat Srivali, Daych Chongnarungsin Tags: Correspondence Source Type: research
S100B protein in children with carbon monoxide poisoning
S100B has been shown to increase in patients with cardiac arrest, stroke, subarachnoid hemorrhage, and traumatic and hypoxic brain damage . In contrast to adult studies, we found that serum S100B protein levels did not increase in pediatric patients with carbon monoxide (CO) poisoning . Patients with a positive history of CO exposure and elevated blood carboxyhemoglobin (>10%) levels associated with relevant clinical findings were diagnosed with CO poisoning. The most common complaints were headache (n = 27), dizziness (n = 27), nausea and vomiting (n = 28), syncope (n = 7), and convulsion (n = 2). In addition, we also cla...
Source: The American Journal of Emergency Medicine - August 12, 2013 Category: Emergency Medicine Authors: Ahmet Zulfikar Akelma, Aydin Celik,, Osman Ozdemir, Fatma Kavak Akelma Tags: Correspondence Source Type: research
Fatal heat stroke associated with topiramate therapy
A 40-year-old man with diabetes and seizure disorder was found at home unresponsive and “very hot to touch” by his father 40 minutes before emergency medical services arrival. His usual medications included topiramate, divalproex sodium, and rosiglitazone/metformin. Paramedics administered oxygen, intravenous fluids, and naloxone. They did not witness or report seizure activity. Upon emergency department arrival, the patient was unresponsive (Glasgow Coma Scale 3), hypotensive (94/50 mm Hg), and tachypneic (32 breaths per minute), with a heart rate of 60 beats per minute and elevated rectal temperature peaking at 43.2...
Source: The American Journal of Emergency Medicine - September 3, 2013 Category: Emergency Medicine Authors: Stephen W Borron, Robert Woolard, Susan Watts Tags: Case Reports Source Type: research
Hemichorea 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. Thus, we concluded that the involuntary movement disorder was caused by right temporal infarction that occurred after multiple bee stings.
Source: The American Journal of Emergency Medicine - October 28, 2013 Category: Emergency Medicine Authors: Jin Young An, Ji Seon Kim, Jin Hong Min, Kyu Hong Han, Jun Ho Kang, Jung Soo Park, Hoon Kim, Suk Woo Lee Tags: Case Reports Source Type: research
N-terminal prohormone of brain natriuretic peptide—how far can we extrapolate?
We read the article by Velibey et al with interest. Their result is consistent with various other studies done in the past, but long-term (4 years) survival prediction on hospital admission with a single plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level is a new and important finding. The mean value of NT-proBNP is significantly correlated with ejection fraction and the functional class (New York Heart Association Class) of heart failure . The author had neither commented on the functional status of the patients nor on the etiology of acute shortness of breath at the time of admission. Testing the...
Source: The American Journal of Emergency Medicine - December 23, 2013 Category: Emergency Medicine Authors: Nayer Jamshed, Fouzia F. Ozair, Meera Ekka, Praveen Aggarwal Tags: Correspondence Source Type: research
A patient with altered mental status and possible seizure reveals an atypical aortic dissection upon workup
In this report, we present the case of a 57-year-old woman who was transported to the emergency department with an acute episode of altered mental status, presenting as a possible stroke with possible seizures. The patient's only complaint was mild low back pain. Physical examination revealed disorientation to time with no other neurologic deficits or abnormal findings. Results from initial noncontrast head computed tomography, chest radiograph, and laboratory studies were all normal, except for an elevated d-dimer and serum creatinine. Chest computed tomography with contrast demonstrated a type A aortic dissection. The pa...
Source: The American Journal of Emergency Medicine - November 18, 2013 Category: Emergency Medicine Authors: Olufolahan J. Lawal, Harinder S. Dhindsa, Joshua W. Loyd Tags: Case Reports Source Type: research
Posterior Cerebral artery stroke presenting as Alexia without Agraphia
Source: The American Journal of Emergency Medicine - April 26, 2014 Category: Emergency Medicine Authors: Bhawna Sharma, Rahul Handa, Swayam Prakash, Kadam Nagpal, Indu Bhana, Pankaj Kumar Gupta, Sunil Kumar, Mahendra Singh Sisodiya Source Type: research
Acute Pediatric Stroke – What’s the Hurry? A Case for Emergency Physician Performed Echocardiography
Source: The American Journal of Emergency Medicine - April 16, 2014 Category: Emergency Medicine Authors: Christopher D. Thom, Scott E. Sparks Source Type: research
Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
Source: The American Journal of Emergency Medicine - April 16, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa Costa Source Type: research
Reperfusion strategy for simultaneous ST-segment elevation myocardial infarction and acute ischemic stroke within a time window
Source: The American Journal of Emergency Medicine - March 5, 2014 Category: Emergency Medicine Authors: Héctor González-Pacheco, Aurelio Méndez-Domínguez, Gerardo Vieyra-Herrera, Francisco Azar-Manzur, Aloja Meave-González, Hugo Rodríguez-Zanella, Carlos Martínez-Sánchez Source Type: research
