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Protective effects of cyclosporine A and hypothermia on neuronal mitochondria in a rat asphyxial cardiac arrest model
Cyclosporine A (CsA) was neuroprotective in the settings of traumatic brain injury and stroke. We sought to investigate the protective effects of CsA and hypothermia on neuronal mitochondria after cardiac arrest.Methods and Results.Five groups were included: sham (S), normothermia (N), CsA (C), hypothermia (H), and CsA plus hypothermia (C+H). Cardiac arrest was induced by 10min of asphyxia. CsA (10mg/kg) was administered immediately after return of spontaneous circulation in the CsA groups. Temperature of the rats was maintained at 33±0.5°C after return of spontaneous circulation in the hypothermia groups.
Source: The American Journal of Emergency Medicine - March 1, 2016 Category: Emergency Medicine Authors: Jie Liu, Yue Wang, Qiwei Zhuang, Meng Chen, Yufeng Wang, Lina Hou, Fei Han Tags: Original Contributions Source Type: research

Cerebral hyperperfusion syndrome: a rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Source Type: research

Higher prehospital blood pressure prolongs door to needle thrombolysis times: a target for quality improvement?
Per the American Heart Association guidelines, blood pressure (BP) should be less than 185/110 to be eligible for stroke thrombolysis. No studies have focused on prehospital BP and its impact on door to needle (DTN) times. We hypothesized that DTN times would be longer for patients with higher prehospital BP.
Source: The American Journal of Emergency Medicine - April 15, 2016 Category: Emergency Medicine Authors: Digvijaya D. Navalkele, Chunyan Cai, Farhaan Vahidy, Mohammad H. Rahbar, Renganayaki Pandurengan, Tzu-Ching Wu, Amrou Sarraj, Andrew Barreto, James C. Grotta, Nicole Gonzales Tags: Brief Report Source Type: research

Letter in response to: Hyperthermia and severe rhabdomyolysis from synthetic cannabinoids. Am J Emerg Med 2016;34:121.e1–2. doi: 10.1016/j.ajem.2015.05.052. Epub 2015 Jun. 12
We read with great interest the case report by Sweeney et al. [1] discussing severe hyperthermia and rhabdomyolysis following a reported exposure to a synthetic cannabinoid receptor agonist (SCRA). SCRA exposures, first reported in NYC in 2010, were at an all-time high in 2015 [2]. Confirmed cases of significant SCRA-associated acute kidney injury, stroke and acute psychosis are reported [3,4].
Source: The American Journal of Emergency Medicine - May 10, 2016 Category: Emergency Medicine Authors: Mark Su, Larissa Laskowski, Robert S. Hoffman Tags: Correspondence Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomography (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurological outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Source Type: research

Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischaemic stroke
A 57-year old man presented to the emergency department with complaints of nausea, fatigue and burning throat which had been present since one week. Except for mild mental retardation and epilepsy for which anti-epileptic medication was used, he was healthy. Physical examination was normal except for tachycardia (133 beats /minute). Laboratory investigation showed creatine kinase (CK) of 220 U/L (10–171), CK-MB 15 U/L (0–15) and troponine 10,8 ug/L (
Source: The American Journal of Emergency Medicine - May 26, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Source Type: research

2016: Emergency Medical Services Annotated Literature in Review
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services (EMS) systems. The provision of high quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature, including cardiac arrest care, trauma, myocardial infarction, and stroke.
Source: The American Journal of Emergency Medicine - July 17, 2016 Category: Emergency Medicine Authors: Jose V. Nable, Benjamin J. Lawner, William J. Brady Source Type: research

Hyperthermia and Severe Rhabdomyolysis From Synthetic Cannabinoids Am J Emerg Med 2016;34:121.e1-2. Doi: 10.1016/j.Ajem.2015.05.052. Epub 2015 Jun 12
We read with great interest the case report by Sweeney et al. [1] discussing severe hyperthermia and rhabdomyolysis following a reported exposure to a synthetic cannabinoid receptor agonist (SCRA). SCRA exposures, first reported in NYC in 2010, were at an all-time high in 2015 [2]. Confirmed cases of significant SCRA-associated acute kidney injury, stroke, and acute psychosis are reported [3,4].
Source: The American Journal of Emergency Medicine - May 10, 2016 Category: Emergency Medicine Authors: Mark Su, Larissa Laskowski, Robert S. Hoffman Tags: Correspondence Source Type: research

2016: Emergency Medical Services Annotated Literature in Review
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services (EMS) systems. The provision of high quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature, including cardiac arrest care, trauma, myocardial infarction, and stroke.
Source: The American Journal of Emergency Medicine - July 17, 2016 Category: Emergency Medicine Authors: Jose V. Nable, Benjamin J. Lawner, William J. Brady Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomographic (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurologic outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Tags: Case Report Source Type: research

Hyperthermia and Severe Rhabdomyolysis From Synthetic Cannabinoids Am J Emerg Med 2016;34:121.e1-2. Doi: 10.1016/j.Ajem.2015.05.052. Epub 2015 Jun 12
We read with great interest the case report by Sweeney et al. [1] discussing severe hyperthermia and rhabdomyolysis following a reported exposure to a synthetic cannabinoid receptor agonist (SCRA). SCRA exposures, first reported in NYC in 2010, were at an all-time high in 2015 [2]. Confirmed cases of significant SCRA-associated acute kidney injury, stroke, and acute psychosis are reported [3,4].
Source: The American Journal of Emergency Medicine - May 10, 2016 Category: Emergency Medicine Authors: Mark Su, Larissa Laskowski, Robert S. Hoffman Tags: Correspondence Source Type: research

Cerebral hyperperfusion syndrome: A rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15 –20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 4, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Tags: Case Report Source Type: research

Brugada electrocardiogram pattern induced by cannabis; is cannabis safe?
The objective of this study was to present a case report that brings attention to relationship between cannabis consumption and Brugada electrocardiogram pattern. Here, we present a case of a 19-year-old male patient with symptomatic Brugada electrocardiogram pattern induced after cannabis consumption. With the potential for more widespread legalization of cannabis, several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 29, 2015 Category: Emergency Medicine Authors: Joaqu ín Valle Alonso, Beatrix Huei-Yi Teo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Intracerebral hemorrhage in a middle aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman with a not declared at admission with a 4 year history of intranasal cocaine hydrochloride who developed an intracerebral subcortical spontaneous hemorragie. She documented a normal blood pressure and a CT angiography did not shown vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Intracerebral hemorrhage in a middle-aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman who did not declare at admission her 4-year history of intranasal cocaine hydrochloride and developed an intracerebral subcortical spontaneous hemorrhage. She documented a normal blood pressure, and computer tomography angiography did not show vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

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