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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
Preclinical and clinical data for factor Xa and “Universal” reversal agents
Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development.
Source: The American Journal of Emergency Medicine - September 27, 2016 Category: Emergency Medicine Authors: Truman J. Milling, Scott Kaatz Tags: Review Source Type: research
Safety of Direct Oral Anticoagulants: Insights from Postmarketing Studies
Direct oral anticoagulants (DOACs) have been marketed in the United States since 2010. While numerous large-scale prospective phase 3 outcomes studies have documented the effectiveness of DOACs for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, the primary safety concern with all of these drugs —as it is with the more established oral anticoagulant warfarin—is the risk of major bleeding. Postmarketing surveillance studies (PMSS) provide the opportunity to evaluate the safety of these recently approved drugs across a spectrum of patients that may be broader than those in...
Source: The American Journal of Emergency Medicine - September 27, 2016 Category: Emergency Medicine Authors: Todd C. Villines, W. Frank Peacock Tags: Review Source Type: research
Central venous sinus thrombosis presenting with generalized tonic –clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurologic exam. Her head CT showed an intraparenchymal hemorrhage of the left frontal lobe, and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 9, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin Simon Tags: Case Report Source Type: research
Hemorrhagic stroke following consumption of an energy drink
We present here the first-ever reported case of an intracranial hemorrhage associated with the consumption of an energy drink. Our patient developed symptoms of sensory changes in the right arm and leg, with ataxia, within minutes of consuming a bottle of Redline, a well-known energy drink. A CT head revealed a small intracranial hemorrhage near the left thalamus. The Redline bottle notes that the serving size is only half a bottle, and also recommends that people with hypertension not use it, but our patient had not read these instructions.
Source: The American Journal of Emergency Medicine - October 10, 2016 Category: Emergency Medicine Authors: A Venkatraman, A Khawaja, AH Shapshak Tags: Case Report Source Type: research
Re: Impact of an emergency medicine pharmacist on time to thrombolysis in acute ischemic stroke: strength of association
To the Editor,
Source: The American Journal of Emergency Medicine - October 17, 2016 Category: Emergency Medicine Authors: Kayla Montgomery, A. Brad Hall Tags: Correspondence Source Type: research
Hemorrhagic stroke after consumption of an energy drink
We present here the first-ever reported case of an intracranial hemorrhage associated with the consumption of an energy drink. Our patient developed symptoms of sensory changes in the right arm and leg, with ataxia, within minutes of consuming a bottle of Redline, a well-known energy drink. A computed tomography of the head revealed a small intracranial hemorrhage near the left thalamus. The Redline bottle notes that the serving size is only half a bottle, and also recommends that people with hypertension not use it, but our patient had not read these instructions.
Source: The American Journal of Emergency Medicine - October 10, 2016 Category: Emergency Medicine Authors: A. Venkatraman, A. Khawaja, A.H. Shapshak Tags: Case Report Source Type: research
Akinetic mutism revealing an ischemic stroke
We describe a 44-year-old man who developed akinetic mutism following a cerebrovascular accident involving his left middle cerebral artery. We discuss this rare condition and its unusual clinical picture.
Source: The American Journal of Emergency Medicine - November 3, 2016 Category: Emergency Medicine Authors: Zidouh Saad, Jidane Said, Belkouch Ahmed, Bakkali Hicham, Belyamani Lahcen Source Type: research
Central venous sinus thrombosis presenting with generalized tonic-clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurological examination. Her head computed tomography (CT) showed an intraparenchymal hemorrhage of the left frontal lobe and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 9, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin L. Simon Tags: Case Reports Source Type: research
Simple and effective method to lower body core temperatures of hyperthermic patients
Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]).
Source: The American Journal of Emergency Medicine - January 29, 2017 Category: Emergency Medicine Authors: John P. O'Connor Source Type: research
Impact of an emergency medicine pharmacist on time to thrombolysis in acute ischemic stroke: strength of association
We appreciate your insight and review of our manuscript in the American Journal of Emergency Medicine [1]. We acknowledge that measures such as odds ratio (OR) or relative risk may help the reader further understand the strength of association of our outcomes.
Source: The American Journal of Emergency Medicine - October 17, 2016 Category: Emergency Medicine Authors: Kayla Montgomery, A. Brad Hall Tags: Correspondence Source Type: research
Alterations in optic nerve sheath diameter according to cerebrovascular disease sub-groups
ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed.
Source: The American Journal of Emergency Medicine - April 29, 2017 Category: Emergency Medicine Authors: Emre G ökcen, İbrahim Caltekin, Atakan Savrun, Hilal Korkmaz, Şeyda Tuba Savrun, Gökhan Yıldırım Source Type: research
Bi-objective approach for placing ground and air ambulance base and helipad locations in order to optimize EMS response
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster.
Source: The American Journal of Emergency Medicine - June 15, 2017 Category: Emergency Medicine Authors: Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi Source Type: research
Investigation of UCH-L1 levels in ischemic stroke, intracranial hemorrhage and metabolic disorder induced impaired consciousness
We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.
Source: The American Journal of Emergency Medicine - June 21, 2017 Category: Emergency Medicine Authors: Ihsan Yigit, Metin Atescelik, Mustafa Yilmaz, Mehmet Cagri Goktekin, Mehtap Gurger, Nevin Ilhan Source Type: research
Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis
This study describes a cohort of patients with FXa inhibitor-associated life-threatening bleeding events, their clinical characteristics, interventions and outcomes.
Source: The American Journal of Emergency Medicine - August 19, 2017 Category: Emergency Medicine Authors: Truman J. Milling, Carol L. Clark, Charles Feronti, Shlee S. Song, Sam S. Torbati, Gregory J. Fermann, Jeffrey Weiss, Dony Patel Source Type: research
Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo
Vertigo is classified as peripheral and central. Differentiation of stroke mimics is the most important diagnostic challenge. There is no clinical guidance for the indications of neuroimaging in isolated vertigo patients. The primary aim of this study is to test the diagnostic value of a DWI-MRI protocol to rule-out a central cause in patients with acute isolated vertigo in the ED.
Source: The American Journal of Emergency Medicine - September 23, 2017 Category: Emergency Medicine Authors: Ebru Unal Akoglu, Haldun Akoglu, Tuba Cimilli Ozturk, Bahaeddin Onur, Serkan Emre Eroglu, Ozge Onur, Arzu Denizbasi Source Type: research
