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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

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Subconjunctival hemorrhage in a patient on dabigatran (Pradaxa)
Dabigatran is a direct thrombin inhibitor that has gained increasing popularity for prevention of thromboembolic events such as stroke, pulmonary embolism, and myocardial ischemia. Because of the increasing use of this drug, emergency department (ED) physicians are going to be evaluating patients taking this medication. It is important to understand the potential for ocular bleeding complications associated with this class of anticoagulant. Traditionally, patients have been placed on vitamin K antagonists to decrease the risk of thromboembolism. In the RE-LY and RE-COVER studies, dabigatran showed non-inferiority to coumad...
Source: The American Journal of Emergency Medicine - September 24, 2012 Category: Emergency Medicine Authors: Tam M. Nguyen, Michael P. Phelan, Xiang Q. Werdich, Paul J. Rychwalski, Christopher M. Huff Tags: Case Reports Source Type: research