• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Dabigatran-related coagulopathy: when can we assume the effect has “worn off”?
This issue of American Journal of Emergency Medicine presents a timely report that should be noted by all practicing emergency physicians. Nzwalo et al [1] describe a 61-year-old man with nonvalvular atrial fibrillation, taking 150 mg dabigatran twice daily for stroke protection, who presented to their emergency department (ED) with an acute ischemic stroke (AIS). The patient had a normal creatinine clearance and a normal thrombin time (TT). He was treated with intravenous recombinant tissue plasminogen activator (rt-PA) with good neurologic outcome and no bleeding complications.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Charles V. Pollack, Jerrold H. Levy, John Eikelboom, Jeffrey I. Weitz, Frank W. Sellke, Menno V. Huisman, Thorsten Steiner, Pieter Kamphuisen, Richard A. Bernstein Tags: Controversies Source Type: research

Spontaneous splenic rupture after thrombolysis for ischemic stroke
We present the first case of an atraumatic pathological splenic rupture following alteplase thrombolysis for ischemic stroke.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Rachid Sirbou, Cindy Tissier, Yannick Bejot, Marc Freysz Tags: Case Report Source Type: research

Simultaneous event of brachial artery occlusion and acute embolic stroke
Although the rapid and accurate diagnosis of both acute ischemic stroke and extremity ischemia is essential to the timely and appropriate treatment, it is not always easy to differentiate between true stroke and stroke mimics. Although in general, limb ischemia due to extremity embolism is not included in stroke mimics or misdiagnosis, limb arterial embolism should be considered in the differential diagnosis of acute monoparesis because the diagnosis may be missed if the other typical manifestations of this presentation (pain, pallor, pulselessness, sensory loss, and coolness of the arm) are overlooked.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Soo Hoon Lee, Nack-Cheon Choi, In Seok Jang, Tae-Sin Kang, Changwoo Kang, Jin Hee Jeong, Dong Seob Kim Tags: Case Report Source Type: research

ED volume and functional status after acute ischemic stroke
Acute ischemic stroke (AIS) is a time-sensitive disease where rapid identification and treatment are critical [1-6]. Increased emergency department (ED) volume has been implicated in poor patient outcomes in other time-sensitive diagnoses [7-11]. Given that most of AIS care is provided at nontertiary care centers, it is important to understand the impact of ED process metrics in the community setting [12]. We sought to evaluate the impact of daily ED volumes on outcomes of patients with AIS in a community hospital.
Source: The American Journal of Emergency Medicine - August 22, 2014 Category: Emergency Medicine Authors: Stephanie Larson, Ken Uchino, Nicole Joseph, Jestin N. Carlson Tags: Correspondence Source Type: research

Drill down analysis of door-to-needle time of acute ischemic stroke patients treated with intravenous tissue plasminogen activator
Target stroke guidelines recommend a door-to-needle time of ≤60 minutes for acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue-type plasminogen activator (tPA). We sought to analyze all diagnostic steps involved in the acute evaluation and treatment of AIS with IV tPA and to look for causes of delay in door to needle time (DNT).
Source: The American Journal of Emergency Medicine - August 7, 2014 Category: Emergency Medicine Authors: Jon W. Schrock, Marija Lum Tags: Original Contribution Source Type: research

Re-administration of Intravenous Alteplase in Acute Ischemic Stroke Patients: Case Series and Systematic Review
Background: Due to a high risk of recurrence of ischemic events, some patients may be candidates for re-administration of intravenous (IV) alteplase. Methods: We performed a single center review and performed a search on PubMed from January 1966 to April 2014 for cases of re-administration of alteplase. Favorable outcome was defined by a modified Rankin scale of 0-2 at discharge or at 1-3 months, improvement of ≥4 points within 24 hours in the National Institutes of Health Stroke Scale (NIHSS) score, or as a major improvement in the 72-hour NIHSS score.
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Adnan I. Qureshi, Ahmed A. Malik, Melissa Freese, Michelle Thompson, Asif A. Khan, M. Fareed K. Suri Source Type: research

Readministration of intravenous alteplase in acute ischemic stroke patients: case series and systematic review
Background: Because of a high risk of recurrence of ischemic events, some patients may be candidates for readministration of intravenous (IV) alteplase. Methods: We performed a single-center review and performed a search on PubMed from January 1966 to April 2014 for cases of readministration of alteplase. Favorable outcome was defined by a modified Rankin scale of 0 to 2 at discharge or at 1 to 3 months, improvement of greater than or equal to 4 points within 24 hours in the National Institutes of Health Stroke Scale score, or as a major improvement in the 72-hour National Institutes of Health Stroke Scale score.
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Adnan I. Qureshi, Ahmed A. Malik, Melissa Freese, Michelle J. Thompson, Asif A. Khan, M. Fareed K. Suri Tags: Case Report Source Type: research

Implementation of a clinical pathway based on a computerized physician order entry system for ischemic stroke attenuates off-hour and weekend effects in the emergency department
Source: The American Journal of Emergency Medicine - May 11, 2014 Category: Emergency Medicine Authors: Jong Min Yang, Yoo Seok Park, Sung Phil Chung, Hyun Soo Chung, Hye Sun Lee, Je Sung You, Shin Ho Lee, Incheol Park Source Type: research

Acute pediatric stroke—what’s the hurry? A case for emergency physician-performed echocardiography
We describe a case of acute ischemic stroke for which emergent, physician-sonographer–performed transthoracic echocardiography (TTE) changed his outcome. The patient in this case presented with left-sided hemiparesis, with subsequent CT Angiography (CTA) imaging and follow-on neurosurgical embolectomy for a proximal middle cerebral artery occlusion after which showed early recovery of muscular deficit.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Christopher D. Thom, Scott E. Sparks Tags: Case Report Source Type: research

Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa e Costa Tags: Case Report Source Type: research

Bun/creatinine ratio-based hydration for preventing stroke-in-evolution after acute ischemic stroke
Source: The American Journal of Emergency Medicine - April 4, 2014 Category: Emergency Medicine Authors: Leng-Chieh Lin, Jiann-Der Lee, Yen-Chu Hung, Chia-Hao Chang, Jen-Tsung Yang 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

Stroke: prospective evaluation of a prehospital management process based on rescuers under medical direction
Abstract: Background: Improving access to thrombolytic therapy for patients with ischemic stroke is challenging. We assessed a prehospital process based on firemen rescuers under strict medical direction, aimed at facilitating thrombolysis of eligible patients.Methods: This was a prospective observational study conducted over 4 months in Paris, France. Prehospital patients with suspected stroke were included after telephone consultation with a physician. If the time since the onset of symptoms was less than 6 hours, patients were transported directly to a neurovascular unit (NVU); if symptom onset was more than 6 hours ago...
Source: The American Journal of Emergency Medicine - February 3, 2014 Category: Emergency Medicine Authors: Laure Alhanati, Stéphane Dubourdieu, Clément Hoffmann, Francis Béguec, Stéphane Travers, Hugues Lefort, Olga Maurin, Daniel Jost, Laurent Domanski, Jean-Pierre Tourtier Tags: Original Contributions Source Type: research

Pages: 1  2  3  4  5  6  7  8  9