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Source: The American Journal of Emergency Medicine

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Total 261 results found since Jan 2013.

The effect of ethyl pyruvate and N-acetylcysteine on ischemia-reperfusion injury in an experimental model of ischemic stroke
Reperfusion therapies play an important role in early-period treatment for patients presenting to the emergency department due to stroke. However, the ischemia-reperfusion injury that may occur with reperfusion must then be considered. The purpose of this study was to determine the effectiveness of N-acetylcysteine (NAC) and ethyl pyruvate in preventing ischemia-reperfusion injury.
Source: The American Journal of Emergency Medicine - June 4, 2016 Category: Emergency Medicine Authors: Suha Turkmen, Ozgen Cekic Gonenc, Yunus Karaca, Ahmet Mentese, Selim Demir, Ercument Beyhun, Aynur Sahin, Abdulkadir Gunduz, Esin Yulug, Suleyman Turedi Source Type: research

Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischemic stroke
Intravenous recombinant transplasminogeen activator (rt-PA) treatment is considered as standard acute phase treatment in ischemic stroke. In the initial stroke guidelines, recent myocardial infarction (MI) was listed as a contraindication for rt-PA treatment due to the increased risk of myocardial wall rupture. However, in the recent American Heart Association/American Stroke Association guideline, it is regarded only as a relative contraindication, and in the European guidelines, currently it is not listed as a contraindication.
Source: The American Journal of Emergency Medicine - May 26, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Tags: Case Reports 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

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

Stroke prevention for patients with atrial fibrillation: values and preferences of Canadian emergency medicine trainees
Atrial fibrillation (AF) is the most common serious cardiac arrhythmia, and it is associated with a 5-fold increase in the risk of ischemic stroke [1 –3] . This risk can be reduced by up to 64% with oral anticoagulation (OAC) [4] . Many patients are first diagnosed with AF in the context of visit to the emergency department (ED), and AF can account for 1% or more of ED visits [5–7] . Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Stroke Prevention for Patients with Atrial Fibrillation: Values and Preferences of Canadian Emergency Medicine Trainees
Atrial Fibrillation (AF) is the most common serious cardiac arrhythmia and it is associated with a five-fold increase in the risk of ischemic stroke[1–3]. This risk can be reduced by up to 64% with oral anticoagulation (OAC)[4]. Many patients are first diagnosed with atrial fibrillation (AF) in the context of visit to the emergency department (ED) and AF can account for 1% or more of ED visits[5–7]. Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Wallenberg's lateral medullary syndrome in an adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Elizabeth Day Ruedrich, Mahesh Chikkannaiah, Gogi Kumar Tags: Case Report Source Type: research

Wallenberg's Lateral Medullary Syndrome in an Adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Elizabeth Ruedrich, Mahesh Chikkannaiah, Gogi Kumar 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

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

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

The Utility of Bolus IV Nicardipine for Hypertensive Emergencies in the Emergency Department
We describe the first two documented cases of use of nicardipine administered as an IV bolus dose in the emergency department for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 21, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED
We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 20, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research