Journal of Emergency Medicine最新文献

{"title":"Emergency Department Preparedness in a Mega Mass Casualty Incident While Under Missile Fire: Lessons Learned from Israel on October 7, 2023.","authors":"Baruch Berzon, Debra West, Eliana Jacobs, Maximilian Nerlander, Shaden Salameh, Eran Tal-Or, Tzachi Slutsky, Jonathan Rieck, Evan Avraham Alpert","doi":"10.1016/j.jemermed.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.jemermed.2026.03.012","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report of Malignancy-Hemophagocytic Lymphohistiocytosis: A Dangerous and Rare Sepsis Mimic","authors":"Rishi Gupta DO ,&nbsp;Christopher J. Coyne MD, MPH","doi":"10.1016/j.jemermed.2025.12.029","DOIUrl":"10.1016/j.jemermed.2025.12.029","url":null,"abstract":"<div><h3>Background</h3><div>Malignancy-hemophagocytic lymphohistiocytosis (M-HLH) is a life-threatening disorder characterized by an aberrant hyperinflammatory immune response triggered by a neoplasm, inherited immune disorders that predispose patients to the development of M-HLH, chemotherapy, infections, and immunotherapy. Due to its aggressive presentation, patients with M-HLH are reported to have a high mortality rate.</div></div><div><h3>Case Report</h3><div>We describe a 66-year-old woman with a history of stage IV breast cancer that presented with multiple admissions for unresolved septic-like presentations. Due to the high clinical suspicion and HLH-2004 criteria, HLH was placed on the differential and further testing revealed a new-onset lymphoma. Treatment was eventually initiated to suppress the hyperinflammatory state of M-HLH and to target the new-onset stage IVB pleomorphic mantle cell lymphoma. Even though treatment was delayed, the patient survived for multiple months longer than the median survival rate.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>Emergency physicians should be aware of M-HLH due the hyperaggressive nature of this disease and its elusive presentation; often mimicking common emergency department presentations such as sepsis. The role of the emergency physician should be to stabilize the patient, assess red flags, identify HLH on the differential, and consult with the hematology/oncology service for further testing and potential early treatment.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 109-113"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Sociodemographic Disparities in Emergency Department Wait Times at an Urban Academic Medical Center”","authors":"Shyam Sundar Sah MD ,&nbsp;Abhishek Kumbhalwar PhD","doi":"10.1016/j.jemermed.2025.12.025","DOIUrl":"10.1016/j.jemermed.2025.12.025","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 132-133"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Appraisal of “Home Use of Nonpharmacologic Interventions for Fracture Pain After Pediatric Emergency Department Discharge”","authors":"Raihan Mohammed Mohiuddin PharmD, FID, FCCPT, AMSP,&nbsp;Mohammed Misbah Ul Haq PharmD, FID, FCCPT, AMSP","doi":"10.1016/j.jemermed.2025.10.036","DOIUrl":"10.1016/j.jemermed.2025.10.036","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 128-129"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infected Femoral Artery Pseudoaneurysm","authors":"Sadara Taylor MD ,&nbsp;Maria Mercurio MD ,&nbsp;Theresa Kim MD ,&nbsp;Joseph Palter MD ,&nbsp;Michael Schindlbeck MD, FACEP, FAAEM","doi":"10.1016/j.jemermed.2025.12.030","DOIUrl":"10.1016/j.jemermed.2025.12.030","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 114-116"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasospastic Angina Following Capecitabine Initiation: A Rare But Serious Cardiotoxic Effect","authors":"Sergio Ponce Simal MD,&nbsp;Mario Martínez Fleta MD,&nbsp;Maria Prados Arnedo MD,&nbsp;Irene Pilar Montón Blasco MD,&nbsp;Sonia Peribáñez Belanche MD,&nbsp;Javier Jimeno Sánchez MD","doi":"10.1016/j.jemermed.2025.12.027","DOIUrl":"10.1016/j.jemermed.2025.12.027","url":null,"abstract":"<div><h3>Background</h3><div>Fluoropyrimidines are widely used chemotherapy agents in the treatment of solid tumors, particularly colorectal cancer (CRC). The cardiotoxic effect most commonly associated with 5-fluorouracil (5-FU) is coronary vasospasm, which typically occurs within the first hours or days following administration and can present with a spectrum of manifestations ranging from stable angina to acute coronary syndrome with hemodynamic instability. Capecitabine, a prodrug of 5-FU, has less defined cardiovascular side effects.</div></div><div><h3>Case Report</h3><div>A 66-year-old man with lower rectal adenocarcinoma, receiving capecitabine, presented with chest pain and diaphoresis 48 h after starting therapy. Initial electrocardiogram (ECG) showed new biphasic T waves. During evaluation, he developed recurrent chest pain and hyperacute T waves in repeat ECG. Nitroglycerin relieved symptoms and normalized ECG changes. Suspecting high-risk Non-ST Elevation Acute Coronary Syndrome, he was admitted and underwent coronary angiography, which showed no obstructive coronary disease. However, acetylcholine provocation induced severe focal vasospasm with corresponding symptoms and ischemic ECG changes, confirming vasospastic angina. Echocardiography revealed normal left ventricular function. Capecitabine was discontinued, and the patient was treated with calcium channel blockers and nitrates. He was discharged after five days and remained symptom-free at follow-up.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>Emergency physicians should suspect fluoropyrimidine-induced cardiotoxicity in patients with chest pain after starting capecitabine, even without cardiac risk factors. Early recognition, drug discontinuation, and vasodilator therapy are critical to prevent serious complications and ensure timely cardiology-oncology coordination.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 94-98"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Sex, Race/Ethnicity, and HEART Score Guideline Implementation for Cardiac Testing in the Emergency Department","authors":"Evangelia Murray MD, MPH ,&nbsp;Kristina Munoz MD ,&nbsp;Emily Hopkins MSPH ,&nbsp;Stephanie Gravitz MPH ,&nbsp;Jason Haukoos MD,MSc ,&nbsp;Stacy Trent MD, MPH","doi":"10.1016/j.jemermed.2025.10.006","DOIUrl":"10.1016/j.jemermed.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in emergency care for acute coronary syndrome (ACS) have been reported across sex and race/ethnicity. Evidence-based decision tools may help reduce these gaps if their components are objective. The history, electrocardiogram (ECG), age, risk factors, troponin levels (HEART) Score is a validated tool for cardiac risk stratification that may support more equitable care.</div></div><div><h3>Objectives</h3><div>To assess whether HEART Score implementation in a large, urban, safety-net emergency department (ED) increased referral for guideline-recommended cardiac testing, and whether effects differed by sex or race/ethnicity.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of a pre–post quasi-experiment evaluating HEART Score-based ACS guideline implementation. Adults (≥18 years) were included if they had a troponin completed and an ICD-10 code for chest pain or ACS. The primary outcome was appropriate referral, defined as HEART Score ≥4, no normal objective testing within the year, and receipt of ED testing, urgent outpatient testing ordered, or inpatient admission for testing. We calculated descriptive statistics and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Among 1170 patients (521 preimplementation; 649 postimplementation), 498 had a HEART Score ≥4 and were included in the primary model. Implementation was associated with higher odds of appropriate referral (adjusted OR 2.74, 95% CI: 1.87–4.03). Sex and race/ethnicity were not independently associated with referral in either period (<em>p</em> = 0.23–0.76).</div></div><div><h3>Conclusions</h3><div>Implementation of the HEART Score was associated with increased odds of appropriate referrals for cardiac testing, with no observed disparities by sex, race, or ethnicity. Standardized risk stratification using the HEART Score may support more equitable ACS evaluation in the ED.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 53-63"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Academy of Emergency Medicine","authors":"","doi":"10.1016/S0736-4679(26)00053-3","DOIUrl":"10.1016/S0736-4679(26)00053-3","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 134-135"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic Temporomandibular Joint","authors":"Nikhil Mistry DMD, MD,&nbsp;Varun Chokshi DDS,&nbsp;Srighana Nadella DMD,&nbsp;Brian Ford DMD, MD","doi":"10.1016/j.jemermed.2025.12.001","DOIUrl":"10.1016/j.jemermed.2025.12.001","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 1-5"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on “Smartwatch-Based Detection of Ventricular Arrhythmias”","authors":"Chien-Chieh Hsieh M.D., Ph.D. ,&nbsp;Fu-Shan Jaw Ph.D. ,&nbsp;Chia-Hua Wu M.D. ,&nbsp;Gomes Felisbela M.D.","doi":"10.1016/j.jemermed.2025.12.012","DOIUrl":"10.1016/j.jemermed.2025.12.012","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"82 ","pages":"Pages 130-131"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}