American Journal of Emergency Medicine最新文献

{"title":"A case of Marchiafava Bignami disease presenting as a cerebrovascular accident.","authors":"Sundip Patel, Kelly Lambert","doi":"10.1016/j.ajem.2024.09.058","DOIUrl":"10.1016/j.ajem.2024.09.058","url":null,"abstract":"<p><p>Marchiafava Bignami Disease (MBD) is a reversible neurological disorder with can be difficult to diagnose initially due to variable neurological presentations that can be seen in patients. Physicians need to consider this diagnosis as the readily available treatment of thiamine can help reverse symptoms and prevent long lasting effects. We present the case of a 52-year-old man with a history of alcohol use disorder who presented with concerns for a cerebrovascular accident. The patient had neurological signs that were vague and included intermittent confusion, subtle droop to the lower lip, and ataxia in their limbs. MRI revealed restricted diffusion in the corpus callosum which helped confirm the diagnosis of MBD. Treatment with thiamine helped the patient get back to their usual state of health with no new neurological deficits. This case emphasizes that MBD is a rare neurological disorder that must be considered in patients with alcohol use disorder who present with varying neurological symptoms as early thiamine treatment can reverse symptoms.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In response to \"Gabapentinoid prescribing patterns and predictors utilizing neural networks: Comment\".","authors":"Christine Ramdin, Emily Chen, Lewis S Nelson, Maryann Mazer-Amirshahi","doi":"10.1016/j.ajem.2024.09.065","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.065","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Utilization of Physical Restraints: A Study of Documentation Compliance and Adverse Events.","authors":"Lauren Klein, Samuel Hoffman, Eric F Decena, Patricia Eckardt, Theresa Tomkin, Denise DeVoe, Lisa Gaeta, Christopher C Raio","doi":"10.1016/j.ajem.2024.09.068","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.068","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Droperidol use in emergency patients with abdominal pain, nausea, and vomiting requires further analysis.","authors":"Damian Swieczkowski, Michal Pruc, Lukasz Szarpak","doi":"10.1016/j.ajem.2024.09.053","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.053","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The preponderance of opioid overdoses among middle-aged individuals in the US: Analysis of 911 dispatch data — Q1 2018 to Q3 2023","authors":"Andrew J. McCabe PhD, MPH,&nbsp;Nae Y. Won PhD, MPH,&nbsp;Linda B. Cottler PhD, MPH, FACE","doi":"10.1016/j.ajem.2024.09.057","DOIUrl":"10.1016/j.ajem.2024.09.057","url":null,"abstract":"<div><h3>Background</h3><div>Opioid overdoses have increased at a concerning rate in recent years. Middle-aged individuals have been reported as an age group of high concern for opioid overdoses. The purpose of this study was to assess trends in opioid overdose 911 dispatches between Q1 2018 and Q3 2023 among different age groups. It was hypothesized that the steepest increase in dispatches would be among middle-aged individuals.</div></div><div><h3>Methods</h3><div>We assessed age-related trends in opioid-related 911 dispatches using emergency medical service (EMS) data collected by biosptial, io. Data encompassed all 50 states and were broken into yearly quarters between Q1 2018 and Q3 2023. Age groups included younger- (10 to 29), middle- (30 to 49), and older-aged (50 to 69) individuals. Joinpoint regression was utilized to examine these trends.</div></div><div><h3>Results</h3><div>There were a total of 1,420,298 opioid-related 911 dispatches reported. Most were reported among middle-aged individuals, accounting for 48.9 % (<em>n</em> = 682,132) of all dispatches. Significant increases in dispatches were identified overall between Q1 2018 and Q2 2021 (β = 0.096, SE = 0.006, <em>P</em> ≤ 0.001). The steepest increase was identified among middle-aged individuals between Q1 2018 and Q2 2021 (β = 0.104, SE = 0.007, <em>P</em> ≤ 0.001). There was a significant decrease in dispatches among younger-aged individuals between Q2 2021 and Q3 2023 (β = −0.024, SE = 0.011, <em>P</em> = .036).</div></div><div><h3>Conclusion</h3><div>Middle-aged individuals experienced significant increases in opioid-related 911 dispatches between Q1 2018 and Q2 2021, and had the steepest increase compared to the other age groups. Conversely, younger-aged individuals have experienced a recent decrease in dispatches. These findings support previous indications that middle-aged individuals are at significant risk for opioid overdose. Additional research is necessary to identify geographic and demographic factors that may affect these trends.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Clinical outcomes of challenging out-of-hospital hypothermia management: A retrospective assessment of DOKEI protocol\" [The American Journal of Emergency Medicine, Volume 85, November 2024, Pages 71-79].","authors":"Kazue Oshiro, Takashi Matsumoto, Takeshi Nawa, Takayuki Sakuta, Tomikazu Murakami","doi":"10.1016/j.ajem.2024.09.048","DOIUrl":"10.1016/j.ajem.2024.09.048","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway management and trauma.","authors":"Soner Yeşilyurt, Nihat Müjdat Hökenek","doi":"10.1016/j.ajem.2024.09.051","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.051","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency surgical airway placement for failed airway in the trauma setting.","authors":"Amiya Kumar Barik, Rakesh Vadakkethil Radhakrishnan, Subhasree Das, Chitta Ranjan Mohanty, Neingutso Lomi","doi":"10.1016/j.ajem.2024.09.055","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.055","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe caffeine poisoning with mexiletine successfully treated by extracorporeal methods: A case report.","authors":"Saeko Kohara, Yoshito Kamijo, Ryoko Kyan, Tomohiro Yoshizawa, Tatsuaki Takahashi, Kijong Shin, Eiju Hasegawa","doi":"10.1016/j.ajem.2024.09.034","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.034","url":null,"abstract":"<p><p>A 20-year-old woman was brought to the hospital in an ambulance after ingesting 18 g of caffeine and 3500 mg of mexiletine 80 min earlier. On arrival at the emergency room, her vital signs were as follows: blood pressure, 65/37 mmHg; heart rate, 140 beats/min; and Glasgow Coma Scale, E4V4M6. Laboratory analyses revealed hypokalemia and lactic acidosis. The patient was treated with mechanical ventilation after intratracheal intubation, intravenous noradrenaline infusion, gastric lavage, and activated charcoal administration. Shortly afterwards, she developed pulseless ventricular tachycardia, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated. As the circulatory collapse continued, hemodialysis (HD) was performed with continuous intravenous infusion of noradrenaline. After the completion of HD, the noradrenaline dose was reduced. On hospital day 2, HD was performed on the second day of hospitalization. On hospital days 3 and 4, the patient was weaned off VA-ECMO and ventilator. The blood concentrations of caffeine and mexiletine at presentation were 387 μg/mL and 1.1 μg/mL respectively. During the first HD, blood concentrations of both drugs were markedly reduced. It has been reported that mexiletine may reduce the clearance of caffeine probably via inhibition of N-demethylation. In this case, the endogenous clearance of caffeine, calculated from blood concentrations, was considerably lower than estimated. If HD had not been performed, it may have taken longer to wean off the VA-ECMO because of reduced caffeine clearance in the presence of mexiletine. Notably, caffeine poisoning is more severe and prolonged when mexiletine is administered.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double defibrillation for patients with refractory ventricular fibrillation.","authors":"Chi-Va Ao, Min-Po Ho","doi":"10.1016/j.ajem.2024.09.054","DOIUrl":"10.1016/j.ajem.2024.09.054","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}