JEM reports最新文献_第10页

Erratum regarding previously published articles 关于以前发表的文章的勘误

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-08-30 DOI: 10.1016/j.jemrpt.2024.100110

引用次数: 0

Case of monocular visual impairment 单眼视力障碍病例

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-11-17 DOI: 10.1016/j.jemrpt.2024.100128

Lev Libet, Edward McCrink, Lawrence Liu

引用次数: 0

Upper gastrointestinal bleeding: A rare presenting sign of pediatric hypothyroidism 上消化道出血：小儿甲状腺功能减退症的罕见症状

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-11-10 DOI: 10.1016/j.jemrpt.2024.100126

Nicholas Aldredge , Sara A. DiVall , Yongtian T. Tan

{"title":"Upper gastrointestinal bleeding: A rare presenting sign of pediatric hypothyroidism","authors":"Nicholas Aldredge , Sara A. DiVall , Yongtian T. Tan","doi":"10.1016/j.jemrpt.2024.100126","DOIUrl":"10.1016/j.jemrpt.2024.100126","url":null,"abstract":"<div><h3>Background</h3><div>Severe pediatric hypothyroidism is a relatively rare endocrine disorder characterized by inadequate thyroid hormone production or action in children. It can have significant effects on various organ systems, including the gastrointestinal (GI) tract, and cause upper GI bleeding (UGIB). It can be challenging to diagnose as the cause in the emergency department (ED).</div></div><div><h3>Case report</h3><div>We present the case of a 13-year-old previously healthy male presenting with hematemesis as the chief complaint to the pediatric emergency department, who was subsequently found to have severe hypothyroidism based on a constellation of vital sign abnormalities in the absence of other likely etiologies. This case illustrates the importance of considering endocrinopathies as part of the overall differential diagnoses for a pediatric patient presenting with isolated hematemesis, especially if there is a disparity between vital signs and other clinical signs.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Recognizing pediatric hypothyroidism as a potential cause of UGIB presents a particular diagnostic challenge for emergency physicians. Symptoms of pediatric hypothyroidism can be varied, and UGIB in this setting is a rare and poorly understood clinical entity. Timely diagnosis and treatment of hypothyroidism are crucial to prevent further complications and optimize the child's growth and development.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100126"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Woman with right eye injury 右眼受伤的妇女

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-08-17 DOI: 10.1016/j.jemrpt.2024.100108

Gabriella Miller, T. Andrew Windsor

引用次数: 0

The voltage Dilemma in electrocardiogram (ECG) 心电图（ECG）中的电压难题

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-10-16 DOI: 10.1016/j.jemrpt.2024.100121

Ezhilkugan Ganessane , B.G. Kowsthubha , V.T. Amrithanand , Anas Mohammed Muthanikkatt , Vasudha Dinesh

{"title":"The voltage Dilemma in electrocardiogram (ECG)","authors":"Ezhilkugan Ganessane , B.G. Kowsthubha , V.T. Amrithanand , Anas Mohammed Muthanikkatt , Vasudha Dinesh","doi":"10.1016/j.jemrpt.2024.100121","DOIUrl":"10.1016/j.jemrpt.2024.100121","url":null,"abstract":"<div><h3>Background</h3><div>Pericardial effusion involves fluid buildup around the heart, potentially leading to cardiac tamponade—a critical condition that can impair heart function. Symptoms vary widely from mild to life-threatening. An electrocardiogram (ECG) is crucial for initial assessment, but interpreting findings can be challenging, especially when classic signs like low voltage QRS complexes are absent. Recognising new voltage changes from the baseline ECG is crucial even when traditional low voltage criteria are not met. Understanding these nuances and their clinical significance is essential for timely diagnosis and effective treatment, highlighting the importance of careful ECG interpretation by emergency physicians.</div></div><div><h3>Case report</h3><div>A 57-year-old male, diagnosed with chronic kidney disease and recently initiated on anti-tubercular treatment for pulmonary tuberculosis, presented to the emergency department with worsening shortness of breath. The baseline ECG a month prior revealed normal sinus rhythm with right atrial enlargement (RAE) and left ventricular hypertrophy (LVH). Upon presentation, the ECG revealed sinus tachycardia without P pulmonale or LVH, suggesting a potential dynamic change. Point-of-care ultrasound (POCUS) confirmed moderate pericardial effusion with early right ventricular diastolic collapse.</div></div><div><h3><strong><em>Why should an emergency physician be aware of this?</em></strong></h3><div>A new decrease in QRS voltages and sinus tachycardia should prompt suspicion of pericardial effusion. Emergency physicians need to understand the complexity of new voltage changes in ECGs. The challenge lies in relying solely on standard ECG criteria, emphasising the importance of considering individual baseline variations. Recognising such subtle ECG changes is crucial for diagnosing and treating cardiac tamponade early, leading to better patient outcomes.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prolonged fever complicated by petechiae in an immunocompetent adult with primary CMV infection: A case report 一名免疫功能正常的成年人因原发性巨细胞病毒感染而长期发热并伴有瘀斑：病例报告

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI: 10.1016/j.jemrpt.2024.100123

Emilie Fraisse , Mads Emil Bruusgaard-Mouritsen , Rasmus Gregersen

{"title":"Prolonged fever complicated by petechiae in an immunocompetent adult with primary CMV infection: A case report","authors":"Emilie Fraisse , Mads Emil Bruusgaard-Mouritsen , Rasmus Gregersen","doi":"10.1016/j.jemrpt.2024.100123","DOIUrl":"10.1016/j.jemrpt.2024.100123","url":null,"abstract":"<div><h3>Background</h3><div>While petechiae can be a sign of a serious underlying condition, the majority are benign. Frequently, an underlying cause is not identified despite extensive diagnostic testing. Petechiae may be caused by CMV infection which is rarely considered in the differential diagnostic process. Most immunocompetent adults with primary CMV infection are asymptomatic or develop a mononucleosis-like syndrome with fever and mild hepatitis.</div></div><div><h3>Case report</h3><div>We report the case of a 30-year-old man who presented to an out-of-hours general physician consult with intermittent fever for three weeks. Examination showed petechiae on the upper extremities. Initial laboratory data revealed lymphocytosis and elevated liver enzyme tests. Further testing showed positive CMV throat swab and CMV/EBV immunoglobulin M and G. His symptoms resolved gradually without any treatment.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>This report shows that primary CMV infection can be a cause of petechiae. Emergency physicians should keep in mind that although uncommon, immunocompetent adults can experience acute symptomatic CMV infections characterized by an extended disease course and testing may avoid unnecessary and extensive diagnostic workup and repeated hospital contacts.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Buprenorphine/naloxone initiation in the emergency department: A series of vignettes 在急诊科开始使用丁丙诺啡/纳洛酮：一系列小故事

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-08-25 DOI: 10.1016/j.jemrpt.2024.100112

Margarita Popova , Karen Chung , Sumitha Raman , Sonal Batra , Damali Nakitende , Keith Boniface

{"title":"Buprenorphine/naloxone initiation in the emergency department: A series of vignettes","authors":"Margarita Popova , Karen Chung , Sumitha Raman , Sonal Batra , Damali Nakitende , Keith Boniface","doi":"10.1016/j.jemrpt.2024.100112","DOIUrl":"10.1016/j.jemrpt.2024.100112","url":null,"abstract":"<div><h3>Background</h3><p>Opioid drug overdose deaths are at an all-time high. Buprenorphine, a medication used to treat opioid use disorder, has dramatic effects on mortality after overdose as well as engagement with outpatient treatment programs. Recent regulatory changes have eased barriers to prescription, yet buprenorphine is infrequently prescribed from the emergency department. Objectives: Emergency physicians see patients who would benefit from this medication on a regular basis. We aim to illustrate how buprenorphine can be initiated from the emergency department.</p></div><div><h3>Discussion</h3><p>Using a series of six cases, the use of buprenorphine for common presentations of patients with opioid use disorder (OUD) is described.</p></div><div><h3>Conclusions</h3><p>We present a series of clinical vignettes in order to increase emergency physicians’ familiarity and comfort with the use of buprenorphine/naloxone in the treatment of OUD. Patients with OUD treated with buprenorphine/naloxone are less likely to die from overdose and more likely to engage in long-term treatment. Emergency departments are well suited to initiate buprenorphine/naloxone for patients who are ready for change and eligible for medications for OUD. Now that barriers to prescribing have been removed, emergency clinicians should seek out patients with opioid use disorder who may benefit from this life-saving treatment, initiated either in the ED or at home.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232024000427/pdfft?md5=184d57bcb51e818d97462b65cedad3da&pid=1-s2.0-S2773232024000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound-guided genicular nerve blocks for acute knee pain in the emergency department: A case series 超声引导下膝神经阻滞治疗急诊科急性膝关节疼痛：病例系列

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI: 10.1016/j.jemrpt.2024.100119

Carlos Gonzalez-Cobos, Gabriel Rose

引用次数: 0

Lateral canthotomy and cantholysis to relieve orbital compartment syndrome caused by a supraorbital hematoma 外侧泪囊切开术和泪囊溶解术缓解眶上血肿引起的眶隔综合征

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-09-12 DOI: 10.1016/j.jemrpt.2024.100117

Andrew Yocum , Ross Ferrise , Erin L. Simon

{"title":"Lateral canthotomy and cantholysis to relieve orbital compartment syndrome caused by a supraorbital hematoma","authors":"Andrew Yocum , Ross Ferrise , Erin L. Simon","doi":"10.1016/j.jemrpt.2024.100117","DOIUrl":"10.1016/j.jemrpt.2024.100117","url":null,"abstract":"<div><h3>Background</h3><div>Lateral canthotomy is a procedure performed emergently for orbital compartment syndrome (OCS) when a patient's intraocular pressure (IOP) becomes elevated beyond 40 mmHg. This ophthalmologic emergency usually occurs from a mass effect within the orbit, commonly from retro-orbital pressure due to bleeding or hematoma. Often, this causes proptosis and stretching of the optic nerve. As the pressure increases, vascular perfusion decreases, causing pain and decreased vision. Supra-orbital injuries causing OCS are rare, making early clinical detection challenging. Proptosis may not occur at all. Definitive treatment of OCS involves lateral orbital canthotomy and cantholysis (LOC) to alleviate pressure and restore blood flow.</div></div><div><h3>Case report</h3><div>A 65-year-old intoxicated male who presented to the emergency department after a ground-level fall. He was unable to report symptoms accurately and sustained a supraorbital hematoma while on clopidogrel. Despite lacking proptosis, the patient experienced a slow rise in IOP until peaking at 45 mmHg. Successful LOC resulted in immediate IOP reduction, and the patient was transferred for oculoplastic surgical evaluation.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>OCS is an ophthalmologic emergency; treatment within 2 h is recommended to avoid permanent vision damage. When a patient is unable to communicate visual symptoms after trauma near the orbits, serial IOP measurements must be taken, even in the absence of clinical signs, until OCS can be definitively ruled out. If pressure rises above 40 mmHg, then an emergent LOC is indicated. This unique case underscores the diagnostic challenges of supraorbital OCS and emphasizes the importance of prompt LOC in preventing irreversible vision damage.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Haemophilus influenzae urethritis and orchiepididymitis: A case report 流感嗜血杆菌尿道炎和睾丸炎：病例报告

JEM reports Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI: 10.1016/j.jemrpt.2024.100120

Mohammad Razban

{"title":"Haemophilus influenzae urethritis and orchiepididymitis: A case report","authors":"Mohammad Razban","doi":"10.1016/j.jemrpt.2024.100120","DOIUrl":"10.1016/j.jemrpt.2024.100120","url":null,"abstract":"<div><h3>Background</h3><div>Mainly known as a cause of pulmonary infections or meningitis, Haemophilus influenzae has rarely been described as an etiology of urinary tract infections and even less as a cause of orchitis or epididymitis.</div></div><div><h3>Case report</h3><div>This paper describes a rare case of a patient who presented to our emergency department with urethral discharge, swelling of the right testicle, and fever consistent with a diagnosis of urethritis and orchepididymitis. Initially, we suspected a sexually transmitted disease such as chlamydia or gonorrhea. However, the urethral smear and urine culture revealed the presence of Haemophilus influenzae as the causative agent. A first therapy with Ceftriaxone and Azithromycin followed by doxycycline did not completely resolve symptoms. A new course of antibiotherapy with Ciprofloxacin led to complete remission.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Haemophilus influenzae can occasionally present with urethral discharge and symptoms of orchiepididymitis similar to those of a sexually transmitted disease. It is crucial for physicians to remember that this pathogen also causes genitourinary tract infections, given that most strains are resistant to Azithromycin. Consequently, they should adapt antibiotic therapy and investigations accordingly in these cases.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"3 4","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0