Journal of education & teaching in emergency medicine最新文献

{"title":"The Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator","authors":"Nicole Finney, Eli M Soyfer, Rory Schwan, Lindsey C Spiegelman","doi":"10.5070/m58260902","DOIUrl":"https://doi.org/10.5070/m58260902","url":null,"abstract":"Syphilis is a progressive sexually transmitted infection that has a wide variety of presentations depending on the disease stage. These variable presentations can make it difficult to differentiate syphilis from other diseases. While tertiary syphilis is less common in the United States compared to primary or secondary syphilis, recognition of the varied manifestations of advanced syphilis can help providers accurately diagnose this disease to help prevent continued spread. In this case report, we present a patient with a history of bilateral palmar wounds. The patient had presented to multiple emergency departments without a diagnosis of syphilis. Upon subsequent emergency department visits, the patient was diagnosed with tertiary syphilis, started on a course of penicillin, and evaluated by dermatology. However, the patient left against medical advice prior to further evaluation and treatment. From this case report, we have learned the importance of considering tertiary syphilis gummas in the differential diagnosis of atypical skin wounds. Topics Sexually transmitted infection (sti), syphilis, tertiary syphilis, gummas, dermatologic lesions.","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"104 1","pages":"V11 - V15"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85212666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of community-acquired tuberculosis in an infant presenting with pneumonia refractory to antibiotic therapy","authors":"Audra Iness, Andrea Cruz, Scott Dorfman, Esther Sampayo","doi":"10.5070/m58160086","DOIUrl":"https://doi.org/10.5070/m58160086","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticholinergic Toxicity","authors":"C. McCoy, R. Honda","doi":"10.5070/m58160091","DOIUrl":"https://doi.org/10.5070/m58160091","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47041060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Findings of Small Bowel Diverticulitis A Case Report","authors":"Albert Zhou, Sarah Bella, Amy Patwa","doi":"10.5070/m58160074","DOIUrl":"https://doi.org/10.5070/m58160074","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Dissection Case Report","authors":"Chelsea Bunce, Christopher Bryczkowski, Mary Rometti","doi":"10.5070/m58160075","DOIUrl":"https://doi.org/10.5070/m58160075","url":null,"abstract":"","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134920502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Community-Acquired Tuberculosis in an Infant Presenting with Pneumonia Refractory to Antibiotic Therapy.","authors":"Audra N Iness,&nbsp;Andrea T Cruz,&nbsp;Scott R Dorfman,&nbsp;Esther M Sampayo","doi":"10.21980/J8X07M","DOIUrl":"https://doi.org/10.21980/J8X07M","url":null,"abstract":"<p><p>Infant tuberculosis (TB) is a rare but potentially deadly infection and difficult to diagnose, especially in infants who may present with non-specific symptoms. Here, we report a case of an United States-born term infant with community-acquired miliary TB and no confirmed TB exposure history. The patient initially presented with respiratory distress at seven weeks of life with chest radiograph showing a right lower lobe (RLL) infiltrate. After failing multiple courses of treatment for community-acquired pneumonia and developing growth faltering, the patient had imaging findings suggestive of TB infection with CNS involvement. The diagnosis of TB was confirmed by QuantiFERON and purified protein derivative (PPD). In infants who fail conventional treatment for bacterial pneumonia, the differential should be broadened to consider alternative etiologies. Additionally, brain imaging should be performed in cases of disseminated TB despite negative cerebrospinal fluid (CSF) studies since these patients are at high risk of central nervous system (CNS) involvement.</p><p><strong>Topics: </strong>Tuberculosis, pneumonia, pediatrics, growth faltering.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"V18-V22"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891617","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}

{"title":"Anticholinergic Toxicity in the Emergency Department.","authors":"C Eric McCoy,&nbsp;Reid Honda","doi":"10.21980/J8D07Z","DOIUrl":"https://doi.org/10.21980/J8D07Z","url":null,"abstract":"<p><strong>Audience: </strong>Emergency medicine residents, internal medicine residents, family medicine residents, community physicians, pediatricians, toxicology fellows.</p><p><strong>Introduction: </strong>There are over 600 compounds which contain anticholinergic properties.1 Medications with anticholinergic properties include antihistamines, atropine, tricyclic antidepressants, antipsychotics, topical mydriatics, antispasmodics, sleep aids, and cold preparations. 1-4 Plants that possess anticholinergic properties such as jimson weed, and street drugs cut with anticholinergics such as scopolamine are sources of accidental or intentional ingestion.1,2,4 Anticholinergic toxicity can cause a myriad of signs and symptoms, including agitation, seizures, hyperthermia, cardiac dysrhythmias, and death. Since poisoning from anticholinergic medications is frequently encountered in the emergency department, is it essential that emergency physicians be familiar with how to manage this toxidrome. This simulation case will allow the learner to evaluate and manage a patient presenting with anticholinergic toxicity.</p><p><strong>Educational objectives: </strong>By the end of this simulation case, learners will be able to: 1) describe the classic clinical presentation of anticholinergic toxicity, 2) discuss common medications and substances that may lead to anticholinergic toxicity, 3) recognize the electrocardiogram (ECG) findings in anticholinergic toxicity that require specific therapy, and 4) review the management of anticholinergic toxicity.</p><p><strong>Educational methods: </strong>This simulation is taught using a high- or moderate-fidelity manikin.</p><p><strong>Research methods: </strong>The educational content was evaluated by the learners immediately after completion and debriefing of the scenario. This case was initially piloted with approximately twenty emergency medicine residents. The group was comprised of first, second-, and third-year residents from a three-year emergency medicine residency. The efficacy of the content was assessed by oral feedback.</p><p><strong>Results: </strong>Overall, the case was well received by learners, who felt it was useful and were engaged throughout the session. The overall feedback was positive and the case was well-received by learners.</p><p><strong>Discussion: </strong>This scenario was eventually tested on over 100 learners over the course of several years, and the overall feedback was positive. It was found to be effective when debriefing sessions using various debriefing techniques (such as advocacy/inquiry) were utilized to discuss both the learners' performance in the case, as well as the debriefing pearls (located at the end of this manuscript).</p><p><strong>Topics: </strong>Anticholinergic toxicity, altered mental status, toxicology.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"S25-S47"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9837115","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}

{"title":"Epilepsy Caused by Neurocysticercosis: A Case Report.","authors":"Mary G McGoldrick,&nbsp;Daniel Polvino,&nbsp;Grant Wei","doi":"10.21980/J81P96","DOIUrl":"https://doi.org/10.21980/J81P96","url":null,"abstract":"<p><p>Neurocysticercosis is one of the most common causes of acquired epilepsy worldwide. This diagnosis is rarely considered in patients presenting to the emergency department (ED) with recurrent seizures in the United States (U.S.). This is the case of a young adult male presenting with post-ictal confusion and recurrent seizures requiring intubation for agitation and airway protection. It illustrates the need to maintain a broad differential when considering etiology of seizures in a globalized patient population.</p><p><strong>Topics: </strong>Seizure, neurocysticercosis, epilepsy, parasitic infection.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"V14-V17"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9837117","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}

{"title":"Electronic Cigarette or Vaping-Associated Lung Injury Case Report","authors":"Amy Chuang, L. Bacon, A. Lucero","doi":"10.5070/m58160088","DOIUrl":"https://doi.org/10.5070/m58160088","url":null,"abstract":"Electronic cigarette (e-cigarette) or vaping associated lung injury (EVALI) cases have increased with the popularity of e-cigarettes in the mostly young, healthy population. Some common symptoms associated with EVALI include shortness of breath and chest pain, and the most common diagnostic imaging findings are organizing pneumonia and diffuse alveolar damage seen on computed tomography (CT). Pneumomediastinum is a known sequela of EVALI.1 In the setting of pneumomediastinum in EVALI, EVALI is a diagnosis of exclusion, so other sources of pneumomediastinum need to be evaluated. EVALI has diverse presentations, and this case is a unique representation of a disease process that is becoming more commonplace with the increase in popularity of vaping. It is important to be aware of the clinical symptoms of EVALI, which can be nonspecific and can include gastrointestinal symptoms along with respiratory symptoms. It is equally important to recognize the diverse image findings of EVALI, which can include subcutaneous emphysema and pneumomediastinum. In this case, pneumomediastinum is seen in EVALI, and the patient was successfully treated with empiric antibiotic coverage, steroids, and conservative measures— making sure to limit any coughing or increases in intrathoracic pressure that can cause worsening of pneumomediastinum. Topics EVALI, vaping, pneumomediastinum, E-cigarette, ground-glass opacity.","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"80 1","pages":"V22 - V27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83941763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Cigarette or Vaping-Associated Lung Injury Case Report.","authors":"Amy Chuang,&nbsp;Lauren Bacon,&nbsp;Anthony Lucero","doi":"10.21980/J8S65P","DOIUrl":"https://doi.org/10.21980/J8S65P","url":null,"abstract":"<p><p>Electronic cigarette (e-cigarette) or vaping associated lung injury (EVALI) cases have increased with the popularity of e-cigarettes in the mostly young, healthy population. Some common symptoms associated with EVALI include shortness of breath and chest pain, and the most common diagnostic imaging findings are organizing pneumonia and diffuse alveolar damage seen on computed tomography (CT). Pneumomediastinum is a known sequela of EVALI.1 In the setting of pneumomediastinum in EVALI, EVALI is a diagnosis of exclusion, so other sources of pneumomediastinum need to be evaluated. EVALI has diverse presentations, and this case is a unique representation of a disease process that is becoming more commonplace with the increase in popularity of vaping. It is important to be aware of the clinical symptoms of EVALI, which can be nonspecific and can include gastrointestinal symptoms along with respiratory symptoms. It is equally important to recognize the diverse image findings of EVALI, which can include subcutaneous emphysema and pneumomediastinum. In this case, pneumomediastinum is seen in EVALI, and the patient was successfully treated with empiric antibiotic coverage, steroids, and conservative measures- making sure to limit any coughing or increases in intrathoracic pressure that can cause worsening of pneumomediastinum.</p><p><strong>Topics: </strong>EVALI, vaping, pneumomediastinum, E-cigarette, ground-glass opacity.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"8 1","pages":"V22-V27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9891613","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}