Jonathan A Edlow, Peter J Pronovost
No abstract text is available yet for this article.
February 28, 2023: JAMA
José Afonso, Jesús Olivares-Jabalera, Ricardo J Fernandes, Filipe Manuel Clemente, Sílvia Rocha-Rodrigues, João Gustavo Claudino, Rodrigo Ramirez-Campillo, Cristina Valente, Renato Andrade, João Espregueira-Mendes
BACKGROUND: Hamstrings injuries are common in sports and the reinjury risk is high. Despite the extensive literature on hamstrings injuries, the effectiveness of the different conservative (i.e., non-surgical) interventions (i.e., modalities and doses) for the rehabilitation of athletes with acute hamstrings injuries is unclear. OBJECTIVE: We aimed to compare the effects of different conservative interventions in time to return to sport (TRTS) and/or time to return to full training (TRFT) and reinjury-related outcomes after acute hamstrings injuries in athletes...
January 9, 2023: Sports Medicine
Niushen Zhang, Matthew S Robbins
Migraine affects about 1 billion people worldwide, and up to 15% of adults in the United States have migraine attacks in any given year. Migraine is associated with substantial adverse socioeconomic and personal effects. It is the second leading cause of years lived with disability worldwide for all ages and the leading cause in women aged 15 to 49 years. Diagnostic uncertainty increases the likelihood of unnecessary investigations and suboptimal management. This article advises clinicians about diagnosing migraine, ruling out secondary headache disorders, developing acute and preventive treatment plans, and deciding when to refer the patient to a specialist...
January 2023: Annals of Internal Medicine
Sean C Rose, Deborah A Levine, Junxin Shi, Krista Wheeler, Taylour Aungst, Rachel M Stanley, Miriam H Beauchamp
BACKGROUND: Brain injury during early childhood may disrupt key periods of neurodevelopment. Most research regarding mild traumatic brain injury (mTBI) has focused on school-age children. We sought to characterize the incidence and healthcare utilization for mTBI in young children presenting to U.S. emergency departments (ED). METHODS: The Nationwide Emergency Department Sample was queried for children age 0-6 years with mTBI from 2016 to 2019. Patients were excluded for focal or diffuse TBI, drowning or abuse mechanism, death in the ED or hospital, Injury Severity Score > 15, neurosurgical intervention, intubation, or blood product transfusion...
March 2023: American Journal of Emergency Medicine
Jeffrey J Perry, David E Newman-Toker, Robert Ohle
No abstract text is available yet for this article.
November 2022: CJEM
Peter Szatmary, Tassos Grammatikopoulos, Wenhao Cai, Wei Huang, Rajarshi Mukherjee, Chris Halloran, Georg Beyer, Robert Sutton
Acute pancreatitis is a common indication for hospital admission, increasing in incidence, including in children, pregnancy and the elderly. Moderately severe acute pancreatitis with fluid and/or necrotic collections causes substantial morbidity, and severe disease with persistent organ failure causes significant mortality. The diagnosis requires two of upper abdominal pain, amylase/lipase ≥ 3 ×upper limit of normal, and/or cross-sectional imaging findings. Gallstones and ethanol predominate while hypertriglyceridaemia and drugs are notable among many causes...
September 8, 2022: Drugs
Christiaan van Nispen, Taylor Reffett, Brit Long, Michael Gottlieb, Thomas C Frawley
The outbreak of monkeypox in May and June 2022 is the largest outside of central and western Africa since the 2003 outbreak in the United States. Monkeypox, like smallpox, is caused by an orthopoxvirus, though its clinical manifestations tend to be less severe. It is characterized by a prodromal flu-like illness with lymphadenopathy followed by a centrifugally spreading rash, sometimes involving the face, palms, soles, and oral mucosa. Although the vast majority of cases resolve with symptomatic management, a small number of patients can suffer severe outcomes including, but not limited to, secondary bacterial skin infections, pneumonitis, ocular sequelae, encephalitis, hypovolemia, and death...
January 2023: Annals of Emergency Medicine
Michael Gottlieb, Brit Long
No abstract text is available yet for this article.
February 2023: Annals of Emergency Medicine
Brit Long, Alex Koyfman, Michael Gottlieb, Stephen Y Liang, Brandon M Carius, Summer Chavez, William J Brady
INTRODUCTION: Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases and expanding knowledge of this has prompted a need for a focused review for practicing clinicians. OBJECTIVE: This narrative review provides a focused overview of the epidemiology, presentation, evaluation, and management of monkeypox for emergency clinicians. DISCUSSION: Monkeypox is an orthopoxvirus endemic to central and western Africa...
November 2022: American Journal of Emergency Medicine
Tobias Zimmermann, Jeanne du Fay de Lavallaz, Thomas Nestelberger, Danielle M Gualandro, Pedro Lopez-Ayala, Patrick Badertscher, Velina Widmer, Samyut Shrestha, Ivo Strebel, Noemi Glarner, Matthias Diebold, Òscar Miró, Michael Christ, Louise Cullen, Martin Than, F Javier Martin-Sanchez, Salvatore Di Somma, W Frank Peacock, Dagmar I Keller, Murat Bilici, Juan Pablo Costabel, Michael Kühne, Tobias Breidthardt, Venkatesh Thiruganasambandamoorthy, Christian Mueller, Maria Belkin, Kathrin Leu, Jens Lohrmann, Jasper Boeddinghaus, Raphael Twerenbold, Luca Koechlin, Joan E Walter, Melissa Amrein, Desiree Wussler, Michael Freese, Christian Puelacher, Damian Kawecki, Beata Morawiec, Emilio Salgado, Gemma Martinez-Nadal, Carolina Isabel Fuenzalida Inostroza, José Bustamante Mandrión, Imke Poepping, Katharina Rentsch, Arnold von Eckardstein, Andreas Buser, Jaimi Greenslade, Tobias Reichlin, Franz Bürgler
BACKGROUND: The Canadian Syncope Risk Score (CSRS) was developed to predict 30-day serious outcomes not evident during emergency department (ED) evaluation. OBJECTIVE: To externally validate the CSRS and compare it with another validated score, the Osservatorio Epidemiologico della Sincope nel Lazio (OESIL) score. DESIGN: Prospective cohort study. SETTING: Large, international, multicenter study recruiting patients in EDs in 8 countries on 3 continents...
June 2022: Annals of Internal Medicine
Martha Gulati, Phillip D Levy, Debabrata Mukherjee, Ezra Amsterdam, Deepak L Bhatt, Kim K Birtcher, Ron Blankstein, Jack Boyd, Renee P Bullock-Palmer, Theresa Conejo, Deborah B Diercks, Federico Gentile, John P Greenwood, Erik P Hess, Steven M Hollenberg, Wael A Jaber, Hani Jneid, José A Joglar, David A Morrow, Robert E O'Connor, Michael A Ross, Leslee J Shaw
AIM: This executive summary of the clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients. METHODS: A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases...
November 30, 2021: Circulation
Brit Long, John Christopher Graybill, Hans Rosenberg
No abstract text is available yet for this article.
March 2022: CJEM
J Gert van Dijk, Ineke A van Rossum, Roland D Thijs
The pathophysiology of vasovagal syncope (VVS) is reviewed, focusing on hemodynamic aspects. Much more is known about orthostatic than about emotional VVS, probably because the former can be studied using a tilt table test (TTT). Recent advances made it possible to quantify the relative contributions of the three factors that control blood pressure: heart rate (HR), stroke volume (SV) and total peripheral resistance (TPR). Orthostatic VVS starts with venous pooling, reflected in a decrease of SV. This is followed by cardioinhibition (CI), which is a decrease of HR that accelerates the ongoing decrease of BP, making the start of CI a literal as well as fundamental turning point...
December 2021: Autonomic Neuroscience: Basic & Clinical
Megan Brenkel, Alexandre Coutin, Shahbaz Syed, Kari Sampsel
No abstract text is available yet for this article.
November 2021: CJEM
Richard Hoang, Kari Sampsel, Andrew Willmore, Katerina Yelle Labre, Venkatesh Thiruganasambandamoorthy, Lisa A Calder
BACKGROUND: The emergency department (ED) is an at-risk area for medical error. We determined the characteristics of patients with unanticipated and anticipated death within 7 days of ED discharge and whether medical error contributed. METHODS: We performed a single-centre health records review of 200 consecutive cases during a 3-year period from 2014 to 2017 in two urban, academic, tertiary care EDs. We included patients evaluated by an emergency physician who were discharged and died within 7 days...
November 2021: CJEM
Sara Manti, Amelia Licari, Salvatore Leonardi, Gian Luigi Marseglia
BACKGROUND: Asthma exacerbations in children is one of the most common medical conditions requiring urgent visits to primary healthcare providers or emergency departments, and even hospitalisations. Currently, there is significant variation in the management of asthma exacerbations expressed in guideline recommendations versus clinical practice. This disconnect affects diagnostic and treatment decisions for the clinician and patient. OBJECTIVE: We systematically reviewed the available guidelines providing recommendations for diagnostic and therapeutic management of asthma exacerbations in the paediatric population...
September 30, 2021: European Respiratory Review: An Official Journal of the European Respiratory Society
Aaron M Yengo-Kahn, Natalie Hibshman, Michael Bezzerides, Michael J Feldman, Adam A Vukovic, Nishit Mummareddy, Shilin Zhao, Cody H Penrod, Christopher M Bonfield, E Haley Vance
INTRODUCTION: Many children are discharged from the pediatric emergency department (PED) with incomplete or inappropriate instructions following a concussion. Our objective was to evaluate the effectiveness of a simple intervention in improving discharge instruction disbursement and completeness following PED diagnosis of concussion. METHODS: A pre/post intervention study of 935 patients (375 preintervention and 560 postintervention) ages 5-19, diagnosed with a concussion and discharged from the PED between July 2016 and November 2019, was performed at a single United States pediatric tertiary-care center...
2021: Pediatric Quality & Safety
Valeska Hofmann, Christian Deininger, Stefan Döbele, Christian Konrads, Florian Wichlas
Fall-related hospitalizations among older adults have been increasing in recent decades. One of the most common reasons for this is minimal or mild traumatic brain injury (mTBI) in older individuals taking anticoagulant medication. In this study, we analyzed all inpatient stays from January 2017 to December 2019 of patients aged > 75 years with a mTBI on anticoagulant therapy who received at least two cranial computer tomography (cCT) scans. Of 1477 inpatient stays, 39 had primary cranial bleeding, and in 1438 the results of initial scans were negative for cranial bleeding...
August 25, 2021: Journal of Clinical Medicine
Ian G Stiell, Kerstin de Wit, Frank X Scheuermeyer, Alain Vadeboncoeur, Paul Angaran, Debra Eagles, Ian D Graham, Clare L Atzema, Patrick M Archambault, Troy Tebbenham, Andrew D McRae, Warren J Cheung, Ratika Parkash, Marc W Deyell, Geneviève Baril, Rick Mann, Rupinder Sahsi, Suneel Upadhye, Erica Brown, Jennifer Brinkhurst, Christian Chabot, Allan Skanes
No abstract text is available yet for this article.
September 2021: CJEM
Graeme J Hankey
The introduction and evolution of evidence-based stroke medicine has realized major advances in our knowledge about stroke, methods of medical research, and patient outcomes that continue to complement traditional individual patient care. It is humbling to recall the state of knowledge and scientific endeavour of our forebears who were unaware of what we know now and yet pursued the highest standards for evaluating and delivering effective stroke care. The science of stroke medicine has evolved from pathophysiological theory to empirical testing...
2021: Cerebrovascular Diseases
2021-08-06 14:03:11
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