The American journal of emergency medicine
-
Case Reports
Susceptibility-weighted imaging in patient with consciousness disturbance after traffic accident.
Both diffuse axonal injury (DAI) and fat embolism syndrome could be the cause of altered consciousness in patients who suffered from traffic accident. In some situations, distinguishing DAI from fat embolism syndrome may be difficult because routine brain imaging could not detect the lesions. ⋯ However, cerebral and cerebellar white matter and splenium of corpus callosum are the areas most vulnerable to cerebral fat embolism. In additional to history, clinical manifestation, and prognosis, evaluating the distribution of hypointense lesions in susceptibility-weighted imaging could be useful to differentiate these 2 conditions.
-
Anaphylaxis is a life-threatening reaction treated primarily with epinephrine. Methylene blue, a competitive inhibitor of guanylate cyclase, interferes with the vasodilatory actions of nitric oxide. It has recently been proposed by the Joint Taskforce on Practice Parameters as an alternative treatment for anaphylaxis with hypotension that is not responsive to classical therapy. ⋯ After infusion of methylene blue, symptom resolution occurred almost immediately, and intubation was spared. Side effects were minimal. We propose methylene blue as a safe treatment option for refractory anaphylaxis, whether with or without hypotension.
-
Therapeutic hypothermia is now regarded as the only effective treatment of global ischemic injury after cardiac arrest. Numerous studies of the neuroprotective effects of 17β-estradiol have yielded conflicting results depending on administration route and dose. Herein, we investigated the neuroprotective effect of postischemic 17β-estradiol administration combined with therapeutic hypothermia. ⋯ Postischemic administration of low-dose 17β-estradiol appears to be neuroprotective after transient global ischemia, and its effect is potentiated by therapeutic hypothermia.
-
Multicenter Study
Gender differences in emergency stroke care and hospital outcome in acute ischemic stroke: a multicenter observational study.
We aimed to investigate the effect of gender difference on the accessibility to emergency care, hospital mortality and disability in acute stroke care. ⋯ The adjusted model for risk factors showed no significant difference on hospital mortality and disability between the 2 genders for stroke patients.