The American journal of emergency medicine
-
The link between minor troponin (cardiac troponin I [cTnI]) elevations and atrial fibrillation (AF) is still debated. ⋯ In patients with acute AF, minor cTnI elevations link to short-term adverse events. Known ischemic vascular disease and older age showed prognostic value only in the long term.
-
The purpose was to determine the proportion of alcohol-positive (AlcPos) trauma patients in different age groups and any association with mortality using the National Trauma Data Bank. ⋯ Trauma patients of all ages may be AlcPos. Being AlcPos is a marker for greater injury in all age groups. After controlling for ISSs, trauma patients 40 years and older who were AlcPos have increased mortality. This study suggests a role for alcohol testing in all age groups.
-
Myeloperoxidase (MPO) and C-reactive protein (CRP) are markers of inflammation and elevated levels have been found in patients with acute coronary syndrome (ACS) unrelated to cocaine. We evaluated the utility of MPO and CRP for diagnosis of ACS and the prediction of 30-day adverse cardiovascular events in patients with cocaine-related chest pain. ⋯ Myeloperoxidase and CRP are not useful for diagnosis or prognosis of patients with cocaine-associated chest pain.
-
Spontaneous urine extravasation from the pelvicalyceal system into the perinephric space is an uncommon condition. It is most commonly seen in the setting of obstructive ureteric calculus. Other rare causes include neoplasms, trauma, and iatrogenic procedures. ⋯ We present a short series of 3 cases of spontaneous pelvis rupture, each with a different etiology. Diagnosis was confirmed by computed tomography. The follow-up and therapeutic approaches are discussed with a short review of literature.
-
Snorting or smoking heroin is a known trigger of acute asthma exacerbation. Heroin abuse may be a risk factor for more severe asthma exacerbations and intubation. Heroin and other opioids provoke pulmonary bronchoconstriction. Naloxone may play a role in decreasing opioid-induced bronchospasm. There are no known clinical cases describing the effect of naloxone on opioid-induced bronchospasm. ⋯ Naloxone may play a role in reducing acute opioid-induced bronchoconstriction, either alone or in combination with albuterol. Future controlled studies should be conducted to determine if the addition of naloxone to standard treatment improves bronchospasm without causing adverse effects.