The American journal of emergency medicine
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Case Reports
Isolated superior mesenteric artery dissection in the emergency department: A rare cause of abdominal pain.
Acute onset abdominal pain constitutes a significant proportion of emergency department visits, but only a small fraction of these cases are attributable to vascular pathologies (Bauersfeld, 1947 [1]). In this case, report, we present an incidental diagnosis of Spontaneous Isolated Superior Mesenteric Artery Dissection (SISMAD). A 69-year-old man was admitted to the emergency department complaining of fever, loss of appetite, vague epigastric pain, dysuria, and a productive cough for several days. ⋯ A contrast-enhanced computerized tomography angiography of the thorax and abdomen was performed to detect pulmonary embolism and the etiology of the abdominal pain. No pulmonary embolism was found; however, multiple metastatic nodules were identified in both lungs, as well as infiltration on the posterobasal field of the right lung, metastases on the liver, focal dilatation, and an intimal flap on the middle-distal part of the superior mesenteric artery (SMA) at 2 cm, with a segment that was compatible with isolated dissection. There was a contrast passage on the distal part of SMA, and no sign of bowel ischemia.
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Thyroid storm is a rare complication with an estimated incidence ranging from 0.61 to 0.76 cases per 100,000 people. Common causes include intrinsic hyperthyroidism, such as in Grave's disease, infection, surgery, severe emotional stress, and acute trauma to the thyroid gland. ⋯ Here, we report a case of a 46-year-old male who presented with a possible food impaction for the past 48 h. The patient developed extreme hypertension, tachycardia, and diaphoresis immediately following rapid sequence intubation (RSI), which, after further work-up, was due to thyroid storm.
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Observational Study
Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management.
The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA. ⋯ There is no significant correlation between rSO2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area.
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Observational Study
Heart failure education in the emergency department markedly reduces readmissions in un- and under-insured patients.
Heart failure (HF) readmissions are a longstanding national healthcare issue for both hospitals and patients. Our purpose was to evaluate the efficacy of a structured, educational intervention targeted towards un- and under-insured emergency department (ED) HF patients. ⋯ An ED educational intervention markedly decreases ED and hospital readmissions in un- and under-insured HF patients.
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Letter Randomized Controlled Trial
Impact of a CPRMeter feedback device on chest compression quality performer by nurses: A randomized crossover study.