The American journal of emergency medicine
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Observational Study
Development and validation of a model for predicting 18-month mortality in type 2 myocardial infarction.
Despite the poor prognosis in patients with type 2 myocardial infarction (MI), no prospective data on risk stratification exists. The aim of this study was to develop and validate a model for prediction of 18-month mortality of among patients with type 2 MI (T2MI) and compare its performance with GRACE and TARRACO scores. ⋯ The risk of mortality among T2MI patients could be accurately predicted by using common clinical characteristics and laboratory tests. Further studies are required with external validation of nomogram prior to clinical implementation.
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To determine HIV testing trends during emergency department (ED) visits among those with and without substance use disorder (SUD) and examine factors associated with test receipt. ⋯ HIV testing in the ED was rare, but slightly more common in individuals with SUD. Efforts to increase ED HIV testing among people with SUD are needed.
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The pediatric population accounts for a small portion of those with severe disease related to COVID-19. There are few published reports of hypercoagulable states in children with COVID-19. ⋯ He returned to the emergency department with vomiting, tachypnea and was found to have a pulmonary embolism. In this case report, we discuss the risk factors for, presentation and evaluation of hypercoagulable state and its relation to COVID-19 in a pediatric patient.
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Case Reports
Spontaneous subperiosteal orbital hematoma in a patient with chronic sinusitis: A case report.
Periorbital swelling is a common presentation to the emergency department (ED), and its etiology can range from benign to acutely vision-threatening. Orbital subperiosteal hematoma is a rare ED diagnosis that is typically associated with trauma, though can infrequently occur spontaneously in the setting of sudden elevations in cranial venous pressure, bleeding diathesis, and sinusitis. We present a case of a 55-year-old female with a history of chronic sinusitis who presented to the ED with a three-day history of left-sided periorbital swelling along with painful extraocular movements and markedly decreased visual acuity following a cross-country road trip through elevation. ⋯ Intravenous antibiotics were started immediately and the patient underwent surgical incision and drainage of the subperiosteal space, where she was diagnosed with a spontaneous subperiosteal orbital hematoma secondary to chronic sinusitis. Within the literature, there are fewer than 20 case reports of orbital subperiosteal hematoma secondary to sinusitis. The purpose of this case report is to assist emergency physicians in considering the rare but potentially vision-threatening condition of spontaneous subperiosteal orbital hematoma within their differential diagnosis of patients with periorbital swelling and proptosis, as well as to provide an approach to management within the ED.