The American journal of emergency medicine
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Coronavirus disease 2019 (COVID-19) is a rapidly escalating pandemic that has spread to many parts of the world. As such, there is urgent need to identify predictors of clinical severity in COVID-19 patients. This may be useful for early identification of patients who may require life-saving interventions. In this meta-analysis, we evaluated whether malignancies are associated with a significantly enhanced odds of COVID-19 severity and mortality. ⋯ Malignancies were significantly associated with a 2-fold increase in the odds of developing severe COVID-19 disease, as well as mortality. Larger studies are needed to corroborate these findings. These patients should be closely monitored for any signs of unfavorable disease progression.
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Ketamine is a versatile analgesic that has become an increasingly popular recreational drug. Chronic ketamine use has been found to cause biliary duct damage and bladder dysfunction. ⋯ We report a case of a teenage patient with the rare simultaneous presentation of ketamine-induced cholangiopathy and ulcerative cystitis. Due to increased recreational and chronic ketamine use, cases of ketamine-induced cholangiopathy and ulcerative cystitis are likely to rise with the increased knowledge, awareness, and reporting of these entities by radiologists and emergency physicians.
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SARS-CoV-2 (COVID-19) infection is frequently associated with thromboembolic complications. In this case report, we describe the diagnosis and management of priapism as a thromboembolic complication of severe COVID-19.
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Letter Multicenter Study
Community-based study of cannabis hyperemesis syndrome.
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Screening for acute myocardial infarction (AMI) in patients with ventricular pacemakers (VP) is a diagnostic challenge. We report a case where application of the Modified Sgarbossa criteria (mSC) would have immediately identified AMI in a patient with a VP and merited strong advocacy for emergent cardiac catheterization. A 94-year-old male with VP presented to the emergency department (ED) after he had burning sensation in his chest. ⋯ This case report highlighted the benefits of applying mSC to patients with VP, which to authors knowledge remains unvalidated. A significant benefit of mSC is that they are unweighted, thus any positive criteria is suggestive of AMI. While the first EKG yielded an oSC score <3, applying the unweighted mSC to the EKG revealed ≤-0.25 ST/S ratio discordant changes in leads III, aVF, I and aVL would have merited strong advocacy for emergent cardiac catherization.