The American journal of emergency medicine
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Prehospital delay is the most critical factor to prognosis of ST-elevation myocardial infarction (STEMI). Few study had examined a series of predictors of prehospital delay by multivariate analysis of sociodemographic and clinical characteristics, onset features, and symptom condition of STEMI in China. ⋯ Multivariate analysis results found that symptom onset-related variables strongly influenced PDT. Onset-related status of STEMI needed to be combined into interventions of participants, and more emergency education should be recommended to both participants and their relatives. Most importantly, more efforts should be taken to educate the public about the symptoms and signs to increase the recognition of STEMI.
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Despite a relatively high frequency of appendix nonvisualization when using ultrasound to diagnose appendicitis, many studies either fail to report these results or inconsistently analyze outcomes. ⋯ We suggest reporting ultrasound results using a 3 × 2 table (including nonvisualized findings) but using the traditional 2 × 2 type of analysis for test characteristic calculations. This approach allows for the determination of diagnostic yield and calculation of likelihood ratios when the appendix is not visualized. This approach to reporting should be considered for all types of diagnostic ultrasound studies.
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An 80-year-old woman presented to the emergency department with failure to thrive and weakness for 14 days. Medical history was significant for polio. On admission her electrocardiogram showed atrial flutter, and cardiac enzymes were elevated. ⋯ She underwent hernia repair. After surgery, the patient was taken off rate control and monitored for 72 hours; she did not have any episode of atrial flutter and was discharged with follow up in a week showing no arrhythmia. Her flutter was caused directly by the mechanical effect of the large hiatal hernia pressing against her heart, as the flutter resolved after the operation.
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It is rare to see a concurrent infection with infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus in Tianjin, China. Until now, there is still no any single recorded case of concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.
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Ventricular parasystole has been known to be a benign rhythm. We present a case of a 53-year-old man with chest pain and ventricular parasystole on electrocardiogram upon initial presentation. ⋯ We highlight this case, as ventricular parasystole has been shown to be associated with cardiovascular disease and is a rhythm that should not be ignored. Our review of the literature shows that a thorough cardiovascular investigation should take place when this rhythm is identified.