Investigation of complications secondary to chest compressions before and after the 2010 cardiopulmonary resuscitation guideline changes by using multi-detector computed tomography: a retrospective study

The purpose of this study was to identify the relationship between the deeper and faster chest compressions suggested by the 2010 cardiopulmonary resuscitation guidelines and complications arising from chest c...

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Geriatric Syncope and Cardiovascular Risk in the Emergency Department

Publication date: Available online 26 January 2017
Source:The Journal of Emergency Medicine
Author(s): Nissa J. Ali, Shamai A. Grossman
BackgroundSyncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow.ObjectiveThis article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk.DiscussionAlthough syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern. History, physical examination, and electrocardiography (ECG) have the greatest utility in evaluating syncope. Additional testing should be guided by history and physical examination. There are multiple scoring tools developed to aid in management and these are reviewed in the article. Common predictors that would indicate a need for further work-up include a history of cardiac or valvular disease (i.e., ventricular dysrhythmia, congestive heart failure), abnormal ECG, anemia or severe volume depletion (i.e., from a gastrointestinal bleed), syncope while supine or with effort, report of palpitations or chest pain, persistent abnormal vital signs, or family history of sudden death. With advancing age, cardiovascular morbidity plays a more frequent and important role in the etiology of syncope.ConclusionsThe syncope work-up should be tailored to the patient's presentation. Disposition should be based on the results of the initial evaluation and risk factors for adverse outcomes.



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Anatomic Relationship and Imaging Relevance of the Perforating Branches of the Peroneal Vessels to the Anterior Talofibular Ligament

Publication date: Available online 26 January 2017
Source:The Journal of Emergency Medicine
Author(s): Yara Younan, Matthew Uriell, Walter Carpenter, Monica Umpierrez, Aparna Kakarala, Jean Jose, Douglas D. Robertson, Ty K. Subhawong, Adam Daniel Singer
BackgroundPatients frequently present to the emergency department after ankle injuries, and the anterior talofibular ligament (ATFL) is commonly damaged. Musculoskeletal ultrasound (US) can help to make a rapid diagnosis. There is a paucity of literature describing techniques to image the ATFL with US, and the complex ankle anatomy and potential pitfalls make imaging challenging.ObjectiveOur aim was to estimate prevalence of perforating branches (PBs) of the peroneal vessels and determine their most frequent position relative to the ATFL. If these vessels are located in a predictable position at the level of the ATFL, they may serve as a sonographic landmark for the correct imaging plane.MethodsMagnetic resonance imaging (MRI) scans of 105 ankles were reviewed to determine the PB prevalence and location at the ATFL. Inter-observer agreement was determined. Additionally, 16 ankles from 8 asymptomatic subjects were scanned using a high-frequency linear transducer and PB prevalence and location were noted.ResultsBy MRI, PBs were detected in 85% of the ankles and 93% of ankles after consensus. In 73% of cases with agreed PB visualization, vessels assumed a medial position with respect to the ATFL. By US, PBs could be seen in 100% of cases, with the arterial PB seen in 81% of cases and assuming a medial position in 88%.ConclusionsPBs are often present, have a predictable course, and may be useful to help optimize US probe positioning when assessing the ATFL.



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Potential diagnostic biomarkers for chronic kidney disease of unknown etiology (CKDu) in Sri Lanka: A pilot study

BMC Nephrology

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Sleepiness and activity in heart failure patients with reduced ejection fraction and central sleep-disordered breathing

Sleep Medicine

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Physical trauma recorded in primary care is associated with the onset of psoriatic arthritis among patients with psoriasis

Annals of Rheumatic Diseases

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Supplemental parenteral nutrition in intensive care patients: A cost saving strategy

Clinical Nutrition

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