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December 09, 2013McConnell`s sign is an echocardiographic finding in patients with acute pulmonary embolism, demonstrating right ventricular free wall hypokinesis with normal apical contractility.
McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol. 1996 Aug 15;78(4):469-73.
December 08, 2013Ultrasonography of the optic nerve sheath diameter is an easy way to detect increased intracranial pressure (ICP). A pooled study of 231 patients showed that ultrasound had a sensitivity of 90% and specificity of 85% for increased ICP with a positive test associated with a 51-fold higher risk of intracranial hypertension.
Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011 Jul;37(7):1059-68.
December 07, 2013Rivaroxaban is the first orally active direct factor Xa inhibitor approved as an alternative to warfarin for stroke prophylaxis in nonvalvular atrial fibrillation. Rivaroxaban is 95% protein-bound and cannot be dialyzed. Reversal agents like activated prothrombin complex concentrates and recombinant factor VII are still being investigated.
Pollack CV, Jr. New Oral Anticoagulants in the ED Setting: A Review. Am J Emerg Med. 2012 Nov;30(9):2046-54.
December 06, 2013All pediatric patients with accidental sulfonylurea exposure should be admitted for observation. The observation time for asymptomatic, euglycemic children should be at least 18 hours, including an overnight fast.
Levine M, et al. Hypoglycemia After Accidental Pediatric Sulfonylurea Ingestions.Pediatric Emergency Care. 2011;27(9):846–849. Lung DD, Olsen KR. Hypoglycemia in Pediatric Sulfonylurea Poisoning: An 8-Year Poison Center retrospective Study. Pediatrics. 2011;127:e1558-e1564.
December 05, 2013Guillain-Barré syndrome is characterized by progressive weakness, tingling in the extremities, and absence of reflexes. Respiratory failure is common with up to 30% of patients requiring mechanical ventilation during their illness.
Hughes RA, et al. Supportive care for patients with Guillain-Barré syndrome. Arch Neurol. 2005;62(8):1194.
December 04, 2013The updated 2012 Surviving Sepsis Campaign fluid resuscitation goals specify a central venous pressure of 8-12 mmHg, central venous oxygen saturation >70% (or mixed venous oxygen saturation >65%), mean arterial pressure >65 mmHg, and urine output of at least 0.5 mL/kg/hr.
Dellinger RP, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Crit Care Med. 2013;41(2):580.
December 03, 2013Patients treated for acute pulmonary embolism are four times as likely to die of recurrent thromboembolism in the next year as patients treated for deep venous thrombosis.
Victor F. Tapson, M.D. Acute Pulmonary Embolism. N Engl J Med 2008; 358:1037-1052
December 02, 2013Meta-analysis of 13 controlled, contrast medium-induced nephropathy studies representing almost 26,000 patients failed to demonstrate any difference in the incidence of acute kidney injury, dialysis and death between patients receiving contrast medium and the control group
McDonald, J. S., McDonald, R. J., Comin, J., Williamson, E. E., Katzberg, R. W., Murad, H. M., & Kalimes, D. F. (2013). Frequency of acute Kidney injury Following intravenous contrast Medium administration: A Systematic Review and Meta-Analysis. Radiology, 267(1), 119–128.
December 01, 2013Multi-slice spiral CT (MSCT) can provide useful information for predicting hyovolemic shock in severe multiple-injury patients. An IVC flatness index > 3.02 suggests the presence of hypovolemic shock in severe multiple-injury patients.
Yang Li, MD, et al. The Flatness Index of Inferior Vena Cava is Useful in Predicting Hypovolemic Shock in Severe Multiple-Injury Patients. The Journal of emergency medicine. 12 August 2013.