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Publisher: Hindawi   (Total: 269 journals)

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Showing 1 - 200 of 269 Journals sorted alphabetically
Abstract and Applied Analysis     Open Access   (Followers: 3, SJR: 0.512, h-index: 32)
Active and Passive Electronic Components     Open Access   (Followers: 7, SJR: 0.157, h-index: 15)
Advances in Acoustics and Vibration     Open Access   (Followers: 29, SJR: 0.259, h-index: 6)
Advances in Agriculture     Open Access   (Followers: 7)
Advances in Artificial Intelligence     Open Access   (Followers: 16)
Advances in Astronomy     Open Access   (Followers: 38, SJR: 0.351, h-index: 17)
Advances in Bioinformatics     Open Access   (Followers: 20, SJR: 0.421, h-index: 8)
Advances in Chemistry     Open Access   (Followers: 15)
Advances in Civil Engineering     Open Access   (Followers: 36, SJR: 0.338, h-index: 8)
Advances in Condensed Matter Physics     Open Access   (Followers: 8, SJR: 0.248, h-index: 10)
Advances in Decision Sciences     Open Access   (Followers: 5, SJR: 0.231, h-index: 6)
Advances in Fuzzy Systems     Open Access   (Followers: 5, SJR: 0.258, h-index: 7)
Advances in Hematology     Open Access   (Followers: 10, SJR: 0.892, h-index: 18)
Advances in High Energy Physics     Open Access   (Followers: 19, SJR: 0.892, h-index: 19)
Advances in Human-Computer Interaction     Open Access   (Followers: 21, SJR: 0.439, h-index: 9)
Advances in Materials Science and Engineering     Open Access   (Followers: 32, SJR: 0.263, h-index: 11)
Advances in Mathematical Physics     Open Access   (Followers: 5, SJR: 0.332, h-index: 10)
Advances in Medicine     Open Access   (Followers: 2)
Advances in Meteorology     Open Access   (Followers: 18, SJR: 0.498, h-index: 10)
Advances in Multimedia     Open Access   (Followers: 2, SJR: 0.191, h-index: 10)
Advances in Nonlinear Optics     Open Access   (Followers: 6)
Advances in Numerical Analysis     Open Access   (Followers: 4)
Advances in Operations Research     Open Access   (Followers: 11, SJR: 0.343, h-index: 7)
Advances in Optical Technologies     Open Access   (Followers: 3, SJR: 0.283, h-index: 16)
Advances in OptoElectronics     Open Access   (Followers: 5, SJR: 0.973, h-index: 16)
Advances in Orthopedics     Open Access   (Followers: 9)
Advances in Pharmacological Sciences     Open Access   (Followers: 7, SJR: 0.695, h-index: 13)
Advances in Physical Chemistry     Open Access   (Followers: 10, SJR: 0.297, h-index: 7)
Advances in Power Electronics     Open Access   (Followers: 28, SJR: 0.26, h-index: 6)
Advances in Preventive Medicine     Open Access   (Followers: 6)
Advances in Public Health     Open Access   (Followers: 23)
Advances in Tribology     Open Access   (Followers: 10, SJR: 0.267, h-index: 6)
Advances in Urology     Open Access   (Followers: 11, SJR: 0.629, h-index: 16)
Advances in Virology     Open Access   (Followers: 7, SJR: 1.04, h-index: 12)
AIDS Research and Treatment     Open Access   (Followers: 3, SJR: 1.125, h-index: 14)
Analytical Cellular Pathology     Open Access   (Followers: 2, SJR: 0.334, h-index: 12)
Anatomy Research Intl.     Open Access   (Followers: 2)
Anemia     Open Access   (Followers: 4, SJR: 0.991, h-index: 11)
Anesthesiology Research and Practice     Open Access   (Followers: 12, SJR: 0.513, h-index: 12)
Applied and Environmental Soil Science     Open Access   (Followers: 17, SJR: 0.53, h-index: 9)
Applied Bionics and Biomechanics     Open Access   (Followers: 8, SJR: 0.23, h-index: 13)
Applied Computational Intelligence and Soft Computing     Open Access   (Followers: 12)
Archaea     Open Access   (Followers: 3, SJR: 1.248, h-index: 27)
Arthritis     Open Access   (Followers: 4)
Autism Research and Treatment     Open Access   (Followers: 28)
Autoimmune Diseases     Open Access   (Followers: 3, SJR: 0.909, h-index: 17)
Behavioural Neurology     Open Access   (Followers: 7, SJR: 0.696, h-index: 34)
Biochemistry Research Intl.     Open Access   (Followers: 6, SJR: 1.085, h-index: 17)
Bioinorganic Chemistry and Applications     Open Access   (Followers: 9, SJR: 0.286, h-index: 19)
BioMed Research Intl.     Open Access   (Followers: 6, SJR: 0.725, h-index: 59)
Biotechnology Research Intl.     Open Access   (Followers: 2)
Bone Marrow Research     Open Access   (Followers: 2)
Canadian J. of Gastroenterology & Hepatology     Open Access   (Followers: 4, SJR: 0.856, h-index: 53)
Canadian J. of Infectious Diseases and Medical Microbiology     Open Access   (Followers: 5, SJR: 0.409, h-index: 25)
Canadian Respiratory J.     Open Access   (Followers: 1, SJR: 0.503, h-index: 42)
Cardiology Research and Practice     Open Access   (Followers: 8, SJR: 0.941, h-index: 17)
Case Reports in Anesthesiology     Open Access   (Followers: 10)
Case Reports in Cardiology     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 9)
Case Reports in Dentistry     Open Access   (Followers: 5)
Case Reports in Dermatological Medicine     Open Access   (Followers: 2)
Case Reports in Emergency Medicine     Open Access   (Followers: 15)
Case Reports in Endocrinology     Open Access   (SJR: 0.326, h-index: 1)
Case Reports in Gastrointestinal Medicine     Open Access   (Followers: 3)
Case Reports in Genetics     Open Access   (Followers: 1)
Case Reports in Hematology     Open Access   (Followers: 5)
Case Reports in Hepatology     Open Access   (Followers: 1)
Case Reports in Immunology     Open Access   (Followers: 4)
Case Reports in Infectious Diseases     Open Access   (Followers: 6)
Case Reports in Medicine     Open Access   (Followers: 3)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Neurological Medicine     Open Access   (Followers: 1)
Case Reports in Obstetrics and Gynecology     Open Access   (Followers: 11)
Case Reports in Oncological Medicine     Open Access   (Followers: 2)
Case Reports in Ophthalmological Medicine     Open Access   (Followers: 4)
Case Reports in Orthopedics     Open Access   (Followers: 7)
Case Reports in Otolaryngology     Open Access   (Followers: 6)
Case Reports in Pathology     Open Access   (Followers: 5)
Case Reports in Pediatrics     Open Access   (Followers: 6)
Case Reports in Psychiatry     Open Access   (Followers: 12)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Case Reports in Radiology     Open Access   (Followers: 9)
Case Reports in Rheumatology     Open Access   (Followers: 5)
Case Reports in Surgery     Open Access   (Followers: 10)
Case Reports in Transplantation     Open Access  
Case Reports in Urology     Open Access   (Followers: 9)
Case Reports in Vascular Medicine     Open Access  
Case Reports in Veterinary Medicine     Open Access   (Followers: 6)
Child Development Research     Open Access   (Followers: 16)
Chinese J. of Engineering     Open Access   (Followers: 2)
Chinese J. of Mathematics     Open Access  
Cholesterol     Open Access   (Followers: 1, SJR: 0.906, h-index: 12)
Complexity     Hybrid Journal   (Followers: 6, SJR: 0.526, h-index: 27)
Computational and Mathematical Methods in Medicine     Open Access   (Followers: 2, SJR: 0.415, h-index: 22)
Computational Intelligence and Neuroscience     Open Access   (Followers: 10, SJR: 0.232, h-index: 30)
Contrast Media & Molecular Imaging     Open Access   (Followers: 3, SJR: 0.932, h-index: 34)
Critical Care Research and Practice     Open Access   (Followers: 10, SJR: 0.916, h-index: 14)
Current Gerontology and Geriatrics Research     Open Access   (Followers: 9, SJR: 0.8, h-index: 12)
Depression Research and Treatment     Open Access   (Followers: 14, SJR: 0.77, h-index: 11)
Dermatology Research and Practice     Open Access   (Followers: 3, SJR: 0.576, h-index: 15)
Diagnostic and Therapeutic Endoscopy     Open Access   (SJR: 0.651, h-index: 18)
Discrete Dynamics in Nature and Society     Open Access   (Followers: 5, SJR: 0.323, h-index: 24)
Disease Markers     Open Access   (Followers: 1, SJR: 0.774, h-index: 49)
Education Research Intl.     Open Access   (Followers: 21)
Emergency Medicine Intl.     Open Access   (Followers: 7)
Enzyme Research     Open Access   (Followers: 4, SJR: 0.457, h-index: 18)
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 20, SJR: 0.615, h-index: 50)
Experimental Diabetes Research     Open Access   (Followers: 13, SJR: 1.591, h-index: 30)
Gastroenterology Research and Practice     Open Access   (Followers: 3, SJR: 0.664, h-index: 21)
Genetics Research Intl.     Open Access   (Followers: 1)
Geofluids     Open Access   (Followers: 4, SJR: 0.693, h-index: 38)
HPB Surgery     Open Access   (Followers: 5, SJR: 0.798, h-index: 22)
Infectious Diseases in Obstetrics and Gynecology     Open Access   (Followers: 7, SJR: 0.976, h-index: 34)
Interdisciplinary Perspectives on Infectious Diseases     Open Access   (Followers: 2, SJR: 0.763, h-index: 15)
Intl. J. of Aerospace Engineering     Open Access   (Followers: 68, SJR: 0.241, h-index: 6)
Intl. J. of Agronomy     Open Access   (Followers: 8, SJR: 0.223, h-index: 2)
Intl. J. of Alzheimer's Disease     Open Access   (Followers: 12, SJR: 1.193, h-index: 25)
Intl. J. of Analysis     Open Access  
Intl. J. of Analytical Chemistry     Open Access   (Followers: 22, SJR: 0.157, h-index: 2)
Intl. J. of Antennas and Propagation     Open Access   (Followers: 11, SJR: 0.385, h-index: 15)
Intl. J. of Biodiversity     Open Access   (Followers: 4)
Intl. J. of Biomaterials     Open Access   (Followers: 5, SJR: 0.485, h-index: 10)
Intl. J. of Biomedical Imaging     Open Access   (Followers: 4, SJR: 0.581, h-index: 23)
Intl. J. of Breast Cancer     Open Access   (Followers: 13)
Intl. J. of Cell Biology     Open Access   (Followers: 4, SJR: 2.658, h-index: 25)
Intl. J. of Chemical Engineering     Open Access   (Followers: 7, SJR: 0.361, h-index: 10)
Intl. J. of Chronic Diseases     Open Access   (Followers: 1)
Intl. J. of Computer Games Technology     Open Access   (Followers: 11, SJR: 0.213, h-index: 12)
Intl. J. of Corrosion     Open Access   (Followers: 11, SJR: 0.19, h-index: 7)
Intl. J. of Dentistry     Open Access   (Followers: 6, SJR: 0.558, h-index: 11)
Intl. J. of Differential Equations     Open Access   (Followers: 8, SJR: 0.363, h-index: 11)
Intl. J. of Digital Multimedia Broadcasting     Open Access   (Followers: 5, SJR: 0.144, h-index: 10)
Intl. J. of Electrochemistry     Open Access   (Followers: 8)
Intl. J. of Endocrinology     Open Access   (Followers: 3, SJR: 0.961, h-index: 24)
Intl. J. of Engineering Mathematics     Open Access   (Followers: 3)
Intl. J. of Food Science     Open Access   (Followers: 3)
Intl. J. of Forestry Research     Open Access   (Followers: 4)
Intl. J. of Genomics     Open Access   (Followers: 2, SJR: 0.721, h-index: 7)
Intl. J. of Hepatology     Open Access   (Followers: 3)
Intl. J. of Hypertension     Open Access   (Followers: 7, SJR: 0.823, h-index: 20)
Intl. J. of Inflammation     Open Access   (SJR: 0.876, h-index: 14)
Intl. J. of Mathematics and Mathematical Sciences     Open Access   (Followers: 3, SJR: 0.346, h-index: 27)
Intl. J. of Medicinal Chemistry     Open Access   (Followers: 6)
Intl. J. of Microbiology     Open Access   (Followers: 5, SJR: 1.006, h-index: 18)
Intl. J. of Navigation and Observation     Open Access   (Followers: 20, SJR: 0.411, h-index: 7)
Intl. J. of Nephrology     Open Access   (Followers: 2, SJR: 0.926, h-index: 14)
Intl. J. of Optics     Open Access   (Followers: 7, SJR: 0.262, h-index: 7)
Intl. J. of Otolaryngology     Open Access   (Followers: 3)
Intl. J. of Pediatrics     Open Access   (Followers: 5)
Intl. J. of Peptides     Open Access   (Followers: 4, SJR: 0.73, h-index: 16)
Intl. J. of Photoenergy     Open Access   (Followers: 2, SJR: 0.348, h-index: 28)
Intl. J. of Plant Genomics     Open Access   (Followers: 4, SJR: 1.578, h-index: 20)
Intl. J. of Polymer Science     Open Access   (Followers: 24, SJR: 0.265, h-index: 11)
Intl. J. of Population Research     Open Access   (Followers: 2)
Intl. J. of Reconfigurable Computing     Open Access   (SJR: 0.182, h-index: 8)
Intl. J. of Reproductive Medicine     Open Access   (Followers: 5)
Intl. J. of Rheumatology     Open Access   (Followers: 4, SJR: 1.015, h-index: 18)
Intl. J. of Rotating Machinery     Open Access   (Followers: 2, SJR: 0.402, h-index: 19)
Intl. J. of Spectroscopy     Open Access   (Followers: 8)
Intl. J. of Stochastic Analysis     Open Access   (Followers: 4, SJR: 0.234, h-index: 19)
Intl. J. of Surgical Oncology     Open Access   (Followers: 1, SJR: 0.753, h-index: 11)
Intl. J. of Telemedicine and Applications     Open Access   (Followers: 4, SJR: 0.757, h-index: 14)
Intl. J. of Vascular Medicine     Open Access   (SJR: 0.865, h-index: 16)
Intl. J. of Zoology     Open Access   (Followers: 2, SJR: 0.389, h-index: 8)
Intl. Scholarly Research Notices     Open Access   (Followers: 205)
ISRN Astronomy and Astrophysics     Open Access   (Followers: 7)
J. of Addiction     Open Access   (Followers: 12)
J. of Advanced Transportation     Hybrid Journal   (Followers: 12, SJR: 0.911, h-index: 24)
J. of Aging Research     Open Access   (Followers: 7, SJR: 1.259, h-index: 23)
J. of Analytical Methods in Chemistry     Open Access   (Followers: 1, SJR: 0.296, h-index: 13)
J. of Applied Chemistry     Open Access   (Followers: 4)
J. of Applied Mathematics     Open Access   (Followers: 2, SJR: 0.341, h-index: 22)
J. of Biomedical Education     Open Access   (Followers: 3)
J. of Blood Transfusion     Open Access   (Followers: 1)
J. of Botany     Open Access   (Followers: 3, SJR: 0.101, h-index: 2)
J. of Cancer Epidemiology     Open Access   (Followers: 7, SJR: 1.427, h-index: 12)
J. of Chemistry     Open Access   (Followers: 5, SJR: 0.225, h-index: 11)
J. of Combustion     Open Access   (Followers: 17, SJR: 0.27, h-index: 8)
J. of Complex Analysis     Open Access   (Followers: 3)
J. of Computer Networks and Communications     Open Access   (Followers: 5, SJR: 0.257, h-index: 8)
J. of Construction Engineering     Open Access   (Followers: 7)
J. of Control Science and Engineering     Open Access   (Followers: 1, SJR: 0.299, h-index: 9)
J. of Diabetes Research     Open Access   (Followers: 11, SJR: 1.024, h-index: 13)
J. of Drug Delivery     Open Access   (Followers: 8, SJR: 4.523, h-index: 2)
J. of Electrical and Computer Engineering     Open Access   (Followers: 9, SJR: 0.225, h-index: 10)
J. of Energy     Open Access   (Followers: 2)
J. of Engineering     Open Access  
J. of Environmental and Public Health     Open Access   (Followers: 17, SJR: 1.136, h-index: 16)
J. of Food Quality     Hybrid Journal   (Followers: 7, SJR: 0.497, h-index: 30)
J. of Function Spaces     Open Access   (SJR: 0.414, h-index: 10)
J. of Geological Research     Open Access   (Followers: 2)
J. of Healthcare Engineering     Open Access   (Followers: 3, SJR: 0.345, h-index: 10)
J. of Immunology Research     Open Access   (Followers: 10, SJR: 1.346, h-index: 41)
J. of Lipids     Open Access  
J. of Marine Biology     Open Access   (Followers: 16)
J. of Materials     Open Access  
J. of Mathematics     Open Access  
J. of Nanomaterials     Open Access   (Followers: 2, SJR: 0.383, h-index: 24)
J. of Nanoscience     Open Access  
J. of Nanotechnology     Open Access   (Followers: 7, SJR: 0.283, h-index: 9)

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Journal Cover Case Reports in Emergency Medicine
  [15 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 2090-648X - ISSN (Online) 2090-6498
   Published by Hindawi Homepage  [269 journals]
  • Delayed Presentation of Submucosal Retained Toothbrush from Self-Inflicted
           Injury in Patient with Schizophrenia

    • Abstract: Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.
      PubDate: Sun, 31 Dec 2017 07:58:38 +000
       
  • A Case of Status-Epilepticus-Associated Transient Hyperammonemia in the
           Emergency Department

    • Abstract: This report describes a case of transient hyperammonemia following tonic-clonic status epilepticus with an initial ammonia level of 537 Umol/L. This appears to be the highest transient ammonia level reported in the literature in this clinical scenario. This is an affirmation that an initial elevated ammonia level in the absence of hepatic dysfunction should be interpreted with caution when associated with status epilepticus. Repeat levels should be drawn to identify transient hyperammonemia and determine the need for treatment if levels do not decrease.
      PubDate: Sun, 24 Dec 2017 00:00:00 +000
       
  • Methicillin-Sensitive Staphylococcus aureus Suppurative Thyroiditis with
           Thyrotoxicosis

    • Abstract: Intravenous drug use (IVDU) can lead to numerous complications from skin abscesses to bacteremia to endocarditis. Here, we present a rare case of acute suppurative thyroiditis as a complication of IVDU, in which a 26-year-old female with a past medical history of IVDU presented to the emergency department for evaluation of a large right sided neck mass. On exam, she had signs of sepsis and thyrotoxicosis. Fine needle aspiration confirmed suppurative thyroiditis. Blood cultures and culture from fine needle aspiration grew Staphylococcus aureus. Patient was treated with 2 weeks of intravenous antibiotics with good resolution of her symptoms.
      PubDate: Tue, 19 Dec 2017 07:05:21 +000
       
  • Fatal Mesenteric Ischemia Induced by Synthetic Cannabinoids: A Case Report
           and Literature Review

    • Abstract: Worldwide use of synthetic cannabinoids (SCs) is rapidly increasing, in part due to the generation of numerous new compounds, sidestepping legal restrictions. Their detection using standard toxicology panels is difficult, due to their vast heterogeneity and lack of structural resemblance to cannabinoids. Sympathetic overactivity and arterial spasm play a role in some of the life-threatening reactions to SCs, such as coronary or cerebral vasoconstriction. Here we report a patient with repeated consumption of SCs that led to mesenteric ischemia and death. A 29-year-old man was frequently evaluated in the Emergency Medicine Department for recurrent transient crampy abdominal pain, associated with the use of the SCs colloquially known as “Mr. Nice Guy.” He was finally hospitalized with a protracted attack, associated with diarrhea and leukocytosis. Initial evaluation including computed tomography was unremarkable. Diarrhea and leukocytosis gradually resolved, but bouts of hypertension and abdominal pain occurred in association with repeated consumption of the SCs. On the fifth hospital day, the patient developed abrupt abdominal pain, associated with profound shock and signs of peritoneal irritation and succumbed within an hour. Postmortem CT scan was consistent with intestinal perforation most probably due to a nonobstructive mesenteric infarction. There was no evidence of a single vessel infarction.
      PubDate: Mon, 18 Dec 2017 00:00:00 +000
       
  • Endobronchial Foreign Body Presenting as Exacerbation of Asthma

    • Abstract: Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a “LEGO” toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy. Our case serves to reemphasize the importance of considering airway foreign bodies as a cause of respiratory distress, especially in young children.
      PubDate: Wed, 13 Dec 2017 00:00:00 +000
       
  • Mechanisms Involving Myocardial Injury in Tropical Stings and Bites

    • Abstract: It is known that a number of toxic substances produce myocardial injury by several mechanisms involving interruption of coronary blood flow due to stimulation of clotting mechanism and coronary vasospasm. Number of toxic substances may cause direct myocardial toxicity independent of coronary blood flow. Acute myocardial injury due to stings and bites is a rare entity and not well understood. Here we illustrate a case of myocardial injury due to Russell’s viper envenomation.
      PubDate: Thu, 02 Nov 2017 07:49:32 +000
       
  • Perforated Duodenal Diverticulum with Subtle Pneumoretroperitoneum on
           Abdominal X-Ray

    • Abstract: Abdominal pain is one of the most common presenting complaints at the Emergency Department (ED). Given the myriad of possible differential diagnoses for abdominal pain, it becomes more important to diagnose conditions requiring emergent surgical intervention early. We present a case of an elderly male patient with abdominal pain secondary to perforated hollow viscus, subtle evidence of pneumoretroperitoneum on the initial supine abdominal X-ray, and review the signs of pneumoperitoneum and pneumoretroperitoneum on plain abdominal X-rays.
      PubDate: Thu, 19 Oct 2017 00:00:00 +000
       
  • Diffuse Subcutaneous Emphysema, Pneumomediastinum, and Pneumothorax
           following Robotic Assisted Laparoscopic Hysterectomy

    • Abstract: Robotic assisted laparoscopic surgery is becoming more widely available, but despite its multiple benefits, it is not without risk. This case is of a 62-year-old female who presented to the emergency department for dyspnea two days after robotic assisted laparoscopic hysterectomy. Physical exam revealed diffuse facial, neck, upper extremity, torso, and lower extremity crepitus, which was diagnosed as diffuse subcutaneous air on computed tomography (CT). Imaging also revealed right apical pneumothorax and pneumomediastinum. The patient progressively improved over one month, with resolution of symptoms.
      PubDate: Thu, 12 Oct 2017 00:00:00 +000
       
  • Severe Decompression Illness: Case Report, Prehospital Recognition, and
           Regional Transport Considerations

    • Abstract: A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system. No abnormality was seen on head CT and the patient had normal mental status. Prehospital nonrebreather oxygen therapy was changed to continuous positive airway pressure (CPAP) upon ED arrival, and the patient was intubated prior to transfer to a hyperbaric facility. However, within 24 hours the patient was found to have multiorgan failure, diffuse cerebral edema, and brain death despite no further episodes of hypotension or hypoxia. No intracranial gas was seen on repeat head CT. Our case demonstrates the importance of early recognition of decompression illness by EMS personnel, consideration of ground versus flight transportation of these patients to the nearest hyperbaric center, and the possible use of prehospital CPAP as an alternative to enhance oxygenation.
      PubDate: Wed, 04 Oct 2017 00:00:00 +000
       
  • Medical Approach to Right Colon Diverticulitis with Perforation

    • Abstract: We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast. Right-sided diverticulitis often presents in a manner similar to appendicitis. In the absence of peritonitis, conservative treatment may be possible. It is predictable that as the population ages, the incidence of right-sided diverticular disease will increase and will result in more presentations of acute right-sided diverticulitis to the emergency department (ED). The aim of this case report is to increase awareness of the incidence, pathophysiology, presentation, work-up (laboratory studies and imaging), and management (medical and surgical) of right-sided diverticulitis among emergency physicians.
      PubDate: Mon, 02 Oct 2017 00:00:00 +000
       
  • Exercise-Induced Acute Bilateral Upper-Arm Compartment Syndrome

    • Abstract: We present a rare case of acute exercise-induced bilateral upper-arm compartment syndrome in a patient who, after a year-long hiatus from exercise, subjected his upper-extremities to the stress of over 100 pushups. The patient presented with severe pain of the bilateral biceps and triceps and complaints of dark urine. Decompressive fasciotomy was performed followed by an intensive care unit (ICU) stay for associated myoglobinuria secondary to rhabdomyolysis. The patient suffered no long-term sequelae as a result of his conditions and recovered full function of the bilateral upper-extremities. Albeit rare, acute exercise-induced compartment syndrome should be considered as a diagnosis following unaccustomed bouts of exercise.
      PubDate: Wed, 20 Sep 2017 00:00:00 +000
       
  • Physician Beware: Severe Cyanide Toxicity from Amygdalin Tablets Ingestion

    • Abstract: Despite the risk of cyanide toxicity and lack of efficacy, amygdalin is still used as alternative cancer treatment. Due to the highly lethal nature of cyanide toxicity, many patients die before getting medical care. Herein, we describe the case of a 73-year-old female with metastatic pancreatic cancer who developed cyanide toxicity from taking amygdalin. Detailed history and physical examination prompted rapid clinical recognition and treatment with hydroxocobalamin, leading to resolution of her cyanide toxicity. Rapid clinical diagnosis and treatment of cyanide toxicity can rapidly improve patients’ clinical outcome and survival. Inquiries for any forms of ingestion should be attempted in patients with clinical signs and symptoms suggestive of poisoning.
      PubDate: Thu, 24 Aug 2017 00:00:00 +000
       
  • A Case of Female Acute Urinary Retention Presenting to the ED

    • Abstract: Introduction. Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories. Case. A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder. The acute retention was relieved with urethral catheterization. A Uterine leiomyoma was confirmed on histology after hysterectomy. Discussion. Once the acute urinary retention has been relieved by insertion of a urethral catheter, the underlying cause of the obstruction must be determined. Although uterine leiomyoma is a fairly common finding in the general population, it is an extremely rare cause of acute urinary retention in women with just a handful of reported cases in the literature.
      PubDate: Wed, 16 Aug 2017 06:11:03 +000
       
  • Combined Dorsal and Ulnarward Carpometacarpal Dislocation Associated with
           

    • Abstract: We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition.
      PubDate: Tue, 15 Aug 2017 00:00:00 +000
       
  • Cigarette Lighter Fluid Induced Gastric Ulcer: A Severe Complication of
           Delayed Foreign Body Removal

    • Abstract: The majority of foreign bodies ingested pass uneventfully through the gastrointestinal tract without endoscopic intervention. Nevertheless, certain ingested objects pose a greater risk for complications and are more challenging to remove than others. This case report describes a 49-year-old male who swallowed a cigarette lighter causing a gastric ulcer. The lighter was successfully removed by flexible endoscopy using a polypectomy snare. Urgent removal is required due to the shape of the object and its hazardous contents. This is the first case report published in the United States describing cigarette lighter ingestion and management.
      PubDate: Tue, 15 Aug 2017 00:00:00 +000
       
  • A Case of Lionfish Envenomation Presenting to an Inland Emergency
           Department

    • Abstract: Lionfish envenomation can cause erythema, edema, necrosis, and severe pain at the exposed site. Treatment often includes supportive wound care, pain management, and hot water immersion. We report a case of lionfish exposure presenting to an inland emergency department treated successfully with these measures.
      PubDate: Sun, 13 Aug 2017 06:44:26 +000
       
  • Second Report of Accidental Intestinal Myiasis due to Eristalis tenax
           (Diptera: Syrphidae) in Iran, 2015

    • Abstract: We have described a new case of accidental intestinal myiasis that had occurred due to Eristalis tenax in Iran. A 4-year-old girl living in rural area near Bajestan city located in the south of Khorasan Razavi province visited the hospital lab with complaints of one live larva in feces and did not have other symptoms, except anal itching. This case had a history of consuming subterranean village water and did not have a history of traveling outside the city or contact with other patients. Conclusion. Based on the morphology characteristic, the larva was identified as “rat-tailed maggot” or larvae fly E. tenax.
      PubDate: Tue, 11 Jul 2017 00:00:00 +000
       
  • Treatment of Community-Acquired Pneumonia: A Case Report and Current
           Treatment Dilemmas

    • Abstract: Resistance to macrolides is rising in the USA and warrants careful consideration when confronted with a patient with suspected pneumonia in the urgent care clinic. This case study exemplifies the potentially serious consequences of treatment failure following prescription of a macrolide for community-acquired bacterial pneumonia. Furthermore, the consequential treatment dilemmas currently faced by physicians are briefly discussed.
      PubDate: Thu, 15 Jun 2017 07:39:03 +000
       
  • The Semantics of Priapism and the First Sign of Chronic Myeloid Leukemia

    • Abstract: Priapism is defined as an erection that persists beyond four hours, lasting beyond or unrelated to sexual stimulation (Salonia et al., 2014). Because the risk of ischemic damage and impotence is high with priapism (35%), management guidelines are directed towards rapid treatment of this condition (Salonia et al., 2014). This report describes the rare case of an 18-year-old male who presented to the Emergency Department (ED) three times with recurrent and worsening episodes of sustained penile erections. On the patient’s third visit, he presented with priapism of greater than six-hour duration that was found to be the result of chronic myeloid leukemia. Clinician awareness of the diagnostic semantics and differential diagnosis surrounding priapism is pivotal in its urgent management.
      PubDate: Tue, 30 May 2017 06:58:29 +000
       
  • Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and
           Nonspecific Abdominal Pain

    • Abstract: Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.
      PubDate: Mon, 29 May 2017 09:13:00 +000
       
  • Unilateral Dilated Pupil and Spontaneous Cardiac Arrest with Successful
           Bystander Resuscitation

    • Abstract: A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient’s wife by telephone, she said that he had fallen and hit his head earlier that day. The crew decided to convey the patient to a Major Trauma Centre that had both neurosurgical and cardiology specialist services (rather than the nearest hospital) so that both traumatic brain injury and cardiac pathologies could be addressed if required. A head CT was normal, but coronary angiography demonstrated occlusion of two coronary arteries. These were successfully treated with stenting, and the patient went home two weeks later. He informed medical staff that his left pupil has been permanently dilated since he was a boy following a traumatic ocular injury. This case illustrates the utility of early deployment of an AED as well as the importance of an accurate history and emergency decision-making by prehospital personnel.
      PubDate: Wed, 17 May 2017 06:27:01 +000
       
  • Clomiphene Associated Inferior STEMI in a Young Female due to Right
           Coronary Artery Dissection

    • Abstract: Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is an uncommon cause of myocardial infarction. It most commonly affects females in the perimenopausal age. NA-SCAD has been associated with many predisposing factors including pregnancy and hormonal therapy for both contraception and ovulation induction. The presented case is a previously healthy 41-year-old woman diagnosed with inferior ST-elevation myocardial infarction due to right descending coronary artery dissection associated with recent use of clomiphene monotherapy for ovulation induction (a previously fertile woman), which was not previously reported. Learning Objectives. Emergency physicians (EPs) should be aware about NA-SCAD as a cause of acute coronary syndrome (ACS) especially in perimenopausal women even with no risk factors. NA-SCAD occurs more commonly in the postpartum period and in females following hormonal therapy. Here, clomiphene monotherapy was reported as a possible contributing factor to NA-SCAD. Guidelines for NA-SCAD management are not up to date, and EPs should avoid some interference before the final diagnosis of the cause of myocardial infarction.
      PubDate: Tue, 16 May 2017 00:00:00 +000
       
  • Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction
           after Ingestion of a Naphazoline-Containing Antiseptic

    • Abstract: Naphazoline is a peripheral -adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express -adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.
      PubDate: Sun, 07 May 2017 00:00:00 +000
       
  • Anti-MuSK-Positive Myasthenic Crisis in a 7-Year-Old Female

    • Abstract: A seven-year-old African American female with anti-MuSK-positive Juvenile Myasthenia Gravis collapsed while at school from progressively worsening weakness and dyspnea. On initial emergency department presentation, she required 15 liters per minute of supplemental oxygen to maintain oxygen saturation above 92%. Initial pulmonary function tests and venous blood gas led to the decision to place her on noninvasive positive pressure ventilation (NPPV) with BiPAP in the emergency department. Due to worsening hypercarbia, she later required mechanical intubation in the PICU and underwent IVIG therapy followed by plasmapheresis in order to achieve a stable discharge from the hospital. A respiratory virus panel PCR was positive for influenza A, influenza B, and rhinovirus, likely precipitating the respiratory failure and myasthenic crisis in this seven-year-old patient. Given the rarity of this condition, this case report is to provide further education to the clinician managing severe, prepubertal Juvenile Myasthenia Gravis and myasthenic crisis.
      PubDate: Sun, 30 Apr 2017 06:29:40 +000
       
  • Vertebral Arteriovenous Fistula: An Unwelcome Thrill

    • Abstract: Cervical vertebral AV fistulae are uncommon vascular lesions involving abnormal communication between the extradural vertebral artery and surrounding venous structures. We examine the case of a female evaluated in the emergency department with a vertebral AV fistula presenting classically as pulsatile tinnitus and later successfully treated with standard endovascular techniques. A discussion on the etiology, pathophysiology, and management of vertebral AV fistulae follows.
      PubDate: Wed, 05 Apr 2017 08:57:19 +000
       
  • Bilateral Pulmonary Embolism after a Short-Haul Flight in a Man with
           Multiple Risk Factors including Sickle Cell Trait

    • Abstract: We report a case of pulmonary embolism (PE) in an Afro-Caribbean man following a short commercial flight of less than 5,000 kilometers (Km) in economy class with a 1-month interval between journeys. He had an elevated body mass index (BMI) and sickle cell trait (SCT) with hyperhomocysteinemia. No other preexisting source of venous thrombosis was found. We posit that venous thromboembolism (VTE) and/or PE may have been a complication of SCT in an individual with other multiple risk factors. We discuss the possible interaction of these risk factors for VTE and/or PE and the implications for travelers at risk. The need for a PE risk score and guidelines for the prophylaxis of thromboembolism among travelers exists.
      PubDate: Wed, 29 Mar 2017 00:00:00 +000
       
  • An Exceptional Case of Diabetic Ketoacidosis

    • Abstract: We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome.
      PubDate: Sun, 26 Mar 2017 07:20:54 +000
       
  • Diffuse Subcutaneous Emphysema and Pneumomediastinum Secondary to a Minor
           Blunt Chest Trauma

    • Abstract: Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall. Computed tomography (CT) demonstrated right-sided costal fractures (ribs 7 to 9), with diffuse subcutaneous emphysema and pneumomediastinum due to laceration of the visceral and parietal pleura and the adjacent lung parenchyma. In addition, a small ipsilateral pneumothorax was found. Surprisingly, the clinical status was only minimally affected by mild to moderate pain and minor functional impairment.
      PubDate: Tue, 14 Mar 2017 08:34:36 +000
       
  • Seat Belt Compression Appendicitis following Motor Vehicle Collision

    • Abstract: Appendicitis and trauma both present in emergency department commonly but their presentation together in the same patient is unusual. We present a case of a middle-aged man brought by emergency medical services (EMS) to the emergency department with complaints of abdominal pain after he was involved in motor vehicle collision. He was perfectly fine before the accident. His primary survey was normal. Secondary survey revealed tenderness in right iliac fossa with seat belt mark overlying it. Computerized tomography (CT) of the abdomen and pelvis was performed which showed 8 mm thickening of appendix with minimal adjacent fat stranding. There is also subcutaneous fat stranding of anterior lower abdominal wall possibly due to bruising. Impression of posttraumatic seat belt compression appendicitis was made. Laparoscopic appendectomy was done and patient recovered uneventfully. Histopathology showed inflamed appendix, proving it to be a case of seat belt compression appendicitis.
      PubDate: Wed, 01 Mar 2017 07:35:06 +000
       
  • Knee Dislocation: A Case Report, Diagnostic Vascular Work-Up, and
           Literature Review

    • Abstract: Knee dislocation is an uncommon, potentially limb-threatening, knee injury. Most often caused by high-velocity trauma, it can also result from low- or even ultra-low-velocity trauma. Rapid identification of the injury, reduction, and definitive management are necessary to minimize neurovascular damage. We present a case of rotatory anterolateral knee dislocation sustained during a twisting sports-related event. Special emphasis is placed on diagnosing vascular injuries associated with knee dislocations.
      PubDate: Wed, 22 Feb 2017 09:53:15 +000
       
 
 
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