Articles related to Emergency Medicine

Improvements in brain imaging and a deeper understanding of the natural history of acute cerebral ischemia are erasing the concept of “transient ischemic attack” (TIA). The better imaging is revealing that symptomatic ischemic attacks – even those with quite transient signs and symptoms – leave residual damage to the brain.

The British Medical Journal reports that people who survive COVID-19 are at increased risk of an array of mental health disorders, including anxiety, depression, and opioid use disorder, cognitive decline, sleep disorders, and more. The authors recommend close monitoring of patients following infection and up-prioritizing managing their mental health disorders.

This Annals of Internal Medicine study reports an 82% decreased risk for reinfection for those previously infected and then vaccinated, versus those previously infected but who remained unvaccinated. Reinfection in both groups was relatively rare.

Can you determine the appropriate case management for a 68-year-old man who is evaluated for an episode of syncope and repeated episodes of near-fainting when standing and working on his tractor? On physical examination, vital signs are normal. Supine blood pressure is 124/78 mm Hg, and pulse rate is 76/min. After the patient stands for three minutes, standing blood pressure is 88/68 mm Hg, and pulse rate is 94/min. The remainder of the examination is normal. How would you proceed?

The CDC has released updated guidelines for prescribing opioids. The newest guidelines focus on patient-centered decisions and reduce some limitations on prescribing that were put in place back in 2016. The updated guidance recognizes the ongoing increase in opioid-related deaths, but seeks to give physicians and patients more direction in managing individual therapy.

A 56-year-old man has had right-upper-quadrant abdominal pain for several months but is otherwise healthy. He does not drink alcohol, has not been exposed to other hepatotoxins, and takes no medications. On physical examination, vital signs are normal. Abdominal examination reveals hepatosplenomegaly. The remainder of the physical exam is normal. What would you do?