Pharmacological Management of Agitation and Delirium in Older Adults: a Survey of Practices in Canadian Emergency Departments.

Agitation is a common presenting symptom of delirium for older adults in the emergency department (ED). No medications have been found to reduce delirium severity, symptoms, or mortality, yet they may cause harm. Guidelines suggest using medications only when patients are posing a risk of harm, situations which may arise frequently in the ED.

Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study.

Background: Between 75% and 80% of patients with sepsis arrive in the hospital through the emergency department. Early diagnosis is important to alter patient prognosis, but currently, there is no reliable biomarker. The innate immune response links inflammation and coagulation.

Ovarian Torsion in a Pediatric Patient: The Importance of Repeat Imaging.

A previously healthy 10-year-old girl presented to the emergency department with a 1-day history of abdominal pain. She was afebrile with an elevated white blood cell count and a negative pelvic ultrasound. The pain resolved while in hospital, and the patient was discharged home.

Virus-induced asthma attack: The importance of allergic inflammation in response to viral antigen in an animal model of asthma.

Asthma exacerbation can be a life-threatening condition, and is most often triggered by common respiratory viruses. Poor asthma control and worsening of respiratory function is associated with increased airway inflammation, including eosinophilia. Prevention of asthma exacerbation relies on treatment with corticosteroids, which preferentially inhibit allergic inflammation like eosinophils.

Back pain in the emergency department: Pathological fracture following spinal manipulation.

Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks.

Comparison of Presentation, Course, and Outcome of Congenital and Acquired Cytomegalovirus Infection in Twins.

Background Cytomegalovirus (CMV) is one of the most common causes of serious viral intrauterine infections. It is universally distributed among the human population with an average incidence of 0.15 to 2%.

Invasive amoebiasis: a review of Entamoeba infections highlighted with case reports.

Entamoeba histolytica infections of the gastrointestinal tract are common in the developing world but rare in North America. The authors present two cases: one involving an individual who had not travelled to an endemic area and another involving an individual who was born in Bulgaria. Both presented with severe abdominal pain and diarrhea.

Identifying hypoxia in a newborn piglet model using urinary NMR metabolomic profiling.

Establishing the severity of hypoxic insult during the delivery of a neonate is key step in the determining the type of therapy administered. While successful therapy is present, current methods for assessing hypoxic injuries in the neonate are limited. Urine Nuclear Magnetic Resonance (NMR) metabolomics allows for the rapid non-invasive assessment of a multitude breakdown products of physiological processes.

Turner Syndrome and apparent absent uterus: a case report and review of the literature.

We report on a patient who initially presented with delayed puberty and an absent uterus on imaging with ultrasound and MRI. She was subsequently diagnosed with Turner Syndrome. Turner Syndrome typically presents with early loss of ovarian function and should be considered when primary ovarian insufficiency is present with apparent absent uterus on imaging.

Rhinovirus has the unique ability to directly activate human T cells in vitro.

Background: Rhinovirus infection is a leading cause of exacerbation of airway diseases. We hypothesize that airway viruses activate inflammatory cells, inducing airway dysfunction. We have previously shown that airway viruses can induce eosinophil degranulation when cocultured with T cells and monocyte-derived dendritic cells (moDCs).

A pilot trial on the treatment of gastroesophageal reflux-related cough in infants.

Background: Diagnosing asthma in infancy is largely made on the basis of the symptoms of cough and wheeze. A similar presentation can be seen in neurologically normal infants with excessive gastroesophageal reflux (GER). There are no randomized placebo controlled studies in infants using proton pump inhibitors (PPI) alone or in addition to prokinetic agents.

[A pilot trial on the treatment of gastroesophageal reflux-related cough in infants].

Objective: Diagnosing asthma in infancy is largely made on the basis of the symptoms of cough and wheezing. A similar presentation can be seen in neurologically normal infants with excessive gastroesophageal reflux (GER). There are no randomized placebo controlled studies in infants using proton pump inhibitors (PPI) alone or in addition to prokinetic agents.

Compound CVT-E002 attenuates allergen-induced airway inflammation and airway hyperresponsiveness, in vivo.

Immune modulation has been a sought after means of therapy for atopic diseases. CVT-E002 is an extract derived from North American Ginseng shown to promote T-helper-1-like responses. We determined what effect CVT-E002 could have in a mouse model of atopic asthma.

Monitoring asthma status.

Purpose: Asthma is a chronic disorder of the airways involving inflammation and airway hyper-reactivity. Clinical diagnosis and monitoring of asthma must incorporate the immunological, biochemical, and histological changes of a chronic disorder, while recognizing acute phenotypic changes in order to optimally tailor therapeutics to each individual.

Recent Findings: Articles published within the previous 18 months are summarized in this article in order to present an up to date review of the latest findings regarding the monitoring of asthma.

Metabolomic profiling of asthma: diagnostic utility of urine nuclear magnetic resonance spectroscopy.

Background: The ability to diagnose and monitor asthma on the basis of noninvasive measurements of airway cellular dysfunction is difficult in the typical clinical setting.

Objective: Metabolomics is the study of molecules created by cellular metabolic pathways. We hypothesized that the metabolic activity of children with asthma would differ from healthy children without asthma.

Metabolomic biomarkers in a model of asthma exacerbation: urine nuclear magnetic resonance.

Rationale: Airway obstruction in patients with asthma is associated with airway dysfunction and inflammation. Objective measurements including sputum analysis can guide therapy, but this is often not possible in typical clinical settings. Metabolomics is the study of molecules generated by metabolic pathways.