Evaluation of the pulmonary embolism rule-out criteria in a retrospective cohort at an urban academic hospital.

Background: The pulmonary embolism rule-out criteria (PERC) is an 8-variable clinical decision rule that identifies patients at low risk for pulmonary embolism (PE) to prevent unnecessary diagnostic testing in the evaluation of suspected PE in the emergency department (ED). The objective of this study was to determine PERC's safety and diagnostic use in our institution's ED population.

Methods: We performed a retrospective analysis on consecutive adult patients evaluated with computed tomographic angiography (CTA) for suspicion of PE at our ED during the dates January 1, 2011, to December 31, 2011.

The shikimate pathway: review of amino acid sequence, function and three-dimensional structures of the enzymes.

The aromatic compounds such as aromatic amino acids, vitamin K and ubiquinone are important prerequisites for the metabolism of an organism. All organisms can synthesize these aromatic metabolites through shikimate pathway, except for mammals which are dependent on their diet for these compounds. The pathway converts phosphoenolpyruvate and erythrose 4-phosphate to chorismate through seven enzymatically catalyzed steps and chorismate serves as a precursor for the synthesis of variety of aromatic compounds.

A case-based approach to noninvasive positive pressure ventilation.

Noninvasive positive pressure ventilation (NIPPV) has revolutionized the concept of mechanical ventilation with the major benefit of avoiding invasive mechanical ventilation in specific situations, thereby preventing associated complications. Noninvasive positive pressure ventilation has emerged as the first line of management of hypercapnic respiratory failure (due to chronic obstructive pulmonary disease and neuromuscular weakness) and cardiogenic pulmonary edema in addition to standard therapy in the acute setting. There is improvement in gas exchange, relief of respiratory muscle fatigue, and clinical outcome with reduced morbidity and mortality.

Does sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?

Background: Patients with obstructive sleep apnea (OSA) have an increased risk of perioperative complications.

Aim: The purpose of this study is to assess whether OSA increases the risk of cardiorespiratory complications in patients undergoing endoscopic procedures.

Methods: A retrospective study was performed.

Intravenous radiocontrast induced anaphylactoid reaction: a rare cause of death.

Anaphylactoid reaction after the injection of iodinated contrast media can be life threatening. A 23-year-old woman presented to the emergency room with abdominal pain and fever, for couple of days duration. After completion of a computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast, the patient complained of feeling hot and shortness of breath.