Hepatic dysfunction and neurotoxicity in a patient receiving long-term low-dose amiodarone therapy.

Background: Amiodarone is commonly used in the treatment of refractory paroxysmal atrial fibrillation. Much of the literature focuses on the toxic effects of this medication in the setting of rapid loading or long-term therapy with high maintenance doses. However, patients have been known to develop multi-organ toxicities with long-term low-dose therapy.

Authorship, collaboration, and predictors of extramural funding in the emergency medicine literature.

Objectives: The objectives of the study were to examine the last decade of general emergency medicine (EM) literature published in the United States for trends with regard to authorship and multidisciplinary collaboration and to estimate the effect on extramural funding.

Methods: Print articles published in the Academic Emergency Medicine, Annals of Emergency Medicine, Journal of Emergency Medicine, and American Journal of Emergency Medicine between 1994 and 2003 were reviewed. Original research, case reports/series, and others (consensus/educational) were considered; abstracts, book reviews, and editorials were not.

Classifying patients suspected of appendicitis with regard to likelihood.

Background: We sought to develop a clinical predictive model for acute appendicitis and contrast it with current clinical practice.

Methods: A prospective observational study of patients presenting with signs or symptoms consistent with acute appendicitis. Random-partition modeling was used to develop an appendicitis likelihood model (ALM).

Funding and publishing trends of original research by emergency medicine investigators over the past decade.

Objectives: To update the profile of author-reported funding of reports of original research published since 1994 in the four U.S. peer-reviewed general emergency medicine (EM) journals.

The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy.

Objective: This study evaluated the correlation between vital signs and hemoperitoneum and the association between abnormal vital signs and tubal rupture.

Study Design: With the use of a retrospective case-control design, the initial heart rate, systolic blood pressure, and heart rate/systolic blood pressure were correlated with respect to degree of hemoperitoneum; predictive values were calculated.

Results: Fifty-two patients were studied (25 ruptured pregnancies and 27 unruptured ectopic pregnancies).

Treatment of hyperkalemia in a patient with unrecognized digitalis toxicity.

Cardiac glycoside toxicity is frequently associated with hyperkalemia and dysrhythmias in patients with renal insufficiency. Two common therapeutic options for these complications (calcium and transvenous cardiac pacing) are considered contraindicated in the setting of cardiac glycoside toxicity. We present the case of a patient presenting with a pronounced bradydysrhythmia and hyperkalemia who was treated with intravenous calcium and transvenous cardiac pacing and later found to have digitalis toxicity and acute renal failure.