A Case of Hemorrhagic Ovarian Cyst Rupture Necessitating Surgical Intervention.

Despite the relatively high incidence of ovarian cysts, particularly in premenopausal women, cyst rupture may on occasion present painfully and require surgical intervention to resolve. Particularly in the case of ruptured hemorrhagic ovarian cysts, resulting hemoperitoneum can create a risk of further adverse events including hypovolemic shock; proper identification and management of such cases are therefore critical. This case focuses on a 22-year-old female that presented to the emergency department (ED) with suprapubic pain in the lower left quadrant of the abdomen.

Anxiety and Depressive Symptoms in Patients with COPD: Modifiable Explanatory Factors.

Anxiety and depressive symptoms affect up to 80% of people with chronic obstructive pulmonary disease (COPD). To reduce this symptom burden, clinicians should target modifiable explanatory factors while accounting for nonmodifiable explanatory factors of these symptoms. The purpose of this secondary data analysis was to examine which modifiable factors explain anxiety and depressive symptoms in COPD.

Triquetrum Fracture with Pisiform Dislocation.

The authors present a case of a triquetrum fracture and pisiform dislocation diagnosed in the emergency department. The patient described wrist pain with no other complaints. However, after a plain radiograph in the emergency department, a minimally displaced avulsion fracture of the triquetrum and subtle pisiform dislocation was detected.

Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Spinal epidural lipomatosis is a condition that is characterized by an excess amount of epidural adipose tissue in the spinal canal. Occasionally, it can narrow the spinal canal enough to cause cord impingement resulting in neurological deficits. The authors report on a case of a 43-year-old man who presented to the emergency department with bilateral lower extremity weakness.

Unvaccinated COVID-19 Pneumonia- a family affair.

The authors present the case of a 15-year-old boy who was infected with COVID-19 by his family and developed pneumonia severe enough to require hospitalization. He was one of several children who required hospitalization, and vaccination was considered by the parent to be "risky" despite this. This case illustrates the complexities of vaccine hesitancy and societal misinformation.

The Burden of Hypercoagulability in COVID-19.

The novel coronavirus disease 2019 (COVID-19) infection has widespread impact on multiple organ systems, including damage to endothelial cells. Various studies have found evidence for direct mechanisms by which interaction between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and endothelial cells lead to extensive damage to the latter, and indirect mechanisms, such as excessively elevated cytokines, can also result in the same outcome. Damage to the endothelium results in release of thrombotic factors and inhibition of fibrinolysis.

Enterococcal Cervical Discitis Following Transcatheter Aortic Valve Replacement.

Prosthetic valve endocarditis (PVE) is a known transcatheter aortic valve replacement (TAVR). Infective endocarditis is associated with a high incidence of embolic events related to bacterial seeding of various sites through hematogenous spread. This seeding can lead to severe morbidity and mortality and requires an increased incidence of clinical suspicion in at-risk patients to diagnose and treat appropriately.

An ominous cause of back pain: Vertebral Osteomyelitis.

The authors present the case of a patient seen for back pain in the emergency department, initially discharged home with a diagnosis of musculoskeletal pain. He returned a week later and was found to have vertebral osteomyelitis based on a thorough neurologic exam. A review of ominous causes of back pain, including the elusive nature of vertebral osteomyelitis/diskitis is discussed.

Salter Harris Fracture Type II.

A 14-year-old boy presented to the emergency department with pain and inability to move the right knee after a fall while playing basketball. X-ray findings identified a Salter-Harris type II fracture of the tibial metaphysis with anterior subluxation of the proximal tibia. The case was then transferred to a pediatric orthopedic subspecialist for operative treatment.

Hill-Sachs Deformity.

The authors present the case of a young man who sustained a Hill Sachs lesion resulting in recurrent shoulder dislocations. The presentation, radiographic findings, management and prognosis are discussed.

Bilateral Maxillary and Mandibular Periapical Abscesses.

Odontogenic infections commonly arise from poor dental hygiene that forms dental caries, which can eventually progress to gingivitis and periodontitis. The authors present a case of facial swelling diagnosed as a periapical abscess with soft tissue swelling that extended into both the maxilla and mandible.

Acute Submandibular Sialadenitis.

Sialadenitis is a stone in the salivary system that often presents as acute pain and swelling and can cause significant distress to patients. Here, we present a case of submandibular sialadenitis in a 41-year-old woman who experienced sudden-onset facial and neck pain and swelling. In addition, we discuss the diagnosis and emergency department management.

Massive Spontaneous Pneumothorax.

Spontaneous pneumothorax (SP) is an abnormal occurrence in which air enters the pleural space, increasing pressure that pushes on the lung, causing it to collapse in part or full. Diagnosis is made by physical exam and can be confirmed by chest X-ray (CXR), chest computed tomography (CT), ultrasonography, and other forms of imaging showing a collapsed lung. We present the case of a 35-year-old male cannabis user presenting with sharp sudden pains in the right chest, who presented almost 12 hours after symptom onset and was diagnosed with a 90% pneumothorax of the right lung.

Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients.

Background: Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy.