Blog and Podcast Watch: Neurologic Emergencies.

Introduction: The Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series.

Low Back Pain in the Emergency Medicine Department: A Flipped Classroom Module.

Introduction: Current residency didactic schedules that are built upon hour-long, lecture-based presentations are incongruous with adult learning theory and the needs of millennial generation residents. An alternative to the traditional lecture, the flipped classroom involves viewing a short video lecture at home, followed by an active discussion during class time. This module was developed for emergency medicine residents and rotating medical students without previous training on the subject.

The Effect of Peer Review on the Quality of Data Graphs in Annals of Emergency Medicine.

Study Objective: We determine how peer review affects the quality of published data graphs and how the appointment of a graphics editor affects the quality of graphs in an academic medical journal.

Methods: We conducted an observational time-series analysis to quantify the qualities of data graphs in original manuscripts and published research articles in Annals of Emergency Medicine from 2006 to 2012. We retrospectively analyzed 3 distinct periods: before the use of a graphics editor, graph review after a manuscript's acceptance, and graph review just before the first request for revision.

Anti-Jk that are detected by solid-phase red blood cell adherence but missed by gel testing can cause hemolytic transfusion reactions.

Background: Kidd blood group antibodies are notorious for transient detection and hemolytic transfusion reactions. This report compares the rate of detection of anti-Jk when using gel column agglutination versus solid-phase red blood cell adherence (SPRCA) testing and documents the occurrence of hemolytic transfusion reactions in 17 recently transfused patients who developed anti-Jk that were detectable by SPRCA but were undetectable by gel.

Study Design And Methods: Before April 20, 2011, the laboratory used gel column agglutination as the primary method for antibody screening and identification.

The Flipped Classroom in Emergency Medicine Using Online Videos with Interpolated Questions.

Background: Utilizing the flipped classroom is an opportunity for a more engaged classroom session. This educational approach is theorized to improve learner engagement and retention and allows for more complex learning during class. No studies to date have been conducted in the postgraduate medical education setting investigating the effects of interactive, interpolated questions in preclassroom online video material.

Three-Dimensional Alveolar Bone Anatomy of the Maxillary First Molars: A Cone-Beam Computed Tomography Study With Implications for Immediate Implant Placement.

Purpose: To retrospectively evaluate alveolar dimensions of healthy maxillary first molars (MFMs), which have implications for (immediate) implant placement and endodontic therapy.

Materials And Methods: Cone-beam computed tomographic records of 95 patients (150 MFMs) were used [32 men and 63 men, aged 37.2 (14.

Treatment of Labial Soft Tissue Recession Around Dental Implants in the Esthetic Zone Using Guided Bone Regeneration With Mineralized Allograft: A Retrospective Clinical Case Series.

Purpose: Soft tissue augmentation procedures are often performed to correct gingival recession on the facial aspects of implants in the esthetic zone. This retrospective clinical case series reports on the use of guided bone regeneration (GBR) and a coronal advancement flap with a resorbable membrane and allograft.

Materials And Methods: We analyzed the records of 14 patients (7 men and 7 women) with a mean age of 36.

The impact of acute coagulopathy on mortality in pediatric trauma patients.

Background: Traumatic coagulopathy (TC) occurs in 24% to 38% of adults and is associated with up to a six-fold increase in mortality. This study's purpose was to determine the incidence of pediatric TC and its impact on mortality.

Methods: A retrospective review (2004-2009) of all trauma patients from our Level I trauma center was performed.

The Effect of Autologous Hamstring Graft Diameter on the Likelihood for Revision of Anterior Cruciate Ligament Reconstruction.

Background: Hamstring autografts for anterior cruciate ligament (ACL) reconstruction (ACLR) have become popular in the past 2 decades; however, it is difficult to predict the diameter of the harvested tendons before surgery. Previous biomechanical studies have suggested that a smaller graft diameter leads to a lower load to failure, but clinical studies looking at various predictors for failure, including graft size, have been inconclusive.

Purpose: To evaluate the relationship of hamstring graft diameter to ACL revision within a large cohort of patients, while controlling for sex, age, body mass index (BMI), and femoral and tibial fixation type.

Pelvic Free Fluid in Asymptomatic Pediatric Blunt Abdominal Trauma Patients: A Case Series and Review of the Literature.

Background: With focused assessment with sonography in trauma (FAST) examinations being performed more commonly on pediatric trauma patients, emergency providers will encounter a positive FAST examination in patients with benign abdominal examinations. This poses a diagnostic dilemma for the provider when deciding whether to obtain a computed tomography (CT) scan of the abdomen/pelvis, observe the patient, or admit the patient.

Case Report: We report a series of pediatric patients involved in blunt abdominal trauma who had small pelvic free fluid on FAST but a benign abdominal examination.

The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time.

Traumatic brain injury (TBI) frequently results in diffuse axonal injury and other white matter damage. The corpus callosum (CC) is particularly vulnerable to injury following TBI. Damage to this white matter tract has been associated with impaired neurocognitive functioning in children with TBI.

The diagnosis of right heart thrombus by focused cardiac ultrasound in a critically ill patient in compensated shock.

Right heart thrombus (RHT) is a life-threatening diagnosis that is rarely made in the emergency department (ED), but with the increasing use of focused cardiac ultrasound (FocUS), more of these cases may be identified in a timely fashion. We present a case of an ill-appearing patient who had an immediate change in management due to the visualization of RHT soon after arrival to the ED. The diagnosis was confirmed after a cardiology-performed ultrasound (US).

Esthetic implant site development.

Bony support is critical for creating and maintaining esthetic and natural-appearing peri-implant soft tissue profiles. A variety of techniques have been shown to be effective for augmenting bone and soft tissue. Ideal implant position and angulation is critical for a natural-appearing outcome.

Three-Dimensional Evaluation of Alveolar Bone and Soft Tissue Dimensions of Maxillary Central Incisors for Immediate Implant Placement: A Cone-Beam Computed Tomography Assisted Analysis.

Introduction: This study explored the relationship between the thickness of bone and soft tissue along the labial and palatal aspect of maxillary central incisors. The influence of overall socket width, labiopalatal positioning of the incisor on the bone, and soft tissue thickness were also investigated.

Materials And Methods: This study used cone-beam computed tomography of 150 patients to determine labial, palatal soft and hard tissue thickness, labiopalatal (B-P) socket width and corelated the same to the labiopalatal positioning of maxillary central incisors.

Chikungunya fever in Los Angeles, California.

We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control. This case demonstrates the importance of the ED for infectious disease case identification and initiation of public health measures.

Impact of boarding pediatric psychiatric patients on a medical ward.

Background And Objectives: Psychiatric disorders account for an increasing number of pediatric hospitalizations. Due to lack of psychiatric beds, patients on involuntary psychiatric holds may be admitted to medical units. Our objectives were to evaluate the rate of admission of psychiatric patients to a medical unit, psychiatric care provided, and estimated cost of care.

Point-of-care ultrasound in diagnosing pyomyositis: a report of three cases.

Background: Pyomyositis is a bacterial infection of skeletal muscle that often results in deep intramuscular abscesses. The absence of external dermatologic manifestations in the early stages of pyomyositis makes this a challenging diagnosis. In addition, physical examination findings can be difficult to distinguish from more common processes, such as soft-tissue cellulitis.

Competency-based pediatric disaster training.

Objective: To assess whether participation in a competency-based pediatric disaster educational curriculum increases participants' knowledge of how to manage pediatric disaster victims.

Design: Pretest/post-test intervention study.

Setting: Large, urban, academic tertiary hospital.