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  1. Article ; Online: Just the facts: traumatic cardiac arrest.

    Sowers, Nicholas / Hung, David

    CJEM

    2023  Volume 25, Issue 9, Page(s) 724–727

    MeSH term(s) Humans ; Heart Arrest/diagnosis ; Heart Arrest/etiology ; Heart Arrest/therapy ; Cardiopulmonary Resuscitation ; Out-of-Hospital Cardiac Arrest/etiology ; Out-of-Hospital Cardiac Arrest/therapy
    Language English
    Publishing date 2023-06-16
    Publishing country England
    Document type Journal Article
    ISSN 1481-8043
    ISSN (online) 1481-8043
    DOI 10.1007/s43678-023-00541-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A Case of Reversible Cerebral Vasoconstriction Syndrome in a Healthy Adult Male.

    Roberts, Alysha / Sowers, Nicholas

    Cureus

    2020  Volume 12, Issue 5, Page(s) e8374

    Abstract: Reversible cerebral vasoconstriction syndrome (RCVS) represents a potentially under-recognized cause of thunderclap headache in patients presenting to the ED. While a rarely made diagnosis in emergency medicine practice, RCVS may be as common as ... ...

    Abstract Reversible cerebral vasoconstriction syndrome (RCVS) represents a potentially under-recognized cause of thunderclap headache in patients presenting to the ED. While a rarely made diagnosis in emergency medicine practice, RCVS may be as common as subarachnoid hemorrhage (SAH). RCVS typically presents as a sudden onset, excruciating headache that may be associated with nausea, vomiting, photophobia, or other features with overlap in the clinical presentation of both SAH and migraine headaches. As a result of historical features overlapping the presentation of SAH, particularly the rapidity of onset and peak of severity, these patients are typically investigated for SAH and when that workup ultimately is reassuring, clinicians may often misattribute RCVS symptoms as migrainous. We present a case of a 35-year-old healthy male who presented with a severe, sudden onset headache, nausea, and photophobia to the ED on four occasions within a nine-day period. He was initially investigated appropriately for SAH; receiving an unenhanced head CT and lumbar puncture, which were both unremarkable. Following this initial workup, he was assessed on several other occasions, treated symptomatically as a migraine, and discharged home. On the fourth ED visit a CT angiogram (CTA) was completed that demonstrated the characteristic "string of beads" appearance of the middle cerebral artery (MCA) diagnostic of RCVS. This case describes the key features and investigations of a patient with RCVS and highlights the importance of early and accurate diagnosis of thunder clap headache in which SAH has been excluded.
    Language English
    Publishing date 2020-05-31
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.8374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Harbinger of infarction: Wellens syndrome electrocardiographic abnormalities in the emergency department.

    Sowers, Nicholas

    Canadian family physician Medecin de famille canadien

    2013  Volume 59, Issue 4, Page(s) 365–366

    MeSH term(s) Aged ; Angina Pectoris/etiology ; Coronary Artery Disease/diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart/physiopathology ; Humans ; Myocardial Infarction/diagnosis ; Myocardial Infarction/physiopathology ; Risk Factors ; Syndrome
    Language English
    Publishing date 2013-04-12
    Publishing country Canada
    Document type Case Reports ; Journal Article
    ZDB-ID 603565-6
    ISSN 1715-5258 ; 0008-350X
    ISSN (online) 1715-5258
    ISSN 0008-350X
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 2236: Show issues Location:
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    Zs.MG 5: Show issues

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  4. Article ; Online: Airway Management in Trauma.

    Kovacs, George / Sowers, Nicholas

    Emergency medicine clinics of North America

    2018  Volume 36, Issue 1, Page(s) 61–84

    Abstract: Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the ... ...

    Abstract Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented.
    Language English
    Publishing date 2018-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605637-4
    ISSN 1558-0539 ; 0733-8627
    ISSN (online) 1558-0539
    ISSN 0733-8627
    DOI 10.1016/j.emc.2017.08.006
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    Zs.A 1919: Show issues Location:
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  5. Article ; Online: Unusual Arteriovenous Malformation in Total Hip Arthroplasty

    Nicholas Dahlgren / Roshan Jacob / Colin Cantrell / Mackenzie Sowers / Ashish B. Shah / Sameer Mahadeorao Naranje

    Revista Brasileira de Ortopedia, Vol 58, Iss 5, Pp 818-

    Case Report of a Complicated Perioperative Course

    2023  Volume 821

    Abstract: Abstract It is not common to encounter arteriovenous malformations (AVMs) during total hip arthroplasty (THA). We report the present case to draw attention to the possibility of an AVM during the direct anterior approach (DAA) for THA, which, if not ... ...

    Abstract Abstract It is not common to encounter arteriovenous malformations (AVMs) during total hip arthroplasty (THA). We report the present case to draw attention to the possibility of an AVM during the direct anterior approach (DAA) for THA, which, if not borne in mind, may lead to the myriad of complications related to excessive bleeding. An 81-year-old female presented to the emergency department with a left femoral neck fracture. She elected to undergo a THA via the DAA. Abnormal appearing blood vessels were present near the ascending circumflex branches, which provided difficulty in achieving hemostasis. Excessive blood loss was noted, and the patient received one unit of packed red blood cells during the operation. Hemoglobin and hematocrit dropped in the days following surgery, requiring several additional transfusions of blood products. When the patient complained of progressive left leg swelling on postoperative day 3, a computed tomography revealed large hematomas within the left adductors and the left iliopsoas muscle. Active extravasation was identified arising from a branch of the left profunda femoral artery, as well as an arteriovenous fistula (AVF) in this area. Bleeding was controlled by selective endovascular coil embolization. As of current knowledge, this is the first reported intraoperative discovery of congenital arteriovenous malformation (AVM) with subsequent development of postoperative arteriovenous fistula and associated symptomatic hematomas in the setting of THA using the DAA. Early recognition and intervention of vascular malformations is essential in preventing potential limb- or life-threatening surgical complication.
    Keywords arteriovenous malformations ; arthroplasty ; replacement ; hip ; vascular malformations ; Medicine ; R ; Orthopedic surgery ; RD701-811
    Subject code 610
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Sociedade Brasileira de Ortopedia e Traumatologia
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Dethiosulfovibrio faecalis

    Grabowski, Stephen / Apolinario, Ethel A / Schneider, Nicholas O / Marshall, Christopher W / Sowers, Kevin

    International journal of systematic and evolutionary microbiology

    2022  Volume 72, Issue 8

    Abstract: ... A ... ...

    Abstract A new
    MeSH term(s) Aquaculture ; Bacterial Typing Techniques ; Base Composition ; Bioreactors ; DNA, Bacterial/genetics ; Fatty Acids/chemistry ; Phylogeny ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Solid Waste ; Sulfur/metabolism
    Chemical Substances DNA, Bacterial ; Fatty Acids ; RNA, Ribosomal, 16S ; Solid Waste ; Sulfur (70FD1KFU70)
    Language English
    Publishing date 2022-06-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2002336-4
    ISSN 1466-5034 ; 1466-5026
    ISSN (online) 1466-5034
    ISSN 1466-5026
    DOI 10.1099/ijsem.0.005456
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    Zs.A 409: Show issues Location:
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  7. Article: Just the Facts: Airway management during the coronavirus disease 2019 (COVID-19) pandemic.

    Kovacs, George / Sowers, Nicholas / Campbell, Samuel / French, James / Atkinson, Paul

    CJEM

    2020  Volume 22, Issue 4, Page(s) 440–444

    Abstract: A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and ... ...

    Abstract A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and the advisory to self-isolate and did so; however, he developed increasing respiratory distress over several days and called 911. On arrival at the emergency department (ED), his heart rate was 130 beats/min, respiratory rate 32 per/min, and oxygenation saturation 82% on room air. As per emergency medical services (EMS) protocol, they placed him on nasal prongs under a surgical mask at 5 L/min and his oxygen saturation improved to 86%.
    MeSH term(s) Airway Management/methods ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/therapy ; Coronavirus Infections/transmission ; Decision Making ; Disease Progression ; Equipment Design ; Humans ; Intubation, Intratracheal ; Occupational Exposure/prevention & control ; Oxygen Inhalation Therapy ; Pandemics/prevention & control ; Personal Protective Equipment ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/therapy ; Pneumonia, Viral/transmission ; Practice Guidelines as Topic ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-03-30
    Publishing country England
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 2059217-6
    ISSN 1481-8035 ; 1481-8035 ; 1488-1543
    ISSN (online) 1481-8035
    ISSN 1481-8035 ; 1488-1543
    DOI 10.1017/cem.2020.353
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Unusual Arteriovenous Malformation in Total Hip Arthroplasty: Case Report of a Complicated Perioperative Course.

    Dahlgren, Nicholas / Jacob, Roshan / Cantrell, Colin / Sowers, Mackenzie / Shah, Ashish B / Naranje, Sameer Mahadeorao

    Revista brasileira de ortopedia

    2021  Volume 58, Issue 5, Page(s) e818–e821

    Abstract: It is not common to encounter arteriovenous malformations (AVMs) during total hip arthroplasty (THA). We report the present case to draw attention to the possibility of an AVM during the direct anterior approach (DAA) for THA, which, if not borne in mind, ...

    Abstract It is not common to encounter arteriovenous malformations (AVMs) during total hip arthroplasty (THA). We report the present case to draw attention to the possibility of an AVM during the direct anterior approach (DAA) for THA, which, if not borne in mind, may lead to the myriad of complications related to excessive bleeding. An 81-year-old female presented to the emergency department with a left femoral neck fracture. She elected to undergo a THA via the DAA. Abnormal appearing blood vessels were present near the ascending circumflex branches, which provided difficulty in achieving hemostasis. Excessive blood loss was noted, and the patient received one unit of packed red blood cells during the operation. Hemoglobin and hematocrit dropped in the days following surgery, requiring several additional transfusions of blood products. When the patient complained of progressive left leg swelling on postoperative day 3, a computed tomography revealed large hematomas within the left adductors and the left iliopsoas muscle. Active extravasation was identified arising from a branch of the left profunda femoral artery, as well as an arteriovenous fistula (AVF) in this area. Bleeding was controlled by selective endovascular coil embolization. As of current knowledge, this is the first reported intraoperative discovery of congenital arteriovenous malformation (AVM) with subsequent development of postoperative arteriovenous fistula and associated symptomatic hematomas in the setting of THA using the DAA. Early recognition and intervention of vascular malformations is essential in preventing potential limb- or life-threatening surgical complication.
    Language English
    Publishing date 2021-11-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2411301-3
    ISSN 1982-4378 ; 0102-3616
    ISSN (online) 1982-4378
    ISSN 0102-3616
    DOI 10.1055/s-0040-1722586
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  9. Article: Use of a Flexible Intubating Scope in Combination with a Channeled Video Laryngoscope for Managing a Difficult Airway in the Emergency Department.

    Sowers, Nicholas / Kovacs, George

    The Journal of emergency medicine

    2016  Volume 50, Issue 2, Page(s) 315–319

    Abstract: Background: Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the ... ...

    Abstract Background: Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the gold standard for managing the anticipated difficult airway in the operating room, is not commonly used in the ED.
    Case: We present a case describing VL-assisted flexible scope intubation performed in the ED as a novel feasible approach to managing the difficult airway. A 65-year-old male, post cardiac arrest, with multiple unsuccessful attempts at prehospital intubation had rapid sequence intubation (RSI) performed and, despite obtaining a view with a King Vision™ VL, the skilled operator was unable to advance the endotracheal tube (ETT). An Ambu™ aScope3 flexible intubating scope (FIS) was placed through the ETT loaded in the channel of the King Vision and advanced through the cords to a position proximal to the carina. The ETT was then advanced easily over the FIS and down the trachea. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although video laryngoscopy is commonly used in the ED, intubation can prove difficult, despite having an adequate view of the glottis. Use of an FIS, however, through a channeled VL makes navigation of the ETT easier and facilitates tube advancement, which can be difficult with VL. Channeled VL-assisted use of an FIS is a viable option for managing the difficult airway.
    MeSH term(s) Aged ; Emergency Service, Hospital ; Heart Arrest/therapy ; Humans ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/methods ; Laryngoscopes ; Male
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2015.10.010
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1895: Show issues Location:
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  10. Article: Involvement of the cerebellum in migraine.

    Wang, Mengya / Tutt, Joseph O / Dorricott, Nicholas O / Parker, Krystal L / Russo, Andrew F / Sowers, Levi P

    Frontiers in systems neuroscience

    2022  Volume 16, Page(s) 984406

    Abstract: Migraine is a disabling neurological disease characterized by moderate or severe headaches and accompanied by sensory abnormalities, e.g., photophobia, allodynia, and vertigo. It affects approximately 15% of people worldwide. Despite advancements in ... ...

    Abstract Migraine is a disabling neurological disease characterized by moderate or severe headaches and accompanied by sensory abnormalities, e.g., photophobia, allodynia, and vertigo. It affects approximately 15% of people worldwide. Despite advancements in current migraine therapeutics, mechanisms underlying migraine remain elusive. Within the central nervous system, studies have hinted that the cerebellum may play an important sensory integrative role in migraine. More specifically, the cerebellum has been proposed to modulate pain processing, and imaging studies have revealed cerebellar alterations in migraine patients. This review aims to summarize the clinical and preclinical studies that link the cerebellum to migraine. We will first discuss cerebellar roles in pain modulation, including cerebellar neuronal connections with pain-related brain regions. Next, we will review cerebellar symptoms and cerebellar imaging data in migraine patients. Lastly, we will highlight the possible roles of the neuropeptide calcitonin gene-related peptide (CGRP) in migraine symptoms, including preclinical cerebellar studies in animal models of migraine.
    Language English
    Publishing date 2022-10-13
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2453005-0
    ISSN 1662-5137
    ISSN 1662-5137
    DOI 10.3389/fnsys.2022.984406
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