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  1. Article ; Online: Bullous Pemphigoid Causing Successive Emergency Department Visits.

    Hsu, Edmund / Kinoshita, Andrew T / McCoy, C Eric

    Clinical practice and cases in emergency medicine

    2024  Volume 7, Issue 4, Page(s) 268–270

    Abstract: Case presentation: In this case presentation, an 84-year-old male with Fitzpatrick type IV skin tone experienced blistering due to bullous pemphigoid (BP), first on the distal upper left extremity and then on the distal lower extremities, chest, and ... ...

    Abstract Case presentation: In this case presentation, an 84-year-old male with Fitzpatrick type IV skin tone experienced blistering due to bullous pemphigoid (BP), first on the distal upper left extremity and then on the distal lower extremities, chest, and back. These symptoms resulted in three visits to the emergency department within a month, as well as an episode of hospitalization. Despite treatment, the blistering did not resolve until future outpatient care with dermatology.
    Discussion: Bullous pemphigoid is a rare autoimmune disease where autoantibodies target hemidesmosomal proteins causing basement membrane destruction and tense subepithelial bullae with pruritus. While uncommon, the incidence of BP is increasing. Bullous pemphigoid tends to affect older adults, appearing as a rash prior to bullae formation on the abdomen, extremities, groin, axillae, or mucosa. Bullous pemphigoid may also be drug-related with atypical symptoms. Diagnosis of BP should be based on immunopathology, and initial treatment of BP is through corticosteroid or doxycycline.
    Language English
    Publishing date 2024-02-13
    Publishing country United States
    Document type Journal Article
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.1415
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Anticholinergic Toxicity in the Emergency Department.

    McCoy, C Eric / Honda, Reid

    Journal of education & teaching in emergency medicine

    2023  Volume 8, Issue 1, Page(s) S25–S47

    Abstract: Audience: Emergency medicine residents, internal medicine residents, family medicine residents, community physicians, pediatricians, toxicology fellows.: Introduction: There are over 600 compounds which contain anticholinergic properties.1 ... ...

    Abstract Audience: Emergency medicine residents, internal medicine residents, family medicine residents, community physicians, pediatricians, toxicology fellows.
    Introduction: There are over 600 compounds which contain anticholinergic properties.1 Medications with anticholinergic properties include antihistamines, atropine, tricyclic antidepressants, antipsychotics, topical mydriatics, antispasmodics, sleep aids, and cold preparations. 1-4 Plants that possess anticholinergic properties such as jimson weed, and street drugs cut with anticholinergics such as scopolamine are sources of accidental or intentional ingestion.1,2,4 Anticholinergic toxicity can cause a myriad of signs and symptoms, including agitation, seizures, hyperthermia, cardiac dysrhythmias, and death. Since poisoning from anticholinergic medications is frequently encountered in the emergency department, is it essential that emergency physicians be familiar with how to manage this toxidrome. This simulation case will allow the learner to evaluate and manage a patient presenting with anticholinergic toxicity.
    Educational objectives: By the end of this simulation case, learners will be able to: 1) describe the classic clinical presentation of anticholinergic toxicity, 2) discuss common medications and substances that may lead to anticholinergic toxicity, 3) recognize the electrocardiogram (ECG) findings in anticholinergic toxicity that require specific therapy, and 4) review the management of anticholinergic toxicity.
    Educational methods: This simulation is taught using a high- or moderate-fidelity manikin.
    Research methods: The educational content was evaluated by the learners immediately after completion and debriefing of the scenario. This case was initially piloted with approximately twenty emergency medicine residents. The group was comprised of first, second-, and third-year residents from a three-year emergency medicine residency. The efficacy of the content was assessed by oral feedback.
    Results: Overall, the case was well received by learners, who felt it was useful and were engaged throughout the session. The overall feedback was positive and the case was well-received by learners.
    Discussion: This scenario was eventually tested on over 100 learners over the course of several years, and the overall feedback was positive. It was found to be effective when debriefing sessions using various debriefing techniques (such as advocacy/inquiry) were utilized to discuss both the learners' performance in the case, as well as the debriefing pearls (located at the end of this manuscript).
    Topics: Anticholinergic toxicity, altered mental status, toxicology.
    Language English
    Publishing date 2023-01-31
    Publishing country United States
    Document type Journal Article
    ISSN 2474-1949
    ISSN (online) 2474-1949
    DOI 10.21980/J8D07Z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Author Response to: "Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue".

    McCoy, C Eric

    The western journal of emergency medicine

    2019  Volume 20, Issue 6, Page(s) 976

    MeSH term(s) Cardiopulmonary Resuscitation ; Humans ; Manikins ; Students, Medical
    Language English
    Publishing date 2019-10-14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-900X
    ISSN (online) 1936-9018
    ISSN 1936-900X
    DOI 10.5811/westjem.2019.8.44853
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Understanding the Use of Composite Endpoints in Clinical Trials.

    McCoy, C Eric

    The western journal of emergency medicine

    2018  Volume 19, Issue 4, Page(s) 631–634

    Abstract: Clinicians, institutions, healthcare networks, and policymakers use outcomes reported in clinical trials as the basis for medical decision-making when managing individual patients or populations. Therefore, the choice of a valid primary endpoint is ... ...

    Abstract Clinicians, institutions, healthcare networks, and policymakers use outcomes reported in clinical trials as the basis for medical decision-making when managing individual patients or populations. Therefore, the choice of a valid primary endpoint is crucial for randomized controlled trials (RCT) to demonstrate efficacy of new therapies. Recent improvements in treatment, however, have led to a decline in the morbidity and mortality of several common diseases, resulting in a reduction in relevant outcomes that can be used as clinical trial endpoints. Composite endpoints have been used as a solution to maintain the feasibility of RCTs, particularly when facing low event rates, high cost, and long follow-up. However, the benefits of using composite endpoints must be weighed against the risks of misinterpretation by clinicians and policymakers, as incorrect interpretation may have a detrimental effect on patients and populations. This paper defines a composite endpoint, discusses the rationale for its use, and provides a practical approach to interpreting results to aid in medical decision-making.
    MeSH term(s) Decision Making ; Drug Therapy ; Endpoint Determination ; Humans ; Randomized Controlled Trials as Topic ; Risk Factors
    Language English
    Publishing date 2018-06-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-900X
    ISSN (online) 1936-9018
    ISSN 1936-900X
    DOI 10.5811/westjem.2018.4.38383
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Comparative Effectiveness of GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP-4 Inhibitors, and Sulfonylureas for Sight-Threatening Diabetic Retinopathy.

    Barkmeier, Andrew J / Herrin, Jeph / Swarna, Kavya Sindhu / Deng, Yihong / Polley, Eric C / Umpierrez, Guillermo E / Gallindo, Rodolfo J / Ross, Joseph S / Mickelson, Mindy M / McCoy, Rozalina G

    Ophthalmology. Retina

    2024  

    Language English
    Publishing date 2024-05-10
    Publishing country United States
    Document type Journal Article
    ISSN 2468-6530
    ISSN (online) 2468-6530
    DOI 10.1016/j.oret.2024.05.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Author Response to

    C. Eric McCoy

    Western Journal of Emergency Medicine, Vol 20, Iss

    “Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue”

    2019  Volume 6

    Keywords Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Language English
    Publishing date 2019-10-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  7. Article ; Online: Understanding the Intention-to-treat Principle in Randomized Controlled Trials.

    McCoy, C Eric

    The western journal of emergency medicine

    2017  Volume 18, Issue 6, Page(s) 1075–1078

    Abstract: Clinicians, institutions, and policy makers use results from randomized controlled trials to make decisions regarding therapeutic interventions for their patients and populations. Knowing the effect the intervention has on patients in clinical trials is ... ...

    Abstract Clinicians, institutions, and policy makers use results from randomized controlled trials to make decisions regarding therapeutic interventions for their patients and populations. Knowing the effect the intervention has on patients in clinical trials is critical for making both individual patient as well as population-based decisions. However, patients in clinical trials do not always adhere to the protocol. Excluding patients from the analysis who violated the research protocol (did not get their intended treatment) can have significant implications that impact the results and analysis of a study. Intention-to-treat analysis is a method for analyzing results in a prospective randomized study where all participants who are randomized are included in the statistical analysis and analyzed according to the group they were originally assigned, regardless of what treatment (if any) they received. This method allows the investigator (or consumer of the medical literature) to draw accurate (unbiased) conclusions regarding the effectiveness of an intervention. This method preserves the benefits of randomization, which cannot be assumed when using other methods of analysis. The risk of bias is increased whenever treatment groups are not analyzed according to the group to which they were originally assigned. If an intervention is truly effective (truth), an intention-to-treat analysis will provide an unbiased estimate of the efficacy of the intervention at the level of adherence in the study. This article will review the "intention-to-treat" principle and its converse, "per-protocol" analysis, and illustrate how using the wrong method of analysis can lead to a significantly biased assessment of the effectiveness of an intervention.
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-900X
    ISSN (online) 1936-9018
    ISSN 1936-900X
    DOI 10.5811/westjem.2017.8.35985
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Bilateral Luxatio Erecta Humeri.

    Martinez-Romo, Miguel A / Lotfipour, Shahram / McCoy, C Eric

    Clinical practice and cases in emergency medicine

    2021  Volume 5, Issue 2, Page(s) 249–250

    Abstract: Case presentation: We describe a middle-aged male presenting to the emergency department with bilateral shoulder pain, holding both arms in abduction after trauma. Radiographs demonstrated a bilateral inferior dislocation of the glenohumeral joints ... ...

    Abstract Case presentation: We describe a middle-aged male presenting to the emergency department with bilateral shoulder pain, holding both arms in abduction after trauma. Radiographs demonstrated a bilateral inferior dislocation of the glenohumeral joints consistent with luxatio erecta humeri.
    Discussion: We review the clinical presentation of luxatio erecta and its complications. We also describe the characteristic presentation on radiographs. Our case illustrates the hallmark findings of luxatio erecta of an abducted humeral shaft parallel to the scapular spine.
    Language English
    Publishing date 2021-08-26
    Publishing country United States
    Document type Journal Article
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.2021.1.51255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Understanding the Use of Composite Endpoints in Clinical Trials

    C. Eric McCoy

    Western Journal of Emergency Medicine, Vol 19, Iss

    2018  Volume 4

    Abstract: Clinicians, institutions, healthcare networks, and policymakers use outcomes reported in clinical trials as the basis for medical decision-making when managing individual patients or populations. Therefore, the choice of a valid primary endpoint is ... ...

    Abstract Clinicians, institutions, healthcare networks, and policymakers use outcomes reported in clinical trials as the basis for medical decision-making when managing individual patients or populations. Therefore, the choice of a valid primary endpoint is crucial for randomized controlled trials (RCT) to demonstrate efficacy of new therapies. Recent improvements in treatment, however, have led to a decline in the morbidity and mortality of several common diseases, resulting in a reduction in relevant outcomes that can be used as clinical trial endpoints. Composite endpoints have been used as a solution to maintain the feasibility of RCTs, particularly when facing low event rates, high cost, and long follow-up. However, the benefits of using composite endpoints must be weighed against the risks of misinterpretation by clinicians and policymakers, as incorrect interpretation may have a detrimental effect on patients and populations. This paper defines a composite endpoint, discusses the rationale for its use, and provides a practical approach to interpreting results to aid in medical decision-making.
    Keywords Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Language English
    Publishing date 2018-06-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  10. Article ; Online: Flail Chest Resulting from a Rocket-type Firework.

    McCoy, C Eric / Zuabi, Nadia / Lotfipour, Shahram

    Clinical practice and cases in emergency medicine

    2018  Volume 2, Issue 4, Page(s) 355–356

    Language English
    Publishing date 2018-10-17
    Publishing country United States
    Document type Journal Article
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.2018.9.39941
    Database MEDical Literature Analysis and Retrieval System OnLINE

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