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Emergency Treatment
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1. The use of intramuscular benzodiazepines and antipsychotic agents in the treatment of acute agitation or violence in the emergency department.
Match Strength: 6.043

The management of an agitated, abusive or violent patient is a common and challenging problem in Emergency Medicine. Priorities include measures to ensure the safety of the patient and the emergency staff, including provision of physical restraint of the patient and evaluation for correctable medical causes of such behavior. Medications used in the treatment of such patients include benzodiazepines and antipsychotic agents. The newer atypical antipsychotic agents seem to provide a safe and effective treatment for such patients. The atypical antipsychotic agents may have fewer short-term side ... Read More »
» Published in J Emerg Med. 2006 Oct;31(3):317-24.

2. The impact of antithrombotic therapy on neurosurgical emergency referral load.
Match Strength: 5.954

The authors sought to determine the impact of antithrombotic therapy on emergency referrals at one neurosurgical centre. All emergency telephone referrals over a 90 day period were carefully documented with particular attention paid to current antithrombotic medications and their indication. Details regarding age, gender, diagnosis, radiological findings and treatment were also recorded. 713 emergency referrals were documented in the data collection period. 174 (24.4%) patients presented with intracranial or spinal haemorrhage and 75 (43.1%) of these were on antithrombotic therapy, ranging in ... Read More »
» Published in Ir Med J. 2006 Jul-Aug;99(7):206-8.

3. Command and control in emergency services operations: a social network analysis.
Match Strength: 5.632

There is increasing interest in the use of social network analysis as a tool to study the performance of teams and organizations. In this paper, processes of command and control in the emergency services are explored from the perspective of social network theory. We report a set of network analyses (comprising visualization, a selection of mathematical metrics, and a discussion of procedures) based on the observation of six emergency service incidents: three fire service operations involving the treatment of hazardous chemicals, and three police operations involving immediate response to ... Read More »
» Published in Ergonomics. 2006 Oct 10-22;49(12-13):1204-25.

4. Mycotic aortic aneurysm following treatment of pyogenic vertebral osteomyelitis.
Match Strength: 4.473

Mycotic aortic aneurysm is a surgical emergency. However, its bizarre presentations could delay the golden hour of surgical reconstruction which is the mainstay of treatment. We report a case of mycotic aneurysm of the aortic arch which developed in the postoperative period after surgical treatment of pyogenic vertebral osteomyelitis at the lower thoracic level ... Read More »
» Published in Asian Cardiovasc Thorac Ann. 2006 Oct;14(5):e102-5.

5. Prevalence of tubo-ovarian abscess in adolescents diagnosed with pelvic inflammatory disease in a pediatric emergency department.
Match Strength: 3.944

OBJECTIVES: The rate of tubo-ovarian abscess (TOA) in adolescents with pelvic inflammatory disease (PID) is reported to range from 17% to 20%. However, no reports have focused specifically on the adolescent patient presenting to the emergency department (ED), regardless of whether they are treated in the inpatient or outpatient setting. Recent changes in the 2002 Centers for Disease Control and Prevention (CDC) Guidelines for the Treatment of Sexually Transmitted Diseases and sexually transmitted infection screening programs are likely to have impacted both the prevalence of PID and the rates ... Read More »
» Published in Pediatr Emerg Care. 2006 Sep;22(9):621-5.

6. Acute abdominal pain caused by a spontaneous intramyometrial hematoma in type III von Willebrand disease.
Match Strength: 3.922

OBJECTIVES: To discuss the clinical picture, differential diagnosis and management of a pediatric patient with von Willebrand disease (vWD) presenting with severe abdominal pain caused by an intramyometrial hematoma. METHODS: A 17-year-old girl with type III vWD was admitted to the emergency department with a complaint of severe lower abdominal pain different from her usual dysmenorrhea. She had no history of trauma to the pelvic region or any sexual intercourse. Transabdominal ultrasonography and magnetic resonance imaging revealed an intramyometrial hematoma in anterofundal region of uterus. ... Read More »
» Published in Pediatr Emerg Care. 2006 Sep;22(9):650-2.

7. Percutaneous CT scan-guided drainage vs. antibiotherapy alone for Hinchey II diverticulitis: a case-control study.
Match Strength: 3.869

PURPOSE: CT-scan-guided percutaneous abscess drainage of Hinchey Stage II diverticulitis is considered the best initial approach to treat conservatively the abscess and to subsequently perform an elective sigmoidectomy. However, drainage is not always technically feasible, may expose the patient to additional morbidity, and has not been critically evaluated in this indication. This study was undertaken to compare the results of percutaneous drainage vs. antibiotic therapy alone in patients with Hinchey II diverticulitis. METHODS: This was a case-control study of all patients who presented in ... Read More »
» Published in Dis Colon Rectum. 2006 Oct;49(10):1533-8.

8. Midazolam and diazepam for pediatric seizures in the prehospital setting.
Match Strength: 3.845

OBJECTIVE: The objective of this study was to compare the efficacy and adverse events associated with the use of diazepam and midazolam for the treatment of pediatric seizures in the prehospital setting. METHODS: This was a retrospective cohort study of all patients younger than 18 years treated for a seizure with a benzodiazepine by emergency medical services in Multnomah County, Oregon, from 1998 to 2001. The emergency medical services system consists of a single private advanced life support transporting ambulance service with fire department first responders that are all advanced life ... Read More »
» Published in Prehosp Emerg Care. 2006 Oct-Dec;10(4):463-7.

9. Survey of California emergency departments about practices for management of suicidal patients and resources available for their care.
Match Strength: 3.677

STUDY OBJECTIVE: To determine the resources available and current practices for the treatment of patients with suicidal ideation or attempts in California emergency departments (EDs). METHODS: We conducted a mail and e-mail survey of the directors of all 346 EDs in the state of California. Data collected included identification of hospital and respondent, type of hospital, presence of separate psychiatric ED, total number of ED patients and number of ED patients with suicidal ideation or attempts who were treated per week, mental health personnel on call to evaluate suicidal patients, criteria ... Read More »
» Published in Ann Emerg Med. 2006 Oct;48(4):452-8, 458.e1-2. Epub 2006 Aug 21. Comment in: Ann Emerg Med. 2006 Oct;48(4):467-9.

10. Rationale for establishing regional ST-elevation myocardial infarction receiving center (SRC) networks.
Match Strength: 3.416

Recent developments have provided a unique opportunity for the organization of regional ST-elevation myocardial infarction (STEMI) receiving center (SRC) networks. Because cumulative evidence has demonstrated that rapid primary percutaneous coronary intervention (PCI) is the most effective reperfusion strategy for acute STEMI, the development of integrated SRC networks could extend the benefits of primary PCI to a much larger segment of the US population. Factors that favor the development of regional SRC networks include results from recently published clinical trials, insight into ... Read More »
» Published in Am Heart J. 2006 Oct;152(4):661-7.

11. What is the rationale for hydrocortisone treatment in children with infection-related adrenal insufficiency and septic shock?
Match Strength: 3.373

Recent studies show that children who die from fulminant meningococcaemia have very low cortisol:adrenocorticotrophic hormone (ACTH) ratios within the first 8 h of presentation to emergency facilities compared with survivors. This observation supports the possibility that adrenal insufficiency may contribute to rapid cardiovascular collapse in these children. In recent years, the use of hydrocortisone treatment has become increasingly popular in the care of adult and paediatric patients with septic shock. In this review, the classical adrenal insufficiency literature is presented and the ... Read More »
» Published in Arch Dis Child. 2007 Feb;92(2):165-9. Epub 2006 Sep 26.

12. Posterior spinal epidural abscess: an unusual complication of vertebroplasty.
Match Strength: 3.118

OBJECTIVE: Complications after vertebroplasty are rare. There are few reported infectious complications requiring surgical management such as corpectomy with anterior reconstruction and posterior stabilization, although we have not seen any reports about epidural abscess in the literature. We present a patient in whom posterior epidural abscess developed after vertebroplasty in which drainage and antibiotherapy were required for treatment. METHODS: A 70-year-old female with a painful T12 osteoporotic compression fracture underwent percutaneous vertebroplasty using polymethylmethacrylate ... Read More »
» Published in Joint Bone Spine. 2006 Dec;73(6):753-5. Epub 2006 Apr 25.

13. Predictors of in-hospital delay to reperfusion in patients with acute myocardial infarction in Japan.
Match Strength: 2.943

The purpose of this study was to identify factors associated with in-hospital delay in patients with acute myocardial infarction (AMI) in Japan. In this observational study, 155 consecutive patients admitted with AMI to one of five urban hospitals were studied. The median door-to-needle time and door-to-catheterization-laboratory time was 19 min and 60 min, respectively. Three variables predicted door-to-catheterization-laboratory times >/= 60 min: failing to call an ambulance, direct admission to the hospital, and absence of diaphoresis (p < 0.05). These findings support the need for ... Read More »
» Published in J Emerg Med. 2006 Oct;31(3):241-5.

14. Facilitated percutaneous coronary intervention.
Match Strength: 2.930

The goal of the initial treatment for ST-segment elevation myocardial infarction is rapid and effective reperfusion. Randomized trials have demonstrated that primary angioplasty is preferred over thrombolysis if done in a timely manner and by an experienced team. However, due to many factors, performance of primary angioplasty within the goal of 90 min is often not possible. A combined strategy of immediate thrombolysis in the emergency room or in the ambulance followed by angioplasty theoretically could provide early reperfusion with subsequent angioplasty to insure complete reperfusion. Over ... Read More »
» Published in J Am Coll Cardiol. 2006 Sep 19;48(6):1120-8. Epub 2006 Aug 28.

15. Effectiveness of prehospital continuous positive airway pressure in the management of acute pulmonary edema.
Match Strength: 2.810

OBJECTIVE: To compare the effectiveness of continuous positive airway pressure (CPAP) with standard pharmacologic treatment in the management of prehospital acute pulmonary edema. METHODS: Using a nonrandomized control group design, all consecutive patients presenting to two participating emergency medical services (EMS) systems with a field impression of acute pulmonary edema between July 1, 2004, and June 30, 2005, were included in the study. The control EMS system patients received standard treatment with oxygen, nitrates, furosemide, morphine, and, if indicated, endotracheal intubation. ... Read More »
» Published in Prehosp Emerg Care. 2006 Oct-Dec;10(4):430-9.

16. Trends in Mental Health and Substance Abuse Services at the Nation's Community Health Centers: 1998-2003.
Match Strength: 2.773

OBJECTIVE: We examined trends in delivery of mental health and substance abuse services at the nation's community health centers. METHODS: Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. RESULTS: Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000. There was an increase in the number of patients per specialty mental health/substance abuse treatment ... Read More »
» Published in Am J Public Health. 2006 Oct;96(10):1779-84.

17. Ictal paralysis with tonic eye gazing mimicking a pontine infarction.
Match Strength: 2.423

PURPOSE: Concomitant positive and negative motor phenomena in a single seizure have not been reported before. METHOD: We used an extensive history review, neurological examination, EEG, MRI and SPECT study to demonstrate a rare combination of motor presentations as an ictal phenomenon. RESULT: A 64-year-old male was brought to the emergency room with dizziness, progressive drowsiness and left hemiparesis. A spontaneous eye deviation to the left side with nystagmus was observed. A right pontine lesion was tentatively diagnosed. However, a focal motor seizure of the patient's left face and limbs ... Read More »
» Published in Seizure. 2006 Dec;15(8):637-42. Epub 2006 Sep 22.

18. Results of streamlined regional ambulance transport and subsequent treatment of acute abdominal aortic aneurysms.
Match Strength: 2.310

OBJECTIVE: To describe the triage of patients operated for non-ruptured and ruptured abdominal aortic aneurysms (AAAs) before the endovascular era. DESIGN: Retrospective single-centre cohort study. METHODS: All patients treated for an acute AAA between 1998 and 2001 and admitted to our hospital were evaluated in the emergency department for urgent AAA surgery. All time intervals, from the telephone call from the patient to the ambulance department, to the arrival of the patient in the operating theatre, were analysed. Intraoperative, hospital and 1-year survival were determined. RESULTS: 160 ... Read More »
» Published in Emerg Med J. 2006 Oct;23(10):807-10.

19. Brief review: angiotensin converting enzyme inhibitors and angioedema: anesthetic implications.
Match Strength: 2.132

PURPOSE: Angiotensin converting enzyme inhibitors (ACEIs) are a group of drugs used to treat hypertension and heart failure, with additional benefits, such as cardiovascular and renal protection, in patients with diabetes. However, angioedema as a complication of ACEI therapy is under-recognized. As there are important implications for anesthesiologists and emergency medicine physicians, a review was undertaken to document the scope of the problem of ACEI-induced angioedema.. METHODS: A review of the published literature (identified by searching Medline, EMBASE and CINAHL) was undertaken, ... Read More »
» Published in Can J Anaesth. 2006 Oct;53(10):994-1003.

20. Relief of acute pain in chronic idiopathic gastroparesis with intravenous phentolamine.
Match Strength: 2.015

OBJECTIVE: To report a case in which complete relief of pain associated with gastroparesis, with promotion of gastric emptying, was achieved with administration of phentolamine. CASE SUMMARY: A 37-year-old opiate-tolerant female with a history of recurrent abdominal pain, gastroparesis, cyclic vomiting syndrome, and migraine headaches was admitted to the emergency department (ED) with severe acute abdominal pain, nausea, and vomiting. The patient had been previously implanted with a permanent gastric electrical stimulator and she was adherent to her prokinetic, antiemetic, analgesic, and ... Read More »
» Published in Ann Pharmacother. 2006 Nov;40(11):2032-6. Epub 2006 Sep 26.

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