Annals of emergency medicine
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We report a case of an iliac apophyseal fracture in a 15-year-old boy, sustained while swinging a baseball bat. He presented with right hip pain one hour after the injury occurred. ⋯ The iliac crest is an unusual site of injury for this avulsion fracture. Only one other well-described case of an acute, noncontact fracture of the iliac apophysis with a similar mechanism of injury has been reported.
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To demonstrate the usefulness of cranial computed tomography (CT) in the emergency department evaluation of HIV-infected patients and patients with risk factors for HIV infection who present with neurologic complaints. ⋯ CT detected clinically significant neuropathology among our study patients. Because lesions and mass effect were associated with nonfocal as well as focal presentations, CT is indicated in every neurologically symptomatic patient with HIV infection or risk factors for infection. Because HIV-related diseases can progress rapidly, repeat CT is recommended even in patients with recent scans.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations.
To compare the tissue adhesive Histoacryl Blue with suturing in the repair of pediatric facial lacerations. ⋯ Histoacryl Blue is a faster and less painful method of facial laceration repair that has cosmetic results similar to the use of sutures.
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Randomized Controlled Trial Clinical Trial
Effect of needle changing and intravenous cannula collection on blood culture contamination rates.
We tested the hypotheses that blood culture positivity and contamination rates were not increased by not changing needles between venipuncture and inoculation of blood culture bottles or by taking blood for culture by freshly inserted IV cannulae. ⋯ The results of this study do not support the practice of changing needles before inoculating blood samples into blood culture bottles. Collection of blood for culture through freshly inserted IV cannulae is associated with a low contamination rate and is an acceptable alternative to direct venipuncture. Sources of bias in this study suggest that further research is needed to determine the optimal technique for collecting blood cultures.
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This study examined the success rate, time required, technical ease, and reported patient discomfort for the use of scapular manipulation in the reduction of anterior shoulder dislocation. This study included a new variation of this technique using the seated position. ⋯ Scapular manipulation generally is a simple, rapid, and reliable technique for the reduction of anterior shoulder dislocation.