Annals of emergency medicine
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This study investigated the hypothesis that modern computed tomographic (CT) imaging is sufficient to exclude subarachnoid hemorrhage (SAH) in patients with severe headache. ⋯ Modern CT imaging is sufficient to exclude 97.5% of SAH in patients presenting to the ED with "worst headache" symptoms.
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Randomized Controlled Trial Clinical Trial
Randomized clinical trial of melatonin after night-shift work: efficacy and neuropsychologic effects.
Melatonin has received considerable publicity for its sleep-promoting properties; however, there is little scientific evidence of its efficacy. The objective of this study is to determine whether there are measurable beneficial effects from exogenous melatonin in emergency physicians after intermittent night-shift duty. ⋯ We found no beneficial effect of melatonin on sleep quality, tiredness, or cognitive function in emergency physicians after night-shift duty. Our results suggest that exogenous melatonin is of limited value in recovery from night-shift work in emergency physicians.
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Comparative Study
Indicators of assault-related injuries among women presenting to the emergency department.
We sought to determine whether women presenting for treatment of assault-related injuries at a public hospital emergency department differed from those presenting for unintentional injuries with regard to a variety of demographic and presentation characteristics, nature and anatomic site of injury, and admission or follow-up treatment for injury. ⋯ Women identified as presenting with assault-related injuries differ from those who present with unintentional injuries in terms of their demographic and presentation characteristics, as well as the nature, anatomic site of injury, and follow-up treatment for injuries. Although some of this information has implications for service delivery to abused women, the use of clinical indicators such as nature and anatomic site of injury have limited predictive value. Therefore we recommend that health care providers routinely screen patients for assault, particularly assault by intimate partners, so that they may respond appropriately by providing better treatment and referral.
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Comparative Study
Preliminary study of the capnogram waveform area to screen for pulmonary embolism.
Acute pulmonary embolism (PE) increases alveolar dead space, which can dilute carbon dioxide content in exhaled breath. This study was undertaken to determine whether the capnogram waveform area from patients with PE is decreased compared with that from patients without PE and to examine the potential role of the capnogram waveform area as a screening test for PE. ⋯ The capnogram waveform area may be useful in screening for PE in the ED.