Annals of emergency medicine
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Editorial Comment
Evidence-based emergency medicine: clinical synopsis. No clear winner among dressings for partial-thickness burns.
The authors searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Wounds Group Specialized Register (May 29, 2008), MEDLINE (1950 to May 2008), EMBASE (1980 to May 2008), and CINAHL (1982 to May 2008). ⋯ Studies were reviewed by 2 authors independently and data were abstracted using standardized forms. The authors abstracted and pooled data from eligible studies by using appropriate analytical methods according to the Cochrane Handbook, version 5.0.0. Studies were assessed for the adequacy of randomization and allocation concealment, blinding of providers and participants, potential selection bias after allocation, and completeness of follow-up.
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Randomized Controlled Trial
Stress cardiac magnetic resonance imaging with observation unit care reduces cost for patients with emergent chest pain: a randomized trial.
We determine whether imaging with cardiac magnetic resonance imaging (MRI) in an observation unit would reduce medical costs among patients with emergent non-low-risk chest pain who otherwise would be managed with an inpatient care strategy. ⋯ Compared with inpatient care, an observation unit strategy involving stress cardiac MRI reduced incident cost without any cases of missed acute coronary syndrome in patients with emergent chest pain.
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Coronary artery calcium scoring (CACS) is a simple and readily available test for identifying coronary artery disease. Our objective is to evaluate whether a CACS of zero will identify chest pain patients who can be safely discharged home, without need for further cardiac testing. ⋯ A majority of patients (61% in our sample) evaluated for chest pain of uncertain cardiac cause have a CACS of 0, which predicts both a normal SPECT result and an excellent short-term outcome. Our results suggest that patients with a CACS of 0 can be discharged home, without further cardiac testing.
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Letter Case Reports
Scorpion antivenom administered by alternative infusions.