The American journal of emergency medicine
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There is little experience with overdose of the relatively new antidepressant bupropion. The case of an 18-year-old healthy adult female patient after an intentional ingestion of 9 g of bupropion is presented. Her hospital course was significant for grand mal seizures, sinus tachycardia without conduction abnormality, and complete neurological recovery. The first pure bupropion overdose in the emergency medicine literature is presented, and the literature pertinent to emergent management of this new antidepressant is reviewed.
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Case Reports
Reversible neurological deficits in a chronic alcohol abuser: a case report of Wernicke's encephalopathy.
The abuse of alcohol presents daily challenges for the emergency medicine physician. Wernicke's encephalopathy represents one of the metabolic complications associated with alcoholism. ⋯ Following administration of intravenous thiamine, the patient's symptoms spontaneously resolved. The pathophysiology, clinical presentation and therapy of this classic disorder are discussed.
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Multicenter Study Comparative Study
Outcome of insulin-treated diabetics receiving epinephrine during cardiac arrest.
The purpose of this study was to determine the effects of epinephrine in insulin-treated diabetics (DM) compared with nondiabetic (ND) controls during cardiopulmonary resuscitation (CPR). A retrospective analysis from a multicenter study of out-of-hospital cardiac arrest included 62 DM and 1,151 ND. Outcome parameters included return of spontaneous circulation (ROSC), blood pressure (BP), emergency department admissions (EDA), hospital admissions (HA), and hospital discharge (DC). ⋯ However, none of the DM given HDE (n = 24) were discharged from the hospital. These results suggest that DM may have improved resuscitation rates with SDE and may be adversely affected with HDE. Larger prospective studies are needed to confirm these findings.
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New research has shown that the incidence of success of replanted avulsed teeth can be greatly increased by differentially diagnosing and treating them according to the length of extraoral time and the physiological width of the apical foramen. A specific treatment regimen has been presented that will give the physician the information necessary to maximize the success of replanted avulsed teeth that may be seen.