The American journal of emergency medicine
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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.
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Comparative Study
Facial trauma in motor vehicle accidents: etiological factors.
The effects of seat belts and the use of alcohol and drugs have been studied as etiological factors in facial trauma to occupants of motor vehicle accidents (MVAs). During a 15-month period, 461 patients were admitted to a regional trauma center as a result of injuries sustained in MVAs. Two hundred thirty-seven (51%) of these patients had facial trauma. ⋯ Head injuries and blunt chest trauma were most commonly associated injuries in these patients. This study suggests that use of alcohol and drugs in occupants of the motor vehicle had a major effect on the etiology of facial trauma. Also it supports the data that suggests that the use of seat belts prevents a wide range of injuries including facial trauma in MVAs.
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Review Case Reports
Imipramine-provoked paradoxical pheochromocytoma crisis: a case of cardiogenic shock.
The dramatic presentation of pheochromocytoma in crisis is uncommon and is classically associated with a state of hemodynamic and sympathetic hyperactivity. The case of a 35-year-old man with an occult pheochromocytoma presenting with hypotension and cardiogenic shock shortly after beginning imipramine therapy is presented. Retrospectively, there was a history of emergency department, inpatient, and outpatient evaluation of symptoms likely to be related to an occult pheochromocytoma. ⋯ Shortly after admission the patient's occult pheochromocytoma was discovered and subsequently specific therapy was initiated. The patient's symptoms resolved after surgical resection of the tumor, and he was ultimately discharged without signs of congestive heart failure. The clinical pathophysiology of cardiomyopathy secondary to pheochromocytoma, and possible mechanisms of pharmacological interactions with tricyclic antidepressants are discussed.
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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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In a retrospective case review of inpatient and emergency department (ED) records during a 55-month period, 155 hospitalizations for Kawasaki syndrome (KS) were identified, of which 44 were seen in the ED. In 16 cases, KS was already suspected by their private physicians and confirmed in the ED by a KS specialist. In the remaining 28, patients presented initially to the ED. ⋯ In four instances, patients were hospitalized for other reasons. In all cases in which the diagnosis of KS was not made in the ED, viral infections or sepsis were suspected. One child presented to the ED in respiratory arrest and severe bradycardia.