The American journal of emergency medicine
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To determine whether age and other readily obtainable clinical and laboratory variables could be used to predict illness severity in febrile adults, data were collected on 39 patients presenting to an emergency department (ED) with rectal temperature > or = 37.8 degrees C (100 degrees F). Serious illness was defined as (1) need for emergency surgery; (2) intubation; (3) hypotension requiring treatment; (4) bacteremia requiring antibiotics; or (5) death. Six variables were associated with serious illness in the univariate analysis. ⋯ Optimal partitioning of these two variables showed that febrile adults younger than 50 years of age with leukocyte counts of less than 15 E9/L have a 5% incidence of serious illness (95% confidence interval [CI], 3% to 8%). In contrast, those who are > or = 50 years of age with leukocyte counts > or = 15 E9/L have a 36% incidence of serious illness (95% CI, 22% to 52%). Patients in this latter category should be carefully examined and considered for hospitalization before concluding that they may be safely discharged from the ED.
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Compartment syndrome is a relatively common condition that can cause serious limb- or life-threatening consequences. Many times the emergency department physician is the first to examine and diagnose this orthopedic emergency. ⋯ The primary goal for any physician is early recognition and appropriate treatment. If left undetected or untreated, the result is amputation of the limb or death.
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To determine if wound excision and superoxide dismutase (SOD) treatment prevent ongoing lipid peroxidation after burn injury, the plasma, kidney, and lung lipid peroxide (LPO) levels in 25% total body surface area (TBSA) burned rats was studied. The animals were given intraperitoneal bovine copper-, zinc-SOD (Cu/Zn-SOD) (50,000 U/kg dissolved in saline) or saline immediately after burns and were operated by wound debridement and allograft 2 hours after the burn. ⋯ The combination of wound excision and Cu/Zn-SOD treatment markedly inhibited the increase in both plasma and tissue LPO levels after the burn, but did not prevent the increase in Mn-SOD. Wound excision in conjunction with SOD-treatment might be therapeutic in the management of severe burns.