The American journal of emergency medicine
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We aimed to develop a clinical prediction rule to distinguish pelvic inflammatory disease (PID) from acute appendicitis in women of childbearing age. ⋯ We developed a prediction rule for childbearing-aged women presenting with acute abdominal pain to distinguish acute appendicitis from PID based on 3 simple, clinical features: migration of pain, bilateral abdominal tenderness, and nausea and vomiting. Prospective validation is needed in other settings.
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We describe the case of an unusual (unbelievable) giant wooden foreign body traversing the neck via the glabella. The relationship between the giant wooden foreign body and the nasopharynx air column was demonstrated through multidetector computed tomography (CT). ⋯ Cases of accidental penetration injury of the head and neck by foreign bodies are not rare, but the entry of giant wooden foreign bodies into the neck via the glabella has never been reported in the literature. In our case patient, such a giant wooden foreign body was detected neither in the emergency department nor during radiologic investigations (conventional radiograms and standard CT) until the patient underwent multidetector CT 8 days after the related accident.
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Multicenter Study Clinical Trial
Accuracy of the cerebrospinal fluid results to differentiate bacterial from non bacterial meningitis, in case of negative gram-stained smear.
The aim of this study was to evaluate the usefulness of various laboratory results for differential diagnosis of bacterial (BM) and nonbacterial meningitis (NBM) with negative initial Gram stain. ⋯ CSF results have a modest role in distinguishing BM from NBM in a negative Gram stain for bacteria. PCT serum levels seem to be an excellent predictor of BM.
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Clinical Trial
Electrocardiographic artifacts due to electrode misplacement and their frequency in different clinical settings.
Misplacement of electrodes can change the morphology of an electrocardiogram (ECG) in clinical important ways. To assess the frequency of these errors in different clinical settings, we collected ECGs routinely performed at the cardiology outpatient clinic and the intensive care unit. ⋯ The frequency of ECG artifacts due to switched electrodes was 0.4% (3/739) at the outpatient clinic and 4.0% (4/99) at the intensive care unit (P = .005). In conclusion, errors in ECG performance do occur with an increasing frequency in an acute medical care setting.
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The purpose of this study was to evaluate the value of elevated cardiac troponin I (cTnI) for prediction of complicated clinical course and in-hospital mortality in patients with confirmed acute pulmonary embolism (PE). ⋯ Our results indicate that elevated cTnI levels are associated with higher risk for inhospital mortality and complicated clinical course. Troponin I may play an important role for the risk assessment of patients with PE. The idea that an elevation in cTnI levels is a valuable parameter for the risk stratification of patients with PE needs to be examined in larger prospective studies.