The American journal of emergency medicine
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Comparative Study
Perpetrators of intimate partner violence use significantly more methamphetamine, cocaine, and alcohol than victims: a report by victims.
Our objectives were (1) to determine demographic characteristics of intimate partner violence (IPV) victims and perpetrators, as reported by victims in a Victim Assistance Unit where police are called to the scene for IPV, and (2) to compare the relative risk of methamphetamine, cocaine, and alcohol use in perpetrators vs victims of IPV, as reported by victims. ⋯ By victim report, perpetrators were more likely to have witnessed IPV as children. By victim report, perpetrators were also more likely to use methamphetamine, cocaine, and alcohol and other drugs. Knowing this correlation may be important to the emergency department physician as screening for drug use, especially methamphetamine, as well as IPV may be useful to identify IPV-related injuries and provide proper referrals for IPV and drug use treatment.
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Case Reports
Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty.
We report a case of symptomatic polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty to alert clinicians to this potential cause of pulmonary emboli. A 77-year-old woman developed acute respiratory failure after multilevel percutaneous vertebroplasty. She received mechanical ventilatory support and anticoagulation with low-molecular-weight heparin and warfarin. ⋯ Polymethyl methacrylate cement extravasation into the vertebral venous circulation is common during vertebroplasty. Pulmonary embolism caused by cement migration after this procedure is extremely rare, as reported in the literature to date. However, the frequency of this complication may increase secondary to the widespread use of percutaneous vertebroplasty and kyphoplasty for osteoporotic compression fractures.
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Diaphragmatic rupture occurs in 0.8% to 3.6% of patients after blunt or penetrating thoracoabdominal trauma, and the preoperative diagnosis is difficult. The diagnosis of traumatic diaphragmatic rupture may be made on initial presentation or at any time later. Right-sided diaphragmatic rupture is rare and occurs in approximately 5% to 20% of all diaphragmatic disruptions. ⋯ He was referred to our hospital with the signs of herniation of the right diaphragm, which was manifested in the chest x-rays. The definite diagnosis was made through thoracoabdominal computed tomography. The diaphragmatic rupture was repaired via abdominal approach.
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This study examined the variability of blood pressure measurements and prevalence estimates of elevated blood pressure in emergency department (ED) patients using 4 different methods of categorization. ⋯ Determination of elevated blood pressure in ED patients is largely dependent on the method of blood pressure categorization.
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Multiple artifacts B lines (B+) at transthoracic lung ultrasound have been proposed as a sonographic sign of pulmonary congestion. Our aim is to assess B+ clearance after medical treatment in acute decompensated heart failure (ADHF) and to compare the usefulness of sonography with other traditional tools in monitoring resolution of pulmonary congestion. ⋯ B line pattern mostly clears after adequate medical treatment of ADHF and represents an easy-to-use alternative bedside diagnostic tool for clinically monitoring pulmonary congestion in patients with ADHF.