The American journal of emergency medicine
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The aim of this study is to determine the predictors of difficult intubation in the emergency setting. ⋯ The thyroid-to-hyoid distance less than 2 fingers is the only independent variable in predicting difficult intubation. Mallampati classification is not a useful tool in classifying the difficult intubation in the ED that the "LEMON" acrostic can be modified to "LEON".
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Severe community-acquired pneumonia (CAP) is usually defined as pneumonia that requires intensive care unit (ICU) admission; the primary pathogen responsible for ICU admission is Streptococcus pneumoniae. In this study, the 2007 Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) consensus criteria for ICU admission were compared with other severity scores in predicting ICU admission and mortality. ⋯ This study confirms the usefulness of the new criteria in predicting severe CAP. The 2001 ATS criteria seem an attractive alternative because they are simple and as effective as the 2007 IDSA/ATS criteria.
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Comparative Study
Urinalysis is not reliable to detect a urinary tract infection in febrile infants presenting to the ED.
Urinary tract infections are a common source of serious bacterial infections in febrile infants younger than 2 years. Our objective was to compare urinalysis with urine culture in the emergency department evaluation of febrile infants. ⋯ Urinalysis is not reliable for the detection of urinary tract infections in febrile infants when compared with urine cultures.
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The aims of this study were to assess the diagnostic value of D-dimer in patients with suspected acute mesenteric ischemia (AMI) and to evaluate the correlation between D-dimer levels and the severity of bowel necrosis. ⋯ Detection of serum D-dimer could not help to differentiate patient with AMI from those with non-AMI. We did not find a correlation between serum D-dimer levels and the severity of AMI. However, measurement of D-dimer levels can be of value for a small decrease in the likelihood of AMI, when the result is low.
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We present a case of a 39-year-old woman presenting to the emergency department with persistent vaginal bleeding with myoma and endometrium thickness. The qualitative urine human chorionic gonadotropin (hCG) showed positive result, however, the quantitative serum hCG had negative result. The negative serum hCG result suggests that the false-positive result was not caused by elevated circulating hCG. ⋯ On the basis of our findings, the false positive pregnancy test was not caused by hemoglobin. It is important to confirm a suspected false-positive urine hCG test using a quantitative serum hCG test. Although it is not certain the mechanism for false positive reaction in this peculiar sample, the ACON urine hCG one-step pregnancy will occasionally yield a false-positive result in this class of patients.