The American journal of emergency medicine
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The aim of the study was to investigate racial/ethnic differences in emergency care for patients with joint dislocation. ⋯ Black patients presenting to the ED with joint dislocations received lower quality of care in some, but not all, areas compared with white patients. Future interventions should target these areas to eliminate racial disparities in dislocation care.
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Survival after in-hospital cardiac arrest (CA) has been reported to be surprisingly low without any major improvement during the last decade. ⋯ An intervention within 1 single hospital (systematic training of all health care professionals in cardiopulmonary resuscitation and implementation of automated external defibrillators) did not reduce treatment delay or increase overall survival. Our results, however, suggest indirect signs of an improved cerebral function among survivors.
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This study was performed to evaluate whether heart-type fatty acid-binding protein (H-FABP) could predict 28-day mortality in patients with severe sepsis and septic shock. ⋯ The H-FABP was an independent prognostic factor and could be a useful biomarker for 28-day mortality in patients with severe sepsis and septic shock.
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Spontaneous urinary bladder perforation is a rare and life-threatening condition similar to traumatic and iatrogenic perforation. The connection with the underlying bladder damage due to previous radiotherapy, inflammation, malignancy, obstruction, or other causes can be found in almost all cases. The symptoms are often nonspecific, and misdiagnosis is common. ⋯ It appears probable that the infection was due to local interference with the blood supply (arterial, capillary, or venous) combined with the systemic metabolic upset that led to the bladder condition. In our case, we observed partial necrosis of the bladder rather than distortion of the entire blood supply to the bladder as consequences of the microvascular effects of diabetes. Urinary bladder perforation must be considered in the differential diagnosis of patients presenting with free fluid in the abdomen/peritonitis, decreased urine output, and hematuria, and in whom increased levels of urea/creatinine are detected in serum and/ or peritoneal fluid aspirate.
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Randomized Controlled Trial
The effects of prewarming the I-gel on fitting to laryngeal structure.
The supraglottic airway, I-gel (Intersurgical, Wokingham, United Kingdom), has a noninflatable cuff, which softens at body temperature to fit to laryngeal structure. The present study was performed to investigate the hypothesis that the cuff of I-gel can fit to laryngeal structure faster when prewarmed to body temperature than kept at room temperature. ⋯ Prewarming the I-gel to body temperature did not have any significant benefits in comparison with the I-gel kept at room temperature.