The American journal of emergency medicine
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Patients who present to the emergency department (ED) with symptoms of potential acute coronary syndrome (ACS) can be safely discharged home after a coronary computed tomographic angiography (CTA) with a negative result. However, the duration of time for which a negative coronary CTA scan result can be used to inform decision making when patients have recurrent symptoms is not known. ⋯ Repeated imaging potentially may not be warranted within 2 years of a negative coronary CTA result. The low rate of progression from subcritical to critical disease is consistent with observations in patients who have had prior negative cardiac catheterizations.
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Matrix metalloproteinases (MMPs) have a central role in disease progression after ischemia-reperfusion injury. However, its prognostic significance in cardiac arrest (CA) patients having cardiopulmonary resuscitation (CPR) is unknown. The aim of this study was to investigate the relation between admission MMP-9 level and early mortality in CA patients. ⋯ High MMP-9 levels were associated with worse clinical and laboratory parameters, and it seems that MMP-9 helps risk stratification in CA patients.
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Letter Randomized Controlled Trial
Predictors of in-person follow-up among subjects in an ED-based smoking cessation trial.
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Randomized Controlled Trial
A randomized controlled trial of adding intravenous pantoprazole to conventional treatment for the immediate relief of dyspeptic pain.
Acute, severe dyspeptic pain is a common condition in the emergency department. Despite the traditional "GI cocktail" (GI indicates gastrointestinal), an intravenous (IV) proton pump inhibitor (PPI), a novel acid-lowering drug, has recently been used to treat this condition. The aim of this study was to evaluate the immediate effect of IV pantoprazole in addition to the conventional GI cocktail in the relief of severe dyspeptic pain. ⋯ Intravenous PPI provides no additional benefit over the conventional GI cocktail in the relief of acute, severe dyspeptic pain. Because of its neutral effect and higher cost, the use of IV PPI to treat such conditions should be discouraged in general clinical practice.
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Randomized Controlled Trial
Efficacy of high-flow oxygen therapy in all types of headache: a prospective, randomized, placebo-controlled trial.
We aimed to assess the efficacy of oxygen inhalation therapy in emergency department (ED) patients presenting with all types of headache. ⋯ In addition to its role in the treatment of cluster headache, high-flow oxygen therapy may provide an effective treatment of all types of headaches in the ED setting.