The American journal of emergency medicine
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The aim of this study was to evaluate the additional predictive value of serum potassium (SK) to Thrombolysis In Myocardial Infarction (TIMI) risk score for malignant ventricular arrhythmias (MVA) in patients within 24 hours of acute myocardial infarction (AMI). ⋯ Serum potassium on admission to the emergency department may be used as a valuable predictor and could add predictive information to some extent to TIMI risk score for MVA attack during 24-hour post-AMI.
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Admitting patients directly to a heart attack center (HAC) catheter laboratory for primary percutaneous coronary intervention (PPCI) bypassing the emergency department (ED) might be beneficial in delivering treatment of ST-elevation myocardial infarction with superior outcome. ⋯ A direct-access catheter laboratory (HAC) model of PPCI bypassing the ED should be the favored approach to service delivery with superior outcome.
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Spinal epidural hematoma is an accumulation of blood in the epidural space that can mechanically compress the spinal cord. It is an uncommon condition, and most cases occur spontaneously. Detailed evaluation of neurologic deficit and detailed history taking are important tools for early diagnosis, and magnetic resonance imaging is currently the diagnostic method of choice. ⋯ Cervical spinal epidural hematoma was confirmed after obtaining magnetic resonance imaging. Patients with this uncommon presentation must be carefully distinguished from acute stroke. This article aimed to highlight the potential pitfalls in diagnosing acute hemiparesis with no cranial nerves deficits and the importance of clinical suspicion.
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The aim of the study was to assess the role of artificial neural networks in the diagnosis of acute appendicitis in patients presenting with right lower abdominal pain. Data from 156 patients presenting with suspected appendicitis over a 12-month period to a rural hospital were collected prospectively. The sensitivity, specificity, and positive and negative predictive values of the artificial neural network were 100%, 97.2%, 96.0%, and 100% respectively. Artificial neural networks can be an effective tool for accurately diagnosing acute appendicitis and may reduce unnecessary appendectomies.