The American journal of emergency medicine
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This work aimed to study the demographic features of patients with emergency department (ED) visits for ulcerative keratitis, including information on insurance coverage and on-site consultant support. ⋯ Emergency department participation by ophthalmologist for ulcerative keratitis was relatively high. Whether the lack of health insurance affects the decision to hospitalize patients with corneal ulcers is a question that deserves further study. What influence the high proportion of uninsured ED patients will have on ophthalmologists coverage in the future may need to be addressed.
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The objective of this study is to determine the association between the duration of high-altitude (>3000 m) pre-exposure and acute mountain sickness (AMS) incidence. ⋯ High-altitude pre-exposure lasting at least 3 days within the preceding 2 months was associated with a significant lower AMS incidence during a subsequent ascent among Jade Mountain trekkers.
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Comparative Study
Cytidine diphosphate choline improves the outcome of cardiac arrest vs epinephrine in rat model.
Cytidine diphosphate choline (CDP-choline) is a cholinergic agent that can both stimulate the cholinergic pathway and increase blood pressure. We aimed to investigate the effects of CDP-choline on the outcome of cardiac arrest in comparison with epinephrine. ⋯ When administered during resuscitation, CDP-choline increased the rate of return of spontaneous circulation similarly to epinephrine. In addition, it did not increase the severity of myocardial injury and postresuscitation myocardial dysfunction, whereas epinephrine appeared to be harmful.
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Calcaneal fractures account for 60% of all tarsal bone fractures. Tongue-type calcaneus fractures are longitudinal fractures that exit the calcaneal tuberosity posteriorly and involve a portion of the articular surface. ⋯ Skin compromise complicates a large percentage of these injuries because of the thin layer of soft tissue and superficial nature of the fracture. Early recognition by the emergency physician and prompt operative repair prevent further injury and obviate the need for surgical soft tissue coverage or potential amputation.
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A 62-year-old male smoker with no other comorbidities presented to emergency department with systemic anaphylaxis, due to oral diclofenac for toothache. He developed acute anterior wall myocardial infarction following IM epinephrine 1 mg 1:1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidence of obstructive coronary artery disease after thrombus aspiration.