The American journal of emergency medicine
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Recently, dedicated cardiac computed tomography (CT) has been performed to rule out acute coronary syndrome in patients with chest pain equivalents. However, acute aortic syndrome (AAS) could mimic acute coronary syndrome. We investigated the reliability of CT with a limited scan range for the detection of AAS. ⋯ Aortic lesions outside of the cardiac CT scan range were not rare. Therefore, using a cardiac CT might not guarantee ruling out AAS completely.
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To evaluate the efficacy and safety of a new F(ab')2 antivenom preparation in the treatment of Crotalinae envenomation in children. ⋯ In this series of children, the F(ab')2 antivenom appeared to be both safe and effective in the treatment of hemotoxicity and local tissue toxicity (swelling) from Crotalinae envenomation.
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Pulseless electrical activity (PEA) during cardiac arrest portends a poor prognosis. There is a paucity of data in the use of thrombolytic therapy in PEA and cardiopulmonary arrest due to confirmed pulmonary embolism (PE). We evaluated the outcome of low-dose systemic thrombolysis with tissue plasminogen activator (tPA) in patients presenting with PEA due to PE. ⋯ Rapid administration of 50 mg of tPA is safe and effective in restoration of spontaneous circulation in PEA due to massive PE leading to enhanced survival and significant reduction in pulmonary artery pressures.
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Comment Letter Multicenter Study Observational Study
A letter to the Editor: routine biological tests in self-poisoning patients: results from an observational prospective multicenter study.
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Acute scrotal pain (ASP) is a common symptom of young adults. Testicular torsion is the most important diagnosis in these cases. It is a medical emergency in which the diagnosis must be made rapidly to prevent testicular loss. This requires a high index of clinical suspicion and prompt surgical intervention. This study was conducted to examine the spectrum of diagnoses in young man with ASP in a prehospital setting, the frequency of significant diagnoses, and their outcomes. ⋯ Testicular torsion is the etiology of ASP in only 0.12% of the visits to the primary care clinic. Patient delay before attending the primary care is responsible for most of the testes lost. Patient education in addition to high index of suspicion of primary care physicians is needed for salvage of more testicles.