The American journal of emergency medicine
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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.
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The objective was to examine associations between cognitive health and unplanned emergency department (ED) revisits 30, 60, and 90 days after the initial visit. ⋯ Our sample of older, mostly female African Americans showed poorer cognitive health compared with standardized norms. However, higher cognitive health scores were linked to lower risk for unplanned ED revisit 60 and 90 days later. A clearer understanding of biological and nonbiological pathways that connect cognitive health to revisit risk in disadvantaged older populations might improve health outcomes, including the avoidance of return trips to the ED.