The American journal of emergency medicine
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Comparative Study Observational Study
Arterial pH selectively predicts critical care needs in emergency department obese patients with acute dyspnea: A prospective comparative study.
Obese patients with acute dyspnea may be prone to misorientation from the emergency department (ED), due to impaired gas exchange evaluation and altered basal respiratory profiles. This study aims to evaluate the prognostic value of arterial blood pH in obese ED patients with acute dyspnea in comparison to non-obese counterparts. ⋯ Arterial blood pH may selectively predict critical care needs in ED obese patients with acute dyspnea, in comparison to non-obese. A falsely reassuring pH < 7.36 should be regarded as a marker of severity when assessing acute dyspnea in obese ED patients.
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Comparative Study
Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction.
The objective of this study was to examine the effects of metoprolol versus diltiazem in the acute management of atrial fibrillation (AF) with rapid ventricular response (RVR) in patients with heart failure with reduced ejection fraction (HFrEF). ⋯ For the acute management of AF with RVR in patients with HFrEF, IVP diltiazem achieved similar rate control with no increase in adverse events when compared to IVP metoprolol.
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We sought to develop a practical Bedside Score for the diagnosis of cholecystitis and test its accuracy against the Tokyo Guidelines (TG13). ⋯ A clinical prediction score for cholecystitis demonstrates accuracy equivalent to TG13. Use of this score may streamline work-up by decreasing the need for comprehensive ultrasound evaluation and CRP measurement and may shorten ED length of stay.
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The objective of this study was to evaluate the temporal relationship between clinical practice guideline development and subsequent research performed, with the goal of providing more data on areas of sparse evidence that serve to underlie guideline recommendations. We aimed to assess the quality of current research efforts to address the American College of Emergency Physicians guideline and to provide suggestions for future research of mild traumatic brain injury. ⋯ The amount of research dedicated to investigation of mild traumatic brain injury continues to be sparse and of poor quality. Study results should always be posted, even if the null hypothesis is confirmed. Efforts to improve the evidence base of a guideline should be realized by designing studies that directly assess and speak to the questions posed by guideline authors.
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Letter Multicenter Study
Epidemiology of and risk factors for iliopsoas abscess in a large community-based study.