The American journal of emergency medicine
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Rhabdomyolysis induced acute kidney injury (AKI) develops due to leakage of the potentially nephrotoxic intracellular content into the circulation. This study aimed to evaluate the prevalence and predictive factors of AKI in Kermanshah earthquake victims. ⋯ The rate of traumatic rhabdomyolysis induced AKI development was estimated to be 2.7%. Time under the rubble and serum levels of CPK, LDH, AST, and uric acid were identified as the most important predictive factors of AKI development.
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Spontaneous pneumomediastinum is a rare complication of viral pneumonia. Here we report a case of a 52 year old male who presented with a spontaneous pneumomediastinum in COVID-19 pneumonia, followed by a severe course of disease. We discuss the pathophysiological mechanisms underlying this association as well as its possible clinical implications as a marker of disease severity in COVID-19.
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Review
Sobering centers, emergency medical services, and emergency departments: A review of the literature.
Acute alcohol intoxication accounts for a large proportion of potentially unnecessary emergency department visits and expenditure. Sobering centers are a cheaper alternative treatment option for alcohol intoxication and can provide an opportunity to treat the psychosocial aspects of alcohol use disorder. ⋯ Sobering centers are a cost effective alternative to emergency department visits for acute alcohol intoxication and further research is required to identify safe, effective protocols for EMS to triage patients to appropriate treatment destinations.
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The COVID-19 pandemic poses significant challenges to patients with end-stage kidney disease who receive treatment in outpatient dialysis centers. These patients represent a fragile population that is at higher risk for both infection and transmission. ⋯ As the pandemic continues, dialysis facilities will have an increasing burden to provide safe and accessible dialysis, while also being able to direct patients to the ED for either emergent dialysis or COVID-19 treatment/testing. We reviewed opinions, recommendations and guidelines developed by professional organizations and dialysis facilities for the management of "patients under investigation" (PUIs) and COVID-19 positive patients that depend on whether the suspicion occurs while the patient is at home vs. at the dialysis center.
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Comparative Study
Comparison of efficacy dimenhydrinate and metoclopramide in the treatment of nausea due to vertigo; a randomized study.
This study aimed to compare the therapeutic efficacy of dimenhydrinate and metoclopramide in patients with nausea and vertigo. ⋯ In conclusion, this prospective, double-blind, randomized study showed that both DMT and MTP have similar efficacy in reducing nausea and vertigo symptoms in the ED.