The American journal of emergency medicine
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Chronic low back pain is an important public health problem, generating high financial and social costs. While most clinical guidelines stress the importance of managing low back pain in primary care, in practice a disproportionate amount of patients with low back pain present to emergency departments. Patients presenting to emergency departments may form a specific group with different factors leading to chronicity. This prospective cohort study aimed to determine the sociodemographic and psychological predictors of persistent low back pain and the length of sick leave due to pain in patients with acute symptoms visiting an emergency department. ⋯ Because of its simplicity, a measurement of self-rated health may be included in future clinical practice for assessing the risk of persistent pain.
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Racial disparities have been well documented in literature regarding pain management. However, few studies have focused on its effect in the pediatric population. This study seeks to examine the relationship between race and opioid prescription patterns for children with fractures. ⋯ Racial bias is suggested in opioid prescription patterns, even in the pediatric population, which may have untoward negative downstream effects. This study delineates the need for improved and standardized methods to adequately treat pain and reduce variations in prescriber habits.
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Comparative Study
Comparative prevalence of anogenital injury following sexual assault in women who have had recent consensual sexual contact.
The purpose of this study was to compare the frequency and types of anogenital trauma in rape victims as a function of the time interval between the assault and recent (72 h) consensual sexual intercourse. ⋯ This is the first clinical study to systematically compare the prevalence and typology of anogenital injuries in sexual assault victims who have had consensual intercourse within four days before a forensic exam. The frequency, type or location of anogenital trauma did not vary significantly based on the time interval from last consensual intercourse to the forensic examination.
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Observational Study
Usefulness of a modified poisoning severity score for predicting prognosis in acute carbon monoxide poisoning.
The poisoning severity score (PSS) was developed to grade the severity of various types of poisoning. However, in its current form, it requires investigating many variables, some of which have been found not to be associated with carbon monoxide (CO) poisoning severity. Therefore, in this study, we modified the PSS for CO poisoning and compared its usefulness to that of the original PSS, as an early prognostic factor of short-term outcome in CO poisoning patients. ⋯ The CO-modified PSS, with fewer variables than the original PSS, was not inferior to predict poor outcomes, and if COHb level is considered together with other parameters, then it can be used both for predicting prognosis and in diagnosis.