Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Baseline electrocardiogram abnormalities and market elevations not associated with myocardial necrosis make accurate diagnosis of myocardial infarction (MI) difficult in patients with cocaine-associated chest pain. Troponin sampling may offer greater diagnostic utility in these patients. ⋯ Most patients with cTnI elevations meet CK-MB criteria for MI, as well as have a high incidence of underlying significant disease. Troponin appears to have an equivalent diagnostic accuracy compared with CK-MB for diagnosing necrosis in patients with cocaine-associated chest pain and suspected MI.
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To test the hypothesis that emergency medicine (EM) has made significant, quantifiable progress within U.S. academic medicine over the past ten years, 1991-2001. ⋯ A quantitatively and statistically significant increase in academic departments of EM within medical schools and EM residency programs at academic medical centers has occurred over the past decade. Half of all medical schools now have academic departments of EM, and two-thirds of academic medical centers house EM residency programs. This has taken place largely within institutions whose academic ranking places them among the top half of all U.S. medical schools.
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The Wood's lamp (WL) has been used in sexual assault evaluations. Recent data have shown that semen does not fluoresce with a WL and that physicians are unable to differentiate semen from other common medicaments using a WL. ⋯ Physicians instructed in the use of an alternate light source (BM 500) are able to identify semen as fluorescing and can differentiate semen (after a training session) from other commonly used products.
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Burns are dynamic injuries that tend to progress over the course of several days. Steroids inhibit the formation of vasoconstrictive prostanoids that may contribute to this progression of injury. The authors hypothesized that adding topical steroids to a standard antimicrobial agent would reduce the progression of burns and accelerate reepithelialization without increasing infection rates. ⋯ Addition of a potent topical steroid to standard antimicrobial topical agents does not reduce burn depth or accelerate reepithelialization after burns.