Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
A highly sensitive ELISA D-dimer increases testing but not diagnosis of pulmonary embolism.
To determine the effect of introducing a rapid enzyme-linked immunosorbent assay (ELISA) D-dimer on the percentage of emergency department (ED) patients evaluated for pulmonary embolism (PE), the use of associated laboratory testing, pulmonary vascular imaging, and the diagnoses of PE. ⋯ In the study's academic ED, introduction of ELISA D-dimer testing was accompanied by an increase in PE evaluations, D-dimer testing, and pulmonary vascular imaging; there was no observed change in the rate of PE diagnosis.
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Patients in emergency departments who use methadone frequently use tricyclic antidepressants (TCAs) and/or benzodiazepines (BZDs). This is a potentially dangerous drug combination. The authors hypothesized that the presence of methadone and a TCA, a BZD, or both is associated with an "accidental" overdose (AOD) death more often than a death from any other cause. ⋯ Among the methadone-positive cases, testing positive for a TCA, a BZD, or both was associated with an AOD death.
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Controversy exists regarding the value and quality of required emergency medicine (EM) resident scholarly projects. ⋯ Resident scholarly projects at one institution were equally likely to use a prospective or retrospective design, and most were conducted at a single center. More than half of the projects were presented at national research meetings, and more than a third were subsequently developed into manuscripts and published in peer-reviewed journals. When an original research study is required for satisfying the scholarly requirement for EM residency graduation, resident projects can contribute to the EM literature.
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A patient's baseline health status may affect the ability to survive an acute illness. Emergency medicine research requires tools to adjust for confounders such as comorbid illnesses. The Charlson Comorbidity Index has been validated in many settings but not extensively in the emergency department (ED). The purpose of this study was to examine the utility of the Charlson Index as a predictor of one-year mortality in a population of ED patients with suspected infection. ⋯ This study suggests that the Charlson Index predicts one-year mortality among ED patients with suspected infection.