European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this retrospective study was to assess the initial management of atrial fibrillation (AF) in the emergency department (ED) and to identify predictive factors of early conversion to sinus rhythm, which could justify a short stay in the ED observation unit (EDOU) instead of longer hospitalization. ⋯ The majority of patients admitted with AF of acute onset had early conversion to sinus rhythm. AF in young patients, with a duration of symptoms of less than 48 h and without signs of heart failure can be managed in the EDOU, thus avoiding a longer hospitalization.
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We report a case of cardiac arrest secondary to acute myocardial infarction that was successfully resolved after thrombolytic therapy. This case suggests that thrombolysis can be used safely also during prolonged cardiopulmonary resuscitation for in-hospital cardiac arrest.
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Pyridoxine (vitamin B6) is a co-factor in many enzymatic pathways involved in amino acid metabolism: the main biologically active form is pyridoxal 5-phosphate. Pyridoxine has been used as an antidote in acute intoxications, including isoniazid overdose, Gyromitra mushroom or false morrel (monomethylhydrazine) poisoning and hydrazine exposure. It is also recommended as a co-factor to improve the conversion of glyoxylic acid into glycine in ethylene glycol poisoning. ⋯ The value of pyridoxine or its congener metadoxine as an agent for hastening ethanol metabolism or improving vigilance in acute alcohol intoxication is controversial. This paper reviews the various indications of pyridoxine in clinical toxicology and the supporting literature. The potential adverse effects of excessive pyridoxine dosage will also be summarized.