European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Pneumonia is the leading cause of mortality in young children in developing countries. A short course of antibiotics in the treatment of nonsevere pneumonia has been suggested as feasible and could lead to decreased costs, risk of adverse events, and development of antimicrobial resistance. This review evaluates the evidence regarding the duration of antibiotic treatment in this population. ⋯ In one study, the 3-day course was associated with higher rates of treatment failure and adverse events, with no adverse event classified as severe. Overall, short and long courses of antibiotics produce similar outcomes treating clinically diagnosed, nonsevere pneumonia in children in developing countries between the ages of 2 to 59 months. Three out of four studies in this review, representing two-thirds of the patients in aggregate, showed no significant difference in treatment failure or relapse rates between a 3-day and 5-day course of antibiotics.
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Randomized Controlled Trial
Evaluating the impact of emergency medicine education on medical interns' knowledge scores.
Emergency medicine is a young specialty in Iran. Since 2005, a 4-week rotation has been allocated to emergency medicine instruction for all medical interns during their medical internship in Tehran University of Medical Sciences. ⋯ It seems that emergency medicine rotation improves the medical interns' knowledge in the field of emergency medicine; and their sex, passed medical blocks and the duration of internship do not affect this knowledge.
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To describe the rates of surgery and nonoperative management (NOM) for patients with blunt splenic trauma in a district general hospital. ⋯ Rates of blunt splenic trauma in a district general hospital remain low with acceptable rates of NOM. Hypotension within 60 min of hospital arrival may be a useful predictor of the need for surgery.
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To characterize prehospital delays in patients presenting with acute ST-elevation myocardial infarction to the emergency department of a tertiary hospital in Asia. A retrospective review of 273 patients with diagnosis of ST-elevation myocardial infarction; symptom to door (S2D) time was described in two ways, time from first onset of symptoms; and time from the onset of the worst episode to presentation at emergency department. The median first onset S2D time was 173 min (interquartile range 80-350 min); and median worst episode S2D time was 131 min (interquartile range 70-261 min). ⋯ There was no difference in S2D times for typical compared with atypical symptoms. A large proportion of patients experienced delay in seeking medical care after the onset of acute coronary symptoms. Self-transport was associated with delay.
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To improve the quality and efficiency of our emergency surgical service. ⋯ Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.