European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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In this study we aimed to determine whether isosorbide dinitrate (ISDN) bolus is associated with hypotension in patients aged at least 75 years presenting to an emergency department (ED) with acute heart failure (AHF) syndrome. This is a retrospective study, and all patients with AHF presenting in our ED during 2007 were included. We included 136 patients: 25 (18%) of them received ISDN in bolus (group B) among other treatments, and 111 (82%) did not (group O). ⋯ The mean lower systolic blood pressure after treatment was similar: 116±18 mmHg in group O compared with 116±19 mmHg in group B+, and was less than 90 mmHg in 0% cases in group B+ versus 3% in group O (P=0.5). Secondary endpoints were not significant, with mortality in group B of 4% versus 10% in group O (P=0.32). ISDN is not associated with more hypotension when used in bolus for elderly patients treated in the ED for AHF.
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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.