European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Clinical Trial
Administration of analgesia for acute abdominal pain sufferers in the accident and emergency setting.
Recent trials suggest that the early administration of analgesia in patients with acute abdominal pain facilitates examination and does not delay diagnosis. We investigated current practice regarding analgesia for these patients. ⋯ This study shows the need for standardized protocols for analgesia usage in patients presenting with acute abdominal pain.
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Hip fracture is a significant injury for older persons. Little has been reported about emergency department (ED) care of these patients. ⋯ The ED visit presents a largely untapped opportunity for focused efforts in fall and hip fracture prevention, especially in countries with comprehensive geriatric services and well integrated healthcare delivery systems. Despite the high likelihood of pain, the administration of analgesics appears to be low and may be a worthy focus for practice improvement.
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Adult coeliac disease, in contrast to its childhood counterpart, almost always has an indolent course with a wider spectrum of clinical manifestations. Approximately half of the patients have no overt gastrointestinal symptoms and many are asymptomatic. ⋯ We report here two cases of adult coeliac disease that presented as coeliac crisis. Coeliac disease should be a differential diagnosis in adult patients with severe acute diarrhoea and acidosis, although a rare presentation.
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Exercise induced rhabdomyolysis has previously been described as occurring in unfit adults or those attempting exhaustive exercise, but is rarely seen in previously fit adults undertaking moderate exercise. This case report describes what we believe to be the first reported case of exercise induced rhabdomyolysis due to the patient completing a 'spinning class' at her local gymnasium. The report also covers diagnosis and management of this condition.
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We describe a pregnant woman with ovarian hyperstimulation syndrome with bilateral pleural effusion and ascites. Ovarian hyperstimulation syndrome is an iatrogenic complication of ovarian stimulation, characterized by a massive crossing of a protein-rich fluid from the vascular compartment into the peritoneal, pleural, or to a lesser extent, pericardial cavities. Management is usually conservative, with fluid and electrolytes correction and thromboprophylaxis. Prevention is very difficult, but an age younger than 35 years, low body mass index, polycystic ovarian disease, a high number of follicles, a high plasma oestradiol concentration, pregnancy, hyperandrogenism, and hypothyroidism are predisposing factors.