European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Clinical Trial
Intravenous magnesium sulphate in the management of moderate to severe acute asthmatic children nonresponding to conventional therapy.
Management of severe acute asthma attacks in children sometimes bring difficulties to the physician. Some current treatment strategies have focused on intravenous magnesium sulphate administration in patients nonresponding to therapy with beta-2 agonists and corticosteroids. The use and efficacy of this drug has been discussed in this randomized, double-blind, placebo-controlled clinical trial consisting of 20 children with moderate to severe acute asthma exacerbation admitted to the emergency department in Dicle University Hospital, Turkey. ⋯ These significant changes persisted at 45, 60, 75 and 90 minutes. No significant side effects were observed. In conclusion, severe asthmatic cases may benefit from magnesium sulphate therapy when beta-2 agonists are inadequate in preventing deterioration.
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We prospectively studied 56 patients with an acute ankle injury and an effusion to determine the significance of the ankle effusion to functional outcome. The average size of effusion was 15 mm. ⋯ No correlation was found with size of effusion and the functional and clinical outcome. We conclude that an ankle effusion does not reliably distinguish which injuries require further investigations and unless there are clinical indications further investigations are not indicated.
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Two case reports characterized by the complete occlusion of the basilar artery, secondary to dissection of the vertebral artery after closed head trauma are described. These lesions, often clinically silent in the beginning, were able to cause severe neurologic impairment, even after minor head trauma in healthy individuals without predisposing structural disorders. ⋯ Therapeutic management is discussed. Anti-coagulants, thrombolytic agents or surgical ligation of the vessel has been proposed to prevent the extension of the lesion and to improve the outcome.
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The aims of our study were to study the early impact of bereavement and to evaluate the effectiveness of the bereavement care given by our multidisciplinary team to close relatives of a sudden death, measured by the intensity of grief reaction (Texas Revised Inventory of Grief). The study sample consisted of close relatives of patients certified dead at the accident and emergency department (AED) between March 1996 and February 1997. The relatives received immediate care at the AED and were supported continually by the members of the bereavement care team. ⋯ The mean score of the intensity of grief reactions were 41.8 and 34.6 in the control (n = 11) and study (n = 18) groups respectively among high risk sample (p = 0.04). However, in the low risk sample, the mean scores were 35.3 and 30.2 in the control (n = 18) and study (n = 25) groups respectively (p = 0.11). Our study suggests that the bereavement care was especially effective in reducing the intensity of the grief at 6 months in the high risk group.