J Emerg Med
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Review Case Reports
Intussusception associated with Henoch-Schonlein purpura.
Henoch-Schonlein purpura is a clinical diagnosis, based on a presentation including rash, arthralgia/arthritis, and abdominal pain, often with renal complications. A rare complication is intussusception, presumably initiated by an edematous vasculitic leading point in the small bowel's mucosal surface. A case is described involving a 3-year-old male, with a brief review of the literature.
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The cases of two patients with methemoglobin levels approaching 30% are presented. No history of exposure to an oxidant was ever determined for the first case; the second patient had taken amyl nitrate orally along with alcohol as well as a self-injected narcotic and antihistamine. Due to their symptomatology, both patients were treated with methylene blue with good results; however, the patient described in case one had a brief episode of symptoms and pulse oximetry changes, not previously emphasized, consistent with the administration of methylene blue. The pathophysiology of methemoglobinemia, the utility of bedside diagnostic techniques, and the use of pulse oximetry are discussed.
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A new quantitative measurement of surgical needle holder performance has been described that records the forces (clamping moment) applied by the needle holder jaws to curved surgical needles. This test has been used to determine the applied clamping forces of four different surgical needle holders made by one manufacturer. By relating the magnitude of the clamping moment of needle holder to the resistance to bending of curved surgical needles, we propose a new scientific basis for selecting surgical needle and needle holders for wound closure.
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Studies in a Baltimore emergency room identified the patient with penetrating trauma as having the highest incidence of Human Immunodeficiency Virus Type I (HIV-1) infection. Anonymous testing over a 15-month period of 165 victims of penetrating trauma presenting to the Medical Center Hospital Emergency Center (San Antonio, Texas) revealed a 0% incidence of HIV-1. This data suggests that HIV-1 trauma patient incidence can be expected to vary between specific geographic areas and patient populations served, independent of community-wide AIDS incidence.