J Emerg Med
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Case Reports
Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.
Acute compartment syndrome, a surgical emergency, is defined as increased pressure in an osseofascial space. The resulting reduction of capillary perfusion to that compartment requires prompt fasciotomy. Treatment delay has a poor prognosis, and is associated with muscle and nerve ischemia, resultant infarction, and late-onset contractures. ⋯ We suggest consideration of a history of anabolic steroid use when evaluating patients with extremity trauma.
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Review Case Reports
Amatoxin poisoning: case reports and review of current therapies.
Diagnosis and management of Amanita mushroom poisoning is a challenging problem for physicians across the United States. With 5902 mushroom exposures and two resultant deaths directly linked to Amanita ingestion in 2009, it is difficult for physicians to determine which patients are at risk for lethal toxicity. Identification of amatoxin poisoning can prove to be difficult due to delay in onset of symptoms and difficulty with identification of mushrooms. Consequently, it is difficult for the Emergency Physician to determine proper disposition. Further, treatment options are controversial. ⋯ We present the successful treatment of 2 patients who ingested what we believe to be an Amanita species never before identified in the northeastern United States.
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Review Case Reports
Bilateral anterior dislocation of the shoulder: review of seventy cases and proposal of a new etiological-mechanical classification.
Although anterior shoulder dislocation is common in everyday practice in Emergency Departments, bilateral presentation is a rare entity. ⋯ The bilateral anterior shoulder dislocation may not be as rare as previously thought and must be taken into account in emergency services. The authors propose a new etiological-mechanical classification. Also, the importance of radiologic diagnosis must be highlighted.
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Multicenter Study
The association between self-reported exercise intensity and acute coronary syndrome in emergency department chest pain patients.
Regular exercise is thought to be protective against coronary artery disease. As a result, some physicians believe that the likelihood of acute coronary syndrome (ACS) in patients with acute chest pain is reduced in those who exercise regularly. We studied the association between self-reported frequency of exercising and the likelihood of ACS in patients presenting to the Emergency Department (ED) with chest pain. ⋯ Although self-reported frequency of exercise was significantly associated with a decrease in ACS in ED patients with chest pain, it should not be used to exclude ACS in symptomatic ED patients.