Emergency medicine journal : EMJ
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Multicenter Study
Diagnostic performance of S100B protein serum measurement in detecting intracranial injury in children with mild head trauma.
To assess the accuracy of S100B serum level to detect intracranial injury in children with mild traumatic brain injury. ⋯ S100B has an excellent sensitivity but poor specificity. It is therefore an accurate tool to help rule out an intracranial injury but cannot be used as the sole marker owing to its specificity. Used with clinical decision rules, S100B may help to reduce the number of unnecessary CT scans.
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Multicenter Study
Serial sampling of copeptin levels improves diagnosis and risk stratification in patients presenting with chest pain: results from the CHOPIN trial.
Copeptin has demonstrated a role in early rule out for acute myocardial infarction (AMI) in combination with a negative troponin. However, management of patients with chest pain with a positive copeptin in the setting of a negative troponin is unclear. ⋯ Patients with chest pain with an initial negative troponin but positive copeptin are common and carry an intermediate risk of AMI. A second copeptin drawn 2 h after presentation may help risk stratify and potentially rule out AMI in this cohort.
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Multicenter Study
Why is it so difficult to recruit patients to research in emergency care? Lessons from the AHEAD study.
In February 2014, all 23 National Institute for Health Research medical research specialities were failing to meet recruitment targets, with 'Injuries and Emergencies' research performing particularly poorly. In this paper, the multicentre AHEAD study was used to explore issues surrounding recruitment in UK emergency departments. ⋯ Many of the barriers to recruiting patients for research studies encountered by research nurses have previously been reported in the literature, but there remain consistent problems. Until solutions are found, researchers will continue to miss recruitment targets and this will have implications for the efficiency and quality of emergency medicine research in the UK.
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Multicenter Study
The effect of preinjury warfarin use on mortality rates in trauma patients: a European multicentre study.
To define the relationship between preinjury warfarin use and mortality in a large European sample of trauma patients. ⋯ Preinjury warfarin use has been demonstrated to be an independent predictor of mortality in trauma patients. Clinicians managing major trauma patients on warfarin need to be aware of the vulnerability of this group.
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Multicenter Study Observational Study
Predictors of infection from dog bite wounds: which patients may benefit from prophylactic antibiotics?
To determine a current infection rate of dog bite wounds and predictors of wounds at risk for infection that may benefit from prophylactic antibiotics. ⋯ Puncture wounds or wounds closed during treatment are dog bite wounds at a high risk of infection and should be considered for treatment with prophylactic antibiotics.