The American journal of emergency medicine
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Septic arthritis is a rare infection usually involving the knee or hip but can infrequently affect less obvious joints such as the pubic symphysis. Risk factors for septic arthritis include joint repair or replacement surgery, systemic infection, intravenous recreational drug use, and alcoholism. ⋯ The infecting pathogen was identified as Streptococcus anginosus or S constellatus, both being normal intestinal flora. Infection by either bacterium is rare in septic arthritis.
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Case Reports
Bispectral index monitoring in subarachnoid hemorrhage-associated out-of hospital cardiac arrest.
Bispectral index (BIS) is a simple, noninvasive, and continuous electroencephalographic monitor that could reflect the level of consciousness. Initially, BIS was developed to measure the anesthetic depth during operation; now, BIS could be used as a predictor of neurologic outcome in postresuscitative care. We report a case that had out-of cardiac arrest due to subarachnoid hemorrhage, and we used BIS to monitor the patient's consciousness level. ⋯ Low bispectral index and high suppression ratio represent decreasing brain activity suggestive hypoxic ischemic encephalopathy. This was confirmed by brain perfusion scan and standard electroencephalographic study. Using BIS, we can identify patients with poor neurologic outcome earlier, and treatment could be alleviated if prognosis is futile.
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Randomized Controlled Trial
The effect of nebulized magnesium sulfate in the treatment of moderate to severe asthma attacks: a randomized clinical trial.
Thirty percent of people with asthma do not respond to standard treatment, and complementary therapies are needed. The objective of this study was to investigate the impact of inhaled magnesium sulfate on the treatment response in emergency department (ED) patients with moderate to severe attacks of asthma. ⋯ Adding nebulized magnesium sulfate to standard therapy in patients with moderate to severe asthma attacks leads to greater and faster improvement in PEFR, respiratory rate, oxygen saturation and respiratory rate. It also reduces hospitalization rates in this patient population.
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Clinical Trial
Usefulness of new and traditional serum biomarkers in children with suspected appendicitis.
The objective of the study is to evaluate the usefulness of the leukocyte (white blood count [WBC]) and neutrophil (absolute neutrophil count [ANC]) counts; the values of C-reactive protein (CRP), procalcitonin, and calprotectin (CP); and the APPY1 Test panel of biomarkers, to identify children with abdominal pain at low risk for appendicitis. ⋯ The APPY1 Test panel with ANC could be useful in identifying children with abdominal pain suggestive of AA who are at low risk for this disease.