The American journal of emergency medicine
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Multicenter Study Comparative Study Observational Study
Early sepsis bundle compliance for non-hypotensive patients with intermediate versus severe hyperlactemia.
To compare the association of 3-h sepsis bundle compliance with hospital mortality in non-hypotensive sepsis patients with intermediate versus severe hyperlactemia. ⋯ We observed a significant interaction between 3-h bundle compliance and initial hyperlactemia. Bundle compliance may be associated with greater mortality benefit for non-hypotensive sepsis patients with less severe hyperlactemia.
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The routine practice of pre-hospital spinal immobilisation (phSI) for patients with suspected spinal injury has existed for decades. However, the controversy surrounding it resulted in the 2013 publication of a Consensus document by the Faculty of Pre-Hospital Care. The question remains as to whether the quality of evidence in the literature is sufficient to support the Consensus guidelines. This critical review aims to determine the validity of current recommendations by balancing the potential benefits and side effects of phSI. ⋯ The literature supports the Consensus Guidelines but raises the question as to whether they go far enough as there is strong evidence to suggest phSI is an inherently harmful procedure without having any proven benefit. These results demonstrate an urgent need for further studies to determine its treatment effect.
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Randomized Controlled Trial Comparative Study
Comparison of loop and primary incision & drainage techniques in adult patients with cutaneous abscess: A preliminary, randomized clinical trial.
The aim of this study is to compare efficacy of loop drainage and standard incision & drainage (I&D) in adult patients with cutaneous abscess in the emergency department. ⋯ This preliminary study revealed that, loop drainage technique is similar to standard I&D technique in abscess resolution and complications. (Clinical Trials Registration ID: NCT02286479).
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Review Case Reports
A rare seizure: Tumor lysis syndrome after radiation therapy of a solid tumor.
Tumor lysis syndrome (TLS) is an uncommon but life threatening condition seen in oncology patients. Due to its underlying pathophysiology, it is classically associated with hematologic malignancies following chemotherapeutic treatment. In this article, we present a case of TLS in the setting of two rare features: a solid tumor malignancy and the absence of recent chemotherapy. We briefly review risk factors and the diagnosis of this potentially fatal but treatable condition.
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Case Reports
Os subtibiale: Mimicking medial malleolar fracture a report of three cases and review of literature.
There are numerous sesamoids and accessory ossicles around the foot which can easily be misdiagnosed as fractures. Os subtibiale is a very rare normal variant of the medial malleolus which is usually diagnosed incidentally in routine ankle radiographs. In this report, we present a case series of 3 patients with os subtibiale who were admitted to the emergency department with ankle sprains and misdiagnosed as medial malleolar fractures. We would like to raise awareness to the very rare and usually asymptomatic os subtibiale as a diagnostic pitfall.