The American journal of emergency medicine
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Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. ⋯ Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data.
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Myiasis designates the infestation of live human and vertebrate animals with dipterous (two-winged) larvae (maggots) and is the fourth most common travel-associated skin disease. Furuncle is the most common aspect of cutaneous myiasis. ⋯ There is an increase in travelers returning from tropical countries. Consequently, travel-associated dermatoses are increasing in non-endemic countries. Context of travel and typical clinical presentation strongly suggested to evoke a cutaneous myiasis. The typical furuncular lesion is a papule or nodule with a central punctum that exudes serosanguinous or purulent fluid. Ultrasound can be used to confirm the diagnosis. Treatment consists of three techniques: methods producing localized hypoxia to force emergence of the larvae, application of toxic substances to the eggs and larvae, and mechanical or surgical debridement. Surgery and antibiotics are usually unnecessary. Prevention of furunculous myiasis is based on vector control and individual actions to improve hygiene.
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Observational Study
Prognosis at 6 and 12months after self-attempted hanging.
Patients surviving a self-attempted hanging have a total neurological recovery in 57-77% of cases at hospital discharge, but no long-term data are available. ⋯ Patients surviving a self-attempted hanging who did not have a CA had a good neurological outcome. The rate of suicidal recidivism is particularly important, which justifies joint work with psychiatrists.
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The aim of this study was to evaluate factors of digoxin use and its relation to mortality in ED patients with atrial fibrillation (AF). ⋯ In ED patients with AF, digoxin was more frequently assigned to vulnerable patients with concomitant HF or valvular heart disease, and digoxin use was not related to a significantly increased risk of mortality.
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To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. ⋯ This case illustrates the long term outcome after agenesis of the LCA while reiterating that prompt access to pediatric defibrillation may be lifesaving-albeit in a minority of pediatric OHCA.