The American journal of emergency medicine
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The purpose of this study was to assess treatment with a fluoroquinolone or trimethoprim-sulfamethoxazole versus cephalosporins for pyelonephritis in discharged patients from a community hospital setting. ⋯ Failure of therapy for pyelonephritis occurred more often in the fluoroquinolone and trimethoprim-sulfamethoxazole group than in the cephalosporin group. The findings in this study are most applicable to patients who are treated on an outpatient basis. A prospective, randomized clinical trial is necessary to confirm these results.
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Laryngopyocele is a rare diagnosis that can cause life-threating conditions such as airway obstruction and even death. Emergency ultrasound (POCUS) can be very helpful during the diagnosis and monitoring of the illness because it is both easy to apply and repeatable. A deep neck infection was diagnosed as laryngopyocele by POCUS in the emergency department; this is the first case in the literature.
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Observational Study
Low dose intramuscular methadone for acute mild to moderate opioid withdrawal syndrome.
To assess the efficacy of 10mg intramuscular (IM) methadone in patients with opioid withdrawal syndrome (OWS). ⋯ A single IM dose of 10mg methadone in the ED reduces the severity of acute mild to moderate OWS by 30min. Larger prospective, randomized controlled, and blinded studies would be needed to confirm these results.
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Differentiating between ischemic and hemorrhagic types is of special importance in the treatment process of patients with stroke. The present study was designed with the aim of evaluating the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) in differentiation of ischemic from hemorrhagic stroke. ⋯ Findings of the present study showed that ultrasonographic diameter of optic nerve sheath has moderate accuracy in differentiation of hemorrhagic and ischemic stroke.
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To evaluate the utility of the quick Sepsis-related Organ Failure Assessment (qSOFA) score to predict risks for emergency department (ED) and hospital mortality among patients in a sub-Saharan Africa (SSA) setting. ⋯ The qSOFA score provided risk stratification for both ED and hospital mortality outcomes in the setting studied, indicating utility in sepsis care in SSA, however, further prospective study in high-burden HIV populations is needed.