The American journal of emergency medicine
-
Meta Analysis Comparative Study
Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis.
Intravenous resuscitation with balanced crystalloid fluids does not reduce mortality or kidney injury compared with normal saline in critically ill patients.
pearl -
Randomized Controlled Trial Comparative Study
Intradermal mesotherapy versus systemic therapy in the treatment of musculoskeletal pain: A prospective randomized study.
Acute musculoskeletal injuries are one of the most common painful presentation when admission to the emergency department. The aim of the study is to compare the tenoxicam mesotherapy with intravenous dexketoprofen in pain control in patients with acute musculoskeletal injury. ⋯ The mesotherapy treatment may be superior than the systemic therapy for pain relief in musculoskeletal injury in short term follow-up in emergency department settings.
-
Multicenter Study Clinical Trial
The relationship between the severity of pain and stone size, hydronephrosis and laboratory parameters in renal colic attack.
In this study, we investigated the relationship between the severity of pain level and hydronephrosis, hematuria and pyuria presence in the acute renal colic attack and whether there was a correlation between the stone size and inflammatory markers. ⋯ We detected that the pain level was not correlated with the stone size and big stones were not statistically riskier in the hydronephrosis development. However, we think that the risk of complications such as hydronephrosis is higher in the patients whose pain level are higher and the infection may be accompanied by this group.
-
Clinical Trial
Clinical usefulness of brain-derived neurotrophic factor and visinin-like protein-1 in early diagnostic tests for acute stroke.
Lack of a rapid biochemical test for acute stroke is a limitation in the diagnosis and management of acute stroke. The aim of this study is to evaluate the efficacy of BDNF and VILIP-1 as diagnostic markers in acute ischemic stroke and as predictors of mortality. ⋯ The BDNF level showed a significant ability to discriminate stroke and control patients but did not predict mortality. The VILIP-1 level showed insignificant ability to discriminate stroke patients and again did not predict mortality.
-
Overdose of valproic acid (VPA) or its derivatives can cause significant toxicities such as hyperammonemia or altered mental status. While levocarnitine has been used historically to manage VPA-associated hyperammonemia, no standard of therapy exists to manage VPA toxicity. We present a case of VPA overdose managed with meropenem in addition to levocarnitine. ⋯ Carbapenem antibiotics inhibit acylpeptide hydrolase in the gastrointestinal tract. Inhibition of this enzyme prevents the reabsorption of metabolized VPA and therefore causes increased elimination. Our patient demonstrated a rapid lowering of VPA levels after administration of meropenem.