The American journal of emergency medicine
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Review Meta Analysis
The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis.
We aimed to perform a systematic review and meta-analysis of the diagnostic performance of pleural fluid procalcitonin (PCT) or C-reactive protein (CRP) in differentiating parapneumonic effusion in patients with pleural effusion. ⋯ The existing literature suggests that both pleural fluid and serum PCT tests have low sensitivity and specificity for differentiating parapneumonic effusion from other etiologies of pleural effusion. Compared with PCT, serum CRP has higher specificity and a higher positive likelihood ratio, and thus, it has a higher rule-in value than PCT.
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Randomized Controlled Trial
Clinical effects of adjunctive atropine during ketamine sedation in pediatric emergency patients.
The prophylactic coadministration of anticholinergics during dissociative sedation has been considered necessary to mitigate ketamine-associated hypersalivation. Given recent conflicting conclusions regarding adjunctive atropine, we compared the incidence of hypersalivation, degree of secretion, and related side effects with atropine or placebo as an adjunct to intravenous (IV) ketamine sedation for children. ⋯ Atropine as an adjunct to IV ketamine sedation in children significantly reduced hypersalivation, without providing a clinical benefit.
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Randomized Controlled Trial
Efficacy of high-flow oxygen therapy in all types of headache: a prospective, randomized, placebo-controlled trial.
We aimed to assess the efficacy of oxygen inhalation therapy in emergency department (ED) patients presenting with all types of headache. ⋯ In addition to its role in the treatment of cluster headache, high-flow oxygen therapy may provide an effective treatment of all types of headaches in the ED setting.
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Randomized Controlled Trial
Intravenous contrast alone vs intravenous and oral contrast computed tomography for the diagnosis of appendicitis in adult ED patients.
When the diagnosis of appendicitis is uncertain, computerized tomography (CT) scans are frequently ordered. Oral contrast is often used but is time consuming and of questionable benefit. This study compared CT with intravenous contrast alone (IV) to CT with IV and oral contrast (IVO) in adult patients with suspected appendicitis. ⋯ Computerized tomography scans with intravenous contrast alone have comparable diagnostic performance to IVO scans for appendicitis in adults. Patients receiving IV scans are discharged from the ED faster than those receiving IVO scans.