The American journal of emergency medicine
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Comparative Study
Age-associated time delays in the treatment of acute myocardial infarction with primary percutaneous transluminal coronary angioplasty.
Multiple studies have shown that age is a significant factor associated with suboptimal treatment for acute myocardial infarction (AMI). We performed a retrospective pilot study using a chart review of patients who presented with AMI who were subsequently treated with percutaneous transluminal coronary angioplasty (PTCA) from November 1995 to January 1997 at our institution. Ninety-four patients met inclusion criteria, with 5 excluded for insufficient data. ⋯ Statistical analysis was performed using analysis of variance ( P = 0.04). In this study, age was associated with treatment delays. There was a parabolic relationship of age with time, with a greater time delay occurring in "younger" and "older" patients.
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The purpose of this study was to investigate eye injuries resulting from frontal automobile crashes and to determine the effects of depowered airbags. The National Automotive Sampling System database files from 1993 to 2000 were examined in a 3-part investigation of 22 236 individual crashes. ⋯ Occupants were at a significantly higher risk to sustain an airbag-induced eye injury when exposed to a full powered airbag compared with occupants exposed to a depowered airbag deployment ( P = .04). Approximately, 90% of the eye injuries in full powered airbag deployments were caused by the airbag, compared to only 35% of the depowered airbag eye injuries.
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To establish a clinical pathway for outpatient enoxaparin therapy in deep venous thrombosis (DVT) and then characterize its implementation and barriers to use. ⋯ The establishment of an organized DVT pathway for outpatient enoxaparin may facilitate home therapy; however, there will remain reasons that make hospital admission unavoidable in some patients.
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Case Reports
Life-threatening presentation of mediastinal neoplasms: report on 7 consecutive pediatric patients.
Cases of respiratory failure at presentation in children with anterior mediastinal malignancies can be very challenging for clinicians. Seven consecutive children presenting with superior mediastinal syndrome are reported needing urgent critical care approach. ⋯ Critical or extreme presentation of mediastinal neoplasms does not preclude a good clinical outcome: an intensive care approach is essential to allow patient recovery and effective antineoplastic therapy administration.
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Comparative Study
Can ruptured appendicitis be detected preoperatively in the ED?
The purpose of this study is to determine which clinical symptoms/signs and computed tomography (CT) signs can help in distinguishing ruptured from simple appendicitis. ⋯ Besides some clinical findings, CT scan can accurately determine appendiceal rupture in acute appendicitis and can further demonstrate the presence of local inflammatory mass, facilitating management decision in the emergency department (ED).