The American journal of emergency medicine
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Comparative Study
A new pepsin assay to detect pulmonary aspiration of gastric contents among newly intubated patients.
Aspiration of gastric contents by endotracheally intubated patients is associated with significant morbidity and mortality. Previous studies suggest that pepsin in tracheal aspirates may be a valuable marker of occult aspiration. We sought to show the sensitivity and specificity of a new, pepsin-specific assay in humans. ⋯ All tracheal aspirates tested negative and all gastric aspirates tested positive for pepsin. Pepstatin halted pepsin activity in all positive samples, ensuring that positive results were due to pepsin. A pepsin-specific assay is extremely reliable for detecting gastric contents in humans.
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Comparative Study
Photokeratoconjunctivitis caused by different light sources.
To assess the current state of photokeratoconjunctivitis (PKC) and compare patients caused by different light sources, we recruited 106 consecutive cases from August 2001 to March 2002 through the emergency department at a teaching hospital in Taiwan and conducted questionnaire interviews and telephone follow-ups. Whereas 85.8% of the cases received exposures from welding, only 3.8% were professional welders, and most cases were of other occupations with occasional use of welding. ⋯ In comparison with cases caused by welding, cases caused by short circuit sparkles had a more acute course, but those caused by UV lamps had a less acute course. Few cases used protection equipment, which highlighted the importance of education.
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Our objective was to examine the effect of ambient temperature, age, and gender on the incidence of emergency department (ED) renal colic visits. We retrospectively analyzed a database of 15 New Jersey EDs from January 1, 1996 to December 31, 2002. We analyzed the number of renal colic visits as a fraction of total visits in monthly intervals. ⋯ Renal colic visits were 16% more likely in warmer than colder months (P<.001) and this effect was greatest in older patients and males. We conclude that higher ambient temperature, older age and male gender are associated with increased incidence of ED renal colic visits. Advice to patients, especially older males, to avoid dehydration particularly during hot weather may help prevent bouts of renal colic.