The American journal of emergency medicine
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In May 1996, Alabama increased the rural interstate highways speed limit to 70 mph. This study was conducted to determine if the faster speed limit had any influence on the number of motor vehicular crash (MVC) deaths. The null hypothesis was that no significant change occurred in the number of deaths since the faster speed was introduced. ⋯ The faster speed limit was associated with an increase in MVC deaths for the first year after the speed limit increase. The decline in the number of MVC deaths for 1998 was unanticipated. There are many other factors that need to be evaluated before determining the cause and effect that higher speed limits have on MVC fatalities.
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The objective of this study was to determine the frequency and types of pain medications taken before ED arrival based on pain intensity, duration of pain, chief complaint, gender, age, and race. A convenience sample of patients in pain was enrolled in this university hospital-based prospective, observational study. A total of 1233 patients were enrolled. ⋯ Race and gender were not associated (chi-squared P >.05) with differences in medication use before arrival. Many patients (44%) take medication before arrival in the ED. Age, severity and duration of pain, as well as chief complaint are associated with differences in frequency of self-administered medication.
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Our objective was to assess efficacy and tolerance of thrombolysis using 0.6 mg/kg of Alteplase in patients with massive pulmonary embolism defined as the association of a pulmonary embolism with shock. We retrospectively included 21 patients presenting with a massive pulmonary embolism confirmed by either scintigraphy or spiral computed tomography. Patients were treated on the basis of a standard rationale followed by thrombolysis with 0.6 mg/kg Alteplase over a period of 15 minutes. ⋯ Systolic and diastolic blood pressure (Sp02) were significantly improved 2 hours after the beginning of thrombolysis. Five minor hemorrhagic events occurred. This study demonstrates that for patients with pulmonary embolism and shock, a bolus treatment with Alteplase is potentially effective and well tolerated.