Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine whether the absence of a gestational sac on transvaginal ultrasonography in patients with a quantitative beta-human chorionic gonadotropin (beta-hCG) > 3,000 mIU/mL and/or menstrual days > 38 excludes the diagnosis of a normal intrauterine pregnancy (IUP). ⋯ In patients with either a beta-hCG > 3,000 mIU/mL or menstrual days > 38 and no gestational sac by transvaginal ultrasonography, the likelihood of a normal IUP is low.
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Comparative Study
Underrecognition of cervical Neisseria gonorrhoeae and Chlamydia trachomatis infections in the emergency department.
1) To quantify the frequency of underrecognized Neisseria gonorrhoeae and Chlamydia trachomatis cervical infections in women tested in the ED, 2) to describe and compare the characteristics of those treated and not treated during the initial visit, and 3) to quantify the delay interval until treatment was provided. ⋯ In this population, both N. gonorrhoeae and C. trachomatis cervical infections are frequently underrecognized in the ED, with isolated C. trachomatis infections associated with significantly higher proportions of underrecognition. Many affected women remain untreated for extended intervals, creating public and individual health risks. Improved point of contact detection, follow-up, and treatment policies are needed to limit these risks.
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Editorial Comment Review
Computerized simulation technology for clinical teaching and testing.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Safety and efficacy of flumazenil in reversing conscious sedation in the emergency department. Emergency Medicine Conscious Sedation Study Group.
To evaluate the safety and efficacy of flumazenil vs placebo in reversing fentanyl and midazolam-induced conscious sedation in ED patients undergoing a short, painful procedure. ⋯ Flumazenil is safe and efficacious in reversing midazolam-induced sedation in ED patients given a combination of fentanyl and midazolam to facilitate the performance of a short, painful procedure. The patients given flumazenil returned to baseline alertness earlier and at a faster rate than did the patients given placebo. However, flumazenil did not alter the actual interval from procedure completion until ED release.