European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this study was to assess how common injuries to the upper limbs are from dry ski slope skiing, to document the pattern of injury to the upper limbs from dry ski slope skiing and to discuss preventative measures. Skier's experience was also determined. The study was carried out on 174 patients attending the accident and emergency department over a period of 3 years who had sustained injuries from dry ski slope skiing. ⋯ Thumb injuries outnumbered other injuries in the upper limb. The mechanism of injury was due to a fall in 94.2% of patients. It is concluded that the lattice network on dry ski slopes significantly contributes to the platform of injuries to the upper limbs, and ways in which the lattice network may be improved are recommended.
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Effective strategies for the aetiologic diagnosis in patients with ischaemic stroke can be implemented based on simple clinical criteria and instrumental tests which can be performed in a modern emergency room (ER) within 24 hours from admission. This may bear prognostic and therapeutic relevance for patients with acute stroke. Therefore, in this study we set out to establish the feasibility and accuracy of the aetiologic diagnosis of ischaemic stroke in an ER. ⋯ Stroke of undetermined origin represented one-third of patients in a consecutive population with acute onset neurologic deficit of ischaemic origin. In approximately half of the patients with negative standard evaluation, cardiogenic or aortic arch embolic sources could be identified by transoesophageal echocardiography. Thus, the latter is indicated in patients with stroke of undetermined origin with negative first-line evaluation in order to identify embolic sources in the aortic arch.
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Computed tomography (CT) and ultrasonography (US) have been proposed as non-invasive diagnostic aids in patients with suspected acute appendicitis. Currently, clear guidelines about the indications to use these techniques are lacking. Using the concepts of decision analysis, a model was created to calculate the effectiveness of US and CT in patients with clinically suspected appendicitis. ⋯ In other words, on average, US (CT) is indicated only if the expert clinician considers the probability of disease to be smaller than 58% (74%). It is concluded that in patients with suspected acute appendicitis, selective rather than routine use of imaging studies is recommended. The exact value of the decision threshold should be determined in function of the local situation.