Can J Emerg Med
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Frequent soaking of lacerations closed with tissue adhesives is not recommended for fear of premature adhesive sloughing and wound dehiscence. This recommendation is based on studies of sutured lacerations, and may not be directly relevant to wounds closed with tissue adhesives. The objective of our study was to determine whether frequent soaking of octylcyanoacrylate would result in premature sloughing of the adhesive. ⋯ Daily immersion accelerates the sloughing of low viscosity octylcyanoacrylate applied to intact skin.
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To compare 5 active torso-warming modalities in a human model of severe hypothermia with shivering heat production inhibited by intravenous meperidine. ⋯ In non-shivering subjects, external heat application was effective in attenuating core temperature afterdrop and facilitating safe core rewarming; this was more evident when heat was delivered preferentially to the chest, and dependent upon the amount of heat donated. The modalities studied appear sufficiently practical and portable for pre-hospital use and should be considered for such situations, particularly in rural or wilderness locations where anticipated transport time to the hospital exceeds 30 minutes.
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To determine the proportion of patients vaccinated with pneumococcal (PVAX) and influenza (IVAX) vaccines under an emergency department (ED) vaccination program, that would not otherwise have been vaccinated by other primary care resources. ⋯ An ED-based program can result in the vaccination of a significant proportion of patients eligible for IVAX and/or PVAX who would otherwise likely go unprotected.
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Orf is a parapoxvirus infection of sheep and goats that causes blistering lesions on the lips, nostrils, udders or toes of affected animals. Human contact can cause transmission by direct inoculation. Human orf has typically been confined to rural settings. ⋯ The lesions resolved completely after 1 month without treatment. Although relatively rare and benign, this infection is probably under-reported and over-treated in this country. This case highlights the fact that urban physicians can expect to encounter once rare or solely rural-based infections with increasing frequency.