J Emerg Med
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intravenous ketorolac and meperidine in the treatment of biliary colic.
To compare the analgesic efficacy and tolerability of intravenous (IV) ketorolac tromethamine with IV meperidine in the treatment of biliary colic, a prospective, randomized, double blind study was carried out upon a convenience sample of patients at a large inner city facility. Patients between the ages of 18 and 65 years of age with a history and physical examination consistent with biliary colic were enrolled over a 2-year period. Patients were randomly assigned to receive ketorolac 30 mg IV or meperidine 50 mg IV. ⋯ Although no significant difference was found in overall drug tolerability, patients receiving meperidine reported higher incidences of nausea and of dizziness than those receiving ketorolac (p = 0.009 and 0.003, respectively). Ketorolac tromethamine is a well-tolerated, effective medication in the treatment of acute biliary colic. It showed similar efficacy to meperidine with a decreased number of adverse effects.
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Review Case Reports
Chronic acetaminophen toxicity: a case report and review of the literature.
Acetaminophen is one of the most frequently used medications in the United States. While usual dosing of acetaminophen is considered harmless, both acute and chronic overdoses can be fatal. ⋯ Our patient ingested approximately 5.0 to 6.5 g of acetaminophen daily for 6 to 8 weeks via multiple medications. The inclusion of acetaminophen in numerous medications combined with the frequency of use of acetaminophen necessitates an increased concern for not only acute but also chronic acetaminophen toxicity.
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It has been suggested that the increase in gambling activity nationally has resulted in an increase in intimate partner violence (IPV). There are apparently no studies that have assessed problem gambling as a risk factor for IPV. To determine if problem gambling in the partner is a risk factor for IPV, a cross-sectional study was conducted at a university-based Emergency Department (ED). ⋯ The presence of both problem gambling and problem drinking in the partner was associated with an even higher OR (adjusted OR: 50; 95% CI: 9-280). Our study shows that problem gambling in the partner is associated with IPV. The causes of IPV are not fully known, but the association of problem gambling in the partner with IPV could lead to new intervention strategies and Emergency Medicine research in the future.
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Skateboarding and in-line skating are popular activities that attract millions of participants yearly and have spawned the development of skateparks (SPs). This study examined the types and distribution of injuries within a local commercial SP. Subjects were prospectively enrolled in a university Emergency Department (ED) after an injury at a local SP. ⋯ Safety equipment use was greater than 91%. Significantly more injuries occurred in the ramp/bars areas compared to the half-pipe and gully areas, suggesting that SP design may significantly influence injury patterns. A substantial number of injuries occurred at the SP, despite controlled conditions and equipment requirements.