J Emerg Med
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Case Reports
Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm?
Post-partum mastitis is a common infection in breastfeeding women, with an incidence of 9.5-16% in recent literature. Over the past decade, community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant pathogen in soft-tissue infections presenting to the emergency department. The incidence of mastitis caused by MRSA is unknown at this time, but likely increasing. ⋯ Recent evidence suggests that just as MRSA has become the prominent pathogen in other soft-tissue infections, mastitis is now increasingly caused by this pathogen. Physicians caring for patients with mastitis need to be aware of this bacteriologic shift to treat appropriately.
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We know very little about differences in Emergency Department (ED) utilization and acuity on weekends compared with weekdays. Understanding such differences may help elucidate the role of the ED in the health care delivery system. ⋯ In Nebraska, EDs care for a greater number of low-acuity patients on weekends than on weekdays. This highlights the important role EDs play within the ambulatory care delivery system.
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The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest. ⋯ Prolonged chest compressions may be necessary in some cardiac arrests. These cases suggest that automated chest compression devices may increase the chance of a favorable outcome in these rare situations.
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Inhalation of hydrogen cyanide from smoke in structural fires is common, but cardiovascular function in these patients is poorly documented. ⋯ Cardiac complications are common in cyanide poisoning in fire survivors.
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Testicular infarction from an incarcerated inguinal hernia is a rare event in children, often not considered in the initial evaluation. ⋯ The diagnosis of testicular torsion is not always straightforward because many conditions may have a similar clinical presentation or may compromise testicular blood supply. This case is an unusual presentation of testicular infarction in the setting of an incarcerated inguinal hernia.