J Emerg Med
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Partial or complete failure to maintain an erection sufficient for coitus is known to occur in a proportion of sexual assailants during the rape episode. ⋯ Erectile impotence occurred in up to 8% of sexual assailants during the rape episode. Despite this erectile dysfunction, the majority of sexual assault victims sustained anogenital trauma. In the attacks with erectile impotence, there was a higher incidence of intra-rape violence and subsequent non-genital injuries.
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The treatment and disposition of patients with neurological disorders is commonplace in the emergency setting, but atypical and uncommon presentations can prove to be especially challenging. In this article we discuss the case of a 31-year-old woman who presented with a rare disorder known as opsoclonus myoclonus syndrome (OMS). ⋯ After an 8-day hospital course, which included several different treatment modalities including plasmapheresis, the patient was discharged after making a complete recovery. Unusual presentations such as the one described in this article illustrate the point that it is crucial to have a systematic approach that can be applied to identify and treat potentially life-threatening neurological conditions.
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Human metapneumovirus (hMPV) is an important emerging respiratory pathogen, previously unreported in the Emergency Medicine literature. It is primarily associated with the clinical syndromes of bronchiolitis and pneumonia. hMPV may predispose to bacterial pneumonia; coinfection with respiratory syncytial virus may lead to increased severity of clinical disease, and complications include asthma and chronic obstructive pulmonary disease exacerbations. ⋯ We report the case of a 13-month old who developed lobar pneumonia 3 weeks after being diagnosed with hMPV. The epidemiology, clinical presentation, complications, and treatment of hMPV are then discussed.
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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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To determine whether receipt of smoking cessation counseling affects satisfaction scores in adult emergency department (ED) smokers. ⋯ ED patients who report having received a tobacco control intervention are more likely to be satisfied with their care. There is a dose-response relationship between the number of patient-reported tobacco interventions received and the global satisfaction score. Of all providers, only physicians' performance of tobacco control was associated with improved satisfaction scores. Routine screening, intervention, and referral of ED patients for smoking will not harm, and may improve, satisfaction scores. The mechanism underlying this effect is unknown.