J Emerg Med
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Splenic artery embolization (SAE) improves non-operative splenic salvage rates in adults, but its utility and safety in the pediatric population is less well defined. ⋯ Splenic artery embolization may be a valuable adjunct in adolescent blunt splenic injury, especially in higher grade injuries or with evidence of splenic vascular injury on ACT.
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Case Reports
Enoxaparin-induced bleeding resulting in compartment syndrome of the thigh: a case report.
Enoxaparin-related bleeding has usually been described as excess minor bleeding. ⋯ Enoxaparin can spontaneously cause serious bleeding with associated compartment syndrome.
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Traditional management of acute pyelonephritis (APN) involves hospitalization and intravenous antibiotics. However, recently issued guidelines recommend that women with mild APN can be treated with oral antibiotics. ⋯ In women with acute pyelonephritis, an older age and diabetes were not found to be independently associated with hospital admission.
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4-Aminopyridine (4-AP) is a potassium channel-blocking drug used to ameliorate symptoms of multiple sclerosis and spinal cord injury by facilitating neural impulse conduction. It is not Food and Drug Administration (FDA) approved, but information about it is disseminated via the Internet, and it is currently available from compounding pharmacies with a physician's prescription. Dose-related toxicity is frequent and includes dizziness, insomnia, paresthesia, asthenia, headache, tremor, delirium, choreoathetosis, and seizures. ⋯ Emergency physicians should be familiar with the signs of 4-AP toxicity. Additionally, they should be aware that 4-AP and other non-FDA-approved medications may be available to patients from compounding pharmacies, and that quality control of made-to-order drug compounding may not be up to the standard that is expected with mass-produced pharmaceuticals.
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Hemorrhage from wounds in the extremities is the leading cause of preventable death on the battlefield. To successfully treat these injuries, the exact source of bleeding must be localized. ⋯ Our results showed a characteristic change in the systolic and diastolic velocities, as well as resistance indices at the injury site in peripheral arteries. These findings may serve as groundwork for development of automated bleeding detection and localization methods, and facilitate various hemorrhage control treatments.