J Emerg Med
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Randomized Controlled Trial
Supraglottic jet ventilation in difficult airway management.
Supraglottic jet ventilation (SJV) via the "jet endotracheal tube" (JET) designed by Wei (WEI JET; Wei Medical LLC, Cherry Hill, NJ) provides adequate oxygenation and ventilation during direct laryngoscopy and tracheal intubation in animals. It has facilitated intubation in apneic pigs with a simulated difficult airway. ⋯ Using the WEI JET with SJV provides adequate oxygenation during tracheal intubation in apneic patients for a prolonged period of time, with no difference in complications compared to the standard intubation technique. PetCO(2) monitoring facilitated intubation in patients with a Grade III glottis view.
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Although the overuse of antibiotics and underuse of bronchodilators for treatment of acute bronchitis is well known, few studies have analyzed these trends in the emergency department (ED). ⋯ Antibiotics are over-prescribed in the ED for acute bronchitis, with broad-spectrum antibiotics making up the majority of the antibiotics prescribed. Age ≥50 years and smoking are associated with higher antibiotic prescribing rates.
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Pulmonary embolism (PE), a major cause of morbidity and mortality, remains an elusive diagnosis. Recently investigators have found a new electrocardiographic (ECG) finding, simultaneous T-wave inversions in the anterior and inferior leads, which may distinguish PE from acute coronary syndrome (ACS). ⋯ In our study, simultaneous T-wave inversions in anterior and inferior leads were associated with PE but are seen in only 4-11% of cases.
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Primary sternal osteomyelitis is a rare disease, whereas secondary sternal osteomyelitis is relatively well known as a complication in post-sternotomy patients. ⋯ Primary sternal osteomyelitis is uncommon and often difficult to diagnose. Complications include abscess formation and distal seeding. Diagnosis can be aided by a detailed history and radiography, and treatment may consist of a prolonged course of antibiotics and incision and drainage.
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Case Reports
Bilateral acute angle-closure glaucoma in a migraine patient receiving topiramate: a case report.
Patients with migraine headaches are frequently prescribed topiramate to treat their condition. ⋯ Acute angle-closure glaucoma secondary to topiramate is an uncommon but serious adverse reaction that may result in severe morbidity such as permanent visual loss if not recognized in a timely manner. Treatment differs from primary acute angle-closure glaucoma in that discontinuation of topiramate is necessary for the glaucoma to resolve.