J Emerg Med
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Case Reports
An unusual case of hypotension after fibrinolysis resulting from mediastinal hemorrhage.
Although bleeding complications may occur after fibrinolysis, mediastinal hemorrhage is extremely rare. ⋯ As fibrinolysis remains a common means of establishing reperfusion in patients with acute MI, emergency physicians should be aware of such unusual complications secondary to fibrinolysis. An orderly clinical approach with an individualized management protocol is essential in such situations so that undue instrumentation and invasive procedures with their attendant risks in a thrombolysed patient are avoided.
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Case Reports
Small bowel obstruction from potato and broccoli phytobezoar mimicking mesenteric ischemia.
Bezoars are concretions of undigested foreign material that form in the gastrointestinal tract. Rare in humans, they are nonetheless a well-documented cause of intraluminal bowel obstruction. ⋯ Although rare in humans, bezoars are a documented cause of small bowel obstruction, and should be considered when intraluminal bowel obstruction occurs. Bezoars causing small bowel obstruction require surgical treatment.
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Although debate exists about the treatment of sepsis, few disagree about the benefits of early, appropriately targeted antibiotic administration. ⋯ This study confirms the need for more rapid and accurate laboratory methods for bloodstream pathogen identification.
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The Emergency Department (ED) has been shown to be a valuable location to screen for family violence. ⋯ This study investigates the victim profile of a large cohort of a Chinese population, providing a unique data set not previously released in this cultural or medical system. The findings give insights to early identification of victims of family violence in the EDs and suggest that screening techniques focused on multiple forms of family violence would improve identification of violence cases. Multidisciplinary collaboration between health, legal, and social service professionals is also warranted to meet the various needs of victims and to reduce hospital readmissions.
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The debate on the quality of health care provided in the United States has continued to be waged as concerns have grown over the years. Stress, sleep deprivation, poor diet, and lack of exercise may lead to inadequate work performance by physicians. ⋯ A majority of residents (90%) did not meet the target number of steps for shifts. More rigorous charting needs, overcrowding, or even spatial limitations may explain this. This warrants further investigation to determine if some daily physical activity regimens may help improve the overall well-being of EM residents.