Emergency medicine journal : EMJ
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Vertigo is not an uncommon presentation to the emergency department. It is most commonly caused by benign peripheral processes, such as inner ear or vestibular nerve dysfunction, but can be due to central brain lesions. ⋯ VAD is increasingly being recognised as an important cause of stroke in young people. We discuss the important features that need to be elicited to distinguish central from peripheral disease and the relevance of VAD.
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To perform a risk analysis study to determine the probability of a spinal fracture being of malignant origin in patients presenting at a level I trauma centre emergency room after trauma. ⋯ Supported by the present results we feel the probability of malignant fractures, although not frequently encountered, should always be considered in elderly and middle-aged patients with a history of malignancy and a non-cervical traumatic fracture.
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Despite the potential impact that emergency pharmacist (EPh) programmes could have on medication safety and quality of care in the emergency department (ED), very few programmes exist. This descriptive survey study aimed to assess staff perceptions of an EPh programme. ⋯ This study reinforced the value of many specific duties of the EPh programme and found that doctors and nurses overwhelmingly favour the presence of an EPh in the ED, frequently seek their advice, and feel they improve quality of care. Staff acceptance is clearly not a barrier to implementation of this programme.
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A short cut review was carried out to establish whether tamsulosin enhances the chances of spontaneous stone expulsion in renal colic. Thirty-five papers were found using the reported searches, of which two (a meta-analysis and one further randomised controlled trial) presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are presented in table 3. It is concluded tamsulosin may be useful during periods of watchful waiting to enhance ureteric stone expulsion.
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Severe peptic ulcer resulting in hypertrophic pyloric stenosis is a rare clinical problem nowadays. Symptoms include vomiting, nausea, early satiety, weight loss, epigastric pain especially after eating. The physical examination may not be helpful because the pyloric mass is difficult to palpate. ⋯ Finally, he agreed to undergo a barium meal examination, which showed severe pyloric stenosis. He underwent vagotomy and enteroanastomosis. The biopsy of the removed segment of the stomach did not show any malignant changes.