Emergency medicine journal : EMJ
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Protein S100B has proven to be a useful biomarker for cerebral damage. The predictive ability of S100B may, however, be affected by extracerebral injuries. The aim of this study was to investigate serum levels of S100B in patients with either isolated head injury (IHI), multi trauma with head injury (MTHI), or no head injury (NHI). The primary aim was to assess if a significant difference in serum levels of S100B could be found between IHI and MTHI patients. ⋯ High serum levels of S100B were found early after trauma. The highest concentrations of S100B were found in patients with multi trauma. This suggests that S100B serum concentrations are significantly affected by extracerebral injuries.
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The aim of this study was to establish the feasibility of a Kenyan emergency department (ED)-based sexual assault centre; and to improve knowledge of the characteristics of sexual assault in the region. ⋯ Development of an ED-based sexual assault centre at a referral hospital in Kenya using a standardised history, physical, and treatment protocol was feasible, and high rates of prophylaxis were provided. Based on characteristics of people who have been assaulted, community prevention efforts should concentrate on decreasing the societal acceptability of rape. In conjunction with improvement of protocols at the centre under consideration, development of similar centres in sub-Saharan African ED should be encouraged.
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A traumatic abdominal wall hernia (TAWH) caused by a handlebar collision is very rare. It is difficult for the emergency physician to exclude the possibility of mesenteric or intestinal injuries when viewing handlebar trauma. ⋯ An unusual case of TAWH caused by a handlebar injury is reported, where a multi-layer muscular defect was found along with a segment of incarcerated jejunum and omentum. The latest literature is reviewed, and valuable ideas on the management of blunt abdominal trauma with TAWH are shared.
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To determine the relationship between near-patient-test (NPT) lactate, white blood cell count (WBC) and C-reactive protein (CRP) and severe bacterial infection (SBI) in children presenting to the emergency department (ED) with infection. ⋯ The data from our study suggest that NPT lactate provides early diagnostic information about the risk of SBI in children presenting to the ED with a suspected infection. Combining NPT lactate with WBC and CRP resulted in a promising rule-in-tool for SBI in children in the ED which, with prospective validation, has the potential to aid early identification of SBI in children.