Emergency medicine journal : EMJ
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Review Meta Analysis
Oxygen therapy for acute myocardial infarction: a systematic review and meta-analysis.
Oxygen (O(2)) is widely recommended in international guidelines for treatment of acute myocardial infarction (AMI), but there is uncertainty about its safety and benefits. A systematic review and meta-analysis were performed to determine whether inhaled O(2) in AMI improves pain or the risk of death. Cochrane CENTRAL Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE, CINAHL, LILACS and PASCAL were searched from start date to February 2010. ⋯ Evidence for O(2) in AMI is sparse, of poor quality and pre-dates advances in reperfusion and trial methods. Evidence is suggestive of harm but lacks power and excess deaths in the O(2) group could be due to chance. More research is required.
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The authors report the case of a 4-year-old boy who presented to the emergency department with acute post-traumatic winging of right scapula following a fall onto his back. The x-ray of his right shoulder showed no fracture. An MRI Scan of cervical spine and brachial plexus did not reveal any abnormalities. ⋯ At 2 years follow-up, there was no improvement in the winging of his right scapula. He was asymptomatic at rest but complains of pain in the right scapular and shoulder region during swimming limiting his swimming activity. Currently he was being evaluated by the orthopaedic team for corrective surgery.
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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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Increasingly emergency departments (ED) and other acute services in the hospital provide first access care, especially out of hours and for poorer families. Studies of detection of child maltreatment in the hospital have focused on children presenting with injury, although maltreatment may be suspected when parents present to the hospital with problems related to violent behaviour, drug abuse or mental health problems. ⋯ Clinicians need to be aware that half the vulnerable children in hospital are identified through one or other parent. It is hypothesised that the availability of an experienced child protection advisor on-site, combined with child protection training, makes it possible for clinicians caring for adults with problems related to violence, drug abuse or acute mental illness, to take action to address the potential vulnerability of their children.