Articles: emergency-department.
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Interv Med Appl Sci · Dec 2013
Case ReportsWhen does a D-dimer test help make the diagnosis of aortic dissection?
We present a case of an 84-year-old woman who presented with vague abdominal discomfort and syncope secondary to a type A acute aortic dissection. In pursuit of the diagnosis, multiple tests were ordered after the history and physical exam were complete. ⋯ A diagnostic testing algorithm being used in our institution using D-dimer, ultrasound, and other tests are provided in patients presenting with possible acute aortic dissection. In this case, bedside ultrasound helped us to rapidly make the diagnosis of acute aortic dissection and arrange for further inpatient care.
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Violence is a growing problem worldwide. In Switzerland, interpersonal violence seems to be an increasing problem as well. The aim of the current study was to describe a comprehensive picture of violence in a swiss city with regard to medical and social aspects. ⋯ There were no relevant changes regarding the number of within the observation period. However, the proportion of affected females increased. Especially at the weekend, there is a need for preventive measures to reduce the high number of affected patients and the associated costs.
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Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). ⋯ WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.
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Review Meta Analysis
The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis.
Acute mesenteric ischemia is an infrequent cause of abdominal pain in emergency department (ED) patients; however, mortality for this condition is high. Rapid diagnosis and surgery are key to survival, but presenting signs are often vague or variable, and there is no pathognomonic laboratory screening test. A systematic review and meta-analysis of the available literature was performed to determine diagnostic test characteristics of patient symptoms, objective signs, laboratory studies, and diagnostic modalities to help rule in or out the diagnosis of acute mesenteric ischemia in the ED. ⋯ The quality of the overall literature base for mesenteric ischemia is varied. Signs, symptoms, and laboratory testing are insufficiently diagnostic for the condition. Only CT angiography had adequate accuracy to establish the diagnosis of acute mesenteric ischemia in lieu of laparotomy.