Articles: emergency-department.
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To determine whether the addition of intravenous dexamethasone to standard emergency department (ED) migraine therapy would decrease the incidence of severe recurrent headache 24 to 48 hours after initial treatment. ⋯ Migraine recurrence is common after "successful" ED treatment. Inflammation may be a critical factor in migraine genesis. Intravenous dexamethasone decreases the incidence of severe recurrent headache after ED treatment and should be offered to patients thought to be at risk of recurrent headache.
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To describe the clinical characteristics and course of γ-hydroxybutyrate (GHB) overdose. ⋯ In our study population, patients who overdosed on GHB presented with a markedly decreased level of consciousness. Coingestion of ethanol or other drugs is common, as are bradycardia, hypothermia, respiratory acidosis, and emesis. Hypotension occurs occasionally. Patients typically regain consciousness spontaneously within 5 hours of the ingestion. [Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD: Clinical course of γ-hydroxybutyrate overdose. Ann Emerg Med June 1998;31: 716-722.].
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We describe seven patients presenting with combination substance abuse involving γ-Hydroxybutyric acid (GHB). ⋯ Emergency physicians should be alerted to this agent, its characteristic effects, and its potential for serious sequelae including respiratory arrest and death. [Li J, Stokes SA, Woeckener A: A tale of novel intoxication: Seven cases of γ-Hydroxybutyric acid overdose. Ann Emerg Med June 1998;31:723-728.].