The Radiographic Quality of Distal Radius Fracture Reduction Using Sedation Versus Hematoma Block.

Introduction: Distal radius fractures (DRFs) are treated in the emergency department (ED) with a closed reduction in order to decrease neurovascular and soft tissue injury and as a first definitive step in conservative treatment. The type of anesthesia used may affect the ability to reduce the fracture and remains controversial.

Objective: The purpose of this study was to compare the quality of radiographic reduction achieved in the ED of DRF reduced using sedation anesthesia to those reduced with hematoma block anesthesia.

Progressive prediction of hospitalisation in the emergency department: uncovering hidden patterns to improve patient flow.

Introduction: One of the factors contributing to ED crowding is the lengthy delay in transferring an admitted patient from the ED to an inpatient department (ie, boarding time). An earlier start of the admission process using an automatic hospitalisation prediction model could potentially shorten these delays and reduce crowding.

Methods: Clinical, operational and demographic data were retrospectively collected on 80 880 visits to the ED of Rambam Health Care Campus in Haifa, Israel, from January 2011 to January 2012.

[INCREASED MORTALITY OF DELAYED PATIENTS IN THE EMERGENCY DEPARTMENT OF A TERTIARY MEDICAL CENTER].

Introduction: Boarding patients awaiting hospitalization in the emergency department increases mortality and complications, and stands in contrast to the recommendations of emergency medicine associations worldwide. Although Israel's Ministry of Health and the media are addressing the issue, boarding patients in emergency departments is common in hospitals throughout the country. There are no current studies that assess the influence of boarding in emergency departments on the patient's mortality and hospitalization.

Sparing ultrasound in emergency department patients with suspected deep vein thrombosis by using clinical scores and D-dimer testing.

Purpose: To evaluate compliance with a management strategy for use in emergency department (ED) patients with suspected deep vein thrombosis (DVT) based on Wells score (WS), D-dimer concentrations, and sonographic (US) examinations.

Methods: Retrospective and prospective data on risk factors, physical examination findings, D-dimer concentrations, and US results were collected and reviewed. The prevalence of DVT for each WS category and D-dimer level was calculated.

Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury.

Purpose: Initial pain level in the acute whiplash injury is the most consistent predictor of transformation to a chronic pain syndrome. The risk factors for those early pain levels were, to our knowledge, scarcely evaluate to this date. We set to evaluate whether gender, age or ethnicity comprise a risk factor for those initial pain levels.

[Health hazards of energy drinks--the situation in Israel and the world].

Since 1987, with the introduction of the first commercial energy drink in Europe, the level of sale of these drinks increased rapidly throughout the western world. These drinks are based on caffeine that is found in them ndependently, and in other ingredients. Other ingredients in these drinks potentiate the effects of caffeine.

Do cervical spine X-rays for trauma have clinically significant incidental findings?

Objectives: About 800,000 cervical X-rays for trauma are taken every year in the USA. Those X-rays are reviewed by orthopedic specialists in the emergency room (ER) for traumatic findings. The quantity of incidental atraumatic findings in this very prevalent examination is unknown.

Capsule endoscopy in acute upper gastrointestinal hemorrhage: a prospective cohort study.

Background And Study Aims: Capsule endoscopy may play a role in the evaluation of patients presenting with acute upper gastrointestinal hemorrhage in the emergency department.

Patients And Methods: We evaluated adults with acute upper gastrointestinal hemorrhage presenting to the emergency departments of two academic centers. Patients ingested a wireless video capsule, which was followed immediately by a nasogastric tube aspiration and later by esophagogastroduodenoscopy (EGD).

Shifting up cutoff value of d-dimer in the evaluation of pulmonary embolism: a viable option? Possible risks and benefits.

Objectives. To evaluate the viability of the possibility to use a higher D-dimer value than the one used today in the clinical algorithms evaluating patients suspected to have pulmonary embolism. Methods.

Perforated gastrointestinal ulcers presenting as acute respiratory distress.

Background: Dyspnea is one of the most common complaints facing the emergency medicine physician. Some of the gastrointestinal causes of dyspnea are self-limited and not life-threatening, yet others are, and early diagnosis and treatment are crucial.

Methods: In this article we presented one of these life-threatening conditions through a clinical description of a patient presenting with acute respiratory distress that was finally diagnosed to be the result of a perforated gastric ulcer.

Pseudopancreatitis in trauma patients.

Objective: The purpose of our study was to review the significance of intra- and peripancreatic fluid in trauma patients who have no other signs of pancreatic injury.

Conclusion: We propose that intra- and peripancreatic fluid may be the consequence of hypovolemic shock treated with hyperhydration when there is significant delay between injury and imaging.

Intestinal intussusception in elderly patients.

Intussusception is the most common cause of bowel obstruction in children, but it is a very rare cause of bowel obstruction in the elderly. Diagnosis is based on a high index of suspicion, complete anamnestic recall, physical examination, and imaging modalities. We find abdominal CT scans to be highly sensitive and accurate for making the diagnosis.

Factitious hyperamylasuria by a nurse: a symptom of Munchausen syndrome.

A 30-year-old nurse presented with abdominal pain and tenderness. Her blood tests, including amylase, were normal. Urinary amylase was extremely high.

Multidetector CT angiography in the evaluation of acute mesenteric ischemia.

The aim of this study was to determine the accuracy of multidetector row CT angiography in the diagnosis of acute mesenteric ischemia. Ninety-three consecutive studies on 91 patients with clinically suspected acute mesenteric ischemia underwent abdominal CT angiography as the first, and usually the sole, diagnostic procedure. CT was performed with a multidetector 16-row CT system from the level of the diaphragm to the pelvis in two phases: early arterial and late portal phase.

Left-sided perforated acute appendicitis in an adult with midgut malrotation: the role of computed tomography.

We report a case of left-sided perforated acute appendicitis in the patient with midgut malrotation. Embryology, clinical findings, and radiological presentation are discussed. Highly prevalent disease presents here in the unusual location and thus in the unusual presentation.

Surgical excision of extensive anal condylomata not associated with risk of anal stenosis.

Introduction: Surgical treatment of extensive and confluent anal condylomata results in large open wounds, which in other contexts of anorectal surgery (e.g., hemorrhoidectomy), have been associated with a relevant risk of stricture formation.

Morbidity of ostomy takedown.

Purpose: Creation of a temporary ostomy is a surgical tool to divert stool from a more distal area of concern (anastomosis, inflammation, etc). To provide a true benefit, the morbidity/mortality from the ostomy takedown itself should be minimal. The aim of our study was therefore to evaluate our own experience and determine the complications and mortality of stoma closure in relation to the type and location of the respective ostomy.

Focused helical CT using rectal contrast material only as the preferred technique for the diagnosis of suspected acute appendicitis: a prospective, randomized, controlled study comparing three different techniques.

Purpose: Focused helical CT using rectal contrast material only has emerged recently as an accurate diagnostic tool for the evaluation of suspected acute appendicitis. This study was designed to prospectively compare the efficacy of rectal contrast CT to other commonly used contrast-enhanced and nonenhanced CT techniques for the detection of acute appendicitis.

Methods: A total of 232 patients with clinically suspected appendicitis were randomly assigned to one of three focused helical CT techniques: noncontrast enhanced CT, CT using rectal contrast material only, and dual-contrast CT using both oral and intravenous material.

Factitious hyperamylasuria by a nurse: symptom of Munchausen's syndrome.

A 30-year-old nurse presented with abdominal pain and tenderness. Her blood tests, including amylase, were normal. Urinary amylase was extremely high.

Laparoscopic diagnostic peritoneal lavage (L-DPL): A method for evaluation of penetrating abdominal stab wounds.

Background: The management of penetrating abdominal stab wounds has been the subject of continued reappraisal and controversy. In the present study a novel method which combines the use of diagnostic laparoscopy and DPL, termed laparoscopic diagnostic peritoneal lavage (L-DPL) is described

Method: Five trauma patients with penetrating injuries to the lower chest or abdomen were included. Standard videoscopic equipment is utilized for the laparoscopic trauma evaluation of the injured patient.