Publications by authors named "Kenneth Frumkin"

Animals and humans can be readily conditioned to associate a novel stimulus (often a unique taste) by pairing it with the effects of a drug or other agent. When later presented with the stimulus alone, their body's systems respond as if the drug or agent were given. The earliest clinical applications demonstrated both conditioned suppression and enhancement of immune processes.

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Background: Every emergency department (ED) faces both a rising tide and a revolving door of elderly patients. Unplanned short-term returns after a recent ED evaluation or hospital admission are sentinel events. Consequences include substantial functional decline, reduced health-related quality of life, and increased risk of dependency or death.

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Background: The emergency department evaluation of patients with abdominal pain is most appropriately directed at identifying acute inflammation, infection, obstruction, or surgical disease. Doing so commonly involves "routine" (and often extensive) diagnostic imaging and laboratory testing. Benign mimics of serious visceral abdominal pain that can be diagnosed by physical exam and confirmed with local anesthetic injections have been identified over the last century.

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Introduction: Unilateral leg swelling with suspicion of deep venous thrombosis (DVT) is a common emergency department (ED) presentation. Proximal DVT (thrombus in the popliteal or femoral veins) can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT) often remains a consideration.

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Ischemic conditioning refers to the ability of brief episodes of controlled hypoperfusion around the time of an acute ischemic event to protect the target organ from reperfusion injury. A considerable body of literature suggests that interventions as simple and safe as repetitively inflating a blood pressure cuff could reduce the size and long-term morbidity of myocardial and cerebral infarction. This review introduces and summarizes the body of evidence contributing to these impressions.

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A 4-year-old presented to the emergency department, asymptomatic, with the strong suspicion (by history, physical examination, and initial radiographic interpretation by the emergency physician) of an esophageal coin. Closer inspection revealed radiographic signs associated with disk battery ingestion, a surgical emergency. In the operating room superimposed coins, mimicking the radiographic appearance of a disk (button) battery, were extracted.

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Background: Emergency Department (ED) headache patients are commonly treated with neuroleptic antiemetics like metoclopramide. Haloperidol has been shown to be effective for migraine treatment.

Study Objective: Our study compared the use of metoclopramide vs.

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Background: Because urinary tract infection (UTI) is the most frequent source of serious bacterial infections in young children, we studied the bacteriology of such infections in our institution.

Objectives: Pediatric urine cultures were reviewed for age- and sex-specific differences in testing, prevalence, causative organisms, and antibiotic sensitivities.

Methods: A retrospective 5-year observational study of all urine cultures from Emergency Department patients aged 0-36 months found 4403 cultures.

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Background: Patients with fever, vomiting, and abdominal pain commonly present to the emergency department, often generating a broad differential diagnosis. We describe the first reported case in the emergency medicine literature of acute lobar nephronia (ALN).

Objectives: To describe the presentation, evaluation, and management of acute lobar nephronia.

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Life-threatening warfarin-associated hemorrhage is common, with a high mortality. In the United States, the most commonly used therapies--fresh frozen plasma and vitamin K--are slow and unpredictable and can result in volume overload. Outside of the United States, prothrombin complex concentrates are often used instead; these pooled plasma products reverse warfarin anticoagulation in minutes rather than hours.

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Background: Epidemiologic issues of testing, treatment, prevention, immunization, mandated reporting, and post-exposure prophylaxis do not often intrude on the Emergency Department management of the well-appearing adolescent or adult with a couple of weeks of cough.

Objectives: Considering that waning immunity to pertussis, the only vaccine-preventable disease with increasing cases and deaths in the United States, is responsible for 12-35% of such illness, such issues need to be considered.

Discussion: Mostly self-limited in adults, transmission of pertussis to infants places them at risk for hospitalization and death.

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