Prednisone for emergency department low back pain: a randomized controlled trial.

Background: Although oral corticosteroids are commonly given to emergency department (ED) patients with musculoskeletal low back pain (LBP), there is little evidence of benefit.

Objective: To determine if a short course of oral corticosteroids benefits LBP ED patients.

Design: Randomized, double-blind, placebo-controlled trial.

Antiepileptic drugs: the old and the new.

During the past decade several new antiepileptic drugs (AEDs) have become available, including new formulations of some of the older medications. Understanding the pharmacokinetics of the new AEDs is important because they are primarily used for adjunctive therapy and interactions with other medications can result in significant toxicities. The new-generation AEDs do not cause serious morbidity in overdose, and treatment is primarily supportive.

Cocaine-associated seizures and incidence of status epilepticus.

Objectives: Acute complications from cocaine abuse are commonly treated in the emergency department (ED); one of the most consequential is status epilepticus. The incidence of this complication is not clearly defined in the prior literature on cocaine-associated sequelae. We evaluated the incidence of status epilepticus in patients with seizures secondary to suspected cocaine use.

Monthly variations in the diagnosis of carbon monoxide exposures in the emergency department.

Introduction: Carbon monoxide (CO) poisoning is the leading cause of toxicological deaths worldwide. Symptoms may be subtle, contributing to its frequent delay in diagnosis. If a seasonal variation occurs, a heightened awareness during peak time may lead to improved recognition and diagnosis.

Survival after an intentional ingestion of crushed abrus seeds.

Abrus precatorius seeds contain one of the most potent toxins known to man. However, because of the seed's outer hard coat the vast majority of ingestions cause only mild symptoms and typically results in complete recovery. If the seeds are crushed and then ingested, more serious toxicity, including death, can occur.

Factors predictive of acute renal failure and need for hemodialysis among ED patients with rhabdomyolysis.

Objective: We assessed the primary causes of rhabdomyolysis, the factors associated with the development of acute renal failure (ARF), and the need for hemodialysis (HD) among a series of patients presenting to an urban emergency department with rhabdomyolysis.

Methods: A chart review between January 1992 and December 1995 was conducted of patients aged 18 years or older with a diagnosis of rhabdomyolysis and an initial serum creatine phosphokinase greater than 1000 U/L. Patients were excluded if they had evidence of myocardial ischemia, cerebrovascular insufficiency, or the development of rhabdomyolysis after hospitalization.

Ecgonine methyl ester protects against cocaine lethality in mice.

Background: Plasma cholinesterase (PChE) metabolizes cocaine to ecgonine methyl ester (EME). Limited data demonstrate that EME is a mild vasodilator. Exogenous PChE protects against cocaine-induced seizures and lethality.

Behavioral risk factor and preventive health care practice survey of immigrants in the emergency department.

Objective: To compare the demographic profiles, behavioral risk factors, and preventive health care practices of adult immigrant and non-immigrant patients while considering the effects of various socioeconomic variables.

Methods: This was a prospective survey administered at a large urban emergency department in New York City. Study subjects were adult immigrant patients presenting in an eight-week period in 1998.

Complications of ultrarapid opioid detoxification with subcutaneous naltrexone pellets.

Unlabelled: Rapid and ultrarapid opioid detoxification (ROD and UROD) centers promise quick, painless, same-day detoxification treatment for patients with opioid addiction. The goal of ROD and UROD is to provide a rapid transition from opioid dependency to oral naltrexone therapy. The patient is given general anesthesia and high-dose opioid antagonists.