Domestic violence in the emergency department: how do women prefer to disclose and discuss the issues?

The purpose of this study was to survey women presenting to the emergency department (ED) and determine from them how best to identify and discuss issues of domestic violence (DV). An anonymous 10-question survey was given to ambulatory females presenting to the ED. It was conducted at two affiliated university hospital EDs, one an urban trauma center (ED 1) and the other an ED in an affluent suburban setting (ED 2).

Current concepts in electrical defibrillation.

The electrical defibrillator has been proven to be a life-saving device in the treatment of cardiac arrest due to ventricular tachycardia or ventricular fibrillation. An understanding of the physiology and technology behind this device is useful for providers of emergency care. In this article, we review the current concepts in electrical defibrillation and briefly discuss the developmental history.

Case reports of two patients with pneumothorax following acupuncture.

We report two patients who presented to the emergency department with pneumothorax related to acupuncture. The first patient developed pleuritic chest pain and shortness of breath while undergoing acupuncture therapy, and the second patient developed similar symptoms 10 min after acupuncture therapy. Neither patient had a previous history of pneumothorax, and both were undergoing acupuncture along the spine, paraspinal region, and shoulders.

Refining the level for anticipated hepatotoxicity in acetaminophen poisoning.

Treatment of an acetaminophen overdose with N-acetyl cysteine usually is based on the position of the 4-h acetaminophen (APAP) level on the Rumack-Matthew nomogram; however, there is disagreement on the level at which clinically relevant hepatotoxicity occurs. A retrospective review of all acute adult formulation APAP exposures reported to our poison center between 1986 and 1993 was performed and cases corresponding to the "possible risk or toxicity" range on the nomogram were identified. Our current poison center protocol for APAP poisoning does not recommend treatment with N-acetylcysteine (NAC) in low-risk patients if the 4-h serum APAP level or the extrapolated equivalent falls within the possible toxicity range on the nomogram.

Cervical spine epidural abscess in a patient with no predisposing risk factors.

We report a case of cervical spine epidural abscess in a 50-year-old man with a 4-day history of neck pain but no neurologic deficits or fever. The patient had no predisposing risk factors such as recent spinal surgery, trauma, instrumentation, distal site of infection, immunosuppression, diabetes, or i.v.

Actinobacillus ureae meningitis: case report and review of the literature.

Actinobacillus urea, formerly known as Pasteurella ureae, is an uncommon commensal of the upper respiratory tract in humans. It has been identified as the primary pathogen in 10 cases of meningitis and several cases of pneumonia, sepsis, and peritonitis. A case is presented that represents another documented case of meningitis due to this rare organism.

Ciguatera fish poisoning. A southern California epidemic.

Ciguatera fish poisoning results from the bioconcentration of a variety of toxins produced by marine dinoflagellates. Signs and symptoms vary widely, but it usually presents as gastrointestinal and neurologic complaints beginning shortly after the ingestion of fish containing the toxins. Symptoms may persist for months and sometimes even years.

The acquired immune deficiency syndrome: an overview for the emergency physician, Part 2.

Human immunodeficiency virus (HIV) affects all organ systems. Infection of the heart can manifest with evidence of myocarditis, pericarditis, or cardiomyopathy. The most common gastrointestinal symptom is diarrhea, which can result from infection with a variety of bacterial, fungal, or protozoal organisms.

The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1.

The acquired immune deficiency syndrome (AIDS) was recognized as a distinct entity in 1981. It began as a medical curiosity affecting only several dozen individuals in a restricted segment of the U.S.

Complexity, chaos and human physiology: the justification for non-linear neural computational analysis.

Background is presented to suggest that a great many biologic processes are chaotic. It is well known that chaotic processes can be accurately characterized by non-linear technologies. Evidence is presented that an artificial neural network, which is a known method for the application of non-linear statistics, is able to perform more accurately in identifying patients with and without myocardial infarction than either physicians or other computer paradigms.