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The emergency physician is faced with a wide variety of acute respiratory emergencies in daily practice. Noninvasive ventilation (NIV), a means of delivering positive pressure ventilation without the use of an endotracheal tube, is a powerful therapeutic tool in the hands of an informed physician. This article will delineate the physiology of NIV. It will provide guidelines for initiation, weaning, and possible complications of NIV. It also will highlight current research in the topic.
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"EMTALA: The Essential Guide to Compliance" from Thomson American Health Consultants, publisher of Emergency Medicine Reports, explains how the changes to EMTALA will affect emergency departments and off-campus clinics.
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The vasomotor flush is viewed as the hallmark of the female climacteric, experienced to some degree by most postmenopausal women. In the Massachusetts Womens Health Study, the incidence of hot flushes increased from 10% during the premenopausal period to about 50% just after cessation of menses.
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Following radiation therapy, adjuvant extrafascial hysterectomy decreased the risk of relapse for patients with bulky stage IB cervical cancer without improving survival.
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Birth weight discordancy of > 15% for same sex and > 30% for different sex confer greatest risk of adverse perinatal outcomes in the absence of abruption.
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The data in this case-control study of combined estrogen plus progestin therapy revealed an increased risk of breast cancer, particularly invasive lobular tumor, regardless of whether the progestin component was taken sequentially or continuously.
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In an intent-to-treat analysis, the use of conjugated equine estrogen combined with continuous medroxyprogesterone acetate by menopausal women increased the hazard ratio of invasive breast cancer to 1.24.
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