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While ST segment changes (both elevation and depression) are associated with an acute coronary syndrome, numerous other clinical entities manifest ST segment depression. Appropriate management partially is dependent upon differentiating these various causes of ST segment depression on the ECG.
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The 12-lead ECG and accompanying rhythm strip in the Figure were obtained from an 84-year-old man who presented to the emergency department with acute dyspnea from pneumonia and heart failure. Whats going on? Is RBBB (right bundle-branch block) among the findings?
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Trauma to the thoracic cavity is responsible for approximately 10-25%
of all trauma-related deaths, with the majority of these deaths
occurring after arrival at the emergency department. The mortality for
isolated chest injury is relatively low (less than 5%); however, with
multiple organ system involvement, the mortality approaches 30%. This
article dissects the critical aspects of thoracic trauma and highlights
acute care management strategies.
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Research misconduct activity reported by institutions in 2002 reached the highest levels since 1997, according to a report in the quarterly newsletter from the Department of Health and Human Services Office of Research Integrity (ORI).
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Hastings Center issues report on reprogenetics; NIH expanding distance learning programs
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The latest news from the womens health initiative (WHI) includes 3 noteworthy reports: the news release announcing the cancellation of the estrogen-only arm of the clinical trial,1 a comparison of the participants in the 2 clinical trial arms(estrogen-progestin and estrogen-only),2 and the updated, adjudicated lorectal cancer results from the estrogen-progestin arm.3
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Leapfrog Groups standards for critical care are not grounded sufficiently in evidence to mandate their stringent and universal implementation. Rather, most of the guidelines are grounded in common sense and rational extrapolation of the data. As such, they are a reasonable starting point for debate by physicians and policymakers about optimal methods of achieving intensivist-guided care of critically ill patients.
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No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use.
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Noninvasive positive-pressure ventilation (NPPV) was assessed in 105 patients with severe acute hypoxemic respiratory failure. The use of noninvasive positive pressure ventilation (NPPV) is effective to reduce intubation and mortality in patients with acute hypoxemic respiratory failure.
