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After a group of severe acute respiratory syndrome (SARS) patients in Toronto in 2003 was tracked to a surgical patient, health care providers there realized no guidelines from international or U.S. groups addressed how to handle SARS patients or avoid SARS transmission in the OR.
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Recently at a conference, I was asked about what frustrates me the most out of all the work we do. It took me less than a second to reply: expense adjustment.
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With 45 million people in the United States speaking a language other than English and another 19 million people with limited proficiency in English, it is more important than ever for same-day surgery programs to make sure that interpreters are available and qualified to translate pre-op and discharge instructions.
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Oral rofecoxib (Vioxx) may have a role in controlling postoperative pain patients undergoing knee surgery.
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A topical estradiol emulsion has been approved for treating symptoms of menopause. Currently available estrogen products include pills, patches, and vaginal rings. The new estrogen emulsion provides another option for estrogen therapy. Novavax Inc markets this topical formulation as Estrasorb.
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The rhythm strip shown in the Figure was obtained from a middle-aged man in severe pain from a musculoskeletal disorder. He was not having chest pain, and had no known history of cardiovascular disease. He had an episode of vomiting shortly before this tracing was recorded. Is there evidence of heart block? If so, what type?
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Previous research failed to show that the angiotensin II antagonist losartan at 50 mg per day was as effective as captopril in reducing mortality in patients with heart failure after myocardial infarction. This raised the question of whether this new class of drugs may be substituted for ACE inhibitors in treating these high-risk patients.
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The daily practice of emergency medicine involves life and death decisions. While training in emergency medicine focuses on life-saving procedures and medications, dying patients often seek care in the ED for symptom relief, psychosocial support, or a variety of other reasons. Education, experience, communication, and compassion can improve the emergency physicians ability to deliver medical care near the end of life that will serve to relieve suffering, improve communication of the patients preferences and goals of medical treatment, and improve overall care of the patient and family.
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Children who present with a history of foreign body ingestion frequently offer both a diagnostic and management challenge to the emergency medicine physician. Esophageal foreign bodies can result in significant injury to or the death of a child. What follows is a review of the literature on the subject of esophageal foreign bodies in children.
