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Clinical syndromes due to altitude can manifest in susceptible individuals with elevations as low as 1500 meters (5000 feet) above sea level. For otherwise healthy adults, altitudes of 2350 meters (8000 feet) are considered the arbitrary cutoff for placing one at risk for more serious syndromes, such as acute mountain sickness (AMS). While decreased ambient oxygen pressure is the most evident change at high altitude and presumably is responsible for most of the pathophysiologic derangements, other factors may have medical implications as well, such as decreased ambient temperature, increased exposure to ultraviolet radiation, and lower humidity.
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Spinal trauma is a rare yet important category of injury. Children account for 10% of spinal injuries, but account for 25% of the mortality. Pediatric patients who present with possible spinal injury pose several unique challenges to the emergency department provider. Unique anatomic and developmental features place pediatric patients at risk for spinal injuries that are not typically seen in the adult population. In addition, unlike adult patients, there is little consensus on the most appropriate workup for potentially injured patients. When evaluating pediatric patients, practitioners must balance the limited available clinical data with the risks and benefits of various imaging modalities. The authors review the spectrum of pediatric spinal injury.
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Despite better compliance with hand hygiene and screening, use of isolation, and other techniques, ICUs remain notorious breeding grounds for hospital-acquired infections. A universal decolonization strategy reduces the total number of ICU bloodborne infections.
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Subarachnoid hemorrhage (SAH) is a stroke syndrome, defined as rapidly developing neurological dysfunction and/or headache because of bleeding into the subarachnoid space (the space between the subarachnoid membrane and the pia mater of the brain or spinal cord), which is not caused by trauma.1 It is a dire condition with high morbidity and mortality.
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NSAIDs and cardiovascular risk; new antithrombotic guidelines; warfarin during surgery; Pfizer selling Viagra online; azithromycin and cardiovascular risk; and FDA actions.
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Moderate or severe EEG abnormalities are frequently seen in patients during therapeutic hypothermia following cardiac arrest and these findings are associated with poor outcomes.
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I started my emergency medicine practice prior to the widespread availability of pediatric-sized fiberoptic endoscopes. At that time, esophagoscopy using rigid endoscopes was a therapeutic option, but the availability of trained practitioners was limited in many communities.
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Case could turn on whether efforts are documented.