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Diagnostic errors are the most common, most costly, and most deadly medical errors, according to a recent analysis of 25 years of malpractice payouts from the National Practitioner Data Bank.1
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Consent to an intervention or treatment is generally implied when a patient comes to the ED, but there are some exceptions to this, according to Andrew H. Koslow, MD, JD, an assistant clinical professor of emergency medicine at Tufts University School of Medicine in Boston, MA, and an emergency physician (EP) at Steward Good Samaritan Medical Center in Brockton, MA.
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All across the country, states, hospital associations, communities, and emergency departments (EDs) are attempting to deal with the growing incidence of prescription pain medication abuse, overdoses, and deaths.1 Opioid pain medications now kill more Americans than cocaine and heroin combined, and over the past five years, there have been more drug-induced deaths than motor vehicle accident deaths.2
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AIDS- and HIV-related infections have changed significantly over the last decade. Although the overall incidence has declined, young adults have shown an increase in AIDS, with 50% of all new HIV infections in this age group. Many of these new HIV infections are in patients who are late presenters. These patients have received less care and are more likely to have unknowingly transmitted the infection. Routine screening identifies patients earlier, decreases the stigma associated with HIV testing, and increases the likelihood of future testing during risky behavior periods. The authors review the current role of the ED provider in identifying and managing patients with potential HIV.
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Regional cerebral blood flow defines distinct patterns of disrupted metabolism in psychogenic vs organic dystonia, with decreased flow in motor and premotor cortex in psychogenic dystonia, but increased flow in subcortical structures.
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Exercise, both aerobic as well as stretching and strengthening, improves motor function and gait in patients with Parkinsons disease.
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Veterans with Gulf War illness had a statistically significant increase of autonomic symptoms, heart rate variability, and abnormalities in sudomotor function, as measured by the Quantitative Sudomotor Axon Reflex Test, compared to control subjects. The study found objective autonomic deficits in veterans with the Gulf War syndrome with autonomic syndrome.
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Chelation therapy for cardiovascular disease; statins and kidney injuries; chlorthalidone for hypertension; and FDA actions.
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After successful treatment of sciatica, routine follow-up MRI of the lumbar spine provides no useful information. Recurrent or persistent symptoms mandate additional evaluation based on clinical symptoms and signs.