Abstract:
:We conducted a study to assess the efficacy of the dipstick leukocyte esterase test (LET) in the detection of cerebrospinal fluid (CSF) leukocytosis as a quick screen for bacterial meningitis. Nine hundred forty-two CSF samples were collected from 800 patients. The LET was compared in a double-blinded fashion with routine cell count determinations and cultures. We reviewed the clinical courses of all patients with positive cultures to assess the significance of culture isolates. Statistical analysis revealed LET sensitivity of 84.4% and specificity of 98.1% for clinical presentations of bacterial meningitis for which initiation of therapy is currently recommended. The LET identified culture-proven cases of meningitis with sensitivity of 73% and specificity of 95%. We propose the LET as an adjunct to, but not a replacement for, CSF cell count and chemistry determination in the initial laboratory assessment of bacterial meningitis. It is a reasonable screen that allows rapid initiation of treatment and directs the laboratory technician to devote extra attention to examination of a CSF specimen with a higher likelihood of pathology.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
DeLozier JS,Auerbach PSdoi
10.1016/s0196-0644(89)80058-7subject
Has Abstractpub_date
1989-11-01 00:00:00pages
1191-8issue
11eissn
0196-0644issn
1097-6760pii
S0196-0644(89)80058-7journal_volume
18pub_type
临床试验,杂志文章abstract:STUDY OBJECTIVE:The literature suggests that the d -dimer is useful in patients suspected of having pulmonary embolism and who have a low pretest probability of disease. A previously defined clinical decision rule, the Wells Criteria, may provide a reliable and reproducible means of determining this pretest probability...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.04.002
更新日期:2004-11-01 00:00:00
abstract::The development of an organized filing system for referencing articles pertinent to emergency medicine is presented. This simple and flexible system allows for modification for the individual needs of the emergency physician. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80306-4
更新日期:1980-09-01 00:00:00
abstract:STUDY OBJECTIVE:Stress is an emergent occupational problem in modern societies. Among workers, medical practitioners are particularly exposed. However, data objectifying stress levels during work time are scarce. The aim of this study was to establish diurnal salivary cortisol levels in a highly stressful work environm...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.109
更新日期:2003-04-01 00:00:00
abstract::The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on th...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.05.013
更新日期:2005-12-01 00:00:00
abstract:STUDY OBJECTIVES:The syndrome of rhabdomyolysis associated with cocaine use has been recently described, but the incidence, severity, risk factors, and complications are unknown. This study sought to describe the spectrum of the syndrome and identify clinical features of patients at risk. DESIGN:Retrospective case ser...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81518-5
更新日期:1990-10-01 00:00:00
abstract::We report the cases of two children with acute plastic fractures of the long bones following trauma. Bowing deformity was evident clinically and radiographically in both cases. The unique radiologic features consisted of absence of fracture lines and of periosteal new bone formation during the healing phase. The mecha...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80997-0
更新日期:1986-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether pediatric patients with acute, mild to moderate acetaminophen exposures, treated with home monitoring alone, develop systemic signs of hepatic injury. METHODS:A prospective, observational study of calls to a regional poison center over a 25-month period was performed. Patients were...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(00)70074-6
更新日期:2000-03-01 00:00:00
abstract::Clinical studies on the use of magnesium in acute myocardial infarction have yielded contradictory results. While the exact reasons for these discrepancies are unclear, it appears that the timing of magnesium administration is crucial to the success or failure of therapy. Although some studies have shown a significant...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(94)70248-9
更新日期:1994-12-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated a strategy to increase use of the test (Dix-Hallpike's test [DHT]) and treatment (canalith repositioning maneuver [CRM]) for benign paroxysmal positional vertigo in emergency department (ED) dizziness visits. METHODS:We conducted a stepped-wedge randomized trial in 6 EDs. The population wa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.annemergmed.2019.09.017
更新日期:2020-04-01 00:00:00
abstract::Many patients seeking care in the modern emergency center are capable of participating in treatment decision making. In the traditional emergency center consent process, the patient or a surrogate is asked to sign a general consent form purporting to authorize any treatment the emergency physician deems necessary. We ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80289-5
更新日期:1987-01-01 00:00:00
abstract::Spontaneous rupture of utero-ovarian vessels during pregnancy is a rare cause of maternal and fetal loss. We report the case of a 30-year-old woman who presented to the emergency department in her third trimester with frank maternal shock. The prompt recognition of shock, correction of hypovolemia, and rapid surgical ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70052-4
更新日期:1994-02-01 00:00:00
abstract:STUDY OBJECTIVE:Allergic reactions are common presentations to the emergency department (ED). An unknown proportion of patients will develop biphasic reactions, and patients are often monitored for prolonged periods to manage potential reactions. We seek to determine the incidence of clinically important biphasic react...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.10.017
更新日期:2014-06-01 00:00:00
abstract::Previously reported cases of botulism in infants have been diagnosed as infant botulism; that is, botulism caused by intestinal colonization by Clostridium botulinum with intraluminal production and absorption of toxin. Foodborne botulism is caused by ingestion of preformed toxin. We describe an unusual case of foodbo...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.259
更新日期:2003-08-01 00:00:00
abstract::Descriptive statistics include measures of central tendency and variability. Measures of central tendency include mean, median, and mode. The mean is the arithmetic average of data from interval or ratio scales. The median reflects the 50th percentile score. The mode is the most frequently occurring value of a data di...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82052-9
更新日期:1990-03-01 00:00:00
abstract::Patients evaluated by paramedics but not transported to the hospital account for 50% to 90% of emergency medical services lawsuits. We reviewed 2,698 consecutive paramedic run reports to examine documentation in these cases. Documentation criteria for prehospital patient release were history, physical examination, vit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82187-0
更新日期:1990-05-01 00:00:00
abstract:STUDY OBJECTIVE:Experts advocate the use of a standard nasal cannula to provide oxygen at flow rates of up to 15 L/minute during emergency intubation. However, because of concerns about potential patient discomfort, some providers avoid providing nasal cannula oxygen at flow rates greater than 6 L/minute. This trial is...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2014.10.023
更新日期:2015-04-01 00:00:00
abstract:STUDY OBJECTIVE:I test the hypothesis that having a gun in the home is a risk factor for adults to be killed (homicide) or to commit suicide. METHODS:Two case-control analyses were based on national samples of subjects 18 years of age or older. Homicide and suicide case subjects were drawn from the 1993 National Morta...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.187
更新日期:2003-06-01 00:00:00
abstract:STUDY OBJECTIVE:It is unclear whether laryngoscopy using a standard-geometry blade shape, able to obtain both direct and indirect views, is associated with different first-attempt success or adverse events during emergency intubation compared with using a hyperangulated blade capable of indirect laryngoscopy only. We s...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.03.011
更新日期:2020-09-01 00:00:00
abstract:STUDY OBJECTIVE:Nearly 3 million patients present to US emergency departments (EDs) annually with undifferentiated musculoskeletal low back pain. Little is known about short- and longer-term outcomes in this group. We seek to describe the pain and functional outcomes 1 week and 3 months after discharge in a sample of E...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.09.012
更新日期:2012-02-01 00:00:00
abstract::In an effort to assess the reliability of patient history in excluding pregnancy, we studied the correlation between specific historical factors and the presence of a positive qualitative serum beta-human chorionic gonadotropin assay. Two hundred eight patients were studied, and information was collected prospectively...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80310-5
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the incidence of serious bacterial infection in infants presenting to the emergency department (ED) with an apparent life-threatening event. METHODS:This was a prospective cohort study of infants younger than 12 months who were treated at an urban children's hospital ED during 1 year and w...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.12.037
更新日期:2009-10-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the feasibility of bilevel positive airway pressure (BiPAP) support for acute respiratory distress (ARD) in the emergency department. METHODS:A convenience sample of patients in ARD as a result of any nontraumatic cause was recruited for a prospective, noncontrolled clinical trial in the E...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(96)70321-9
更新日期:1996-02-01 00:00:00
abstract::Risperidone is an investigational antipsychotic agent currently being tested in an international multicenter drug trial. We report the first case of a risperidone overdose in an apparent suicide attempt. This was without serious clinical side effects and manifested mainly as ECG abnormalities. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80421-4
更新日期:1993-12-01 00:00:00
abstract::We present the case of a patient who presented with persistent hiccups induced by a hair irritating the tympanic membrane and activating the vagally mediated hiccup neural reflex arc. Commonly identified etiologies and treatments of this condition are then reviewed. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80009-7
更新日期:1982-01-01 00:00:00
abstract::A seven-year-old boy ingested 3,000 mg (125 mg/kg) of isoniazid. Initial blood levels of isoniazid were 250 micrograms/mL approximately six hours after ingestion. Despite IV treatment in the emergency department with 3,000 mg pyridoxine and a repeat of the same antidote one hour later in the intensive care unit, the h...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80509-2
更新日期:1988-01-01 00:00:00
abstract::To evaluate the effects of acute alcohol intoxication on serum amylase and isoamylase levels, 58 clinically intoxicated patients with blood alcohol levels greater than 100 mg/dL were studied. Comparisons were made to normal control and a sober chronic alcoholic group. Admitting serum isoamylase levels were determined ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80511-3
更新日期:1983-05-01 00:00:00
abstract:STUDY OBJECTIVE:Availability of timely follow-up care is essential in emergency medicine. We describe nonprice barriers to care experienced by callers reporting to be emergency department (ED) patients in need of follow-up care. METHODS:This was a secondary analysis of data collected during a survey of ambulatory clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2007.10.027
更新日期:2008-05-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers. STUDY DESIGN:Prospective. SETTING:Pediatric emergency d...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70032-x
更新日期:1994-02-01 00:00:00
abstract:STUDY OBJECTIVE:Traumatic eye injuries are common emergency department presentations worldwide, and diagnosis may be delayed because of concurrent injuries and lack of guidelines in regard to the utility of clinical examination, computed tomography (CT), and point-of-care ultrasonography. In this study, we compare poin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.02.001
更新日期:2019-09-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time. METHODS:We randomized emergency department patients older than 18 years who need...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2018.11.016
更新日期:2019-05-01 00:00:00