Jacobi ring catheter treatment of Bartholin's abscesses.
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Abscess↗
Biomedical subjects
Siu Fai Li
Publications and source records attributed to Siu Fai Li.
Patient attitudes toward emergency physician attire.
Previous studies have suggested that Emergency Department (ED) patient satisfaction is unaffected by physician attire. We conducted a before-and-after trial to test this hypothesis. A convenience sample of ED patients was surveyed during a 2-week period. In the first week, emergency physicians wore white coats and formal attire. In the second week, the same physicians wore scrubs. Patients were asked to indicate on a 100-mm visual analog scale (VAS) their ratings of physician appearance, satisfaction, and professionalism. The primary outcome was the difference in VAS scores between the two dress styles. There were 111 patients surveyed. There were no significant differences between patients' evaluation of appearance (Delta=-.68 mm VAS, 95% confidence interval [CI] -5.5 to 4.1), satisfaction (Delta=.83 mm VAS, 95% CI -3.0 to 4.6), or professionalism (Delta=-.46 mm VAS, 95% CI -3.6 to 2.6) between the two dress styles. Emergency physician attire does not affect patient satisfaction.
Adolescent↗
Laboratory tests in adults with monoarticular arthritis: can they rule out a septic joint?
UNLABELLED: It is difficult to differentiate septic arthritis from other causes of monoarticular arthritis solely with a history and physical examination. The clinician must rely on ancillary tests to make a diagnosis, such as the white blood cell count of peripheral blood (WBC), the erythrocyte sedimentation rate (ESR), and the white blood cell count of the joint fluid (jWBC) obtained from arthrocentesis. Although it is known that septic arthritis is associated with abnormalities in these tests, the majority of the data are based on studies in the pediatric population. In addition, although several emergency medicine texts indicate that a jWBC greater than 50,000 cells/mm(3) is "positive," it is known that septic arthritis can occur in patients with low jWBCs. OBJECTIVES: To determine whether specific ancillary tests have sufficiently high sensitivities to rule out septic arthritis in adults. METHODS: This was a retrospective consecutive case series of patients from an urban emergency department (ED). Patients at least 18 years old who had septic arthritis confirmed by positive arthrocentesis culture or operative findings were included in the study. WBC greater than 11,000 cells/mm(3), ESR greater than 30 mm/hr, and jWBC greater than 50,000 cells/mm(3) were considered elevated. RESULTS: Seventy-three patients met the inclusion criteria. The sensitivities of an elevated WBC, ESR, or jWBC in adults who had septic arthritis were 48%, 96%, and 64%, respectively. There were broad ranges of WBC, ESR, or jWBC among the patients. More than one third of adult patients with septic arthritis had jWBCs less than 50,000 cells/mm(3). All patients had an abnormality in at least one of these tests. CONCLUSIONS: The WBC, ESR, and jWBC are extremely variable in adults with septic arthritis. Laboratory tests do not rule out septic arthritis with accuracy.
Arthritis, Infectious↗
SAEM abstracts to articles: 1997 and 1999-2001.
OBJECTIVES: The Society for Academic Emergency Medicine (SAEM) annual meeting is the primary research conference in emergency medicine. An abstract presented at the 2000 SAEM meeting found a trend of decreasing publication rates of articles based on SAEM abstracts from 47% in 1995 to 33% in 1997. The authors wished to determine whether the publication rates of articles based on SAEM abstracts continued to decline since 1997. METHODS: A MEDLINE search of all SAEM abstracts from 1997 and 1999-2001 was conducted. The primary outcome was the publication rates of articles based on abstracts presented each year. Secondary outcomes included comparison of publication rates by oral versus poster presentation and category of research. RESULTS: Thirty-eight percent of 2,054 SAEM abstracts were published as articles by fall 2003, with 40% in 1997, 40% in 1999, 38% in 2000, and 35% in 2001. The publication rate was higher for oral presentations (50%) than poster presentations (34%). Publication rates ranged from 32% to 53% by category of research; the highest rates were in wound (53%) and cardiopulmonary resuscitation/resuscitation (51%), and the lowest rates were in administration (32%) and cardiovascular (33%). Twenty-six percent of articles were published in emergency medicine journals. The times to publication were similar across the years: 4%-7% were published in the same year of the meeting, 15%-17% one year later, 10%-11% two years later, 5% three years later, and 3%-5% after three years. CONCLUSIONS: The publication rate of articles based on SAEM abstracts has held steady at 40% in recent years when the time delay to publication is taken into account.
Abstracting and Indexing↗
How distracting is distracting pain?
The study was to determine the effect of preexisting pain on the perception of a painful stimulus. We conducted a cross-section study at an urban ED using convenience sampling. Adult patients who had a 20-g IV catheter placed as part of their ED care were eligible for the study. Patients were excluded for the following reasons: more than one IV attempt, altered mental status, visual impairment, intoxication, or a physical abnormality at the IV site. Patients were asked to indicate on a 10-cm visual analog scale (VAS) the amount of pain they had at baseline immediately before IV placement. They were then asked to indicate on a separate VAS the amount of pain caused by the IV placement. Correlation between baseline pain and pain of the IV was assessed using Pearson's rho. One hundred patients were enrolled in the study. The pain of IV placement did not differ significantly by gender, race, who placed the IV, or the location of the IV. The correlation between baseline pain and pain of the IV placement was poor (rho =.14, confidence interval:-.06-.33). The response to a standardized painful stimulus among ED patients does not correlate highly with the severity of preexisting pain.
Adult↗
Oral contraceptives and the risk of myocardial infarction.
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Cocaine↗
Toothpick injury mimicking renal colic: case report and systematic review.
We describe a case of a patient with left flank pain that was caused by a perforation in the splenic flexure of the colon by a toothpick. We conducted a systematic review of the literature to examine the nature of injuries caused by ingested toothpicks. Articles were analyzed for the following outcome variables: presenting complaint, site of injury, recollection of toothpick ingestion, time to presentation, findings from imaging studies, and mortality. Most patients (70%) presented with abdominal pain. Few patients (12%) remember swallowing a toothpick. The onset of symptoms ranged from <1 day to 15 years. Toothpicks caused perforation most frequently at the duodenum and the sigmoid. In some cases, toothpicks migrated outside the gastrointestinal tract and were found in the pleura, pericardium, ureter, or bladder. Toothpicks were apparent on imaging studies in 14% of the cases. The definitive diagnosis was most commonly made at laparotomy (53%), followed by endoscopy (19%). Overall mortality was 18%. Ingested toothpicks may cause significant gastrointestinal injuries, and must be treated with caution.
Abdominal Pain↗