- Email: [email protected]
Expanded TOC
CONTENTS (continued)
61
Thinking Globally, Acting Locally (Editorial) RL Wears, DJ Magid
64
Pontine Hemorrhage Presenting as an Isolated Facial Nerve Palsy (Case Report) SC Sherman, TT Thompson We report a case of an isolated facial nerve palsy in a young, otherwise healthy man who was found to have a pontine hemorrhage on computed tomography. Pontine hemorrhage is a rare cause of facial nerve palsy and has been reported in the literature as an isolated neurologic finding in only 1 other instance. This case reminds the emergency physician to remain vigilant for alternative causes of facial nerve palsy other than idiopathic Bell’s palsy.
GENERAL MEDICINE 67
Evaluation of a Brief Intervention in an Inner-City Emergency Department (Original Research) S Bazargan-Hejazi, E Bing, M Bazargan, C Der-Martirosian, E Hardin, J Bernstein, E Bernstein What is already known on this topic: Millions of patients with alcohol-related complaints present to the emergency department (ED) every year. The detection and early treatment of patients with alcohol problems may reduce alcohol-related injuries and save unnecessary costs in the health care system. What question this study addressed: This randomized controlled trial screened ED patients for at-risk drinking using a standardized tool (CAGE questionnaire), and then those assigned to the intervention group individually underwent a brief negotiated interactive and motivational interview. Patients were reassessed at 3 months. What this study adds to our knowledge: In 295 patients enrolled, those who had moderately risky drinking and who received the intervention decreased their self-reported drinking behavior at 3 months compared with those who only received standard ED care. How this might change clinical practice: ED patients identified at risk for alcohol problems and given brief personal interventions may reduce their subsequent drinking, although additional resources would be needed. Additional long-term assessment of actual impact on drinking remains to be determined.
77
Epidemiology of Epistaxis in US Emergency Departments, 1992 to 2001 (Brief Research Report) DJ Pallin, Y-M Chng, MP McKay, JA Emond, AJ Pelletier, CA Camargo What is already known on this topic: US population–based epidemiologic features of emergency department (ED) visits for epistaxis are unknown. What question this study addressed: Drawing from the National Hospital Ambulatory Medical Care Survey during a decade, this study examined ED visits for epistaxis stratified by age, etiology, and season and estimated annual visit and admission rates. What this study adds to our knowledge: This study provides better evidence to support previous teaching that epistaxis increases with age and occurs more commonly in winter. About 1 in 200 ED visits are for epistaxis, which amounts to 1 to 2 visits per 1,000 US population. Of these, only about 1 in 20 patients requires admission. How this might change clinical practice: This study provides epidemiologic evidence that the elderly, particularly during winter, constitute the primary target population for educational interventions aimed at prevention and home treatment of recurrent epistaxis after an ED visit.
INFECTIOUS DISEASE 82
Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, Or Other Nonoccupational Exposure to HIV in the United States (CDC Update)
84
Commentary (CDC Update) RC Merchant
Volume , . : July
Annals of Emergency Medicine 11A
61
Thinking Globally, Acting Locally (Editorial) RL Wears, DJ Magid
64
Pontine Hemorrhage Presenting as an Isolated Facial Nerve Palsy (Case Report) SC Sherman, TT Thompson We report a case of an isolated facial nerve palsy in a young, otherwise healthy man who was found to have a pontine hemorrhage on computed tomography. Pontine hemorrhage is a rare cause of facial nerve palsy and has been reported in the literature as an isolated neurologic finding in only 1 other instance. This case reminds the emergency physician to remain vigilant for alternative causes of facial nerve palsy other than idiopathic Bell’s palsy.
GENERAL MEDICINE 67
Evaluation of a Brief Intervention in an Inner-City Emergency Department (Original Research) S Bazargan-Hejazi, E Bing, M Bazargan, C Der-Martirosian, E Hardin, J Bernstein, E Bernstein What is already known on this topic: Millions of patients with alcohol-related complaints present to the emergency department (ED) every year. The detection and early treatment of patients with alcohol problems may reduce alcohol-related injuries and save unnecessary costs in the health care system. What question this study addressed: This randomized controlled trial screened ED patients for at-risk drinking using a standardized tool (CAGE questionnaire), and then those assigned to the intervention group individually underwent a brief negotiated interactive and motivational interview. Patients were reassessed at 3 months. What this study adds to our knowledge: In 295 patients enrolled, those who had moderately risky drinking and who received the intervention decreased their self-reported drinking behavior at 3 months compared with those who only received standard ED care. How this might change clinical practice: ED patients identified at risk for alcohol problems and given brief personal interventions may reduce their subsequent drinking, although additional resources would be needed. Additional long-term assessment of actual impact on drinking remains to be determined.
77
Epidemiology of Epistaxis in US Emergency Departments, 1992 to 2001 (Brief Research Report) DJ Pallin, Y-M Chng, MP McKay, JA Emond, AJ Pelletier, CA Camargo What is already known on this topic: US population–based epidemiologic features of emergency department (ED) visits for epistaxis are unknown. What question this study addressed: Drawing from the National Hospital Ambulatory Medical Care Survey during a decade, this study examined ED visits for epistaxis stratified by age, etiology, and season and estimated annual visit and admission rates. What this study adds to our knowledge: This study provides better evidence to support previous teaching that epistaxis increases with age and occurs more commonly in winter. About 1 in 200 ED visits are for epistaxis, which amounts to 1 to 2 visits per 1,000 US population. Of these, only about 1 in 20 patients requires admission. How this might change clinical practice: This study provides epidemiologic evidence that the elderly, particularly during winter, constitute the primary target population for educational interventions aimed at prevention and home treatment of recurrent epistaxis after an ED visit.
INFECTIOUS DISEASE 82
Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, Or Other Nonoccupational Exposure to HIV in the United States (CDC Update)
84
Commentary (CDC Update) RC Merchant
Volume , . : July
Annals of Emergency Medicine 11A