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The rhythm strip shown in the Figure was obtained from a middle-aged man in severe pain from a musculoskeletal disorder. He was not having chest pain, and had no known history of cardiovascular disease. He had an episode of vomiting shortly before this tracing was recorded. Is there evidence of heart block? If so, what type?
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Previous research failed to show that the angiotensin II antagonist losartan at 50 mg per day was as effective as captopril in reducing mortality in patients with heart failure after myocardial infarction. This raised the question of whether this new class of drugs may be substituted for ACE inhibitors in treating these high-risk patients.
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The daily practice of emergency medicine involves life and death decisions. While training in emergency medicine focuses on life-saving procedures and medications, dying patients often seek care in the ED for symptom relief, psychosocial support, or a variety of other reasons. Education, experience, communication, and compassion can improve the emergency physicians ability to deliver medical care near the end of life that will serve to relieve suffering, improve communication of the patients preferences and goals of medical treatment, and improve overall care of the patient and family.
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Children who present with a history of foreign body ingestion frequently offer both a diagnostic and management challenge to the emergency medicine physician. Esophageal foreign bodies can result in significant injury to or the death of a child. What follows is a review of the literature on the subject of esophageal foreign bodies in children.
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Sleep restriction (to 4 hours a night) resulted in increased appetite, increased cortisol levels, lowered TSH levels, worsened glucose tolerance and lower heart rate variability compared with sleep extension (to 12 hours a night) in young healthy volunteers.
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A new randomized trial using either a calcium channel blocker or an ACE inhibitor to lower systolic blood pressure to the low 120s prevented cardiac events in patients with coronary artery disease compared with systolic blood pressures around 130.
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Over a 7-year period, there was a dramatic increase in the isolation of community-acquired MRSA in the San Francisco area. Molecular typing showed movement of community-acquired strains into hospitals.
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A new non-aluminum, non-calcium, phosphate binder has been approved by the FDA.