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A rattlesnake bite wound hours after the incident. There is swelling of the digit and palm with hemorrhagic bullous formation circumferentially around the finger. Erythema is present in the affected digit. The patient reported pain. Presentations like this may lead to unnecessary use of antibiotics. In this case, no antibiotics were administered and no infection developed.

Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites (video)

Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage […]

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The Limits of Cardiac Performance: Can Too Much Exercise Damage the Heart?

  Routine moderate-intensity physical activity confers numerous cardiovascular benefits and reduces all-cause mortality. However, the health impact of exercise doses that exceed contemporary physical activity guidelines remains incompletely understood, and an emerging body of literature suggests that high levels of exercise may have the capacity to damage the cardiovascular system. This review focuses on the […]

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Intra-Abdominal Varix Rupture: A Life-Threatening Cause of Hemoperitoneum

A 54-year-old male with decompensated alcoholic cirrhosis presented after a syncopal event and ground-level fall. Initial examination noted a distended abdomen without overlying bruising. At admission, his hemoglobin was 6.3 g/dL from a baseline of 8-10 g/dL. A computed tomography scan of the abdomen was notable for “complex ascites” adjacent to his liver concerning for […]

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Myocardial Infarction

J. Heuser
19. June 2006

Short-Term Prognosis of Myocardial Injury, Type 1, and Type 2 Myocardial Infarction in the Emergency Unit

Type 2 myocardial infarction and nonischemic myocardial injury, corresponding to troponin elevation without atherothrombosis, are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles, and short-term prognoses remain to be investigated. METHODS Among all the patients admitted from January 2014 to December 2016 in a university hospital ED […]

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Death or Debt? National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer

The purpose of this study was to evaluate the impact of cancer upon a patient’s net worth and debt in the US. Methods This longitudinal study used the Health and Retirement Study from 1998–2014. Persons ≥50 years with newly-diagnosed malignancies were included, excluding minor skin cancers. Multivariable generalized linear models assessed changes in net worth […]

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Twenty Children, Six Teachers, Two Sets of Eyes, a Dog, and a Transformation

Twenty children, six teachers, two sets of eyes, and a dog were a terribly tragic catalyst for my metamorphosis as a physician and person. Let me explain. Until the cataclysmic event, I was an academic physician at an Ivy League institution who worshipped at the altar of evidence-based medicine and thought housestaff and students should […]

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