ABSTRACT
Violence against women has received increasing public attention over the past 20 years. The past two decades have highlighted the problem of intimate partner violence as a major cause of intentional injury to women. Many of these women present themselves to emergency departments where emergency physicians have a unique opportunity to intervene.
Subject(s)
Emergency Treatment/methods , Spouse Abuse/diagnosis , Spouse Abuse/therapy , Female , Humans , Incidence , Male , Mass Screening , Patient Care Planning , Prevalence , Risk Assessment , Safety , Spouse Abuse/statistics & numerical data , United States/epidemiology , Women's HealthABSTRACT
The social, economic, legal, and linguistic isolation that women in the international community often endure may make it more difficult for them to seek medical, legal, or social assistance in an effort to free themselves from abusive domestic situations. This article describes and defines potentially dangerous domestic situations and discusses the role of the emergency department in lessening the global health threat of violence among women.
Subject(s)
Emergency Medicine/methods , Global Health , Spouse Abuse/diagnosis , Spouse Abuse/therapy , Communication Barriers , Emigration and Immigration , Female , Forecasting , Health Knowledge, Attitudes, Practice , Humans , Physician's Role , Spouse Abuse/statistics & numerical data , StereotypingABSTRACT
We present a systematic review of meningitis associated with transsphenoidal surgery. Patients present within the first 4 days after surgery with symptoms of headache, fever, and confusion. Overt cerebrospinal rhinorrhea or nuchal rigidity at the time of presentation is an infrequent finding. Although postoperative aseptic meningitis may be difficult to distinguish from early bacterial meningitis, the findings of hypoglycorrhachia, pleocytosis, and hyperproteinemia in the setting of fever and neurological deficit strongly suggest bacterial infection. The preponderance of cases of gram-negative meningitis observed in this series and in previous reports related to posttraumatic CSF leaks indicates that empirical regimens should include agents suitable for treating infections caused by nosocomial pathogens. In general, patients with uncomplicated meningitis in this setting can be expected to recover and do well. Questions remain as to the role of prophylactic antibiotics in the development of gram-negative meningitis in the setting of transsphenoidal surgery. A multicenter trial might be better able to define this role.