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"Hispanic" and "emergency department"

Douglas A Salguero, Pamela A Barletta, Willaim Sierraalta
BACKGROUND: Multiple myeloma is a hematologic disease with high mortality rates all over the world. The diagnosis has always been challenging since the first case was reported in 1844. For that reason the diagnostic criteria have evolved over years to include the features of the disease more comprehensively. Unusual presentations are infrequent and a diagnostic challenge. For this reason we report this rare case in which diarrhea and abdominal pain were the initial presenting symptoms of multiple myeloma with a plasmacytoma...
March 18, 2018: Journal of Medical Case Reports
Kei Ouchi, Guruprasad D Jambaulikar, Samuel Hohmann, Naomi R George, Emily L Aaronson, Rebecca Sudore, Mara A Schonberg, James A Tulsky, Jeremiah D Schuur, Daniel J Pallin
OBJECTIVES: To inform the shared decision-making process between clinicians and older adults and their surrogates regarding emergency intubation. DESIGN: Retrospective cohort study. SETTING: Multicenter, emergency department (ED)-based cohort. PARTICIPANTS: Adults aged 65 and older intubated in the ED from 2008 to 2015 from 262 hospitals across the United States (>95% of U.S. nonprofit academic medical centers). MEASUREMENTS: Our primary outcome was age-specific in-hospital mortality...
March 15, 2018: Journal of the American Geriatrics Society
Rebecca Burch, Paul Rizzoli, Elizabeth Loder
BACKGROUND AND OBJECTIVES: In this targeted systematic review, we aimed to identify up-to-date prevalence estimates of migraine and severe headache in adults from population-based US government surveys. Our goal was to assess the stability of prevalence estimates over time, and to identify additional information pertinent to the burden and treatment of migraine and other severe headache conditions. METHODS: We searched for the most current publicly available summary statistics from the National Health Interview Survey (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Ambulatory Medical Care Survey (NAMCS)...
March 12, 2018: Headache
Thomas M Ludden, Yhenneko J Taylor, Laura K Simmons, Heather A Smith, Brisa Urquieta de Hernandez, Hazel Tapp, Owen J Furuseth, Michael F Dulin
Hispanic immigrant communities across the U.S. experience persistent health disparities and barriers to primary care. We examined whether community-based participatory research (CBPR) and geospatial modeling could systematically and reproducibly pinpoint neighborhoods in Charlotte, North Carolina with large proportions of Hispanic immigrants who were at-risk for poor health outcomes and health disparities. Using a CBPR framework, we identified 21 social determinants of health measures and developed a geospatial model from a subset of those measures to identify neighborhoods with large proportions of Hispanic immigrant populations at risk for poor health outcomes...
February 26, 2018: Journal of Primary Prevention
David G Li, Fan Di Xia, Hasan Khosravi, Anna K Dewan, Daniel J Pallin, Christopher W Baugh, Karl Laskowski, Cara Joyce, Arash Mostaghimi
Importance: Many inflammatory skin dermatoses mimic cellulitis (pseudocellulitis) and are treated with antibiotics and/or hospitalization, leading to unnecessary patient morbidity and substantial health care spending. Objective: To evaluate the impact of early dermatology consultation on clinical and economic outcomes associated with misdiagnosed cellulitis. Design, Setting, and Participants: This prospective cohort study enrolled patients with presumed diagnosis of cellulitis in the emergency department, in the emergency department observation unit, or within 24 hours of admission to an inpatient unit of a large urban teaching hospital between February and September 2017...
February 16, 2018: JAMA Dermatology
Francesca L Beaudoin, Roee Gutman, Wanting Zhai, Roland C Merchant, Melissa A Clark, Kenneth A Bollen, Phyllis Hendry, Michael C Kurz, Christopher Lewandowski, Claire Pearson, Brian O'Neil, Elizabeth Datner, Patricia Mitchell, Robert Domeier, Samuel A McLean
African-Americans experience a greater burden of acute pain than non-Hispanic white individuals across of variety of acute medical conditions, but it is unknown if this is the case following trauma. We evaluated pain, pain-related characteristics (e.g. peri-traumatic distress), and analgesic treatment in two cohorts of individuals (African-American (n=931) and non-Hispanic white (n=948)) presenting to the emergency department after a motor-vehicle crash (MVC). We performed a propensity-matched analysis (n=796 in each group) to assess racial differences in acute pain in the ED...
February 9, 2018: Pain
Hunter Singh Lau, Matthew M Hollander, Jeremy T Cushman, Eva H DuGoff, Courtney M C Jones, Amy J H Kind, Michael T Lohmeier, Eric A Coleman, Manish N Shah
OBJECTIVE: The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition...
February 12, 2018: Prehospital Emergency Care
Hatice S Zahran, Cathy M Bailey, Scott A Damon, Paul L Garbe, Patrick N Breysse
BACKGROUND: Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Although asthma cannot be cured, most of the time, asthma symptoms can be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for asthma education and appropriate medical care. METHODS: CDC analyzed asthma data from the 2001-2016 National Health Interview Survey for children aged 0-17 years to examine trends and demographic differences in health outcomes and health care use...
February 9, 2018: MMWR. Morbidity and Mortality Weekly Report
Kristen Pogreba-Brown, Erika Barrett
BACKGROUND: Rates of Campylobacter infection in Arizona have historically been higher than the national average, with the highest rates in Hispanic populations. The purpose of this retrospective case-case analysis was to determine how risk factors and disease presentation differ by ethnicity (Hispanic vs. Non-Hispanic) in cases of campylobacteriosis from 2012 to 2015 in Maricopa County, Arizona. METHODS: Basic demographics and seasonality, including standardized morbidity ratios (SMRs), were analyzed to determine differences by ethnicity...
January 29, 2018: Foodborne Pathogens and Disease
Tracy E Madsen, Samuel McLean, Wanting Zhai, Sarah Linnstaedt, Michael C Kurz, Robert Swor, Phyllis Hendry, David Peak, Christopher Lewandowski, Claire Pearson, Brian O'Neil, Elizabeth Datner, David Lee, Francesca Beaudoin
PURPOSE: Little is known about gender differences in the treatment of pain after motor vehicle collisions (MVCs) in an emergency department (ED). We aimed to describe gender differences in pain experiences and treatment, specifically the use of opioids and benzodiazepines after ED discharge, for MVC-related pain. METHODS: This was a secondary analysis of previously collected data from the CRASH Injury studies. We included patients who were seen and discharged from an ED after an MVC and who were enrolled in 1 of 2 multicenter longitudinal prospective cohort studies (1 black/non-Hispanic and 1 white/non-Hispanic)...
January 19, 2018: Clinical Therapeutics
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
Moira C McManus, Robert J Cramer, Maureen Boshier, Muge Akpinar-Elci, Bonnie Van Lunen
Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations...
January 13, 2018: International Journal of Environmental Research and Public Health
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
Jonathan D Chevinsky, Neil V Shah, Mikhail Tretiakov, Alexandr Aylyarov, Gregory S Penny, Joanne C Dekis, Jonathan N Chorney, Natasha Ahmed, Nipun Sodhi, Alyeesha B Wilhelm, William P Urban, Carl B Paulino, Jared M Newman
INTRODUCTION: Tennis injuries are not uncommon, and efforts have been made to reduce the risk of these injuries. There are a number of different factors that have been shown to influence injury rates of tennis players, in particular patient-related risks. Therefore, the purpose of this study was to investigate the epidemiology of tennis-related injuries. Specifically, we evaluated: 1) demographics; 2) incidence and trends of injuries; and 3) incidence and trends of body parts that were injured...
December 22, 2017: Surgical Technology International
Allison Cheng, Rita Manfredi, Gia Badolato, Monika Goyal
OBJECTIVES: The objective of this study was to describe coping mechanisms used by adolescents during emergency treatment. METHODS: A convenience sample of adolescent patients (aged 12-18 years) was surveyed in our large (87,000 annual visits) urban academic pediatric emergency department (ED) with an adapted Adolescent Coping Orientation for Problem Experiences survey. Parents were surveyed about their perceptions of their child's coping mechanisms. Participants were excluded if they were non-English speaking, in police custody, had altered mental status, or were hemodynamically unstable...
January 2, 2018: Pediatric Emergency Care
Consuelo M Beck-Sague, Alejandro Arrieta, M Claudia Pinzon-Iregui, Benjamin Ortiz, Andrew G Dean, Andrew Cuddihy, Janvier Gasana
Nationally, racial and ethnic disparities in childhood asthma plateaued from 2005 to 2013. We assessed trends in childhood asthma in Miami, Florida using Youth Risk Behavior Surveillance System (YRBSS) data and emergency department (ED) utilization and hospitalization rates by zip code population characteristics. Asthma prevalence in Miami did not vary significantly by race/ethnicity in YRBSS respondents in 2005 (16.2-17.2%, all groups), but rose in African-Americans and Hispanics and declined in Whites by 2013 to 27...
December 30, 2017: Journal of Immigrant and Minority Health
Emanuel Alcala, Ricardo Cisneros, John A Capitman
BACKGROUND: California's San Joaquin Valley is a region with a history of poverty, low health care access, and high rates of pediatric asthma. It is important to understand the potential barriers to care that challenge vulnerable populations. OBJECTIVE: The objective was to describe pediatric asthma-related utilization patterns in the emergency department (ED) and hospital by insurance coverage as well as to identify contributing individual-level indicators (age, sex, race/ethnicity, and insurance coverage) and neighborhood-level indicators of health care access...
December 20, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Michelle Trivedi, Janki Patel, Darleen Lessard, Ted Kremer, Nancy Byatt, Wanda Phipatanakul, Lori Pbert, Robert Goldberg
OBJECTIVE: We examined the impact of a novel, school nurse-supervised asthma therapy program on healthcare utilization. METHODS: We retrospectively reviewed charts of 84 children enrolled in this program in central Massachusetts between 2012 and 2015. Physicians identified children with persistent asthma and poor medication adherence. These children were enrolled in the program to receive daily-inhaled corticosteroid at school, supervised by their school nurse, with ongoing communication between physician's office and school nurse through the school year...
December 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Yongwen Jiang, Deborah DeBare, Lynne-Marie Shea, Samara Viner-Brown
Violence against women is a public health issue. Monitoring assault-related injury and homicide death among women is imperative for understanding this public health issue. We used data from the 2014 Rhode Island emergency department (ED), hospital discharge (HD), and 2004-2014 Rhode Island violent death reporting system (RIVDRS) to provide a broad picture for violence against women injuries and deaths in Rhode Island. ED visit and HD data show that the majority of female assault injuries occurred among women aged 25-44, resided in the core cities, and had public insurance...
December 1, 2017: Rhode Island Medical Journal
Blake Sterling Sanford, Laith Potrous, Maricela Castillo MacKenzie
A 43-year-old Hispanic woman presented to the clinic complaining of fever, chills and cough for 14 days. The patient reported a recent trip to Asia 12 days prior to presenting symptoms. Given her physical examination findings, she was treated empirically for community acquired pneumonia. Since her symptoms worsened despite the antibiotic, she was referred to the Emergency Department for further evaluation. The patient was ultimately diagnosed with pneumonia and malaria. When evaluating patients with history of recent travel, it is important to consider communicable diseases that are endemic to the areas visited, as well as multiple disease aetiologies for complicated and refractory cases...
November 25, 2017: BMJ Case Reports
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