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https://www.readbyqxmd.com/read/28214994/cancelled-primary-care-appointments-a-prospective-cohort-study-of-diabetic-patients
#1
Sara McComb, Zhiyi Tian, Laura Sands, Ayten Turkcan, Lingsong Zhang, Shree Frazier, Mark Lawley
Patients scheduled for primary care appointments often cancel or no show. For diabetic patients, nonattendance can affect continuity of care and result in higher emergency department (ED) and hospital use. Nonattendance also impacts appointment scheduling, patient access, and clinic work load. While no show has received significant attention, little research has addressed the prevalence and impact of appointment cancellation. Data on 46,710 appointments for 7586 adult diabetic patients was used to conduct a prospective cohort study examining primary care appointment behavior...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#2
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
February 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214474/emergency-department-utilisation-by-older-people-in-metropolitan-melbourne-2008-12-findings-from-the-reducing-older-patient
#3
Danielle Mazza, Christopher Pearce, Angela Joe, Lyle R Turner, Bianca Brijnath, Colette Browning, Marianne Shearer, Judy Lowthian
Objective Older patients are over-represented in emergency departments (ED), with many presenting for conditions that could potentially be managed in general practice. The aims of the present study were to examine the characteristics of ED presentations by older patients and to identify patient factors contributing to potentially avoidable general practitioner (PAGP)-type presentations.Methods A retrospective analysis was performed of routinely collected data comprising ED presentations by patients aged ≥70 years at public hospitals across metropolitan Melbourne from January 2008 to December 2012...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#4
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#5
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28214106/multicenter-study-of-cigarette-smoking-among-adults-with-asthma-exacerbations-in-the-emergency-department-2011-2012
#6
Robert A Silverman, Kohei Hasegawa, Daniel J Egan, Kirk A Stiffler, Ashley F Sullivan, Carlos A Camargo
INTRODUCTION: Previous studies demonstrated a high prevalence of cigarette smoking in patients presenting to the emergency department (ED) with acute asthma. Despite the clinical and public health importance, there have been no recent multicenter efforts to characterize this patient population. We aimed to update the prevalence of cigarette smoking among ED patients with asthma exacerbations. METHODS: Multicenter chart review study of 48 EDs across 23 US states...
February 7, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#7
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213767/mountaintop-removal-coal-mining-and-emergent-cases-of-psychological-disorder-in-kentucky
#8
Will H Canu, John Paul Jameson, Ellen H Steele, Michael Denslow
Although mountaintop removal (MTR) coal extraction techniques have been employed in Appalachia for decades, relatively little research has examined its potential psychological impact on people living in close proximity to MTR activity. The current study taps the State Emergency Department Database (Healthcare Cost and Utilization Project, Kentucky State Emergency Department Database, 2008) to examine the relative risk for diagnoses of depressive, substance use, and anxiety disorders originating in areas with and without MTR activity...
February 17, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#9
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28213317/developing-and-assessing-the-acceptability-of-an-epilepsy-first-aid-training-intervention-for-patients-who-visit-uk-emergency-departments-a-multi-method-study-of-patients-and-professionals
#10
Darlene A Snape, Myfanwy Morgan, Leone Ridsdale, Steve Goodacre, Anthony G Marson, Adam J Noble
Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures...
February 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#11
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28212197/screening-children-for-abuse-and-neglect-a-review-of-the-literature
#12
Mary Hoft, Lisa Haddad
Child abuse and neglect occur in epidemic numbers in the United States and around the world, resulting in major physical and mental health consequences for abused children in the present and future. A vast amount of information is available on the signs and symptoms and short- and long-term consequences of abuse. A limited number of instruments have been empirically developed to screen for child abuse, with most focused on physical abuse in the context of the emergency department, which have been found to be minimally effective and lacking rigor...
January 2017: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/28211278/endoscopic-removal-of-multiple-sharp-gastro-duodenal-foreign-bodies
#13
Samuel Costa, Raquel Gonçalves, Carla Rolanda
A 45 years old female,with bipolar disorder,was brought to the Emergency Department with abdominal pain. The patient was hemodynamically stable,with no signs of respiratory distress. On abdominal examination she had pain in the upper quadrants,without peritoneal irritation. The successful endoscopic removal decreases if delayed approach, beyond 12 h, and sharp objects. Moreover in case of sharp objects, even if already into the stomach or duodenum, they should be retrieved endoscopically if it can be accomplished safely, because the risk of a complication during its natural exteriorization is as high as 35%...
February 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28211119/cross-sectional-study-of-emergency-department-presentation-triage-categories-at-goondiwindi-hospital-and-their-effect-on-the-treatment-of-acute-emergencies
#14
Ashraf Saleh
OBJECTIVE: The objective of this study was to investigate the number and proportion of non-acute presentations to a district hospital emergency department in Goondiwindi, a rural Queensland town, both in the treatment of emergency cases and potential barriers patients have in seeing a medical practitioner in the general practice setting. DESIGN: Occasions of service to Goondiwindi Hospital were collated from administrative records according to Australasian Triage Scale categories and analysed by Student's t-test for monthly variations in triage category presentations...
February 17, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#15
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28210838/urinary-ngal-deficiency-in-recurrent-urinary-tract-infections
#16
Catherine S Forster, Kathryn Johnson, Viral Patel, Rebecca Wax, Nancy Rodig, Jonathan Barasch, Richard Bachur, Richard S Lee
INTRODUCTION: Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI...
February 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28210835/a-10-year-review-of-cannabis-exposure-in-children-under-3-years-of-age-do-we-need-a-more-global-approach
#17
Isabelle Claudet, Mathilde Le Breton, Camille Bréhin, Nicolas Franchitto
: Pediatricians working in an emergency environment are confronted with children admitted to emergency departments for intoxication on a daily basis. We carried out a retrospective cohort study of children admitted to a pediatric emergency department due to unintentional cannabis exposure over a 10-year period from 2004 to 2014. Twenty-nine children under the age of 3 were admitted with a positive cannabis urine test. Eighty-seven percent of intoxications occurred at the family home. Resin was the main form of ingested cannabis (69%)...
February 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28210569/infant-acute-myocarditis-mimicking-acute-myocardial-infarction
#18
Maher Jedidi, Samia Tilouche, Tasnim Masmoudi, Maha Sahnoun, Youssef Chkirbène, Sarra Mestiri, Lamia Boughamoura, Mohamed Ben Dhiab, Mohamed Kamel Souguir
Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28210514/hemorrhagic-colloid-cyst-presenting-with-acute-hydrocephaly
#19
Reza Akhavan, Behrouz Zandi, Masoud Pezeshki-Rad, Donya Farrokh, Bita Abbasi
Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28210363/using-the-electronic-medical-record-to-reduce-unnecessary-ordering-of-coagulation-studies-for-patients-with-chest-pain
#20
Jeremiah S Hinson, Binoy Mistry, Yu-Hsiang Hsieh, Nicholas Risko, David Scordino, Karolina Paziana, Susan Peterson, Rodney Omron
INTRODUCTION: Our goal was to reduce ordering of coagulation studies in the emergency department (ED) that have no added value for patients presenting with chest pain. We hypothesized this could be achieved via implementation of a stopgap measure in the electronic medical record (EMR). METHODS: We used a pre and post quasi-experimental study design to evaluate the impact of an EMR-based intervention on coagulation study ordering for patients with chest pain. A simple interactive prompt was incorporated into the EMR of our ED that required clinicians to indicate whether patients were on anticoagulation therapy prior to completion of orders for coagulation studies...
February 2017: Western Journal of Emergency Medicine
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