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"Emergency departement"

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https://www.readbyqxmd.com/read/29031177/giant-gastric-lipoma-presenting-as-gi-bleed-enucleation-or-resection
#1
Salah Termos, Ossama Reslan, Omar Alqabandi, Abdullah AlDuwaisan, Saud Al-Subaie, Khalifa Alyatama, Mohammad Alali, Ahmad AlSaleh
INTRODUCTION: Gastric lipomas are unusual benign lesions and account for less than 1% of all tumours of the stomach and 5% of all gastrointestinal lipomas (Thompson et al.2003; Fernandez et al. 1983 [1,2]). Although predominantly asymptomatic and indolent; they may present with gastric outlet obstruction and upper gastrointestinal (GI) bleeding owing to size and ulceration. Only a few cases have been reported, presenting large in size with massive GI bleeding (Alcalde Escribano et al...
October 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#2
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29029061/effects-of-access-to-radiology-in-out-of-hours-primary-care-in-the-netherlands-a-prospective-observational-study
#3
Martijn Hendrik Rutten, Marleen Smits, Yvonne Anthonia Sebastiana Peters, Willem Jan Jozef Assendelft, Gert Pieter Westert, Paul Hendrikus Josephus Giesen
Background: In the Netherlands, out-of-hours primary care is provided in general-practitioner-cooperatives (GPCs). These are increasingly located on site with emergency departments (ED), forming Emergency-Care-Access-Points (ECAP). A more efficient and economical organization of out-of-hours primary emergency care could be realized by increased collaboration at an ECAP. In this study, we compared the effects of different models with respect to access to (hospital) radiology by the GPC...
September 28, 2017: Family Practice
https://www.readbyqxmd.com/read/29028964/the-cost-effectiveness-of-hiv-testing-and-treatment-engagement-initiatives-in-british-columbia-canada-2011-2013
#4
B Nosyk, J E Min, E Krebs, X Zang, M Compton, R Gustafson, R Barrios, J S G Montaner
Background: Recognition of the secondary preventive benefits of antiretroviral therapy (ART) has mobilized global efforts to 'seek, test, treat and retain' people living with HIV/AIDS (PLHIV) in HIV care. We aimed to determine the cost-effectiveness of a set of HIV testing and treatment engagement interventions initiated in British Columbia (BC), Canada in 2011-2013. Methods: Using a previously-validated dynamic, compartmental HIV transmission model, linked individual-level health administrative data for PLHIV and aggregate-level HIV testing data, we estimated the cost-effectiveness of primary care testing (hospital, emergency department, outpatient), ART initiation and ART retention initiatives, versus a counterfactual scenario approximating the status quo...
September 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29028809/nasal-dna-methylation-differentiates-corticosteroid-treatment-response-in-pediatric-asthma-a-pilot-study
#5
Xue Zhang, Jocelyn M Biagini Myers, Veda K Yadagiri, Ashley Ulm, Xiaoting Chen, Matthew T Weirauch, Gurjit K Khurana Hershey, Hong Ji
BACKGROUND: Treatment response to systemic corticosteroid in asthmatic children is heterogeneous and may be mediated by epigenetic mechanism(s). We aim to identify DNA methylation (DNAm) changes responsive to steroid, and DNAm biomarkers that distinguish treatment response. MATERIALS AND METHODS: We followed 33 children (ages 5-18) presenting to the Emergency Department (ED) for asthma exacerbation. Based on whether they met discharge criteria in ≤24 hours, participants were grouped into good and poor responders to steroid treatment...
2017: PloS One
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#6
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29028076/intestinal-probiotics-in-relieving-clinical-symptoms-of-severe-hand-foot-and-mouth-disease-and-potential-mechanism-analysis
#7
F Zhu, Z Jiang, H-W Li
OBJECTIVE: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital. PATIENTS AND METHODS: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29027621/use-of-carboxyhemoglobin-as-a-biomarker-of-environmental-co-exposure-critical-evaluation-of-the-literature
#8
Agnese Veronesi, Valentina Pecoraro, Stefano Zauli, Marta Ottone, Giovanni Leonardi, Paolo Lauriola, Tommaso Trenti
Carbon monoxide (CO) poisoning is the primary cause for access to emergency department (ED) services for more than 50,000 persons in Europe and the USA every year. CO poisoning diagnosis is based on multiple factors and is usually confirmed by high carboxyhemoglobin (COHb) levels in the blood. We conducted a systematic evaluation of literature to investigate the usefulness of COHb as a biomarker of environmental CO exposure. We conducted an electronic search in Medline, Embase, and the Cochrane Library databases...
October 13, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29027297/factors-associated-with-ambulatory-care-sensitive-emergency-department-visits-for-south-carolina-medicaid-members-with-intellectual-disability
#9
S McDermott, J Royer, J R Mann, B S Armour
INTRODUCTION: Ambulatory care sensitive conditions (ACSCs) can be seen as failure of access or management in primary care settings. Identifying factors associated with ACSCs for individuals with an Intellectual Disability (ID) provide insight into potential interventions. METHOD: To assess the association between emergency department (ED) ACSC visits and a number of demographic and health characteristics of South Carolina Medicaid members with ID. A retrospective cohort of adults with ID was followed from 2001 to 2011...
October 13, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29026893/descending-necrotizing-mediastinitis-after-a-trigger-point-injection
#10
Jae Young Choe, Jong Kun Kim, Dong Eun Lee, Kang Suk Seo, Jung Bae Park, Mi Jin Lee, Hyun Wook Ryoo, Jae Yun Ahn, Sungbae Moon
Descending necrotizing mediastinitis (DNM) is a rare form of mediastinal infection. Most cases are associated with esophageal rupture. DNM after a trigger point injection in the upper trapezius has not been described previously. We present a case of DNM after a trigger point injection in the upper trapezius. A 70-year-old man visited the emergency department with chest discomfort and fever after a trigger point injection in the left upper trapezius. Chest computed tomography showed evidence of DNM, and antibiotic therapy was immediately administered intravenously...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026892/prompt-diagnosis-of-st-elevation-myocardial-infarction-with-papillary-muscle-rupture-by-point-of-care-ultrasound-in-the-emergency-department
#11
Koon Ho Cheung, Colin Graham Alexander
A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026891/effect-of-emergency-medical-service-use-on-time-interval-from-symptom-onset-to-hospital-admission-for-definitive-care-among-patients-with-intracerebral-hemorrhage-a-multicenter-observational-study
#12
Dae Gon Kim, Yu Jin Kim, Sang Do Shin, Kyoung Jun Song, Eui Jung Lee, Yu Jin Lee, Ki Jeong Hong, Ju Ok Park, Young Sun Ro, Yoo Mi Park
OBJECTIVE: This study evaluated whether emergency medical service (EMS) use was associated with early arrival and admission for definitive care among intracerebral hemorrhage (ICH) patients. METHODS: Patients with ICH were enrolled from 29 hospitals between November 2007 and December 2012, excluding those patients with subarachnoid hemorrhage, traumatic ICH, and missing information. The patients were divided into four groups based on visit type to the definitive hospital emergency department (ED): direct visit by EMS (EMS-direct), direct visit without EMS (non-EMS-direct), transferred from a primary hospital by EMS (EMS-transfer), and transferred from a primary hospital without EMS (non-EMS-transfer)...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026889/study-design-of-real-world-evidence-for-treatment-of-hyperkalemia-in-the-emergency-department-reveal-ed-a-multicenter-prospective-observational-study
#13
Zubaid Rafique, Mikhail Kosiborod, Carol L Clark, Adam J Singer, Stewart Turner, Joseph Miller, Douglas Char, W Frank Peacock
OBJECTIVE: Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#14
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026886/clinical-characteristics-of-acute-drug-induced-dystonia-in-pediatric-patients
#15
Hyun Woong Park, Jae Ryung Kwak, Ji Sook Lee
OBJECTIVE: Dystonia is a movement disorder in which muscles contract uncontrollably. Acute drug-induced dystonia (DID) can be diagnosed through detailed history taking and physical examination. This study aimed to identify the clinical characteristics of DID in children, which could help emergency physicians diagnose these conditions more efficiently. METHODS: We reviewed medical records of children aged below 18 years diagnosed with drug-related dystonia after discharge from the emergency department over 10 years...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026885/emergency-department-point-of-care-ultrasonography-improves-time-to-pericardiocentesis-for-clinically-significant-effusions
#16
Evan Avraham Alpert, Uri Amit, Larisa Guranda, Rafea Mahagna, Shamai A Grossman, Ariel Bentancur
OBJECTIVE: Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). METHODS: This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026884/review-of-the-potential-use-of-blood-neuro-biomarkers-in-the-diagnosis-of-mild-traumatic-brain-injury
#17
REVIEW
Alastair Jones, Paul Jarvis
Head injury is a common presenting complaint amongst emergency department patients. To date, there has been no widespread utilization of neuro-biomarkers to aid the diagnosis of traumatic brain injury. This review article explores which neuro-biomarkers could be used in the emergency department in aiding the clinical diagnosis of mild traumatic brain injury. Based on the available evidence, the most promising neuro-biomarkers appear to be Glial fibrillary acidic protein (GFAP) and Ubiquitin C-Terminal Hydrolase Isozyme L1 (UCH-L1) as these show significant rises in peripheral blood levels shortly after injury and these have been demonstrated to correlate with long-term clinical outcomes...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026632/salmonella-oranienburg-haemorrhagic-cystitis-in-an-immunocompetent-young-male
#18
Jiasian Teh, Mark Quinlan, Damien Bolton
Introduction. Non-typhoidal salmonella (NTS) bacteriuria is extremely rare. Haemorrhagic cystitis is defined by urinary symptoms including haematuria, frequency, urgency and dysuria. Reports of haemorrhagic cystitis caused by NTS are exceptionally uncommon, especially in immunocompetent, young, male patients. Case presentation. A 27-year-old male with no past medical history presented to the Emergency Department with a 24 h history of visible haematuria having returned five days earlier from a five month trip across South America...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29026630/sinister-seafood-bacteraemia-secondary-to-non-o1-o139-vibrio-cholerae-infection
#19
Maxime J Billick, Philip W Lam, Isaac I Bogoch
Introduction.Vibrio species are curved, motile Gram-negative bacilli found in estuarine and marine environments, and are known to cause to gastroenteritis, skin and soft tissue infections, and septicaemia. While not responsible for cholera epidemics, non-O1/O139 Vibrio cholerae (NOVC) is increasingly reported as a cause of gastroenteritis. Case presentation. A 66-year-old man presented to an emergency department with a 1 week history of epigastric pain, emesis and fever. Blood cultures drawn on admission initially demonstrated Gram-negative bacilli, and ultimately grew NOVC, which was later confirmed by matrix-assisted laser desorption ionization-time of flight MS...
July 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29026563/methotrexate-induced-leukoencephalopathy-presenting-as-stroke-in-the-emergency-department
#20
Maria Teresa Cruz-Carreras, Patrick Chaftari, Anna Shamsnia, Nandita Guha-Thakurta, Carmen Gonzalez
Methotrexate-induced leukoencephalopathy is to be considered as a potential etiology in any patient presenting with stroke-like symptoms after receiving methotrexate. One of our cases suggests that the method of administration of the methotrexate can be IV or intrathecal and still results in leukoencephalopathy.
October 2017: Clinical Case Reports
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