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Preventable emergency visits

Anthony Jerant, Paul Duberstein, Camille Cipri, Bethany Bullard, Deborah Stone, Debora Paterniti
OBJECTIVES: Nearly half of all men who die by suicide visit a primary care clinician (PCC) in the month before death, yet few disclose suicide thoughts. We solicited stakeholders' views to guide development of a tailored multimedia program to activate middle-aged men experiencing suicide thoughts to engage with PCCs. METHODS: We conducted semi-structured interviews with 44 adults self-identifying as: suicide attempt survivor; family member/loved one of person(s) who attempted or died by suicide; PCC; non-PCC office staff; health administrator; and/or prevention advocate...
September 8, 2018: Patient Education and Counseling
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Pneumonia is the leading cause of morbidity and mortality worldwide. Pneumococcal conjugate vaccines have reduced the burden of pneumonia, but data on the current burden of pneumonia and its impact on the healthcare system are needed to inform the development and use of new vaccines and other preventive measures. METHODS: We retrospectively analyzed the frequency of pneumonia in the US during 2008-2014 using data from the MarketScan® Commercial Claims and Encounters database...
September 14, 2018: BMC Health Services Research
Negar Chooback, Shilo Lefresne, Sally C Lau, Cheryl Ho
PURPOSE: Patients with epidermal growth factor receptor (EGFR) mutation-positive (EGFRm) non-small-cell lung cancer commonly experience disease progression in the CNS. Here, we assess the impact of CNS disease on resource utilization and outcomes in patients who are EGFRm. METHODS: We completed a retrospective review of all advanced patients who were EGFRm, referred to BC Cancer, and treated with a first- and/or second-generation EGFR tyrosine kinase inhibitor from 2010 to 2015...
September 14, 2018: Journal of Oncology Practice
Hyekyun Rhee, Tanzy Love, Jennifer Mammen
BACKGROUND: Adequate assessment of control is critical to asthma management. The Asthma Control Questionnaire (ACQ) and the National Asthma Education and Prevention Program (NAEPP) criteria are commonly used measures of asthma control. OBJECTIVE: This study is to examine the relationships between the ACQ and NEAPP criteria and compare the validity in association with lung function, asthma exacerbation and quality of life. METHODS: The ACQ and the NAEPP criteria were administered to 373 adolescents with asthma, aged 12-20...
September 10, 2018: Annals of Allergy, Asthma & Immunology
Diane S Rohlman, Shelly Campo, Jennifer Hall, Erin L Robinson, Kevin M Kelly
Small enterprises have fewer resources, are more financially precarious, and have higher rates of occupational injury and illness compared with larger enterprises. Interventions that address the promotion of health and well-being in addition to traditional occupational safety and health hazards, a Total Worker Health® (TWH) approach, may be effective in reducing injuries and preventing illness. However, little research has examined the impact of TWH interventions in small enterprises. The aim of this research was to explore and characterize health and safety practices, policies, and programs in small Midwestern enterprises from a TWH perspective...
September 13, 2018: Annals of Work Exposures and Health
Pavly Youssef, Roman Povolotskiy, Thayer J Mukherjee, Aron Kandinov, Boris Paskhover
PURPOSE: The aims of this study were as follows: To determine the national incidence of facial fractures among infants, toddlers, and children; to evaluate the types of facial fractures; and to analyze common products/activities associated with the fractures. MATERIALS AND METHODS: A retrospective review was conducted to explore patterns of facial fractures among infants (<1 year), toddlers (1-3 years), and children (3-5 years), using the National Electronic Injury Surveillance System (NEISS) from the Consumer Product Safety Commission (CPSC)...
September 2018: Journal of Cranio-maxillo-facial Surgery
Eric Macy, Janis F Yao, Wansu Chen
BACKGROUND: Without accurate data on deaths directly caused by asthma, prevention will be difficult. OBJECTIVE: Determine how often asthma could be confirmed as a proximal cause of death in a large well-defined population with active health plan membership and no acute barriers to medical care. METHODS: All deaths occurring in active Kaiser Permanente Southern California health plan members between 2007 and 2015 were identified. Asthma-coded deaths were manually audited for cause...
September 4, 2018: Journal of Allergy and Clinical Immunology in Practice
Angela Lumba-Brown, Keith Owen Yeates, Kelly Sarmiento, Matthew J Breiding, Tamara M Haegerich, Gerard A Gioia, Michael Turner, Edward C Benzel, Stacy J Suskauer, Christopher C Giza, Madeline Joseph, Catherine Broomand, Barbara Weissman, Wayne Gordon, David W Wright, Rosemarie Scolaro Moser, Karen McAvoy, Linda Ewing-Cobbs, Ann-Christine Duhaime, Margot Putukian, Barbara Holshouser, David Paulk, Shari L Wade, Stanley A Herring, Mark Halstead, Heather T Keenan, Meeryo Choe, Cindy W Christian, Kevin Guskiewicz, P B Raksin, Andrew Gregory, Anne Mucha, H Gerry Taylor, James M Callahan, John DeWitt, Michael W Collins, Michael W Kirkwood, John Ragheb, Richard G Ellenbogen, Theodore J Spinks, Theodore G Ganiats, Linda J Sabelhaus, Katrina Altenhofen, Rosanne Hoffman, Tom Getchius, Gary Gronseth, Zoe Donnell, Robert E O'Connor, Shelly D Timmons
Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI...
September 4, 2018: JAMA Pediatrics
Michael J Durkin, Matthew Keller, Anne M Butler, Jennie H Kwon, Erik R Dubberke, Aaron C Miller, Phillip M Polgreen, Margaret A Olsen
Background: In 2011, The Infectious Diseases Society of America released a clinical practice guideline (CPG) that recommended short-course antibiotic therapy and avoidance of fluoroquinolones for uncomplicated urinary tract infections (UTIs). Recommendations from this CPG were rapidly disseminated to clinicians via review articles, UpToDate, and the Centers for Disease Control and Prevention website; however, it is unclear if this CPG had an impact on national antibiotic prescribing practices...
September 2018: Open Forum Infectious Diseases
Matthew D Ritchey, Hilary K Wall, Pamela L Owens, Janet S Wright
INTRODUCTION: Despite its preventability, cardiovascular disease remains a leading cause of morbidity, mortality, and health care costs in the United States. This study describes the burden, in 2016, of nonfatal and fatal cardiovascular events targeted for prevention by Million Hearts 2022, a national initiative working to prevent one million cardiovascular events during 2017-2021. METHODS: Emergency department (ED) visits and hospitalizations were identified using Healthcare Cost and Utilization Project databases, and deaths were identified using National Vital Statistics System data...
September 7, 2018: MMWR. Morbidity and Mortality Weekly Report
Eun Seok Choi, Jae Ho Jang, Jae Hyug Woo, Ji Uk Choi, Jin Seong Cho, Hyuk Jun Yang
PURPOSE: Trampoline-related injuries are steadily increasing. To our knowledge, there have been very few studies on trampoline injuries in Asia. The purpose of this study is to report the characteristics of pediatric trampoline injuries in Korea. MATERIALS AND METHODS: We conducted a nationwide retrospective cohort study. Data were collected from prospective nationwide databases (Emergency Department-based Injury In-depth Surveillance databases of the Korea Centers for Disease Control and Prevention) for patients who visited emergency departments (EDs) after injuries during 2011-2016...
October 2018: Yonsei Medical Journal
Rafael Figueiredo, Jordan Rattai, Kerri Fournier, Liran Levin
BACKGROUND/AIMS: Dental trauma represents a significant cause for concern in emergency departments (ED). The aim of this study was to report on the prevalence of ED visits for dental problems associated with trauma (DPAT) in Alberta, Canada. The specific objectives were to provide up-to-date information regarding ED utilization for dental trauma concerning the demographics of users and distribution of ED visits across the Province of Alberta, allowing for an assessment of possible trends over the period of time observed...
September 6, 2018: Dental Traumatology: Official Publication of International Association for Dental Traumatology
Maria Y Kwok, Martin V Pusic, Keven I Cabrera, Deborah V York, June Lee, David Evans
OBJECTIVE: The aim of this study was to identify the educational needs of inner-city children with persistent asthma and their caregivers who utilize the emergency department (ED) for asthma care as well as determine their guideline adherence, factors associated with ED use, and comfort with computers. METHODS: Cross-sectional survey of children aged 2 to 18 years with previous diagnosis of asthma presenting with asthma-related complaints or acute asthma exacerbations to an urban pediatric ED...
September 2018: Pediatric Emergency Care
Nahid Punjani, Brent Lanting, J Andrew McClure, Jennifer Winick-Ng, Blayne Welk
BACKGROUND: Periprosthetic infections after total hip arthroplasty (THA) or total knee arthroplasty (TKA) are substantial complications, and there are conflicting reports of their association with urologic complications. Our objective was to determine whether urinary tract infection (UTI) and acute urinary retention (AUR) are significant risk factors for joint infections after THA or TKA. METHODS: We performed a population-based, retrospective cohort study of patients who were ≥66 years old when they underwent an initial THA or TKA between April 2003 and March 2013...
September 5, 2018: Journal of Bone and Joint Surgery. American Volume
Mercy N Mumba, Lilian J Findlay, Diane E Snow
Approximately 10% of the 20 million Americans who are suffering from substance use disorders are suffering from prescription opioid and heroine misuse. This has led to a rise in overdoses as well as emergency room visits, with over 1000 individuals across the United States being seen in emergency rooms every day. Unfortunately, about 90% of drug overdoses are unintentional. Therefore, finding effective ways to treat opioid use disorders and preventing relapse has now become a national priority. This review of the relevant literature highlights current treatment options available for opioid use disorders, including motivational interviewing, cognitive behavioral therapy, mindfulness meditation, mindfulness based relapse prevention, medication assisted therapies, and combination therapies...
July 2018: Journal of Addictions Nursing
Stephanie M Davis, Jonas Z Hines, Melissa Habel, Jonathan M Grund, Renee Ridzon, Brittney Baack, Jonathan Davitte, Anne Thomas, Valerian Kiggundu, Naomi Bock, Paran Pordell, Caroline Cooney, Irum Zaidi, Carlos Toledo
OBJECTIVE: This article provides an overview and interpretation of the performance of the US President's Emergency Plan for AIDS Relief's (PEPFAR's) male circumcision programme which has supported the majority of voluntary medical male circumcisions (VMMCs) performed for HIV prevention, from its 2007 inception to 2017, and client characteristics in 2017. DESIGN: Longitudinal collection of routine programme data and disaggregations. SETTING: 14 countries in sub-Saharan Africa with low baseline male circumcision coverage, high HIV prevalence and PEPFAR-supported VMMC programmes...
September 1, 2018: BMJ Open
Yuriko Sato, Yoshiyasu Aizawa, Taishi Fujisawa, Shogo Ito, Kousuke Katano, Nozomi Fuse, Akira Miyabe, Kimihiro Osada, Ryuuma Ishihara, Atushi Tosaka, Toshitake Tamamura, Taisuke Mizumura, Youichi Sugimura, Kazuaki Nakajima, Yoshinori Katsumata, Takahiko Nishiyama, Takehiro Kimura, Yoshiko Furukawa, Seiji Takatsuki, Kenjiro Kosaki, Keiichi Fukuda
A 50-year-old woman visited the emergency department with a high fever due to pneumonia. Incessant monomorphic ventricular tachycardia occurred and was terminated by intravenous lidocaine. Her ECG during sinus rhythm demonstrated ST segment elevation suggestive of Brugada syndrome (BS). An intensive examination could not detect any structural disease, and typical coved-type ST elevation was unmasked by a pilsicainide injection leading to a diagnosis of BS. An ICD was implanted for secondary prevention of ventricular arrhythmia...
August 2018: Journal of Arrhythmia
Astrid H León, Ferdynand Hebal, Christine Stake, Kerry Baldwin, Katherine A Barsness
Hypergranulation tissue formation is a common complication after gastrostomy tube (G-tube) placement, occurring in 44%-68% of children. Hydrocolloid dressings are often used in the treatment of hypergranulation tissue but have not been studied for the prevention of postoperative hypergranulation tissue. An institutional review board (IRB)-approved, prospective, randomised study was performed in paediatric patients who underwent G-tube placement at a single, large children's hospital from January 2011 to November 2016...
August 30, 2018: International Wound Journal
M Margaret Weigel, Rodrigo X Armijos
Household food insecurity (HFI) has been linked to poorer cardiometabolic health and reduced health care access but few studies have examined these issues in the large Mexican immigrant population living on the U.S.-Mexico border. This exploratory study examined the association of HFI with cardiometabolic conditions and health care in 40-84 year urban border immigrants (n = 75). Data were collected on HFI, self-reported and clinical cardiometabolic conditions, health care sources and use. HFI affected 45% of participants...
August 29, 2018: Journal of Immigrant and Minority Health
K N O'Neill, S M McHugh, M L Tracey, A P Fitzgerald, P M Kearney
AIMS: To estimate the health service use and direct healthcare costs attributable to diabetes using best available data and methods. METHODS: A nationally representative sample of adults aged ≥50 years was analysed (n=8107). Health service use in the previous 12 months included the number of general practitioner visits, outpatient department visits, hospital admissions, and accident and emergency department attendances. Multivariable negative binomial regression was used to estimate the associations between diabetes and frequency of visits...
August 28, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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