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Preventable emergency visits

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https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#1
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#2
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#3
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28635549/a-missed-primary-care-appointment-correlates-with-a-subsequent-emergency-department-visit-among-children-with-asthma
#4
Colleen Marie McGovern, Margaret Redmond, Kimberly Arcoleo, David R Stukus
OBJECTIVE: Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits...
March 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#5
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28629455/an-investigation-of-the-relationship-between-autonomy-childbirth-practices-and-obstetric-fistula-among-women-in-rural-lilongwe-district-malawi
#6
Julika Ayla Kaplan, Jonathan Kandodo, Joseph Sclafani, Susan Raine, Jennifer Blumenthal-Barby, Alison Norris, Abigail Norris-Turner, Elly Chemey, John Michael Beckham, Zara Khan, Reginald Chunda
BACKGROUND: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor...
June 19, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#7
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28627851/zika-virus-practical-guidelines
#8
Gilles Eperon, Manuel Schibler, Noémie Wagner, François Chappuis, Isabelle Eperon
Zika virus suddenly emerged in Latin America in 2015‑2016. Congenital malformations have been observed in infected pregnant women, causing a major public health impact in affected countries, particularly in Brazil. In addition, sexual transmission of Zika virus has been well documented. This led to the development of prevention strategies and recommendations for travellers visiting at risk countries. These documents are regularly amended depending on the evolution of scientific knowledge, the epidemiologic trends and the national and international guidelines...
May 3, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28626848/older-adult-falls-prevention-behaviors-60-days-post-discharge-from-an-urban-emergency-department-after-treatment-for-a-fall
#9
Kalpana Narayan Shankar, Nicole J Treadway, Alyssa A Taylor, Alan H Breaud, Elizabeth W Peterson, Jonathan Howland
BACKGROUND: Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28626826/adverse-drug-events-leading-to-emergency-department-visits-at-an-eye-hospital-a-brief-report
#10
Safa Alizadeh, Niayesh Mohebbi, Kheirollah Gholami, Mahmoud Jabbarvand
PURPOSE: To evaluate adverse drug events (ADEs) resulting in emergency department visits in an eye hospital. METHOD: Emergency department visits at Farabi Eye Hospital were assessed for a 7-day period. The patients' eye disorders and drug history were evaluated to detect ADEs. RESULTS: Of 1631 emergency visits, 5 (0.3%, 95% CI: 0.13-0.71%) were drug related. Tetracaine eye drops accounted for 4 (80%, 95% CI: 38-96%) cases with corneal involvement...
June 2017: Journal of Current Ophthalmology
https://www.readbyqxmd.com/read/28617897/recreational-activity-and-facial-trauma-among-older-adults
#11
Andrea Plawecki, Michael Bobian, Aron Kandinov, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Michael Carron
Importance: As the US population ages, public health agencies have released guidelines encouraging aerobic activity and muscle-strengthening exercises among older individuals. Facial trauma from such activities among elderly individuals has long been underappreciated. Objectives: To evaluate the incidence of recreational activity-associated facial fractures among older adults and to further delineate injury characteristics including demographics, fracture location, and specific activities...
June 15, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28614101/clinical-characteristics-of-allergy-to-hymenoptera-stings
#12
Nualanong Visitsunthorn, Teera Kijmassuwan, Kittipos Visitsunthorn, Panchama Pacharn, Orathai Jirapongsananuruk
OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics of allergy to stings from the Hymenoptera order of insects in a hospital in Thailand. METHODS: A descriptive retrospective analytical study was carried out in inpatients and outpatients suffering from Hymenoptera stings from 2009 to 2013 in Siriraj Hospital. RESULTS: Medical records of 386 patients with an allergy to Hymenoptera stings were evaluated. Anaphylaxis was more common in patients younger than 15 years, who comprised 22...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28610634/medication-related-visits-in-a-pediatric-emergency-department-an-8-years-retrospective-analysis
#13
Cristiano Rosafio, Serena Paioli, Cinzia Del Giovane, Valentina Cenciarelli, Nilla Viani, Paolo Bertolani, Lorenzo Iughetti
BACKGROUND: There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients. METHODS: We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment...
June 13, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28607230/preventing-torture-for-people-deprived-of-freedom-the-atlantic-hope-and-black-swan-prison-model
#14
Ernest N Ogbozor, Mara L Schoeny, Andrew Baer
International law and minimum standards provide certain protection for detainees and prisoners of war (POW) against torture and ill-treatment. Places of detention and parties to conflicts are often monitored to ensure that they adhere to the required standards through, for example, visits to individual detainees and the assessment of facilities. However, monitoring between the point of arrest and eventual remand in prisons is largely inadequate. This paper explains an emerging model to enhance protection of prisoners through readiness training for prospective humanitarian personnel...
2017: Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture
https://www.readbyqxmd.com/read/28602059/depth-and-combined-infection-is-important-predictor-of-lower-extremity-amputations-in-hospitalized-diabetic-foot-ulcer-patients
#15
Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
Background/Aims: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization. Methods: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review...
June 7, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28596981/differentiating-nonoccupational-postexposure-prophylaxis-seroconverters-and-non-seroconverters-in-a-community-based-clinic-in-los-angeles-california
#16
Matthew R Beymer, Robert E Weiss, Robert K Bolan, Ryan M Kofron, Risa P Flynn, David L Pieribone, Sonali P Kulkarni, Raphael J Landovitz
BACKGROUND: Nonoccupational postexposure prophylaxis (nPEP) is a 28-day regimen of antiretroviral medications taken within 72 hours of human immunodeficiency virus (HIV) exposure to prevent HIV acquisition. Although nPEP has been recommended since 1998, few studies have analyzed the characteristics that distinguish nPEP failures (seroconverters) and successes (non-seroconverters). METHODS: This retrospective study analyzed all nPEP courses prompted by sexual exposure that were prescribed at the Los Angeles LGBT Center between March 2010 and July 2014...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28591866/effectiveness-of-influenza-vaccines-in-asthma-a-systematic-review-and-meta-analysis
#17
Eleftheria Vasileiou, Aziz Sheikh, Chris Butler, Karim El Ferkh, Beatrix von Wissmann, Jim McMenamin, Lewis Ritchie, Jürgen Schwarze, Nikolaos G Papadopoulos, Sebastian L Johnston, Lilly Tian, Colin R Simpson
There is uncertainty about the effectiveness of influenza vaccination in people with asthma and its impact on asthma outcomes, which may contribute to the sub-optimal vaccination rates in people with asthma. This systematic review and meta-analysis involved searching 12 international databases for randomized controlled trials (RCTs) and high quality quasi-experimental and epidemiological studies (1970 to 2016). The risk of bias was low for three included RCTs. The quality of three included observational studies was moderate...
June 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28586939/-urgent-visits-to-nursing-homes-a-general-practitioner-s-perspective
#18
Markus Bleckwenn, David Ashrafnia, Rieke Schnakenberg, Klaus Weckbecker
Aim of the study Due to demographic changes, home visits to nursing care facilities are increasing. Urgent home visits represent a challenge for general practitioners. There are no recommendations for the implementation of urgent home visits. Therefore, in this study, we investigated how GP practices deal with urgent home visits and what improvements can be made to the medical emergency care. Methods A total of 15 teaching doctors of the Department of Family Medicine at the University of Bonn were interviewed using semi-structured interviews on the subject...
June 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28579823/use-of-immediate-release-opioids-as-supplemental-analgesia-during-management-of-moderate-to-severe-chronic-pain-with-buprenorphine-transdermal-system
#19
Sanford Silverman, Robert B Raffa, Marc J Cataldo, Monica Kwarcinski, Steven R Ripa
BACKGROUND: The buprenorphine transdermal system (BTDS) is approved in the US for the management of chronic pain. Due to its high affinity for μ-opioid receptors with a slow dissociation profile, buprenorphine may potentially displace or prevent the binding of competing μ-opioid-receptor agonists, including immediate-release (IR) opioids, in a dose-dependent manner. Health care professionals may assume that the use of IR opioids for supplemental analgesia during BTDS therapy is not acceptable...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28578608/do-gender-predominant-primary-health-care-organizations-have-an-impact-on-patient-experience-of-care-use-of-services-and-unmet-needs
#20
Raynald Pineault, Roxane Borgès Da Silva, Sylvie Provost, Michel Fournier, Alexandre Prud'homme, Jean-Frédéric Levesque
Physicians' gender can have an impact on many aspects of patient experience of care. Organization processes through which the influence of gender is exerted have not been fully explored. The aim of this article is to compare primary health care (PHC) organizations in which female or male doctors are predominant regarding organization and patient characteristics, and to assess their influence on experience of care, preventive care delivery, use of services, and unmet needs. In 2010, we conducted surveys of a population stratified sample (N = 9180) and of all PHC organizations (N = 606) in 2 regions of the province of Québec, Canada...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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