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https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#1
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29775092/a-prospective-multi-centre-us-clinical-trial-to-determine-accuracy-of-febridx-point-of-care-testing-for-acute-upper-respiratory-infections-with-and-without-a-confirmed-fever
#2
Nathan I Shapiro, Wesley H Self, Jeffrey Rosen, Stephan C Sharp, Michael R Filbin, Peter C Hou, Amisha D Parekh, Michael C Kurz, Robert Sambursky
BACKGROUND: FebriDx is a 10-minute disposable point-of-care test designed to identify clinically significant systemic host immune responses and aid in the differentiation of bacterial and viral respiratory infection by simultaneously detecting C-reactive protein (CRP) and myxovirus resistance protein A (MxA) from a fingerstick blood sample. FebriDx diagnostic accuracy was evaluated in the emergency room and urgent care setting. METHODS: A prospective, multicentre, observational cohort study of acute upper respiratory tract infections (URIs), with and without a confirmed fever at the time of enrolment, was performed to evaluate the diagnostic accuracy of FebriDx to identify clinically significant bacterial infection with host response and acute pathogenic viral infection...
May 18, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29762982/the-role-and-experiences-of-advanced-nurse-practitioners-working-in-out-of-hours-urgent-care-services-in-a-primary-care-setting
#3
Jacci Yuill
GPs' workload has increased significantly in recent years affecting their ability to provide high-quality services, and consequently there is increasing focus on nurses to provide a solution. There is little evidence of how advanced nurse practitioners (ANPs) experience their role in out of hours (OOH) services, and it is important to understand their perceptions of this and the challenges they may face in supporting service development and improvement. This article evaluates the role and experiences of ANPs working in an OOH urgent primary care service and identifies important factors that affect their roles...
May 15, 2018: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#4
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29750550/knowledge-of-hiv-testing-guidelines-among-us-internal-medicine-residents-a-decade-after-the-centers-for-disease-control-and-prevention-s-routine-hiv-testing-recommendations
#5
Dima Dandachi, Bich N Dang, Rita Wilson Dib, Harvey Friedman, Thomas Giordano
Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records...
May 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29748341/general-practitioners-providing-non-urgent-care-in-emergency-department-a-natural-experiment
#6
Olalekan A Uthman, Clare Walker, Sudakshina Lahiri, David Jenkinson, Victor Adekanmbi, Wendy Robertson, Aileen Clarke
OBJECTIVE: To examine whether care provided by general practitioners (GPs) to non-urgent patients in the emergency department differs significantly from care provided by usual accident and emergency (A&E) staff in terms of process outcomes and A&E clinical quality indicators. DESIGN: Propensity score matched cohort study. SETTING: GPs in A&E colocated within the University Hospitals Coventry and Warwickshire NHS Trust between May 2015 and March 2016...
May 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29731234/effective-contraception-use-by-usual-source-of-care-an-opportunity-for-prevention
#7
Martina T Caldwell, Hwajung Choi, Phillip Levy, Vanessa K Dalton, Dawn Phillips Misra
INTRODUCTION: Women using emergency departments (ED) or urgent care facilities for their usual care may lack access to contraception. This study examined the relationship between effectiveness of current contraception use (highly effective/effective methods vs. less effective/no method) and usual source of care in the clinic (referent group), urgent care, ED or none among U.S. reproductive-aged females at risk for unintended pregnancy. METHODS: Using the National Survey of Family Growth, we conducted logistic regression analyses using pooled, as well as age- and insurance-stratified data...
May 3, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29720156/trends-in-healthcare-utilization-and-costs-associated-with-acute-otitis-media-in-the-united-states-during-2008-2014
#8
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Acute otitis media (AOM) is the most common cause of pediatric medical visits and antibiotic prescriptions worldwide, but its current impact on the US healthcare system is not clear. The aim of this study was to investigate changes in the incidence of AOM from 2008, just before 13-valent pneumococcal conjugate vaccine was introduced, to 2014 using US insurance records in the Truven MarketScan® database. The study also examined the costs associated with index AOM events during the two most recent years for which data were available (2013-2014)...
May 2, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29700663/reaching-and-supporting-at-risk-community-based-seniors-results-of-a-multi-church-partnership
#9
Julie L Ellis, Jeffrey A Morzinski
The purpose of this study was to determine the impact of a nurse-led, church-based educational support group for "at-risk," older African Americans on hospitalization and emergency department use. Study nurses enrolled 81 "at-risk" older adult members of ten churches. Participants completed a trifold pamphlet identifying personal health information and support, and they attended eight monthly educational/support group sessions in their church during the 10-month intervention. Study nurses completed a risk assessment interview with each senior both pre- and post-participation...
April 26, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29695389/previously-misdiagnosed-linear-iga-dermatosis-resolved-with-dapsone
#10
Vinicius Tieppo Francio, Chris Towery, Saeid Davani, Travis Allen, Tony L Brown
This is the case of a 25-year-old African American woman with a 3-week history of itching with burning, blistering lesions on her torso and extremities. Medical history was unremarkable. Medical treatments included three visits to urgent care, where she was treated with antivirals, oral and topical steroids, antibiotics and antifungals unsuccessfully. We performed a skin biopsy, and immunoflorescent studies revealed a linear deposition of IgA antigen at the basement membrane. The clinical diagnosis of linear IgA dermatosis (LAD) was established, with no eliciting cause, other than potential occupational exposure to Chlamydophila psittaci via her employment in a pet store...
April 25, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29688823/analysis-of-a-pediatric-telemedicine-program
#11
Shayan Vyas, Joanne Murren-Boezem, Patricia Solo-Josephson
BACKGROUND: Telemedicine serves millions of patients and is transforming healthcare delivery worldwide. In October of 2015, Nemours Children's Health System began offering direct-to-consumer (DTC) pediatric telemedicine on the Nemours CareConnect (NCC) platform. INTRODUCTION: Currently, there are no descriptive data available on pediatric-specific DTC 24/7 programs. This is the first article to our knowledge that provides data on such a program. MATERIALS AND METHODS: A retrospective data analysis of the first 1,000 visits was conducted...
April 24, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29685874/impact-of-oral-side-effects-from-conditioning-therapy-before-hematopoietic-stem-cell-transplantation-protocol-for-a-multicenter-study
#12
Michael T Brennan, Bengt Hasséus, Allan J Hovan, Judith E Raber-Durlacher, Nicole Ma Blijlevens, Marie-Charlotte Huysmans, Karin Garming Legert, Jan-Erik Johansson, Charity G Moore, Inger von Bültzingslöwen
BACKGROUND: The oral cavity is a common site of complications related to the cytotoxic effect of high-dose chemotherapy and radiation therapy. Considering our limited understanding of the burden of illness in the oral cavity from various cytotoxic therapies, it is difficult to produce evidence-based, preventive and management protocols. A prospective multicenter study is necessary to collect data on the burden of illness from various cytotoxic regimens. OBJECTIVE: The objectives of this prospective international observational multicenter study in hematopoietic stem cell transplant (HSCT) patients are to establish the nature, incidence and temporal relationship of oral complications related to conditioning regimens (chemotherapy with or without total body irradiation), stem cell transplantation and the immunologic reactions (mainly graft-vs-host-disease) that may follow, and to determine what subjective and objective oral complications related to treatment can predict negative clinical and economic outcomes and reduced quality of life...
April 23, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29678177/healthcare-resource-use-and-economic-burden-attributable-to-respiratory-syncytial-virus-in-the-united-states-a-claims-database-analysis
#13
Caroline Amand, Sabine Tong, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system. METHODS: This retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013...
April 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29664768/determinants-of-parent-satisfaction-with-emergency-or-urgent-care-when-the-patient-has-autism
#14
Sarah F Kirsch, David L Meryash, Bárbara González-Arévalo
OBJECTIVE: The purpose of this study was to identify factors that predict parent satisfaction (PS) with their child with autism spectrum disorder (ASD)'s visit to a hospital emergency department (ED) or urgent care (UC) center. METHODS: Parents recruited through a national database whose child (3-21 years; N = 378) with ASD had been treated in an ED/UC center within the previous 3 years completed an anonymous on-line questionnaire. They answered questions about whether they were satisfied overall with the visit and the care provided, their demographics, patient characteristics, their expectations and preparation for the visit, and the ED/UC center experience itself, including their observations of staff interpersonal and communication skills (ICSs) and behaviors, and whether the patient was disruptive (D)...
April 16, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/29661629/a-collaborative-program-to-increase-adult-pneumococcal-vaccination-rates-among-a-high-risk-patient-population-receiving-care-at-urgent-care-clinics
#15
Nicholas Lehman, Carrie F Koenigsfeld, Geoffrey C Wall, Catherine Renner, Danielle Hahn, Brian Sheesley, Lisa A Veach, Adam Bjornson
We report a project that utilized pharmacy students to increase pneumococcal vaccination rates in patients aged 19-64 years with high-risk medical conditions within urgent care clinics. The study also sought to better identify the number of patients previously vaccinated for pneumococcal disease. A total of 1,178 patients were considered eligible for pneumococcal vaccination during the study period, 287 (24.4%) of whom were determined to be previously vaccinated through chart assessment or patient interview...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#16
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29649550/healthcare-workers-exposure-to-middle-east-respiratory-syndrome-corona-virus-mers-cov-revision-of-screening-strategies-urgently-needed
#17
Hala Amer, Abdulrahman S Alqahtani, Faisal Alaklobi, Juhaina Altayeb, Ziad A Memish
OBJECTIVES: MERS-CoV continues to cause frequent hospital outbreaks in Saudi Arabia with emergency departments as the initial site of the spread of this virus. METHODS: We assessed the transmission risks of MERS-CoV infection to HCWs in an outbreak in Riyadh. All HCWs with unprotected exposure to confirmed cases were tested after 24hours of exposure. Two negative results for MERS-CoV 3days apart and being free of any suggestive signs and symptoms were used to stop their isolation...
April 9, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29626164/neighborhood-child-opportunity-and-individual-level-pediatric-acute-care-use-and-diagnoses
#18
Ellen E Kersten, Nancy E Adler, Laura Gottlieb, Douglas P Jutte, Sarah Robinson, Katrina Roundfield, Kaja Z LeWinn
: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. METHODS: This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011...
April 6, 2018: Pediatrics
https://www.readbyqxmd.com/read/29609916/impact-of-marijuana-legalization-in-colorado-on-adolescent-emergency-and-urgent-care-visits
#19
George Sam Wang, Sara Deakyne Davies, Laurie Seidel Halmo, Amy Sass, Rakesh D Mistry
PURPOSE: Approximately 6%-8% of U.S. adolescents are daily/past-month users of marijuana. However, survey data may not reliably reflect the impact of legalization on adolescents. The objective was to evaluate the impact of marijuana legalization on adolescent emergency department and urgent cares visits to a children's hospital in Colorado, a state that has allowed both medical and recreational marijuana. METHODS: Retrospective review of marijuana-related visits by International Classification of Diseases codes and urine drug screens, from 2005 through 2015, for patients ≥ 13 and < 21 years old...
March 30, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29609855/influenza-vaccine-availability-at-urgent-care-centers-in-the-state-of-arizona
#20
Norman L Beatty, Kelly M Hager, Kyle R McKeown, Francisco Mora, Kathryn R Matthias, David E Nix, Mayar Al Mohajer
We surveyed urgent care centers (UCCs) in the state of Arizona to determine whether they offered the influenza vaccine during the 2016-2017 influenza season. Overall vaccine availability was 80.3% at these facilities. During this season, one-third of the UCCs offered influenza vaccination to children 6 months or older; approximately two-thirds offered influenza vaccination to children and young adults 16 years or older. This is the first study of influenza vaccine availability at UCCs.
March 30, 2018: American Journal of Infection Control
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