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"Emergency department"

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https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#1
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550443/timing-to-antibiotic-therapy-in-septic-oncologic-patients-presenting-without-hypotension
#2
Kathleen Morneau, Gary B Chisholm, Frank Tverdek, Jeffrey Bruno, Katy M Toale
PURPOSE: Sepsis accounts for only 2% of the hospitalizations worldwide but more than 17% of total in-hospital mortality. Inappropriate antimicrobial selection and delays in appropriate therapy have been associated with reduced survival in severe sepsis and septic shock. No studies to date have exclusively targeted septic oncologic patients without hypotension. METHODS: This study was a retrospective chart review of 100 adult cancer patients presenting to the emergency department with sepsis without hypotension...
May 26, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28550343/the-association-of-ambient-temperature-with-incidence-of-cardiac-arrhythmias-in-a-short-timescale
#3
Jayeun Kim, Ho Kim
The body response time and an association between the exposure to outdoor temperature and cardiac arrhythmia were not fully understood. Hence, we further investigated the association between ambient temperature and the exacerbations of arrhythmia symptoms on a short timescale using the emergency department (ED) visit data. We used a total of 17,088 arrhythmia-related ED visits in Seoul, from 2008 to 2011 and fitted the model adjusting for other meteorological variables and air pollutants under the case-crossover analysis with the same year-month time stratification...
May 27, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28550278/torsion-of-a-giant-antimesenteric-lipoma-of-the-ileum-a-rare-cause-of-acute-abdominal-pain
#4
Ta-Wei Yang, Yi-Wei Tsuei, Chung-Cheng Kao, Wen-Hsien Kuo, Yan-Lin Chen, Yen-Yue Lin
BACKGROUND Torsion of an intra-abdominal lipoma is rarely the cause of acute abdominal pain. Most of the previously reported cases of intra-abdominal lipoma torsion originated in the mesentery or omentum. However, an antimesenteric lipoma of the ileum with torsion has not been reported before. CASE REPORT A 67-year-old man presented to the emergency department with acute abdominal pain. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis only showed a giant fat-containing, soft-tissue, intra-abdominal tumor, suspected to be a lipoma...
May 27, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28550143/kicked-to-touch-hoodwinked-by-torticollis
#5
Ciaran K Mc Donald, Niall Mc Goldrick, Cliodhna Ni Fhoghlu, Fintan Shannon
A 2-year-old girl presented to the emergency department with a 3-day history of a painful stiff neck after getting a kick to her head from her older brother. Her general practitioner had recently started her on oral antibiotics for otitis media. Plain film imaging of her cervical spine on admission revealed anterior subluxation of C2 on C3 suggestive of bifacetal dislocation. Subsequent CT imaging confirmed malalignment of the upper cervical spine. The patient was admitted and worked up with MRI of the cervical spine which unexpectedly revealed a large 4×2 cm retropharyngeal abscess extending from C1 to C4...
May 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28549581/a-cross-sectional-emergency-department-survey-of-novel-psychoactive-substance-prevalence
#6
Callan Fockele, Patil Armenian
No abstract text is available yet for this article.
April 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#7
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28549018/intimate-partner-violence-in-ophthalmology-a-global-call-to-action
#8
Ali R Cohen, Lynette M Renner, Erin M Shriver
PURPOSE OF REVIEW: Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral...
April 25, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#9
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548868/inhaled-corticosteroid-prescribing-in-a-pediatric-emergency-department-sustained-success-and-prescription-filling-rates
#10
Sarah Nicole Adams, Mary Abel, Dustin Fowler, Jennifer Braden, Myla D Ebeling, Annie N Simpson, M Olivia Titus, Annie Lintzenich Andrews
OBJECTIVE: To determine if improvement in Inhaled Corticosteroid (ICS) prescribing in the pediatric emergency department (PED) can be sustained after transition from intense intervention to low-intervention phase, and to determine ICS fill rates. METHODS: A Quality Improvement (QI) project began in Aug 2012. Results through Feb 2014 were previously published. In Feb 2014 interventions were scaled back to determine the sustainability of QI success. Eligible patients included children aged 2-17 seen in the PED for asthma between Feb 2014 and Sept 2016...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548631/effectiveness-of-a-respiratory-day-hospital-program-to-reduce-admissions-for-exacerbation-in-patients-with-severe-copd-a-prospective-multicenter-study
#11
Daniel Huertas, Concepción Montón, Alicia Marín, Ingrid Solanes, Marta López-Sánchez, Xavier Pomares, Mariana Muñoz-Esquerre, Jordi Dorca, Salud Santos
The respiratory Day Hospital (DH) is a care facility currently operating at various healthcare institutions. It monitors patients with severe chronic obstructive pulmonary disease (COPD) presenting repeated exacerbations with at least two hospital admissions per year. The main aim of the study was to evaluate the effectiveness of the DH program for controlling admissions for COPD exacerbations in this cohort of patients, and to identify clinical factors associated with hospitalizations and mortality. An observational prospective multicenter study was carried out at three hospitals...
June 2017: COPD
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#12
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548292/hypertriglyceridemic-acute-pancreatitis-in-an-emergency-department-the-typical-clinical-features-and-genetic-variants
#13
Wan Jun Chen, Xiao Fan Sun, Rui Xue Zhang, Min Jie Xu, Tong Hai Dou, Xiao Bin Zhang, Min Zhong, Wei Qiang Yang, Li Liu, Xiao Ye Lu, Chang Qing Zhu
OBJECTIVE: To investigate the clinical characteristics of hypertriglyceridemic acute pancreatitis (HTGAP), and the molecular foundation contributing to the hypertriglyceridemia in this group of patients. METHODS: Clinical data from 329 patients with AP were collected and analyzed. All the patients were divided into 1) HTGAP group (n = 40), with fasting serum triglyceride ≥ 500 mg/dL; and 2) NHTGAP group (n = 289). Next, the targeted next-generation sequencing was applied in 11 HTGAP patients to detect the genetic mutation associated with hypertriglyceridemia that included apolipoprotein A-5 (APOA5), apolipoprotein C-3 (APOC3), apolipoprotein E (APOE), BLK proto-oncogene, lipoprotein lipase (LPL), apolipoprotein C-2 (APOC2), glycosylphosphatidylinositol anchored high density lipoprotein binding protein-1(GPIHBP1), and lipase maturation factor-1(LMF1)...
May 26, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28548220/bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department-methodological-and-statistical-issues-on-diagnostic-value
#14
Fatemeh Koohi, Siamak Sabour
We were interested to read the recent paper by Gungor F and colleagues published in May issue of the Acad Emerg Med 2017.(1) The aim of the authors was to evaluate diagnostic value of point-of-care US (POCUS) in clinical decision making of emergency physicians (EPs) for acute appendicitis (AA) in the emergency department (ED).(1) A total of 264 patients were included into a prospective observational clinical study and based on their results 169 (64%) had a diagnosis of AA. This article is protected by copyright...
May 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28547753/the-cost-effectiveness-of-patient-controlled-analgesia-vs-standard-care-in-patients-presenting-to-the-emergency-department-in-pain-who-are-subsequently-admitted-to-hospital
#15
C Pritchard, J E Smith, S Creanor, R Squire, A Barton, J Benger, L Cocking, P Ewings, M Rockett
The clinical effectiveness of patient-controlled analgesia has been demonstrated in a variety of settings. However, patient-controlled analgesia is rarely utilised in the emergency department. The aim of this study was to compare the cost-effectiveness of patient-controlled analgesia vs. standard care in participants admitted to hospital from the emergency department with pain due to traumatic injury or non-traumatic abdominal pain. Pain scores were measured hourly for 12 h using a visual analogue scale. Cost-effectiveness was measured as the additional cost per hour in moderate to severe pain avoided by using patient-controlled analgesia rather than standard care (the incremental cost-effectiveness ratio)...
May 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#16
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#17
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28546986/factors-affecting-the-overcrowding-in-outpatient-healthcare
#18
Mohammadkarim Bahadori, Ehsan Teymourzadeh, Ramin Ravangard, Mehdi Raadabadi
BACKGROUND: The expansion of outpatient services and the desire to provide more outpatient care than inpatient care create some problems such as the overcrowding in the outpatient clinics. Given the importance of overcrowding in the outpatient clinics, this qualitative study aimed to determine the factors influencing the overcrowding in the specialty and subspecialty clinic of a teaching hospital. MATERIALS AND METHODS: This was a qualitative study conducted in the specialty and subspecialty clinic of a hospital using content analysis method in the period of January to March 2014...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28546981/nurses-commitment-to-respecting-patient-dignity
#19
Zahra Raee, Heidarali Abedi, Mohsen Shahriari
BACKGROUND: Although respecting human dignity is a cornerstone of all nursing practices, industrialization has gradually decreased the attention paid to this subject in nursing care. Therefore, the present study aimed to investigate nurses' commitment to respecting patient dignity in hospitals of Isfahan, Iran. METHODS: This descriptive-analytical study was conducted in hospitals of Isfahan. Overall, 401 inpatients were selected by cluster sampling and then selected simple random sampling from different wards...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#20
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
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