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Emergency retrospective

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https://www.readbyqxmd.com/read/29222268/tailoring-front-line-therapy-in-diffuse-large-b-cell-lymphoma-who-should-we-treat-differently
#1
REVIEW
Andrew Davies
Although there have been significant insights into the biology of diffuse large B-cell lymphoma (DLBCL) over recent years, progress in our therapeutic approach has been disappointing over the same timeframe. This is not for want of trying. In 2017, R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) remains the "gold standard," despite all of our insights into cell-of-origin and other subgroups. We have traditionally used clinical risk factors to tailor our therapies and have tested intensification of chemotherapy with little success...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#2
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221691/characteristics-and-outcomes-of-pediatric-heart-failure-related-emergency-department-visits-in-the-united-states-a-population-based-study
#3
Erika J Mejia, Matthew J O'Connor, Kimberly Y Lin, Lihai Song, Heather Griffis, Christopher E Mascio, Pirouz Shamszad, Aaron Donoghue, Chitra Ravishankar, Robert E Shaddy, Joseph W Rossano
OBJECTIVES: To describe the frequency, characteristics, and outcomes of heart failure-related emergency department (ED) visits in pediatric patients. We aimed to test the hypothesis that these visits are associated with higher admission rates, mortality, and resource utilization. STUDY DESIGN: A retrospective analysis of the Nationwide Emergency Department Sample for 2010 of patients ≤18 years of age was performed to describe ED visits with and without heart failure...
December 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29221291/airway-stenting-in-patients-requiring-intubation-due-to-malignant-airway-stenosis-a-10-year-experience
#4
Masahide Oki, Hideo Saka, Kazumi Hori
Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29219875/ehealth-interventions-for-parents-in-neonatal-intensive-care-units-a-systematic-review
#5
Justine Dol, Alannah Delahunty-Pike, Sheren Anwar Siani, Marsha Campbell-Yeo
BACKGROUND: As technology becomes increasingly more advanced, particularly video technology and interactive learning platforms, some neonatal intensive care units are embracing electronic health (eHealth) technologies to enhance and expand their family-centered care environments. Despite the emergence of eHealth, there has been a lack of systematic evaluation of its effectiveness thus far. OBJECTIVES: To examine the effect of eHealth interventions used in neonatal intensive care units on parent-related and infant outcomes...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219140/-near-miss-obstetric-events-and-maternal-mortality-in-a-tertiary-care-hospital
#6
Shravya Tallapureddy, Revathi Velagaleti, Himabindu Palutla, Chaitanya Venkata Satti
Obstetric near-miss or severe acute maternal morbidity is gaining interest internationally as a new indicator of the quality of obstetric care. This is a retrospective study conducted using "The WHO Near-Miss Approach" to provide insight into obstetric emergencies, near-miss cases, and maternal deaths in our hospital. The maternal near-miss ratio was 8.4/1000 live births, maternal near-miss to mortality ratio was 5.3:1. Hemorrhage was the leading cause (43.7%) of morbidity in near-miss cases while hypertensive disorders were the leading cause in maternal deaths (66...
October 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#7
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29218668/early-laparoscopic-adhesiolysis-for-small-bowel-obstruction-retrospective-study-of-main-advantages
#8
Claudia Hannele Mazzetti, Francesco Serinaldi, Eric Lebrun, Jean Lemaitre
BACKGROUND: The problem of managing adhesional small bowel obstruction (ASBO) is still unsolved. A conservative medical attitude is privileged even if it is associated to a high rate of recurrences, while surgery is applied to cases showing no improvement after 48-72 h. Adhesiolysis via laparotomy has been the standard surgical management, but it causes other adhesions in a vicious circle. The aim of the study is to evaluate the advantages of early laparoscopic adhesiolysis as an alternative approach...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29218615/advanced-ct-for-diagnosis-of-seizure-related-stroke-mimics
#9
Friederike Austein, Monika Huhndorf, Johannes Meyne, Helmut Laufs, Olav Jansen, Thomas Lindner
BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM. METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29218316/the-feasibility-of-colorectal-endoscopic-submucosal-dissection-for-the-treatment-of-residual-or-recurrent-tumor-localized-in-therapeutic-scar-tissue
#10
Ryosuke Kobayashi, Kingo Hirasawa, Ryosuke Ikeda, Takeh de Fukuchi, Yasuaki Ishii, Hiroaki Kaneko, Makomo Makazu, Chiko Sato, Shin Maeda
Background and study aims:  Endoscopic submucosal dissection (ESD) is used to treat superficial colorectal tumors. Previous studies have reported the efficacy of ESD for treating residual or local recurrent colorectal tumors. This study sought to evaluate the efficacy of ESD in treating these lesions and to assess factors that prevent successful ESD. Methods:  This retrospective study assessed 25 cases of residual or local recurrent lesions that were previously treated using EMR (18 lesions), TEM (5 lesions), ESD (1 lesion) or surgery (1 lesion), and 459 primary lesions treated using ESD between April 2008 and September 2015...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29217362/rethinking-prehospital-stroke-notification-assessing-utility-of-emergency-medical-services-impression-and-cincinnati-prehospital-stroke-scale
#11
Stephen W English, Alejandro A Rabinstein, Jay Mandrekar, James P Klaas
BACKGROUND AND PURPOSE: Although prehospital stroke notification has improved stroke treatment, incorporation of these systems into existing infrastructure has resulted in new challenges. The goal of our study was to design an effective prehospital notification system that allows for early and accurate identification of patients presenting with acute stroke. METHODS: We conducted a retrospective single-center cohort study of patients presenting with suspicion of acute stroke from 2014 to 2015...
December 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29217285/outcomes-and-palliative-care-utilization-in-patients-with-dementia-and-acute-abdominal-emergency-opportunities-for-surgical-quality-improvement
#12
Ana Berlin, Franchesca Hwang, Ranbir Singh, Sri Ram Pentakota, Roshansa Singh, Brad Chernock, Anne C Mosenthal
BACKGROUND: When patients with dementia develop acute surgical abdomen, patients, surrogates, and surgeons need accurate prognostic information to facilitate goal-concordant decision making. Palliative care can assist with communication, symptom management, and family and caregiver support in this population. We aimed to characterize outcomes and patterns of palliative care utilization among patients with dementia, presenting with abdominal surgical emergency. METHOD: We retrospectively queried the National Inpatient Sample for patients aged >50 years with dementia and acute abdominal emergency who were admitted nonelectively 2009-2013, utilizing ICD-9-CM codes for dementia and surgical indication...
December 4, 2017: Surgery
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#13
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29217021/practice-patterns-in-the-interdisciplinary-management-of-corneal-abrasions
#14
Michael Ross, Jean Deschênes
OBJECTIVE: To characterize the treatment and follow-up patterns of corneal abrasions at an academic health centre. METHODS: This is a retrospective review of 90 cases of corneal abrasions over a 2-year period at a tertiary care academic hospital, of which 75 were seen by the ophthalmology department. All consultations primarily for corneal abrasion, as determined by the emergency department physician, were included in the study. Information on treatment regimen, corneal findings by emergency and ophthalmology physicians, time between follow-ups, and final outcomes was collected...
December 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29216942/-comparison-of-national-early-warning-score-rapid-emergency-medicine-score-and-acute-physiology-and-chronic-health-evaluation-ii-score-for-predicting-outcome-among-emergency-severe-patients
#15
Li Chen, Lipu Deng, Hongmei Zhao, Xiaoying Huang, Xianghua He, Xiangmin Li, Ben Liu, Yongxiang Xie
OBJECTIVE: To analyze the comparation of national early warning score (NEWS), rapid emergency medicine score (REMS) and acute physiology and chronic health evaluation II (APACHE II) score in predicting prognosis of critically ill patients in emergency department (ED). METHODS: A retrospective study was conducted. Critically ill patients, aged > 16 years, hospitalized > 24 hours, and admitted to the ED of Nanhua Hospital Affiliated to South China University from January 2016 to June 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216753/the-impact-of-safety-plans-in-an-outpatient-clinic
#16
Jess Zonana, Jessica Simberlund, Paul Christos
BACKGROUND: Safety plans are recommended as tools to mitigate suicide risk; however, their effectiveness remains unclear. AIM: To evaluate the impact of safety plans on patient care at an outpatient mental health clinic. METHOD: In this retrospective chart review, patients' treatment engagement, health-care utilization, and risk behaviors were measured. Patients served as their own historical controls, and we compared outcomes in the 6 months before and 6 months after creation of safety plans...
December 8, 2017: Crisis
https://www.readbyqxmd.com/read/29216198/hcv-kinetic-and-modeling-analyses-project-shorter-durations-to-cure-under-combined-therapy-with-daclatasvir-and-asunaprevir-in-chronic-hcv-infected-patients
#17
Laetitia Canini, Michio Imamura, Yoshiiku Kawakami, Susan L Uprichard, Scott J Cotler, Harel Dahari, Kazuaki Chayama
BACKGROUND & AIMS: High cure rates are achieved in HCV genotype-1b patients treated with daclatasvir and asunaprevir, DCV/ASV. Here we analyzed early HCV kinetics in genotype-1b infected Japanese subjects treated with DCV/ASV and retrospectively projected, using mathematical modeling, whether shorter treatment durations might be effective. METHODS: HCV RNA levels were measured frequently during DCV/ASV therapy in 95 consecutively treated patients at a single center in Japan...
2017: PloS One
https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#18
REVIEW
Annelie Slaar, M M Fockens, Junfeng Wang, Mario Maas, David J Wilson, J Carel Goslings, Niels Wl Schep, Rick R van Rijn
BACKGROUND: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging is needed in adults presenting for blunt trauma screening at the emergency department...
December 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29215499/post-operative-emergency-department-utilization-and-hospital-readmission-after-cervical-spine-arthrodesis-rates-trends-causes-and-risk-factors
#19
Peter B Derman, Lukas P Lampe, Ting Jung Pan, Stephan N Salzmann, Janina Kueper, Federico P Girardi, Stephen Lyman, Alexander P Hughes
STUDY DESIGN: Retrospective state database analysis. OBJECTIVE: To quantify the 30-day and 90-day emergency department (ED) utilization and inpatient readmission rates after primary cervical arthrodesis, to stratify these findings by surgical approach and to describe risk factors and conditions precipitating these events. SUMMARY OF BACKGROUND DATA: Limited data exist on ED utilization and hospital readmission rates after cervical spine arthrodesis...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29215494/descriptive-analysis-of-state-and-federal-spine-surgery-malpractice-litigation-in-the-united-states
#20
Nitin Agarwal, Raghav Gupta, Prateek Agarwal, Pravin Matthew, Richard Wolferz Jr, Aakash Shah, Nimer Adeeb, Arpan V Prabhu, Adam S Kanter, David O Okonkwo, D Kojo Hamilton
STUDY DESIGN: Retrospective Review OBJECTIVE.: This study aimed to determine the factors associated with malpractice litigation in cases involving spine surgery in the United States. SUMMARY OF BACKGROUND DATA: Medical malpractice is of substantial interest to the medical community due to concerns of increased healthcare costs and medical decision-making for the sole purpose of reducing legal liability. METHODS: The Westlaw online legal database (Thomson Reuters, New York, NY) was searched for verdict and settlement reports pertaining to spine surgery from 2010 to 2015...
December 5, 2017: Spine
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