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Emergency retrospective

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https://www.readbyqxmd.com/read/29053543/decreased-time-to-antibiotic-prophylaxis-for-open-fractures-at-a-level-one-trauma-center
#1
Joey P Johnson, Avi D Goodman, Adam M Haag, Roman A Hayda
OBJECTIVE: To determine whether time to administration of antibiotics decreased after the implementation of an open fracture working group and antibiotic prophylaxis protocol. DESIGN: Retrospective cohort study. SETTING: One Level 1 Trauma Center. PATIENTS: Patients 18 years of age and older who sustained an open fracture and presented directly to our emergency department. INTERVENTION: Prompt irrigation and debridement in the operating room and fracture stabilization dictated by the treating surgeon...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053033/hyaluronidase-allergy-mimicking-orbital-cellulitis
#2
Nirav D Raichura, Md Shahid Alam, V V Jaichandran, Saurabh Mistry, Bipasha Mukherjee
PURPOSE: Hyaluronidase enzyme is a common additive with local anesthetic agent to facilitate faster permeation of the anesthetic in periocular tissues during ophthalmic surgery. We report a series of five subjects presenting with clinical features mimicking orbital cellulitis following peribulbar anesthesia and consequently diagnosed with hyaluronidase hypersensitivity. SETTING: The study was conducted at a tertiary eye care center in Southern India. DESIGN: It was a retrospective interventional case series...
October 20, 2017: Orbit
https://www.readbyqxmd.com/read/29052940/outcomes-of-percutaneous-cholecystostomy-and-predictors-of-subsequent-cholecystectomy
#3
Scott Cooper, Michael Donovan, David A Grieve
BACKGROUND: The use of a percutaneous cholecystostomy (PC) in the management of severe acute cholecystitis is a well recognized alternative to acute cholecystectomy. The need for definitive surgical management remains controversial. METHODS: A retrospective analysis of hospital records at Nambour General Hospital between 2012 and 2016 was conducted and data relating to indications, demographics, comorbidities and outcomes were collected. RESULTS: Thirty PC patients (20 male and 10 female) were identified, with a mean age of 77 years (range 46-93)...
October 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29052830/diaphragmatic-rupture-a-single-institution-experience-and-literature-review
#4
Carlo Corbellini, Stefano Costa, Tiberio Canini, Roberta Villa, Ettore Contessini Avesani
BACKGROUND: Diaphragmatic rupture (DR) is a rare and potentially life-threatening event caused by trauma or spontaneously. DR occasionally occurs several months after the injury. Chest X-ray and computed tomography are the most effective diagnostic methods. Delay in DR diagnosis occurs frequently. This study aimed to examine and improve our understanding of the etiology, clinical presentation, and management of DR. METHODS: This study was performed at the Emergency and General Surgery Department of Fondazione I...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052826/fournier-s-gangrene-a-retrospective-analysis-of-25-patients
#5
Metin Yücel, Adnan Özpek, Fatih Başak, Ali Kılıç, Ethem Ünal, Sema Yüksekdağ, Aylin Acar, Gürhan Baş
BACKGROUND: Fournier's gangrene is a surgical emergency that progresses rapidly and insidiously and results in high morbidity and mortality rates unless it is immediately diagnosed and managed. Here we analyze the outcomes of patients who were followed up and treated for Fournier's gangrene. METHODS: We conducted a retrospective analysis of the medical data of 25 patients operated on for Fournier's gangrene between January 2010 and June 2015. The diagnosis of Fournier's gangrene was made by performing a physical examination...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052825/managing-endoscopic-retrograde-cholangiopancreatography-related-complications-in-patients-referred-to-the-surgical-emergency-unit
#6
Osman Şimşek, Arife Şimşek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci
BACKGROUND: The goal of this study was to present our experience in the management of endoscopic retrograde cholangiopancreatography-related complications in patients referred to our surgical emergency unit by various endoscopy centers. METHODS: A retrospective investigation was conducted on the records of the 54 patients who were referred to our surgical emergency unit between October 2005 and January 2014 due to endoscopic retrograde cholangiopancreatography-related complications...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052823/can-we-predict-mortality-in-patients-with-necrotizing-fasciitis-using-conventional-scoring-systems
#7
Necdet Fatih Yaşar, Mustafa Ufuk Uylaş, Bartu Badak, Uğur Bilge, Setenay Öner, Enver İhtiyar, Tarık Çağa, Ercüment Paşaoğlu
BACKGROUND: This study compared the predictive accuracy of four scoring systems, namely Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score II (SAPS II), and Mortality in Emergency Department (MEDS), for estimating prognosis in patients with necrotizing fasciitis. METHODS: Seventy-four patients who presented with necrotizing fasciitis were retrospectively examined. The ability of the scoring systems to predict mortality was assessed by comparing the estimated mortality rates in mortality groups (survivors/non-survivors), and mortality rates among survivors and non-survivors with an estimated mortality of >10%, 30%, and 50% in the scoring systems were compared in pairs...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052799/treatment-and-outcome-of-subdural-hematoma-in-patients-with-spontaneous-intracranial-hypotension-a-report-of-35-cases
#8
Enrico Ferrante, Fabio Rubino, Federica Beretta, Caroline Regna-Gladin, M Mirko Ferrante
Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, low CSF pressure and diffuse pachymeningeal enhancement on brain MRI. SIH results from spontaneous CSF leakage leading to brain sag. Sometimes, tearing of bridging veins may produce subdural hematomas (SDHs). Patients with SDH were identified retrospectively from 212 consecutive SIH patients. Data were collected on demographics, clinical courses, neuroimaging findings, treatment and outcome of SDH. Thirty-five patients (16%), (6 women, 29 men; aged 33-68; mean, 50 years) with SDH were recruited...
October 20, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29052534/specialist-advice-may-improve-patient-selection-for-decompression-therapy-following-diving-accidents-a-retrospective-observational-study
#9
Daniel Steffensmeier, Roland Albrecht, Jürg Wendling, Roger Melliger, Donat R Spahn, Philipp Stein, Christophe Wyss
BACKGROUND: Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low. Thus, a collaboration between the Swiss Air-Ambulance (Rega) and the divers alert network (DAN) was initiated to improve patient treatment and identification of decompression injury and necessity of hyperbaric oxygen therapy (HBO)...
October 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29052532/stereotactic-body-radiation-therapy-sbrt-for-definitive-treatment-and-as-a-bridge-to-liver-transplantation-in-early-stage-inoperable-hepatocellular-carcinoma
#10
Assaf Moore, Michal Cohen-Naftaly, Anna Tobar, Yulia Kundel, Ofer Benjaminov, Marius Braun, Assaf Issachar, Eytan Mor, Michal Sarfaty, Dimitri Bragilovski, Ran Ben Hur, Noa Gordon, Salomon M Stemmer, Aaron M Allen
BACKGROUND AND PURPOSE: Stereotactic body radiotherapy (SBRT) is an emerging modality for definitive treatment of Hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This retrospective study included all early stage HCC patients who were not candidates for primary resection and/or local therapy, treated with SBRT between 11/2011 and 1/2016. RESULTS: Twenty-three patients were included. The median age was 62 years; 70% males; 30% females; 70% viral hepatitis carriers; 100% cirrhotic; 13 Child Pugh [CP]-A and 10 [CP]-B...
October 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29052224/opiate-prescribing-in-hospitalized-older-adults-patterns-and-outcomes
#11
Sutapa Maiti, Liron Sinvani, Michele Pisano, Andrzej Kozikowski, Vidhi Patel, Meredith Akerman, Karishma Patel, Christopher Smilios, Christian Nouryan, Guang Qiu, Renee Pekmezaris, Gisele Wolf-Klein
BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. DESIGN: Retrospective cohort study. SETTING: Tertiary care facility. PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80...
October 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#12
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
October 19, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29051964/identification-of-quality-improvement-areas-in-pediatric-mri-from-analysis-of-patient-safety-reports
#13
Camilo Jaimes, Diana J Murcia, Karen Miguel, Cathryn DeFuria, Pallavi Sagar, Michael S Gee
BACKGROUND: Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. OBJECTIVE: To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. MATERIALS AND METHODS: In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015...
October 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29051525/virulence-characteristics-of-carbapenem-resistant-klebsiella-pneumoniae-strains-from-patients-with-necrotizing-skin-and-soft-tissue-infections
#14
Fiorella Krapp, Andrew R Morris, Egon A Ozer, Alan R Hauser
Two types of Klebsiella pneumoniae (KP) strains are currently emerging: hypervirulent (hvKP) strains and carbapenem-resistant (CR-KP) strains. To date, these two strain types rarely overlap. Recent reports, however, suggest that CR-KP strains are increasing in virulence. hvKP strains frequently present as highly invasive infections, such as necrotizing skin and soft tissue infections (NSSTI). To examine whether CR-KP strains with features of hvKP were present in our U.S. hospital, we retrospectively identified four cases of CR-KP NSSTI diagnosed between January 2012 and January 2016...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29051208/redefining-the-pulvinar-sign-in-fabry-disease
#15
S Cocozza, C Russo, A Pisani, G Olivo, E Riccio, A Cervo, G Pontillo, S Feriozzi, M Veroux, Y Battaglia, D Concolino, F Pieruzzi, R Mignani, P Borrelli, M Imbriaco, A Brunetti, E Tedeschi, G Palma
BACKGROUND AND PURPOSE: The pulvinar sign refers to exclusive T1WI hyperintensity of the lateral pulvinar. Long considered a common sign of Fabry disease, the pulvinar sign has been reported in many pathologic conditions. The exact incidence of the pulvinar sign has never been tested in representative cohorts of patients with Fabry disease. The aim of this study was to assess the prevalence of the pulvinar sign in Fabry disease by analyzing T1WI in a large Fabry disease cohort, determining whether relaxometry changes could be detected in this region independent of the pulvinar sign positivity...
October 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29049690/surgical-treatment-of-postinfarction-ventricular-septal-defect-risk-factors-and-outcome-analysis
#16
Marek Pojar, Jan Harrer, Nedal Omran, Zdenek Turek, Jana Striteska, Jan Vojacek
OBJECTIVES: Postinfarction ventricular septal defect is a serious mechanical complication of acute myocardial infarction associated with high postoperative mortality. The aim of this study was to review our experience with surgical repair of postinfarction ventricular septal defect and to identify predictors of early and late outcomes. METHODS: Thirty-nine patients (19 men and 20 women, mean age 68.4 ± 9.9 years) with postinfarction ventricular septal defect who underwent surgical repair at our institution between 1996 and 2016 were retrospectively evaluated...
August 24, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049533/association-of-antidepressant-medications-with-incident-type-2-diabetes-among-medicaid-insured-youths
#17
Mehmet Burcu, Julie M Zito, Daniel J Safer, Laurence S Magder, Susan dosReis, Fadia T Shaya, Geoffrey L Rosenthal
Importance: Antidepressants are one of the most commonly prescribed classes of psychotropic medications among US youths. For adults, there is emerging evidence on the increased risk of type 2 diabetes in association with antidepressant use. However, little is known about the antidepressant treatment-emergent risk of type 2 diabetes among youths. Objective: To assess the association between antidepressant use and the risk of incident type 2 diabetes in youths by antidepressant subclass and according to duration of use, cumulative dose, and average daily dose...
October 16, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29049457/association-of-patient-frailty-with-increased-morbidity-after-common-ambulatory-general-surgery-operations
#18
Carolyn D Seib, Holly Rochefort, Kathryn Chomsky-Higgins, Jessica E Gosnell, Insoo Suh, Wen T Shen, Quan-Yang Duh, Emily Finlayson
Importance: Frailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established. Objective: To determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations. Design, Setting, and Participants: A retrospective cohort study was conducted of 140 828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049132/one-year-survival-after-in-hospital-cardiac-arrest-does-pre-arrest-sepsis-matter
#19
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with in-hospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011-2014 (n = 607) were reviewed retrospectively to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29048133/vasa-previa-prenatal-diagnosis-and-outcomes-thirty-five-cases-from-a-single-maternal-fetal-medicine-practice
#20
Ankita Kulkarni, Jennifer Powel, Michael Aziz, Leena Shah, Susan Lashley, Carlos Benito, Yinka Oyelese
OBJECTIVES: To assess the accuracy and effectiveness of routine screening for vasa previa, to describe our experience, and to assess factors that contribute to missed cases of vasa previa. METHODS: A retrospective descriptive study of all cases of vasa previa from a single maternal-fetal medicine service between 2009 and 2017 was performed. Ultrasound findings and obstetric and neonatal outcomes were reviewed and analyzed. RESULTS: Thirty-five cases of vasa previa were identified...
October 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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