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Emergency retrospective

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https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#1
(no author information available yet)
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 24, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28231023/increasing-nocardia-incidence-associated-with-bronchiectasis-at-a-tertiary-care-center
#2
Michael H Woodworth, Jennifer L Saullo, Paul M Lantos, Gary M Cox, Jason E Stout
RATIONALE: Nocardia is a genus of pathogens that most commonly afflicts immunocompromised hosts, but may be an emerging infection among persons with bronchiectasis. OBJECTIVES: To examine the epidemiology and clinical presentation of adult patients with Nocardia and bronchiectasis relative to other patient groups. METHODS: We examined a retrospectively-assembled cohort of adults at Duke University Hospital in Durham, North Carolina with at least one positive culture from a bodily fluid or tissue specimen for Nocardia between January 1996 and December 2013...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28231021/high-complication-rate-after-introduction-of-transbronchial-cryobiopsy-into-clinical-practice-at-an-academic-medical-center
#3
David M DiBardino, Andrew R Haas, Anthony R Lanfranco, Leslie A Litzky, Daniel Sterman, Jamie L Bessich
RATIONALE: Transbronchial cryobiopsy is an emerging technique for obtaining biopsies of lung parenchyma. Despite limited evidence of safety and efficacy in direct comparison to other available biopsy procedures, pulmonologists are integrating this technique into clinical practice with the hope of avoiding the risks of surgical lung biopsy. OBJECTIVES: To report the rate of severe complications and diagnostic outcomes immediately after introduction of transbronchial cryobiopsy into the clinical practice of a single-center, high-volume, interventional pulmonary group at a large academic medical center in the United States...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230661/predicting-progression-in-barrett-s-esophagus-development-and-validation-of-the-barrett-s-esophagus-assessment-of-risk-score-bear-score
#4
Craig S Brown, Brittany Lapin, Jay L Goldstein, John G Linn, Mark S Talamonti, Joann Carbray, Michael B Ujiki
OBJECTIVE: To develop and validate a scoring tool capable of accurately predicting which patients with Barrett's esophagus (BE) will progress to dysplasia and/or esophageal adenocarcinoma. BACKGROUND: Endoscopic therapies have emerged capable of eradicating BE with high efficacy and low complication rates, but which patients should receive treatment is still debated. Current knowledge of risk factors is insufficient to allow for the accurate prediction of which patients will progress to dysplasia or adenocarcinoma...
February 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28230457/comparative-effectiveness-of-rapid-acting-insulins-in-adults-with-diabetes
#5
Patrick N Racsa, Yunus Meah, Jeffrey J Ellis, Kimberly R Saverno
BACKGROUND: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available. OBJECTIVE: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230446/economic-impact-of-treatment-duration-and-persistence-with-basal-insulin-in-previously-insulin-naive-users
#6
Samaneh Kalirai, Ran Duan, Dongju Liu, Beverly L Reed
BACKGROUND: Although insulin is a well-established therapy that is associated with improved clinical outcomes, adherence and persistence with insulin regimens are poor in patients with type 2 diabetes mellitus (T2DM). Diabetes-related health care costs and the impact of insulin persistence patterns on these health care costs have been previously studied; however, these aspects of insulin therapy have limited data beyond the first year of use and have not been characterized among patients previously naive to basal insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229224/factors-affecting-survival-of-patients-in-the-acute-phase-of-upper-cervical-spine-injuries
#7
Tomonori Morita, Tsuneo Takebayashi, Hideto Irifune, Hirofumi Ohnishi, Suguru Hirayama, Toshihiko Yamashita
INTRODUCTION: In recent years, on the one hand, the mortality rates of upper cervical spine injuries, such as odontoid fractures, were suggested to be not so high, but on the other hand reported to be significantly high. Furthermore, it has not been well documented the relationship between survival rates and various clinical features in those patients during the acute phase of injury because of few reports. This study aimed to evaluate survival rates and acute-phase clinical features of upper cervical spine injuries...
February 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28228575/risk-of-pulmonary-embolism-after-cerebral-venous-thrombosis
#8
Ava L Liberman, Alexander E Merkler, Gino Gialdini, Steven R Messé, Michael P Lerario, Santosh B Murthy, Hooman Kamel, Babak B Navi
BACKGROUND AND PURPOSE: Cerebral vein thrombosis (CVT) is a type of venous thromboembolism. Whether the risk of pulmonary embolism (PE) after CVT is similar to the risk after deep venous thrombosis (DVT) is unknown. METHODS: We performed a retrospective cohort study using administrative data from all emergency department visits and hospitalizations in California, New York, and Florida from 2005 to 2013. We identified patients with CVT or DVT and the outcome of PE using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification codes...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228344/emergency-department-return-visits-within-a-large-geographic-area
#9
Mimi Truong, Garth Meckler, Quynh H Doan
BACKGROUND: Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area. OBJECTIVE: We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228342/evaluation-of-the-implementation-of-the-south-african-triage-system-at-an-academic-hospital-in-central-haiti
#10
Shada A Rouhani, Emily Aaronson, Angella Jacques, Sandy Brice, Regan H Marsh
BACKGROUND: Effective triage is an important part of high quality emergency care, yet is frequently lacking in resource-limited settings. The South African Triage Scale (SATS) is designed for these settings and consists of a numeric score (triage early warning score, TEWS) and a list of clinical signs (known as discriminators). Our objective was to evaluate the implementation of SATS at a new teaching hospital in Haiti. METHODS: A random sample of emergency department charts from October 2013 were retrospectively reviewed for the completeness and accuracy of the triage form, correct calculation of the triage score, and final patient disposition...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28228205/long-term-surgical-outcome-of-trocar-site-hernia-repair
#11
Yoon-Hye Kwon, Eun Kyung Choe, Seung-Bum Ryoo, Jeong-Ki Kim, Kyu Joo Park
Port site hernias are emerging as a problematic complication of laparoscopic surgery. The aim of this study was to elucidate the characteristics of port site hernias and determine the long-term outcomes based on the interval between primary surgery and hernia occurrence. Twenty-four patients were surgically treated for trocar site hernia between 1997 and 2013. The patients were grouped into early-onset group (EOG; less than one month) and late-onset group (LOG; more than one month) based on the interval between laparoscopic surgery and hernia onset...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28228138/current-management-practices-for-patients-presenting-with-low-back-pain-to-a-large-emergency-department-in-canada
#12
Matthew L Nunn, Jill A Hayden, Kirk Magee
BACKGROUND: Low back pain (LBP) is one of the leading causes of disability. Presentations to the emergency department (ED) are common and consume significant healthcare resources. However, treatment of patients with LBP is variable and highly physician dependent. Our study objective was to describe the demographic and clinical characteristics of patients presenting to the ED with LBP, the diagnostic strategies employed by ED physicians, and the subsequent management. METHODS: We conducted a retrospective study using clinical and electronic health data at the Queen Elizabeth II Health Science Center's Charles V...
February 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#13
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28225051/low-muscle-mass-at-initiation-of-anti-tnf-therapy-for-inflammatory-bowel-disease-is-associated-with-early-treatment-failure-a-retrospective-analysis
#14
D Q Holt, P Varma, B J G Strauss, A S Rajadurai, G T Moore
BACKGROUND/OBJECTIVES: Delayed treatment failure occurs in a significant proportion of inflammatory bowel disease (IBD) patients treated with tumor necrosis factor-alpha (TNF) antagonists. Identification of predictors of loss of response (LOR) may help to optimize therapy. We sought to determine whether body composition parameters at the commencement of anti-TNF therapy were associated with earlier treatment failure. SUBJECTS/METHODS: A retrospective cohort study was performed on 68 patients who had undergone cross-sectional abdominal imaging coincident with the commencement of anti-TNF drugs...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28223728/levothyroxine-therapy-and-impaired-clearance-are-the-strongest-contributors-to-small-intestinal-bacterial-overgrowth-results-of-a-retrospective-cohort-study
#15
Thorsten Brechmann, Andre Sperlbaum, Wolff Schmiegel
AIM: To identify a set of contributors, and weight and rank them on a pathophysiological basis. METHODS: Patients who have undergone a lactulose or glucose hydrogen breath test to rule out small intestinal bacterial overgrowth (SIBO) for various clinical symptoms, including diarrhoea, weight loss, abdominal pain, cramping or bloating, were seen as eligible for inclusion in a retrospective single-centre study. Clinical data such as co-morbidities, medication, laboratory parameters and other possible risk factors have been identified from the electronic data system...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223070/-repeated-poisoning-episodes-alarm-sign-of-risk-situations
#16
Elsa García González, Victoria Trenchs Sainz de la Maza, Lidia Martínez Sánchez, Nuria Ferrer Bosch, Carles Luaces Cubells
INTRODUCTION: Prevention is an essential aspect in paediatric poisonings, especially when recurrent episodes are detected. The aims of this article are to detect the recurrence rate for suspected poisoning in emergency consultations, as well as to identify the cases in which specific preventive measures are indicated, and to determine whether the creation of a specific item for recurrent episodes in the computerised medical records system facilitates its detection. MATERIAL AND METHODS: A retrospective study was conducted on patients less than 18 years of age treated in the emergency room due to suspected poisoning during 2013 and 2014...
February 18, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#17
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#18
Michael W Hubble, Clark Tyson
: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28221242/disseminated-intravascular-coagulation-in-emergency-department-patients-with-primary-postpartum-hemorrhage
#19
Chang Hwan Sohn, So Ra Kim, Youn-Jung Kim, Dong Woo Seo, Shin Ahn, Yoon-Seon Lee, Jae Ho Lee, Bum Jin Oh, Hye-Sung Won, Jae-Yoon Shim, Kyoung-Soo Lim, Won Young Kim
The aim of this study was to evaluate the prevalence of disseminated intravascular coagulation and to determine whether the presence of disseminated intravascular coagulation is associated with major adverse events in patients with primary postpartum hemorrhage who present to the emergency department.This retrospective case-control study was conducted in the emergency department of a university-affiliated, tertiary referral center between January 1, 2004 and December 31, 2013. Patients were classified into disseminated intravascular coagulation (disseminated intravascular coagulation score ≥ 5) and non-disseminated intravascular coagulation groups...
February 17, 2017: Shock
https://www.readbyqxmd.com/read/28221049/childhood-gender-typed-behavior-and-adolescent-sexual-orientation-a-longitudinal-population-based-study
#20
Gu Li, Karson T F Kung, Melissa Hines
Lesbian and gay individuals have been reported to show more interest in other-sex, and/or less interest in same-sex, toys, playmates, and activities in childhood than heterosexual counterparts. Yet, most of the relevant evidence comes from retrospective studies or from prospective studies of clinically referred, extremely gender nonconforming children. In addition, findings are mixed regarding the relation between childhood gender-typed behavior and the later sexual orientation spectrum from exclusively heterosexual to exclusively lesbian/gay...
February 20, 2017: Developmental Psychology
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