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Emergency retrospective

Fabian Grasss, Basile Pache, David Martin, Valérie Addor, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines advocate early postoperative mobilisation to counteract catabolic changes due to immobilisation and maintain muscle strength. The present study aimed to assess compliance to postoperative mobilisation according to ERAS recommendations. MATERIALS AND METHODS: This is a retrospective cohort study on consecutive colorectal surgical procedures treated within an established ERAS protocol within a single center between May 2011 and May 2017...
June 20, 2018: International Journal of Surgery
Ralph M Turner, Qinli Ma, Kate Lorig, Jay Greenberg, Andrea R DeVries
BACKGROUND: An estimated 30.3 million Americans have diabetes mellitus. The US Department of Health and Human Services created national objectives via its Healthy People 2020 initiative to improve the quality of life for people who either have or are at risk for diabetes mellitus, and hence, lower the personal and national economic burden of this debilitating chronic disease. Diabetes self-management education interventions are a primary focus of this initiative. OBJECTIVE: The aim of this study was to evaluate the impact of the Better Choices Better Health Diabetes (BCBH-D) self-management program on comorbid illness related to diabetes mellitus, health care utilization, and cost...
June 22, 2018: Journal of Medical Internet Research
Daniel Ospina-Delgado, Laura Marcela Mosquera Salas, Alejandro Enríquez-Marulanda, Jaime Hernández-Morales, Robinson Pacheco, Javier Lobato-Polo
OBJECTIVE: This study aims to describe cases of traumatic brain injury due to gunshot wounds in civilian population over 18 years of age, treated at a referral hospital in Cali, Colombia and compare the clinical outcomes at discharge. METHODS: An observational, descriptive cross-sectional study was conducted by retrospectively collecting clinical data related to adult patients that presented traumatic brain injury due to civil gunshot-wounds and that consulted to the emergency room at Fundación Valle del Lili Hospital in Cali, Colombia between January 2010 and February of 2016...
June 19, 2018: Neurocirugía
Charles W Hwang, Desmond E Fitzpatrick, Torben K Becker, Jason M Jones
BACKGROUND: Freestanding emergency departments (FSED) are equipped to care for most emergencies, but do not have all the resources that hospital-based emergency departments (ED) offer. As the number of FSEDs grows rapidly, emergency medical services (EMS) must routinely determine whether a FSED is an appropriate destination. Inappropriate triage may delay definitive care, potentially increasing morbidity, mortality, and resource utilization. We sought to evaluate paramedics' ability in determining whether a FSED is the most appropriate destination...
June 12, 2018: American Journal of Emergency Medicine
Ayako Shiba, Shigehiko Uchino, Tomoko Fujii, Masanori Takinami, Shoichi Uezono
BACKGROUND: Acute kidney injury (AKI) occurs in 6.1%-22.4% of patients undergoing major noncardiac surgery. Previous studies have shown no association between intraoperative urine output and postoperative acute renal failure. However, these studies used various definitions of acute renal failure. We therefore investigated the association between intraoperative oliguria and postoperative AKI defined by the serum creatinine criteria of the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) classification...
June 20, 2018: Anesthesia and Analgesia
Jessica Keim-Malpass, Kyle B Enfield, James Forrest Calland, Douglas E Lake, Matthew T Clark
Predictive analytics monitoring that informs clinicians of the risk for failed extubation would help minimize both the duration of mechanical ventilation and the risk of emergency re-intubation in ICU patients. We hypothesized that dynamic monitoring of cardiorespiratory data, vital signs, and lab test results would add information to standard clinical risk factors. To develop predictive analytic models for patients who failed extubation in critical care settings in an academic medical center using standard and novel risk factors...
June 22, 2018: Physiological Measurement
Ahmet Bindayi, Michelle L Mcdonald, Alp T Beksac, Gerant Rivera-Sanfeliz, Ahmed Shabaik, Fiona Hughes, Lejla Aganovic, Donna E Hansel, Ithaar H Derweesh
OBJECTIVE: To investigate the utility of multiphase computed tomography (CT) and percutaneous renal mass biopsy (PRMB) in differentiating between papillary renal cell carcinoma (pRCC)-Type 1 and -Type 2, as emerging data have suggested differential enhancement patterns in different renal tumor histologies. MATERIAL AND METHODS: Retrospective analysis of 51 patients (23 pRCC-Type 1/28 pRCC-Type 2) who underwent multiphase CT followed by surgery from July 2011 to April 2016 was performed...
July 2018: Turkish Journal of Urology
Dong-Hun Kang, Woong Yoon, Seul Kee Kim, Byung Hyun Baek, Yun Young Lee, Yong-Won Kim, Yong-Sun Kim, Yang-Ha Hwang, Joon-Tae Kim, Man Seok Park
OBJECTIVE The optimal treatment strategy for patients with emergent large vessel occlusion (ELVO) due to underlying severe intracranial atherosclerotic stenosis (ICAS) is unclear. The purpose of this study was to compare treatment outcomes from intracranial angioplasty with or without stenting and intraarterial infusion of a glycoprotein IIb/IIIa inhibitor in patients with ELVO due to severe ICAS, and to investigate predictors of outcome after endovascular therapy in such patients. METHODS A total of 140 consecutive patients with ELVO attributable to severe ICAS underwent endovascular therapy at two stroke centers (A and B)...
June 22, 2018: Journal of Neurosurgery
Orgest Lajthia, Jerry W Chao, Max Mandelbaum, John S Myseros, Chima Oluigbo, Suresh N Magge, Christopher S Zarella, Albert K Oh, Gary F Rogers, Robert F Keating
OBJECTIVE Intracranial empyema is a life-threatening condition associated with a high mortality rate and residual deleterious neurological effects if not diagnosed and managed promptly. The authors present their institutional experience with immediate reimplantation of the craniotomy flap and clarify the success of this method in terms of cranial integrity, risk of recurrent infection, and need for secondary procedures. METHODS A retrospective analysis of patients admitted for management of intracranial empyema during a 19-year period (1997-2016) identified 33 patients who underwent emergency drainage and decompression with a follow-up duration longer than 6 months, 23 of whom received immediate bone replacement...
June 22, 2018: Journal of Neurosurgery. Pediatrics
Matteo Danielis, Martina Chittaro, Amato De Monte, Giulio Trillò, Davide Durì
BACKGROUND: The reporting and analysing of data of out-of-hospital cardiac arrests encourages the quality improvement of the emergency medical services. For this reason, the establishment of a sufficiently large patient database is intended to allow analysis of resuscitation treatments for out-of-hospital cardiac arrests and performances of different emergency medical services. AIMS: The aim of this study was to describe the demographics, characteristics, outcomes and determinant factors of survival for patients who suffered an out-of-hospital cardiac arrest...
June 1, 2018: European Journal of Cardiovascular Nursing
Gurinder Singh, Amitesh Agarwal, Wei Zhang, Yong-Fang Kuo, Rizwana Sultana, Gulshan Sharma
OBJECTIVE: Growing evidence supports that patients with chronic obstructive pulmonary disease (COPD) and coexisting obstructive sleep apnea (OSA) have poor prognosis. This association is described as overlap syndrome. Positive airway pressure (PAP) therapy is now the preferred treatment for OSA. We hypothesized that use of PAP therapy in elderly patients with overlap syndrome would be associated with lower healthcare utilization. METHODS: In this retrospective cohort study, we analyzed data from 5% national sample of fee-for-service Medicare beneficiaries with a diagnosis of COPD who were newly started on PAP therapy in 2011...
June 22, 2018: Sleep & Breathing, Schlaf & Atmung
Christine M McDonald, Sarah West, David Dushenski, Stephen E Lapinsky, Christine Soong, Kate van den Broek, Melanie Ashby, Gillian Wilde-Friel, Carrie Kan, Mark McIntyre, Andrew Morris
Objective: To develop a triage-based screening algorithm and treatment order-sets aimed at improving the quality of care of all patients with sepsis presenting to our emergency department (ED). Design: Retrospective cohort study conducted during a pre-intervention period from 1 April 2010 to 31 March 2011 and a post-intervention period from 1 September 2014 to 30 April 2015. Setting: A large teaching hospital located in Toronto, Ontario, Canada with a 35-bed ED...
June 20, 2018: International Journal for Quality in Health Care
Gozde Gundogdu Meydaneri, Sertac Meydaneri
Background Neutrophil lymphocyte rate (NLR), platelet lymphocyte rate (PLR), and systemic immune inflammatory index (SIII) are rates obtained from hemogram parameters, and they are biomarkers used for the diagnoses of many diseases and their severity, and prediction of disease. In addition to the NLR, PLR, and SIII, platelets, plateletcrit (PCT), and platelet distribution width (PDW), which are platelet indices, are also investigated as biomarkers in many diseases. There are limited studies on the use of hemogram derivates (NLR, PLR, and SIII) in the diagnosis and severity determination of psychiatric disorders...
April 19, 2018: Curēus
Shannon McConville, Alyssa C Mooney, Brie A Williams, Renee Y Hsia
OBJECTIVE: To assess the patterns of emergency department (ED) utilisation among those with and without criminal justice contact in California in 2014, comparing variation in ED use, visit frequency, diagnoses and insurance coverage. DESIGN: Retrospective, cross-sectional study. SETTING: Analyses included ED visits to all licensed hospitals in California using statewide data on all ED encounters in 2014. PARTICIPANTS: Study participants included 3 757 870 non-elderly adult ED patients who made at least one ED visit in 2014...
June 21, 2018: BMJ Open
Yen-Fu Cheng, Yuan-Chia Chu, Tzong-Yang Tu, An-Suey Shiao, Shang-Liang Wu, Wen-Huei Liao
BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is an emergency clinical otology condition defined as hearing loss greater than 30 dB over three consecutive frequencies within 72 h. We aimed to integrate pretreatment hearing grades with reports of treatment recovery outcomes of SSNHL using the modified Siegel's criteria. METHODS: This was a retrospective cohort study comprising 110 patients with SSNHL seen between January 2014 and January 2015. The patients were treated with combined systemic and intra-tympanic steroid therapy...
June 18, 2018: Journal of the Chinese Medical Association: JCMA
Norihiko Kamioka, Vasilis Babaliaros, Michael Andrew Morse, Tiberio Frisoli, Stamatios Lerakis, Jose Miguel Iturbe, Jose Binongo, Frank Corrigan, Altayyeb Yousef, Patrick Gleason, John A Wells, Hope Caughron, Andy Dong, Evelio Rodriguez, Bradley Leshnower, William O'Neill, Gaetano Paone, Marvin Eng, Robert Guyton, Peter C Block, Adam Greenbaum
OBJECTIVES: There are minimal data regarding clinical outcomes and echocardiographic findings after transcatheter mitral valve-in-valve replacement (TMVR) compared with redo surgical mitral valve replacement (SMVR). BACKGROUND: TMVR therapy has emerged as therapy for a degenerated bioprosthetic valve failure. METHODS: The authors retrospectively identified patients with degenerated mitral bioprostheses who underwent redo SMVR or TMVR at 3 U...
June 25, 2018: JACC. Cardiovascular Interventions
Eleonora Iob, Clemens Kirschbaum, Andrew Steptoe
INTRODUCTION: While positive social support is associated with lower prevalence of disease and better treatment outcomes, negative social relationships can instead have unfavourable consequences for several physical and mental health conditions. However, the specific mechanisms by which this nexus might operate remain poorly understood. Hypothalamic-pituitary-adrenal (HPA) axis hyperactivity owing to psychosocial stress has been proposed as a potential pathway underlying the link between social support and health...
June 12, 2018: Psychoneuroendocrinology
Sunao Kojima, Kensaku Nishihira, Misa Takegami, Yoko M Nakao, Satoshi Honda, Jun Takahashi, Morimasa Takayama, Hiroaki Shimokawa, Tetsuya Sumiyoshi, Hisao Ogawa, Kazuo Kimura, Satoshi Yasuda
Background: Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database...
September 2018: IJC Heart & Vasculature
Sabine Flommersfeld, Carsten Mand, Christian A Kühne, Gregor Bein, Steffen Ruchholtz, Ulrich J Sachs
Background: Immediate supply of red blood cell (RBC) concentrates is crucial in the initial treatment of exsanguinating patients in the emergency room. General shortage of RhD- RBCs has led to protocols in which patients with unknown blood groups are initially transfused with group O, RhD+ RBCs. Limited data are available regarding the safety of such an approach. Methods: Transfusion protocols for all multiple injured patients from the regional polytrauma database were retrospectively analyzed over a period of 5 years...
May 2018: Transfusion Medicine and Hemotherapy
Samuel H Kim, Nimesh Patel, Kanika Thapar, Ananda V Pandurangadu, Amit Bahl
Objectives: Greater saphenous vein (GSV) thrombosis is concerning due to its close proximity to the deep femoral vein. This study sought to identify the risk of propagation to deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients with isolated proximal GSV superficial thrombosis and describe provider practice patterns related to treatment. Materials and methods: This is an Institutional Review Board-approved retrospective multi-center study. Patients presented to one of three possible emergency departments in a large health system...
2018: Vascular Health and Risk Management
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