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https://www.readbyqxmd.com/read/29782079/the-dipep-diagnosis-of-pe-in-pregnancy-study-an-observational-study-of-the-diagnostic-accuracy-of-clinical-assessment-d-dimer-and-chest-x-ray-for-suspected-pulmonary-embolism-in-pregnancy-and-postpartum
#1
Steve Goodacre, Kimberley Horspool, Catherine Nelson-Piercy, Marian Knight, Neil Shephard, Fiona Lecky, Steven Thomas, Beverley J Hunt, Gordon Fuller
OBJECTIVE: To identify clinical features associated with PE diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women. DESIGN: Observational cohort study augmented with additional cases. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites and maternity units in the United Kingdom Obstetric Surveillance System (UKOSS). POPULATION: 324 pregnant/postpartum women with suspected PE and 198 pregnant/postpartum women with diagnosed PE...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29779550/peer-workers-in-the-behavioral-and-integrated-health-workforce-opportunities-and-future-directions
#2
Cheryl A Gagne, Wanda L Finch, Keris J Myrick, Livia M Davis
The growth of the peer workforce in behavioral health services is bringing opportunities to organizations and institutions that serve people living with mental and substance use disorders and their families. Peer workers are defined as people in recovery from mental illness or substance use disorders or both that possess specific peer support competencies. Similar roles are identified for families of people in recovery. Peer support has been implemented in a vast range of behavioral health services, including in the relatively new use of peer support in criminal justice and emergency service environments...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#3
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#4
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767402/connecting-refugees-to-medical-homes-through-multi-sector-collaboration
#5
Lemaat Michael, Alexandra K Brady, Greg Russell, Scott D Rhodes, Shahla Namak, Laura Cody, Andrea Vasquez, Andrea Caldwell, Jennifer Foy, Julie M Linton
As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative's impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (n = 285) were included...
May 16, 2018: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29766127/grey-s-anatomy-effect-television-portrayal-of-patients-with-trauma-may-cultivate-unrealistic-patient-and-family-expectations-after-injury
#6
Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
Background: Expectations of the healthcare experience may be influenced by television dramas set in the hospital workplace. It is our perception that the fictional television portrayal of hospitalization after injury in such dramas is misrepresentative. The purpose of this study was to compare trauma outcomes on television dramas versus reality. Methods: We screened 269 episodes of Grey's Anatomy , a popular medical drama. A television (TV) registry was constructed by collecting data for each fictional trauma portrayed in the television series...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29762334/toddler-s-paralysis-an-acute-case-of-leg-stiffening-in-a-previously-healthy-2-year-old
#7
Kimberly Renee Kahne, Ee Tein Tay
Vegetarian and vegan diets are gaining popularity in the United States. Although appropriately planned vegetarian diets, including vegan diets, are healthful and nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases, not all families are aware of the nutritional supplements that may be required for their children. We describe a case of a 2-year-old previously healthy child consuming a vegan diet who presented to the pediatric emergency department with an acute inability to move her legs...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#8
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29760857/retrospective-chart-review-of-synthetic-cannabinoid-intoxication-with-toxicologic-analysis
#9
Payal Sud, Miles Gordon, Laura Tortora, Matthew Stripp, Damon Borg, Adam Berman
Introduction: Use of synthetic cannabinoids (SC) has recently emerged as a new drug epidemic. Our emergency departments (EDs) received a surge of SC users presenting with lethargy and bradycardia, contrasting prior reports of SC-induced tachycardia and agitation. Our goal was to describe these novel presentations and characterize the compounds. Methods: We present a case series of patients with SC intoxication who presented to our toxicology service covering two tertiary care EDs between 2/11/2015 and 6/23/2015...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753581/preoperative-risk-score-for-the-prediction-of-mortality-after-repair-of-ruptured-abdominal-aortic-aneurysms
#10
Brandon T Garland, Patrick J Danaher, Sarasi Desikan, Nam T Tran, Elina Quiroga, Niten Singh, Benjamin W Starnes
OBJECTIVE: Even in the ruptured endovascular aneurysm repair first era, there are still patients who will not survive their ruptured abdominal aortic aneurysm (rAAA). All previously published mortality risk scores include intraoperative variables and are not helpful with the decision to operate or in providing preoperative patient and family counseling. The purpose of this study was to develop a practical preoperative risk score to predict mortality after repair of rAAA. METHODS: Data of all patients with rAAA presenting between January 1, 2002, and October 31, 2013, were collected...
May 9, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#11
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29752844/exploring-family-members-experiences-during-a-death-process-in-the-emergency-department-a-grounded-theory-study
#12
Carme Berbís-Morelló, Gerard Mora-López, Marta Berenguer-Poblet, Laia Raigal-Aran, Pilar Montesó-Curto, Carme Ferré-Grau
AIMS AND OBJECTIVES: To identify which are the needs arised from feelings, perceptions, and experiences of the family members during any time within the death process in an emergency service of an acute care hospital, with regards to the assistance received. BACKGROUND: The publications refer to the needs expressed by bereaved families, who explain the support they received right after the death of a relative in an emergency service, and during the months after the tragedy...
May 12, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29751600/inflamed-phylloides-tumour-in-a-girl-a-challenging-diagnosis-in-paediatric-breast-lesions
#13
Ilaria Testa, Cristina Salvatori, Marco Prestipino, Maria Elena Laurenti, Paolo Gerli, Giuseppe Di Cara, Nicola Principi, Susanna Esposito, Mirko Bertozzi
Introduction : Phylloides tumours (PTs) are rare fibroepithelial neoplasms that account for 0.3⁻0.9% of all breast tumours. These tumours typically occur in women aged 30⁻70 years. The occurrence of these tumours in older children and adolescents poses particular diagnostic and therapeutic problems. However, early diagnosis is mandatory because although most of the cases of PTs in children are benign, the borderline and malignant cases with potential negative outcomes cannot be excluded. Case presentation : A 12-year-old girl presented at the Paediatric Emergency Department for hyperaemia and warmth of the left breast that occurred a few days prior without fever...
May 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29746538/use-of-the-emergency-department-by-refugees-under-the-interim-federal-health-program-a-health-records-review
#14
Francis Bakewell, Sarah Addleman, Garth Dickinson, Venkatesh Thiruganasambandamoorthy
INTRODUCTION: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. METHODS: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits where an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011-2013)...
2018: PloS One
https://www.readbyqxmd.com/read/29742059/autoinflammatory-diseases-as-a-cause-of-acute-abdominal-pain-in-the-emergency-department
#15
REVIEW
Giovanni Maconi, Laura Obici, Stefania Carmagnola, Stefano Guzzetti
Autoinflammatory diseases (AIDs) usually present with acute abdominal pain and fever, both of which are also the main causes of referral in the emergency department. As some patients with acute abdominal pain may be discharged from the emergency department without a definitive diagnosis, it is not surprising that, due to their rarity, most cases of AID remain undiagnosed or are misdiagnosed as acute appendicitis. Indeed, the diagnosis of familial Mediterranean fever and autoinflammatory syndromes requires a high index of suspicion and careful assessment of clinical history...
January 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29739759/reflex-anoxic-seizures-ras-in-an-adult-patient-a-separate-entity-from-epilepsy
#16
Laith Cebe, Harpreet Singh
Reflex anoxic seizures (RAS) are essential in the differential diagnosis of non-epileptic paroxysmal seizures. They are precipitated by vagally mediated brief cardiac asystole, which in turn leads to transient cerebral ischaemia. RAS are usually seen in infants and preschool children, but in this case happened in a middle-aged man. Our patient is a 61-year-old man who presented with sudden, repeated contractions of his left upper arm and urine incontinence, followed by loss of consciousness for about 30 s...
May 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29738447/systematic-literature-review-of-attempted-suicide-and-offspring
#17
REVIEW
Ingeborg Lunde, Marte Myhre Reigstad, Kristin Frisch Moe, Tine K Grimholt
Background : Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt...
May 8, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29733982/the-giving-parents-support-study-a-randomized-clinical-trial-of-a-parent-navigator-intervention-to-improve-outcomes-after-neonatal-intensive-care-unit-discharge
#18
Cara L Carty, Lamia M Soghier, Katherine I Kritikos, Lisa K Tuchman, Michelle Jiggetts, Penny Glass, Randi Streisand, Karen R Fratantoni
Parents of infants hospitalized in a neonatal intensive care unit (NICU) experience increased anxiety and stress, which may persist after discharge. The rationale and design of a randomized clinical trial assessing the impact of a 1-year, post-discharge, peer support intervention (parent navigation) on parental mental health and infant health care utilization is described. Qualitative methods guided the adaptation of an existing parent support program to target emotional and resource-related needs of NICU families...
May 4, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29731386/characteristics-and-outcomes-of-do-not-resuscitate-patients-admitted-to-the-emergency-department-intensive-care-unit
#19
An-Yi Wang, Hon-Ping Ma, Wei-Fong Kao, Shin-Han Tsai, Cheng-Kuei Chang
BACKGROUND: Appropriate utilization of intensive care unit (ICU) beds are essential. Patients with critical illness who have do not resuscitate (DNR) have a reduced priority of intensive care. However, the possibility of recovery/survival is ambiguous and multifactorial. OBJECTIVE: To deliberate the characteristics and outcomes of critical illness in patients with prior DNR who were admitted to the emergency department (ED)-ICU. METHOD: This was a retrospective cohort study conducted between April 2015 and November 2015 in a university-based hospital...
May 3, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29731234/effective-contraception-use-by-usual-source-of-care-an-opportunity-for-prevention
#20
Martina T Caldwell, Hwajung Choi, Phillip Levy, Vanessa K Dalton, Dawn Phillips Misra
INTRODUCTION: Women using emergency departments (ED) or urgent care facilities for their usual care may lack access to contraception. This study examined the relationship between effectiveness of current contraception use (highly effective/effective methods vs. less effective/no method) and usual source of care in the clinic (referent group), urgent care, ED or none among U.S. reproductive-aged females at risk for unintended pregnancy. METHODS: Using the National Survey of Family Growth, we conducted logistic regression analyses using pooled, as well as age- and insurance-stratified data...
May 3, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
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