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https://www.readbyqxmd.com/read/29149379/efficacy-of-systemic-and-intratympanic-corticosteroid-combination-therapy-versus-intratympanic-or-systemic-therapy-in-patients-with-idiopathic-sudden-sensorineural-hearing-loss-a-randomized-controlled-trial
#1
Mohammadtaghi Khorsandi Ashtiani, Farzad Firouzi, Shahin Bastaninejad, Sasan Dabiri, Sevil Nasirmohtaram, Niloufar Saeedi, Hossein Ghazavi, Leyla Sahebi
OBJECTIVE: The present study was conducted to compare the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies. STUDY DESIGN: Triple-blind randomized clinical trial. SETTINGS: Tertiary referral hospital. SUBJECTS AND METHODS: A total of 112 patients who were admitted to the ENT emergency department randomly divided into three groups: an oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group)...
November 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29149124/how-do-you-adapt-your-plans-for-a-nursing-career-when-the-unexpected-occurs
#2
Nadia Spawn
I graduated nursing school seven months pregnant in November 2015. My plans were to take the NCLEX immediately, give birth, take three months to adjust, and begin my nursing career in a glamorous emergency department position by the spring.
 Fast forward to January 2016. My family lost three members in a car accident and my daughter was born high-needs, requiring multiple hospitalizations. Although she and my family needed me, I was anxious about taking too much time off after nursing school, which could delay my career advancement...
December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29129835/how-do-deaf-adults-define-quality-of-life
#3
Emilee R McAbee, Erik Drasgow, K Alisa Lowrey
Six deaf adults defined quality of life (QOL) in personal interviews. Questions were based on an eight-domain QOL framework: physical well-being, emotional well-being, interpersonal relations, social inclusion, personal development, material well-being, self-determination, and rights (Schalock & Alonso, 2002). The interview process had three phases. First, a pilot study (N = 3) evaluated the questions for logic, clarity, and applicability. Next, six deaf adults participated in videotaped, structured interviews...
2017: American Annals of the Deaf
https://www.readbyqxmd.com/read/29128989/infant-mortality-lessons-learned-from-a-fetal-and-infant-mortality-review-program
#4
Haywood L Brown, Mark Smith, Yvonne Beasley, Teri Conard, Anne Lise Musselman, Virginia A Caine
Objective To review fetal and infant deaths from women enrolled in Indianapolis Healthy Start using the National Fetal and Infant Mortality Review (FIMR) methods to provide strategies for prevention. METHODS: Marion County Public Health Department (MCPHD) FIMR staff identified and reviewed 22 fetal and infant deaths to Indianapolis Healthy Start program participants between 2005 and 2012. Trained FIMR nurses completed 13 of 20 maternal interviews and compiled case summaries of all deaths from the MCPHD FIMR database...
November 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29127225/exploring-the-characteristics-of-the-high-cost-population-from-the-family-perspective-a-cross-sectional-study-in-jiangsu-province-china
#5
Yudong Miao, Dongfu Qian, Sandeep Sandeep, Ting Ye, Yadong Niu, Dan Hu, Liang Zhang
BACKGROUND: Across a range of healthcare settings, 5% of the population accounts for half of healthcare spending: these patients are identified as a 'high-cost population'. Characterising high-cost users is essential for predicting potential high-cost patients and the development of appropriate interventions to improve the management and financing of these patients. OBJECTIVE: This cross-sectional study aimed to explore the characteristics of this high-cost population from a family perspective in China and provide suggestions for social health insurance policy development...
November 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/29126579/chest-pain-as-a-manifestation-of-hypokalemia-in-a-pediatric-patient
#6
Jonathan S Schiffman
Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease...
November 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29126365/suicidal-ideation-suicide-attempts-and-psychological-distress-among-intoxicated-adolescents-in-the-pediatric-emergency-department
#7
Varpu Puuskari, Terhi Aalto-Setälä, Erkki Komulainen, Mauri Marttunen
BACKGROUND: Studies have emphasized screening for psychiatric disorders, especially suicide risk in emergency departments. Psychiatric disorders and experimentation with alcohol increase in adolescence and intoxications among patients challenge the staff in emergency departments. AIMS: This study examined the degree of suicidal ideation (SI) and suicidal behavior in adolescents, and the extent to which they differed from non-suicidal patients in terms of alcohol use, psychological distress, self-esteem, and perceived social support...
November 10, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/29120839/mental-health-follow-up-after-deliberate-self-harm-and-risk-for-repeat-self-harm-and-death
#8
Jon Hunter, Robert Maunder, Paul Kurdyak, Andrew S Wilton, Andrea Gruneir, Simone Vigod
Morbidity and mortality after deliberate self-harm (DSH) are high, so mental health care shortly after DSH is recommended. Using population-level health data we determined the association between a mental health visit and risk for repeat DSH with or without intensive care unit (ICU) admission or all-cause death. Over two years, 23,140 individuals had emergency department treatment for DSH. Within 30 days, 10.7% had a family physician mental health visit, 17.1% visited a psychiatrist, 3.6% visited both and 68...
September 13, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#9
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29108757/prevalence-and-features-of-asthma-in-young-adults-in-urban-areas-of-argentina
#10
Sergio J Arias, Hugo Neffen, Juan Carlos Bossio, Carina A Calabrese, Alejandro J Videla, Gustavo A Armando, Joseph M Antó
OBJECTIVE: To investigate the burden of asthma in a young adult population in urban areas of Argentina. DESIGN: A nationwide telephone survey in subjects aged 20-44 years was performed in urban areas in Argentina. The European Community Respiratory Health Survey questionnaire was used. Asthma was defined as an exacerbation in the last year or use of asthma medications. RESULTS: In total, 1,521 subjects responded (62.4% females, mean age 33 years), of whom 91 were classified as asthmatics (5...
November 3, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29105289/predictors-of-care-for-patients-with-cancer-of-unknown-primary-site-in-three-australian-hospitals
#11
Simon Y S Tan, Siobhan O'Neill, David Goldstein, Robyn L Ward, Benjamin Daniels, Claire M Vajdic
AIM: Cancer of unknown primary site (CUP) is a medically challenging malignancy with a poor prognosis. We describe an incident tertiary CUP patient cohort and identify factors predictive of specific types of health care. METHODS: We reviewed the medical records of 217 patients diagnosed with CUP (2006-2011) in three public hospitals in New South Wales, Australia. We systematically abstracted data and performed multivariable logistic regression to identify factors predictive of tumor biopsy, surgery, chemotherapy, radiotherapy and palliative care...
November 3, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29102746/associations-of-herbs-and-nonvitamin-dietary-supplements-use-with-clinical-outcomes-among-adult-and-pediatric-patients-with-asthma-in-the-united-states
#12
Nan Huo, Jingjing Qian
BACKGROUND: Herbs and nonvitamin dietary supplements (NVDS) have been commonly used among patients with asthma, yet evidence of their impact on patients' clinical outcomes is limited. OBJECTIVE: This study examined the associations of herbs and NVDS use with asthma episodes and asthma-related emergency department (ED) visits among US adults and pediatric patients with asthma. METHODS: A cross-sectional analysis of the 2012 National Health Interview Survey data included 2,930 US adults and 1923 children with self-reported asthma...
November 1, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29099699/epidemiological-features-of-the-perinatal-risk-factors-and-neonatal-outcomes-in-georgia-pilot-study
#13
N Tskimanauri, N Khachapuridze, T Chanadiri, S Bakhtadze
The purpose of this work was to identify and evaluate the epidemiological features, like the point prevalence of the perinatal risk factors and related to them pathological conditions revealing at the neonatal period. The descriptive population based prospective pilot study of children population of age 0-2 years was con-ducted in the City Tbilisi (in clinical centers "Medcapital", "family center N3" and "Valeo"), also in medical centers of districts of Mtsketa and Dusheti in period January 2015- January 2017...
October 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29095782/a-rare-case-of-infantile-myofibromatosis-presenting-to-the-emergency-department-as-undiagnosed-long-bone-fractures
#14
Melissa A McGuire, Phyllis L Hendry, Nancy Hong
Infantile myofibromatosis is a disorder of mesenchymal tumors that usually presents within the first 2 years of life. Most patients initially present because of the presence of visible or palpable subcutaneous tumors. We report a case of a fussy 5-week-old infant who presented to an emergency department with bilateral femur fractures initially thought to be due to nonaccidental trauma or a metabolic bone disorder. She was ultimately diagnosed after admission with infantile myofibromatosis after taking an extensive family history and after further laboratory and radiologic evaluation...
November 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29080483/implementation-and-evaluation-of-health-passport-communication-tools-in-emergency-departments
#15
Marina Heifetz, Yona Lunsky
BACKGROUND: People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. AIMS: To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario...
October 25, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/29078976/abnormal-uterine-bleeding-including-coagulopathies-and-other-menstrual-disorders
#16
REVIEW
Efthimios Deligeoroglou, Vasileios Karountzos
Abnormal Uterine Bleeding (AUB) is a frequent cause of visits to the emergency department and a major reason for concern among adolescents and their families. The most common cause of AUB, in otherwise healthy adolescents, is ovulatory dysfunction, although 5-36% of adolescents who present with heavy menstrual bleeding, have an underlying bleeding disorder (BD). The most common form of BDs is von Willebrand Disease, reflecting 13% of adolescents with AUB. Management of AUB depends on the underlying etiology, the bleeding severity, as well as the need for hospitalization...
October 9, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29075301/insulinoma-masquerading-as-a-loss-of-consciousness-in-a-teenage-girl-case-report-and-literature-review
#17
Meghana Gudala, Mahmuda Ahmed, Rushika Conroy, Ksenia Tonyushkina
BACKGROUND: Hypoglycemia due to a pancreatic beta cell neoplasm - insulinoma, is uncommon with only a few cases described. We report on a previously healthy 15-year-old Hispanic female with insulinoma who presented with a loss of consciousness due to hypoglycemia unawareness. CASE PRESENTATION: EM was first brought to the emergency department (ED) after she was found unresponsive at home with point of care (POC) glucose of 29 mg/dL(1.6 mmol/L) documented by emergency medical services (EMS) upon arrival...
2017: International Journal of Pediatric Endocrinology
https://www.readbyqxmd.com/read/29074734/the-impact-of-out-of-hospital-models-of-care-on-paediatric-emergency-department-presentations
#18
Russell M Viner, Frances Blackburn, Francesca White, Randy Mannie, Tracy Parr, Sara Nelson, Claire Lemer, Anna Riddell, Mando Watson, Francesca Cleugh, Michelle Heys, Dougal S Hargreaves
OBJECTIVE: To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP). DESIGN: Observational study. PATIENTS & SETTING: Data collected prospectively on 3020 CYP 0â€"17.9 years from 6 London EDs during 14 days by 25 supernumerary clinicians. CYP with transient acute illness, exacerbation of long-term condition (LTC), complex LTC/disability and injury/trauma were considered manageable within OOHM...
October 26, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29069916/the-impact-of-visibility-on-teamwork-collaborative-communication-and-security-in-emergency-departments-an-exploratory-study
#19
Arsalan Gharaveis, D Kirk Hamilton, Debajyoti Pati, Mardelle Shepley
The aim of this study was to examine the influence of visibility on teamwork, collaborative communication, and security issues in emergency departments (EDs). This research explored whether with high visibility in EDs, teamwork and collaborative communication can be improved while the security issues will be reduced. Visibility has been regarded as a critical design consideration and can be directly and considerably impacted by ED's physical design. Teamwork is one of the major related operational outcomes of visibility and involves nurses, support staff, and physicians...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/29066187/a-case-of-primary-adrenal-failure-in-the-emergency-department
#20
Al Giwa
BACKGROUND: Primary adrenal failure is considered to be an extremely rare disease presenting in the ED, with an incidence reported to be as low as 50 cases per 1,000,000 persons (Klauer, 2017). I would like to present a case of a young man who presented to the ED, with what I suspected to be this rare entity. CASE REPORT: A 26year old otherwise healthy male presented to our ED with complaints of weakness, nausea, vomiting, and hiccups of 1.5-day duration. He also complained of lightheadedness, describing it as if he was going to pass out...
October 16, 2017: American Journal of Emergency Medicine
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