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https://www.readbyqxmd.com/read/29341110/eurogin-roadmap-2017-triage-strategies-for-the-management-of-hpv-positive-women-in-cervical-screening-programmes
#1
REVIEW
K Cuschieri, G Ronco, A Lorincz, L Smith, G Ogilvie, L Mirabello, F Carozzi, H Cubie, N Wentzensen, P Snijders, M Arbyn, J Monsonego J, S Franceschi
Cervical cancer screening will rely, increasingly, on HPV testing as a primary screen. The requirement for triage tests which can delineate clinically significant infection is thus prescient. In this EUROGIN 2017 roadmap, justification behind the most evidenced triages is outlined, as are challenges for implementation. Cytology is the triage with the most follow-up data; the existence of an HR-HPV positive, cytology negative group presents a challenge and re-testing intervals for this group (and choice of re-test) require careful consideration...
January 17, 2018: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29340526/simulating-the-behavior-of-patients-who-leave-a-public-hospital-emergency-department-without-being-seen-by-a-physician-a-cellular-automaton-and-agent-based-framework
#2
Milad Yousefi, Moslem Yousefi, F S Fogliatto, R P M Ferreira, J H Kim
The objective of this study was to develop an agent based modeling (ABM) framework to simulate the behavior of patients who leave a public hospital emergency department (ED) without being seen (LWBS). In doing so, the study complements computer modeling and cellular automata (CA) techniques to simulate the behavior of patients in an ED. After verifying and validating the model by comparing it with data from a real case study, the significance of four preventive policies including increasing number of triage nurses, fast-track treatment, increasing the waiting room capacity and reducing treatment time were investigated by utilizing ordinary least squares regression...
January 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29338968/an-alternative-tool-for-triaging-patients-with-possible-acute-coronary-symptoms-before-admission-to-a-chest-pain-unit
#3
Kuang-Chau Tsai, Ray F Lin, Chieh Lee, Ai-Hsien Li
OBJECTIVE: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU). METHODS: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression. RESULTS: The ACS triage model, logit (suspected ACS patient)=-5...
December 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335793/accuracy-of-emergency-department-triage-using-the-emergency-severity-index-and-independent-predictors-of-under-triage-and-over-triage-in-brazil-a-retrospective-cohort-analysis
#4
Jeremiah S Hinson, Diego A Martinez, Paulo S K Schmitz, Matthew Toerper, Danieli Radu, James Scheulen, Sarah A Stewart de Ramirez, Scott Levin
BACKGROUND: Emergency department (ED) triage is performed to prioritize care for patients with critical and time-sensitive illness. Triage errors create opportunity for increased morbidity and mortality. Here, we sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each. METHODS: This was a single-center retrospective cohort study. The accuracy of initial ESI score assignment was determined by comparison with a score entered at the close of each ED encounter by treating physicians with full knowledge of actual resource utilization, disposition, and acute outcomes...
January 15, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29334826/patient-safety-culture-in-out-of-hours-primary-care-services-in-the-netherlands-a-cross-sectional-survey
#5
Marleen Smits, Ellen Keizer, Paul Giesen, Ellen Catharina Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik
OBJECTIVE: To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. DESIGN: Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services...
January 15, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29334564/validating-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-risk-stratification-of-surgical-inpatients-in-the-postoperative-setting-retrospective-cohort-study
#6
Bartlomiej Bartkowiak, Ashley M Snyder, Andrew Benjamin, Andrew Schneider, Nicole M Twu, Matthew M Churpek, Kevin K Roggin, Dana P Edelson
OBJECTIVE: Assess the accuracy of 3 early warning scores for predicting severe adverse events in postoperative inpatients. SUMMARY OF BACKGROUND DATA: Postoperative clinical deterioration on inpatient hospital services is associated with increased morbidity, mortality, and cost. Early warning scores have been developed to detect inpatient clinical deterioration and trigger rapid response activation, but knowledge regarding the application of early warning scores to postoperative inpatients is limited...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#7
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero López, Concepción González Herrero, Paula López Vázquez, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29330606/the-associations-of-poor-psychiatric-well-being-among-incarcerated-men-with-injecting-drug-use-histories-in-victoria-australia
#8
Reece Cossar, Mark Stoové, Stuart A Kinner, Paul Dietze, Campbell Aitken, Michael Curtis, Amy Kirwan, James R P Ogloff
BACKGROUND: Dual substance dependence and psychiatric and psychological morbidities are overrepresented in prison populations and associated with reoffending. In the context of an increasing prison population in Australia, investigating the needs of vulnerable people in prison with a dual diagnosis can help inform in-prison screening and treatment and improve prison and community service integration and continuation of care. In this study we quantified psychiatric well-being in a sample of people in prison with a history of injecting drug use in Victoria, Australia, and identified factors associated with this outcome...
January 13, 2018: Health & Justice
https://www.readbyqxmd.com/read/29327350/adopting-innovation-in-gynaecology-the-introduction-of-e-consult
#9
Rebecca Mann, Peter H M van de Weijer
OBJECTIVE: To describe the development of an e-consultation service as part of the triaging and grading process of referrals and to report on the efficacy and safety of such a service. METHODS: All gynaecology e-consults in the study period June 2015 to March 2016 were retrospectively reviewed. The outcomes of interest were the initial reduction in first face-to-face hospital visits, and the rate of re-referrals. Acute admission for the same reason, a subsequent diagnosis of underlying (pre)-malignancy, or patient death from the condition related to the index referral were selected as measures for patient safety...
January 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29326039/a-descriptive-study-of-registered-nurses-application-of-the-triage-scale-retts%C3%A2-a-swedish-reliability-study
#10
Sara C Wireklint, Carina Elmqvist, Nicola Parenti, Katarina E Göransson
BACKGROUND: From a patient safety perspective, it is of great importance that decision support systems such as triage scales are evidence based. In the most recent national survey, the majority of Swedish Emergency Departments (EDs) apply the Swedish triage scale known as the Medical Emergency Triage Treatment Scale (METTS), subsequently renamed the Rapid Emergency Triage Treatment Scale (RETTS©). Despite national widespread implementation, there has been limited research on METTS/RETTS©...
January 8, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29325520/factors-associated-with-low-patient-satisfaction-in-out-of-hours-primary-care-in-denmark-a-population-based-cross-sectional-study
#11
Mette Tranberg, Peter Vedsted, Bodil Hammer Bech, Morten Bondo Christensen, Søren Birkeland, Grete Moth
BACKGROUND: Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction. METHODS: The study was based on data from a 1-year population-based survey of OOH-PC (LV-KOS) in the Central Denmark Region in 2010-2011...
January 11, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#12
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324469/parafibromin-deficient-hpt-jt-type-cdc73-mutated-parathyroid-tumors-demonstrate-distinctive-morphologic-features
#13
Anthony J Gill, Grace Lim, Veronica K Y Cheung, Juliana Andrici, Joanna L Perry-Keene, Julie Paik, Loretta Sioson, Adele Clarkson, Amy Sheen, Catherine Luxford, Marianne S Elston, Goswin Y Meyer-Rochow, M Teresa Nano, Schelto Kruijff, Anton F Engelsman, Mark Sywak, Stanley B Sidhu, Leigh W Delbridge, Bruce G Robinson, Deborah J Marsh, Christopher W Toon, Angela Chou, Roderick J Clifton-Bligh
The gene CDC73 (previously known as HRPT2) encodes the protein parafibromin. Biallelic mutation of CDC73 is strongly associated with malignancy in parathyroid tumors. Heterozygous germline mutations cause hyperparathyroidism jaw tumor syndrome,which is associated with a high life-time risk of parathyroid carcinoma. Therefore loss of parafibromin expression by immunohistochemistry may triage genetic testing for hyperparathyroidism jaw tumor syndrome and be associated with malignant behavior in atypical parathyroid tumors...
January 10, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#14
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
January 11, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29321339/detection-of-anterior-circulation-large-artery-occlusion-in-ischemic-stroke-using-noninvasive-cerebral-oximetry
#15
Alexander C Flint, Shiv G Bhandari, Sean P Cullen, Adhikari V Reddy, Daniel P Hsu, Vivek A Rao, Minal Patel, Jasmeen Pombra, Nancy J Edwards, Sheila L Chan
BACKGROUND AND PURPOSE: Large artery occlusion (LAO) in ischemic stroke requires recognition and triage to an endovascular stroke treatment center. Noninvasive LAO detection is needed to improve triage. METHODS: Prospective study to test whether noninvasive cerebral oximetry can detect anterior circulation LAO in acute stroke. Interhemispheric ΔBrSO2 in LAO was compared with controls. RESULTS: In LAO stroke, mean interhemispheric ΔBrSO2 was -8...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#16
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29320313/acute-radiologic-manifestations-of-america-s-opioid-epidemic
#17
David D B Bates, Katherine Gallagher, HeiShun Yu, Jennifer Uyeda, Akira M Murakami, Bindu N Setty, Stephan W Anderson, Mariza O Clement
The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29320160/efforts-aimed-to-reduce-attrition-in-antimalarial-drug-discovery-a-systematic-evaluation-of-current-antimalarial-targets-portfolio
#18
María Jesus Chaparro, Felix Calderon, Pablo Castañeda, Elena Fernandez Alvaro, Raquel Gabarro, Francisco-Javier Gamo, María G Gómez-Lorenzo, Julio Martín, Esther Fernandez
Malaria remains a major global health problem. In 2015 alone, more than 200 million cases of malaria were reported, and more than 400,000 deaths occurred. Since 2010, emerging resistance to current front-line ACTs (Artemisinin Combination Therapies) has been detected in endemic countries. Therefore, there is an urgency for new therapies based on novel modes of action, able to relieve symptoms as fast as the artemisinins and/or block malaria transmission. During the past few years, the antimalarial community has focused their efforts on phenotypic screening as a pragmatic approach to identify new hits...
January 10, 2018: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29319593/effects-of-interruptions-on-triage-process-in-emergency-department-a-prospective-observational-study
#19
Kimberly D Johnson, Gordon L Gillespie, Kimberly Vance
For 130 million people seeking emergency treatment in the United States, incomplete or inaccurate triage examination can result in delays, which could compromise patient outcomes. The purpose of this study was to identify triage interruptions and determine how interruptions affect the triage process. A significant difference was seen in triage duration between interrupted and uninterrupted interviews. Understanding the impact of interruptions on patient outcomes will allow nurses and other health care providers to develop interventions to mitigate the impact...
January 9, 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29319365/the-prognostic-value-of-mid-regional-pro-adrenomedullin-in-the-evaluation-of-acute-dyspnea
#20
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
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