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https://www.readbyqxmd.com/read/28086867/process-evaluation-of-an-integrated-care-pathway-in-geriatric-rehabilitation-for-people-with-complex-health-problems
#1
Irma H J Everink, Jolanda C M van Haastregt, Jose M C Maessen, Jos M G A Schols, Gertrudis I J M Kempen
BACKGROUND: An integrated care pathway in geriatric rehabilitation was developed to improve coordination and continuity of care for community-living older adults in the Netherlands, who go through the process of hospital admission, admission to a geriatric rehabilitation facility and discharge back to the home situation. This pathway is a complex intervention and is focused on improving communication, triage and transfers of patients between the hospital, geriatric rehabilitation facility and primary care organisations...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28077253/a-survey-of-patients-with-bed-bugs-in-the-emergency-department
#2
Johnathan M Sheele, Stephanie Gaines, Nicholas Maurer, Katirina Coppolino, Jennifer S Li, Amy Pound, Jeffrey H Luk, Ed Mandac
Bed bugs are one of the most important human ectoparasites in the United States, and a growing problem in the emergency department. We evaluated 40 emergency department (ED) patients found with a bed bug. The data show that ED patients with bed bugs are statistically more likely to be male, older, more likely to be admitted to the hospital, have higher triage emergency severity index (ESI) scores, and arrive by ambulance than the general ED patient population (p<0.05). On average bed bugs were found 108min after a patient arrived to the ED, after 35% of subjects had already received a blood draw, and after 23% had already received a radiology study; putting other ED patients and staff at risk for acquiring the infestation...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28076252/a-clinical-aid-for-detecting-skin-cancer-the-triage-amalgamated-dermoscopic-algorithm-tada
#3
T Rogers, M L Marino, S W Dusza, S Bajaj, R P Usatine, M A Marchetti, A A Marghoob
PURPOSE: Family physicians (FPs) frequently evaluate skin lesions but may not have the necessary training to accurately and confidently identify lesions that require skin biopsy or specialist referral. We evaluated the diagnostic performance of a new, simplified dermoscopy algorithm for skin cancer detection. METHODS: In this cross-sectional, observation study, attendees of a dermoscopy course evaluated 50 polarized dermoscopy images of skin lesions (27 malignant and 23 benign) using the Triage Amalgamated Dermoscopic Algorithm (TADA)...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28073650/the-utilisation-of-one-district-hospital-emergency-department-by-people-with-parkinson-s-disease
#4
Marion Harris, Margaret Fry
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder in Australia and the economic burden is more than $8.3 billion a year and predicted to escalate. However, little is known of the trends and characteristics of people with Parkinson's disease presenting to emergency departments (ED). METHOD: The study design was a 12 month retrospective medical record audit. The study was conducted in one metropolitan 300 bed district hospital in an outer suburb of Sydney...
January 7, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28073583/clinical-factors-associated-with-subclinical-spread-of-in-situ-melanoma
#5
Thuzar M Shin, Jeremy R Etzkorn, Joseph F Sobanko, David J Margolis, Joel M Gelfand, Emily Y Chu, Rosalie Elenitsas, Waqas R Shaikh, Christopher J Miller
BACKGROUND: Subclinical spread of in situ melanoma occurs at a wide frequency, ranging from 12% to 71%. OBJECTIVE: To identify clinical factors associated with subclinical spread of in situ melanoma. METHODS: We used a retrospective, cross-sectional study of 674 consecutive in situ melanomas to examine 627 patients treated with Mohs surgery and melanoma antigen recognized by T cells 1 immunostaining. The presence of subclinical spread was correlated with clinical characteristics...
January 7, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#6
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28065200/testing-the-start-triage-protocol-can-it-improve-the-ability-of-nonmedical-personnel-to-better-triage-patients-during-disasters-and-mass-casualties-incidents
#7
Stefano Badiali, Aimone Giugni, Lucia Marcis
OBJECTIVE: START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. METHODS: In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group)...
January 9, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28062332/psychosocial-concerns-in-the-postoperative-oncology-patient
#8
REVIEW
Elizabeth Ercolano
OBJECTIVES: To describe psychosocial concerns associated with the postoperative cancer patient and to discuss current psychosocial evidence-based approaches to manage these psychosocial concerns. DATA SOURCES: Published peer-reviewed literature. CONCLUSION: The postoperative phase of cancer care may be associated with a range of overlapping acute and chronic psychosocial concerns related to the surgery itself, the cancer diagnosis, and the need for ongoing cancer treatments...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28059860/diagnosis-and-treatment-of-upper-airway-oedema-caused-by-acute-angio-oedema-in-the-emergency-department-a-french-consensus-statement
#9
Bernard Floccard, Nicolas Javaud, Alban Deroux, Isabelle Boccon-Gibod, Olivier Fain, Stéphanie Amarger, Claire Blanchard-Delaunay, Pierre Y Jeandel, Nicolas Marmion, Yann Ollivier, Pauline Pralong, Stéphane Gayet, Aurélie Du-Thanh, Fabien Pelletier, Laurent Sailler, Philip Robinson, David Launay, Laurence Bouillet
Angio-oedema is a transitory, localized, noninflammatory oedema of subcutaneous tissue or mucous. When the oedema affects the mouth, lips, tongue or larynx, it can result in fatal asphyxiation in the absence of specific treatment. Oedema secondary to plasma extravasation is usually mediated by either histamine or bradykinin. As laboratory tests are not available in an emergency setting, the implicated mediator cannot be readily determined. The challenge for the emergency physician is to determine the aetiological type, evaluate severity and initiate adapted treatment by means of a structured approach...
January 4, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28059838/comparison-of-the-prognostic-significance-of-initial-blood-lactate-and-base-deficit-in-trauma-patients
#10
Mathieu Raux, Yannick Le Manach, Tobias Gauss, Romain Baumgarten, Sophie Hamada, Anatole Harrois, Bruno Riou, Jacques Duranteau, Olivier Langeron, Jean Mantz, Catherine Paugam-Burtz, Bernard Vigue
BACKGROUND: Initial blood lactate and base deficit have been shown to be prognostic biomarkers in trauma, but their respective performances have not been compared. METHODS: Blood lactate levels and base deficit were measured at admission in trauma patients in three level 1 trauma centers. This was a retrospective analysis of prospectively acquired data. The association of initial blood lactate and base deficit with mortality was tested using receiver operating characteristics curve, logistic regression using triage scores (Revised Trauma Score and Mechanism Glasgow scale and Arterial Pressure score), and Trauma Related Injury Severity Score as a reference standard...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28059233/cytopathological-image-analysis-using-deep-learning-networks-in-microfluidic-microscopy
#11
G Gopakumar, K Hari Babu, Deepak Mishra, Sai Siva Gorthi, Gorthi R K Sai Subrahmanyam
Cytopathologic testing is one of the most critical steps in the diagnosis of diseases, including cancer. However, the task is laborious and demands skill. Associated high cost and low throughput drew considerable interest in automating the testing process. Several neural network architectures were designed to provide human expertise to machines. In this paper, we explore and propose the feasibility of using deep-learning networks for cytopathologic analysis by performing the classification of three important unlabeled, unstained leukemia cell lines (K562, MOLT, and HL60)...
January 1, 2017: Journal of the Optical Society of America. A, Optics, Image Science, and Vision
https://www.readbyqxmd.com/read/28057320/chief-complaints-of-elderly-individuals-on-presentation-to-emergency-department-a-retrospective-analysis-of-south-korean-national-data-2014
#12
Misoon Song, Xianglan Jin, Ha Na Ko, Sunghee H Tak
PURPOSE: We aimed to assess the chief complaints (CCs) of elderly individuals on presentation to the emergency department (ED) according to gender, age, and disease-related and injury-related visits. METHODS: The 2014 registry database of the National Emergency Department Information System in South Korea, which included data on 908,761 ED visits by individuals aged 65 years and over, was reviewed. RESULTS: We found that 80.7% ED visits were related to disease, whereas the remaining visits were related to injury...
December 2016: Asian Nursing Research
https://www.readbyqxmd.com/read/28057048/a-preliminary-study-of-a-novel-emergency-department-nursing-triage-simulation-for-research-applications
#13
Steven L Dubovsky, Daniel Antonius, David G Ellis, Werner Ceusters, Robert C Sugarman, Renee Roberts, Sevie Kandifer, James Phillips, Elsa C Daurignac, Kenneth E Leonard, Lisa D Butler, Jessica P Castner, G Richard Braen
BACKGROUND: Studying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28057029/the-norwegian-guidelines-for-the-prehospital-management-of-adult-trauma-patients-with-potential-spinal-injury
#14
REVIEW
Daniel K Kornhall, Jørgen Joakim Jørgensen, Tor Brommeland, Per Kristian Hyldmo, Helge Asbjørnsen, Thomas Dolven, Thomas Hansen, Elisabeth Jeppesen
The traditional prehospital management of trauma victims with potential spinal injury has become increasingly questioned as authors and clinicians have raised concerns about over-triage and harm. In order to address these concerns, the Norwegian National Competence Service for Traumatology commissioned a faculty to provide a national guideline for pre-hospital spinal stabilisation. This work is based on a systematic review of available literature and a standardised consensus process. The faculty recommends a selective approach to spinal stabilisation as well as the implementation of triaging tools based on clinical findings...
January 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28055239/the-evolving-role-of-pathology-in-new-developments-classification-terminology-and-diagnosis-of-pancreatobiliary-neoplasms
#15
Michelle D Reid, Melinda M Lewis, Field F Willingham, Volkan Adsay
Pancreatobiliary tract lesions are increasingly being discovered because of more sensitive imaging modalities. Magnetic resonance imaging has identified incidental pancreatic cysts in 13.5% of patients of progressively increasing age. Pancreatobiliary tissue is more accessible through endoscopic ultrasound and magnetic resonance imaging-guided biopsy procedures, and is now an integral part of pathologists' routine practice. Accordingly, several new tumor categories have been recently recognized, including intraductal tubulopapillary neoplasm, a new addition to tumoral intraepithelial neoplasms...
January 5, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#16
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
January 4, 2017: Gut
https://www.readbyqxmd.com/read/28052328/type-dependent-association-between-risk-of-cervical-intraepithelial-neoplasia-and-viral-load-of-oncogenic-human-papillomavirus-types-other-than-types-16-and-18
#17
Long Fu Xi, Mark Schiffman, Yang Ke, James P Hughes, Denise A Galloway, Zhonghu He, Ayaka Hulbert, Rachel L Winer, Laura A Koutsky, Nancy B Kiviat
Studies of the clinical relevance of human papillomavirus (HPV) DNA load have focused mainly on HPV16 and HPV18. Data on other oncogenic types are rare. Study subjects were women enrolled in the Atypical Squamous Cells of Undetermined Significance (ASC-US) and Low-Grade Squamous Intraepithelial Lesion (LSIL) Triage Study who had ≥1 of 11 non-HPV16/18 oncogenic types detected during a 2-year follow-up at 6-month intervals. Viral load measurements were performed on the first type-specific HPV-positive specimens...
January 4, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#18
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28050447/current-status-of-role-of-serum-amylase-and-lipase-to-triage-blunt-pancreatic-trauma
#19
Abhishek Mahajan
No abstract text is available yet for this article.
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28050223/geriatric-homelessness-association-with-emergency-department-utilization
#20
Ana Hategan, Daniel Tisi, Mariam Abdurrahman, James A Bourgeois
BACKGROUND: Homeless adults frequently use emergency departments (EDs), yet previous studies investigating ED utilization by the older segment received little attention. This study sought to characterize older homeless adults who utilized local urban EDs. METHODS: ED encounters at three hospitals in Hamilton (Ont.) were analyzed, and demographic and clinical characteristics of the older homeless (age > 50) vs. younger counterparts (age ≤ 50) were compared during a 24-month period...
December 2016: Canadian Geriatrics Journal: CGJ
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