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https://www.readbyqxmd.com/read/28096039/the-impact-of-emergency-medical-services-in-acute-heart-failure
#1
Pia Harjola, James Boyd, Tuukka Tarvasmäki, Juho Mattila, Reijo Koski, Markku Kuisma, Veli-Pekka Harjola
BACKGROUND: Real-life data on the role of emergency medical services (EMS) in acute heart failure (AHF) are scarce. Our aim was to describe prehospital treatment of AHF and to compare patients using EMS with self-presented, non-EMS patients. METHODS: Data were collected retrospectively from three university hospitals in Helsinki metropolitan area between July 1, 2012 and July 31, 2013. According to the use of EMS, patients were divided into EMS and non-EMS groups...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28096032/creation-of-an-intensive-care-unit-and-organizational-changes-in-an-adult-emergency-department-impact-on-acute-stroke-management
#2
Laurent Puy, Chantal Lamy, Sandrine Canaple, Audrey Arnoux, Nicolas Laine, Ella Iacob, Jean-Marc Constans, Olivier Godefroy
BACKGROUND AND PURPOSE: Following the reorganization of a University Medical Center onto a single campus, an Intensive Care Unit was created within the adult Emergency Department (ED ICU). We assessed the effects of these organizational changes on acute stroke management and the intravenous administration of recombinant tissue plasminogen activator (IV rtPA), as characterized by the thrombolysis rate, door-to-needle time (DNT) and outcome at 3months. METHODS: Between October 2013 and September 2015, we performed a retrospective, observational, single-center, comparative study of patients admitted for ischemic stroke and treated with IV rtPA during two 321-day periods (before and after the creation of the ED ICU)...
January 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28091839/impact-of-the-2014-2015-influenza-season-on-the-activity-of-an-academic-emergency-department
#3
Nicolas Beysard, Bertrand Yersin, Pascal Meylan, Olivier Hugli, Pierre-Nicolas Carron
The morbidity and mortality of the 2014-2015 influenza season were more important than those in previous years. We assessed the impact of the 2014-2015 influenza season on the length of stay (LOS) and workload in an academic emergency department (ED). This is a monocentric retrospective study. The database of the microbiology laboratory was used to identify influenza nasal swabs performed during the influenza seasons from 2010 to 2015. Patients admitted to the ED during these periods were identified through the administrative database and cross-checked with patients who underwent an influenza nasal swab in the ED...
January 16, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28079461/building-the-evidence-base-for-tele-emergency-care-efforts-to-identify-a-standardized-set-of-outcome-measures
#4
Yael Harris, Boyd Gilman, Marcia M Ward, Jonathan Ladinsky, Jacqueline Crowley, Cannon Warren, Craig Caplan
BACKGROUND: To enhance the quality of emergency department (ED) care, some rural hospitals have adopted the use of telemedicine (tele-ED). Without a common set of metrics, it is difficult to quantify the impact of this technology. INTRODUCTION: To address this limitation, the Health Resources and Services Administration funded the identification and testing of a core set of measures that could be used to build a business case for the value of tele-ED care. METHODS: A comprehensive environmental scan was conducted to identify existing measures relevant to assessing ED care and the use of telemedicine...
January 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28075692/comparing-emergency-department-use-among-medicaid-and-commercial-patients-using-all-payer-all-claims-data
#5
Hyunjee Kim, K John McConnell, Benjamin C Sun
The high rate of emergency department (ED) use by Medicaid patients is not fully understood. The objective of this paper is (1) to provide context for ED service use by comparing Medicaid and commercial patients' differences across ED and non-ED health service use, and (2) to assess the extent to which Medicaid-commercial differences in ED use can be explained by observable factors in administrative data. Statistical decomposition methods were applied to ED, mental health, and inpatient care using 2011-2013 Medicaid and commercial insurance claims from the Oregon All Payer All Claims database...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28072664/clinical-pathway-effectiveness-febrile-young-infant-clinical-pathway-in-a-pediatric-emergency-department
#6
Ashlee Lynn Murray, Elizabeth Alpern, Jane Lavelle, Cynthia Mollen
OBJECTIVE: Young infants are often treated in emergency departments (EDs) for febrile illnesses. Any delay in care or ineffective management could lead to increased patient morbidity and mortality. A standardized ED clinical pathway may improve care for these patients. The objective of this study is to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care. METHODS: This study used a before-and-after retrospective observational study design comparing 2 separate periods: prepathway from September 2007 through August 2008 and postpathway from September 2009 through August 2010...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28069483/epinephrine-use-in-older-patients-with-anaphylaxis-clinical-outcomes-and-cardiovascular-complications
#7
Takahisa Kawano, Frank Xavier Scheuermeyer, Robert Stenstrom, Brian H Rowe, Eric Grafstein, Brian Grunau
BACKGROUND: There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. METHODS: This retrospective cohort study was conducted at two urban emergency departments (ED) over a 5 year-period, and included adults who met a pre-specified criteria for anaphylaxis. Patients≥50years of age were defined as "older". Univariate logistic regression was performed to compare the difference in frequency of epi administration between the "older" and "younger" groups...
January 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28068917/emergency-department-presentations-for-atrial-fibrillation-and-flutter-in-alberta-a-large-population-based-study
#8
Rhonda J Rosychuk, Michelle M Graham, Brian R Holroyd, Brian H Rowe
BACKGROUND: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta. METHODS: Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Data extracted included demographics, ED visit timing, and subsequent visits to non-ED settings...
January 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28066825/a-blinded-randomised-placebo-controlled-trial-investigating-the-efficacy-of-morphine-analgesia-for-procedural-pain-in-infants-trial-protocol
#9
Rebeccah Slater, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E Norman, Chetan Patel, Kayleigh Stanbury, Amy Hoskin, Gabrielle Green
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia...
November 15, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28065773/using-the-electronic-medical-record-to-identify-patients-at-high-risk-for-frequent-ed-visits-and-high-system-costs
#10
David W Frost, Shankar Vembu, Jiayi Wang, Karen Tu, Quaid Morris, Howard B Abrams
BACKGROUND: A small proportion of patients accounts for a very high proportion of healthcare utilization. Accurate pre-emptive identification may facilitate tailored intervention. We sought to determine whether Machine Learning techniques using text from a family practice Electronic Medical Record (EMR) can be used to predict future high Emergency Department (ED) use and total costs by patients who are not yet high ED users or high cost to the healthcare system. METHODS: Text from fields of the Cumulative Patient Profile within an EMR (PS Suite) of 43,111 patients was indexed...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28046080/the-annual-burden-of-seasonal-influenza-in-the-us-veterans-affairs-population
#11
Yinong Young-Xu, Robertus van Aalst, Ellyn Russo, Jason K H Lee, Ayman Chit
Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population...
2017: PloS One
https://www.readbyqxmd.com/read/28045940/applying-the-integrated-practice-unit-concept-to-a-modified-virtual-ward-model-of-care-for-patients-at-highest-risk-of-readmission-a-randomized-controlled-trial
#12
Lian Leng Low, Shu Yun Tan, Matthew Joo Ming Ng, Wei Yi Tay, Lee Beng Ng, Kanchana Balasubramaniam, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Emerging evidence from the virtual ward care model showed that multidisciplinary case management are inadequate to reduce readmissions or death for high risk patients. There is consensus that interventions should encompass both pre-hospital discharge and post-discharge transitional care to be effective. Integrated practice units (IPU) had been proposed as an approach of restructuring the organization and work processes of multidisciplinary teams to achieve value in healthcare...
2017: PloS One
https://www.readbyqxmd.com/read/28044424/ocular-nerve-growth-factor-administration-modulates-brain-derived-neurotrophic-factor-signaling-in-prefrontal-cortex-of-healthy-and-diabetic-rats
#13
Pamela Rosso, Sara De Nicolò, Valentina Carito, Marco Fiore, Angela Iannitelli, Sandra Moreno, Paola Tirassa
AIMS: Nerve growth factor (NGF) eyedrops (ed-NGF) activate brain neurons, stimulate growth factors, including brain-derived neurotrophic factor (BDNF), and exert neuroprotection in the forebrain of streptozotocin-induced diabetic rats (STZ rats). In this study, the effects of ed-NGF on BDNF signaling in the prefrontal cortex (PFC) were explored in healthy and STZ-diabetic rats, in which cortical neuronal and axonal loss, and altered circulating BDNF associated with depressive phenotype are also described...
January 3, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28041853/stem-cells-in-male-sexual-dysfunction-are-we-getting-somewhere
#14
REVIEW
Mohammad Ayodhia Soebadi, Uros Milenkovic, Emmanuel Weyne, Fabio Castiglione, Maarten Albersen
INTRODUCTION: Stem cells for sexual disorders are steadily being introduced into clinical trials. Two conditions of importance are the main target for this line of treatment, especially when regarding the wide array of translational and basic science highlighting the potential advantages of regenerative therapy: erectile dysfunction (ED) and more recently Peyronie disease (PD). Cellular therapy offers a treatment modality that might reverse disease progression. It would be used in a curative setting, in contrast to other pharmaceutical agents that are currently available...
December 29, 2016: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28032826/variation-in-emergency-department-transfer-rates-from-nursing-homes-in-ontario-canada
#15
Andrea Gruneir, Susan E Bronskill, Alice Newman, Chaim M Bell, Peter Gozdyra, Geoffrey M Anderson, Paula A Rochon
BACKGROUND: Nursing home (NH) residents are frequently transferred to the emergency department (ED) but there is little data on inter-facility variation, which has implications for intervention planning and implementation. OBJECTIVES: To describe variation in ED transfer rates (TRs) across NHs and the association with NH characteristics. DESIGN/SETTING: Retrospective cohort study using linked administrative data from Ontario. PARTICIPANTS: 71,780 residents of 604 NHs in 2010 and followed for one year...
November 2016: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28028867/the-clinical-status-and-economic-savings-associated-with-remission-among-patients-with-rheumatoid-arthritis-leveraging-linked-registry-and-claims-data-for-synergistic-insights
#16
Jeffrey R Curtis, Lang Chen, Jeffrey D Greenberg, Leslie Harrold, Meredith L Kilgore, Joel M Kremer, Daniel H Solomon, Huifeng Yun
INTRODUCTION: Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. METHODS: We used Corrona linked to Medicare data to identify RA patients. Time varying disease activity was measured using Clinical Disease Activity Index (CDAI); outcomes included all-cause hospitalization, a composite of hospitalization or emergency department (ED) visits, mortality, and medical costs...
December 28, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28017774/identification-of-esterase-involved-in-the-metabolism-of-two-corticosteroid-soft-drugs
#17
Ahmed Samir, Nicholas Bodor, Teruko Imai
The soft drug approach is successful in obtaining high local therapeutic efficacy without systemic adverse effects, because soft drugs are designed to be bioconverted to inactive form by hydrolytic enzymes in systemic circulation. However, there is little information about the exact nature of these metabolic enzymes. In this study, the human enzymes for biotransformation of soft drugs were investigated. Loteprednol etabonate (LE) and etiprednol dicloacetate (ED) were designed from Δ(1)-cortienic acid (Δ(1)-CA), the inactive metabolite of prednisolone, by introducing two labile ester bonds to restore the corticosteroidal activity...
December 22, 2016: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28004512/a-rapid-access-clinic-to-improve-delivery-of-ambulatory-care-to-cancer-patients
#18
James C Kuo, Madhawa De Silva, Chandra Diwakarla, Desmond Yip
BACKGROUND: Cancer patients may find it challenging to access timely advice and care. We evaluated the improvement in delivering ambulatory care in establishing a Rapid Assessment Clinic (RAC) in a cancer center. METHODS: Patients receiving chemotherapy who presented for assessment at the RAC from September 2013 to June 2014 were included for review. Patient demographics, tumor characteristics, presenting complaints, time to assessment, total time spent at the RAC and assessment outcome were extracted...
December 22, 2016: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28003036/improving-pediatric-education-for-emergency-medical-services-providers-a-qualitative-study
#19
Seth A Brown, Theresa C Hayden, Kimberly A Randell, Lara Rappaport, Michelle D Stevenson, In K Kim
OBJECTIVES: Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. METHODS: Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural)...
December 22, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27998640/vaccine-coverage-and-adherence-to-epi-schedules-in-eight-resource-poor-settings-in-the-mal-ed-cohort-study
#20
Christel Hoest, Jessica C Seidman, Gwenyth Lee, James A Platts-Mills, Asad Ali, Maribel Paredes Olortegui, Pascal Bessong, Ram Chandyo, Sudhir Babji, Venkata Raghava Mohan, Dinesh Mondal, Mustafa Mahfuz, Estomih R Mduma, Emanuel Nyathi, Claudia Abreu, Mark A Miller, William Pan, Carl J Mason, Stacey L Knobler
BACKGROUND: Launched in 1974, the Expanded Program on Immunization (EPI) is estimated to prevent two-three million deaths annually from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus. Additional lives could be saved through better understanding what influences adherence to the EPI schedule in specific settings. METHODS: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study followed cohorts in eight sites in South Asia, Africa, and South America and monitored vaccine receipt over the first two years of life for the children enrolled in the study...
January 11, 2017: Vaccine
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