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https://www.readbyqxmd.com/read/29346836/emergency-demand-repeat-and-frequent-presentations-by-older-patients-in-metropolitan-melbourne-a-retrospective-cohort-study-using-routinely-collected-hospital-data
#1
Judy Lowthian, Lyle Turner, Angela Joe, Christopher Pearce, Bianca Brijnath, Colette Browning, Marianne Shearer, Danielle Mazza
OBJECTIVE: To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. METHODS: Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare; numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations...
January 18, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29346558/thoraco-abdominal-aortic-aneurysm-rupture-in-a-patient-with-shprintzen-goldberg-syndrome
#2
Naritaka Kimura, Yu Inaba, Kaori Kameyama, Hideyuki Shimizu
Shprintzen-Goldberg syndrome is a rare systemic connective tissue disorder characterized by craniosynostosis, skeletal abnormalities, infantile hypotonia, mild-to-moderate intellectual disability and cardiovascular anomalies. To our knowledge, this is the first report of a Shprintzen-Goldberg syndrome patient who developed a thoraco-abdominal aortic aneurysm. The aneurysm grew rapidly necessitating emergent thoraco-abdominal aortic replacement. The postoperative course was uneventful, and a careful lifetime follow-up was planned...
January 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29346512/validation-of-the-pids-idsa-severity-criteria-in-children-with-community-acquired-pneumonia
#3
Todd A Florin, Cole Brokamp, Rachel Mantyla, Bradley DePaoli, Richard Ruddy, Samir S Shah, Lilliam Ambroggio
Background: The Pediatric Infectious Diseases Society (PIDS)/Infectious Diseases Society of America (IDSA) guideline for community-acquired pneumonia (CAP) recommends intensive care unit (ICU) admission or continuous monitoring for children meeting severity criteria. Our objective was to validate these criteria. Methods: This was a retrospective cohort study of children age 3 months-18 years diagnosed with CAP in a pediatric Emergency Department (ED) from 9/2014-8/2015...
January 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29346354/compassion-from-a-palliative-care-perspective
#4
Antonio Fernando, Conor Rea, Phillipa J Malpas
BACKGROUND: Compassion is a core virtue in medicine and lies at the heart of good medical care. It connects us to each other and reflects our need for relationships with others. AIM: Our aim is to explore how palliative care patients perceive, understand and experience compassion from health professionals, and to inform clinical practice. METHODS: Seven hospice managers in the North Island of New Zealand were contacted and invited to join the study...
January 19, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29346333/platelet-rich-plasma-new-insights-for-cutaneous-wound-healing-management
#5
REVIEW
Deborah Chicharro-Alcántara, Mónica Rubio-Zaragoza, Elena Damiá-Giménez, José M Carrillo-Poveda, Belén Cuervo-Serrato, Pau Peláez-Gorrea, Joaquín J Sopena-Juncosa
The overall increase of chronic degenerative diseases associated with ageing makes wound care a tremendous socioeconomic burden. Thus, there is a growing need to develop novel wound healing therapies to improve cutaneous wound healing. The use of regenerative therapies is becoming increasingly popular due to the low-invasive procedures needed to apply them. Platelet-rich plasma (PRP) is gaining interest due to its potential to stimulate and accelerate the wound healing process. The cytokines and growth factors forming PRP play a crucial role in the healing process...
January 18, 2018: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/29346234/a-qualitative-study-of-multidisciplinary-providers-experiences-with-the-transfer-process-for-injured-children-and-ideas-for-improvement
#6
Marcie Gawel, Beth Emerson, John S Giuliano, Alana Rosenberg, Karl E Minges, Shelli Feder, Pina Violano, Patricia Morrell, Judy Petersen, Emily Christison-Lagay, Marc Auerbach
OBJECTIVE: Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. METHODS: This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#7
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#8
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346231/the-complex-association-of-race-ethnicity-with-pain-treatment-quality-in-an-urban-medical-center-with-2-pediatric-emergency-departments
#9
Erika M Kipping, James M Chamberlain
OBJECTIVE: This study aimed to explore racial differences in analgesia quality. METHODS: A retrospective cross-sectional study of 24,733 visits by individuals 21 years or younger with pain scores of 4 to 10 was performed using electronic medical records. We compared 2 process metrics, treatment with any analgesics within 60 minutes and treatment with opioids within 60 minutes, and one outcome metric, a reduction in pain score by 2 or more points within 90 minutes...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346222/-to-err-is-human-but-disclosure-must-be-taught-a-simulation-based-assessment-study
#10
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346193/perceptions-of-infection-risk-with-immunomodulatory-medications
#11
Rebecca Sharim, Preethi Thomas, Leny Mathew, Michael George, Misha Rosenbach
OBJECTIVES: Physicians of many specialties encounter patients treated with immunomodulatory medications and must weigh the risk of infection when making medical decisions. We explored how physician perceptions of the infection risk of immunomodulatory medications differ by specialty and level of experience. METHODS: A survey was distributed to physicians from the internal medicine, family medicine, emergency medicine, rheumatology, dermatology, and infectious disease departments at 1 tertiary care institution...
January 9, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29346142/neonatal-abstinence-syndrome-an-update
#12
Lauren A Sanlorenzo, Ann R Stark, Stephen W Patrick
PURPOSE OF REVIEW: The current review provides an update focused on the evolving epidemiology of neonatal abstinence syndrome (NAS), factors influencing disease expression, advances in clinical assessment of withdrawal, novel approaches to NAS treatment, and the emerging role of quality improvement in assessment and management of NAS. RECENT FINDINGS: The rise in the incidence of NAS disproportionately occurred in rural and suburban areas. Polysubstance exposure and genetic polymorphisms have been shown to modify NAS expression and severity...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29346039/evaluation-of-a-french-regional-telemedicine-network-dedicated-to-neurological-emergencies-a-14-year-study
#13
Elisabeth Medeiros de Bustos, Eric Berthier, Didier Chavot, Benjamin Bouamra, Thierry Moulin
BACKGROUND: Equality in healthcare between urban and rural areas is problematic in France. Telemedicine networks are expected to improve equality in expertise assessment. We aimed to evaluate the use and impact of a regional rural French telemedicine network, dedicated to medical and surgical neurological emergencies, on interhospital patient transfers. METHODS: Eight community hospital emergency departments were remotely connected to the only university hospital in Franche-Comté, France...
January 18, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29346031/2016-new-horizons-lecture-beyond-imaging-radiology-of-tomorrow
#14
Hedvig Hricak
This article is based on the New Horizons lecture delivered at the 2016 Radiological Society of North America Annual Meeting. It addresses looming changes for radiology, many of which stem from the disruptive effects of the Fourth Industrial Revolution. This is an emerging era of unprecedented rapid innovation marked by the integration of diverse disciplines and technologies, including data science, machine learning, and artificial intelligence-technologies that narrow the gap between man and machine. Technologic advances and the convergence of life sciences, physical sciences, and bioengineering are creating extraordinary opportunities in diagnostic radiology, image-guided therapy, targeted radionuclide therapy, and radiology informatics, including radiologic image analysis...
January 18, 2018: Radiology
https://www.readbyqxmd.com/read/29345516/association-between-weather-related-factors-and-cardiac-arrest-of-presumed-cardiac-etiology-a-prospective-observational-study-based-on-out-of-hospital-care-data
#15
Mario Hensel, Daniel Geppert, Jan F Kersten, Markus Stuhr, Jürgen Lorenz, Sebastian Wirtz, Thoralf Kerner
OBJECTIVE: The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Weather data (temperature, humidity, air pressure, wind speed) were obtained every minute and matched with the associated rescue mission data...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29345508/response-by-twin-italian-hub-hospitals-in-a-double-seismic-event-a-retrospective-observational-investigation
#16
Alberto Barbieri, Gabriele Melegari, Valentina Lob, Lorenzo Mazzali, Luca D'Amelio, Andrea Giovannoni, Enrico Giuliani
INTRODUCTION: The objectives of this study were to compare prevalence rates of different pathologies, ambulance system and emergency department management times, and patient survival and hazard ratios for codes 2 and 3 in two hub hospitals in Modena in the 36-month period across the stages of two major earthquakes in short sequence in Northern Italy in 2012. METHODS: Clinical records pertaining to the emergency care of patients were analyzed and only those assigned status codes 2 and 3 by ambulance professionals were included (if the assessment was confirmed by emergency department triage)...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29345427/review-article-best-practice-management-of-common-shoulder-injuries-and-conditions-in-the-emergency-department-part-4-of-the-musculoskeletal-injuries-rapid-review-series
#17
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Shoulder injuries are a commonly presenting complaint to the ED. In the absence of an obvious deformity, they can be difficult to assess and definitively diagnose because of the multiple structures that cause shoulder pain, the acuity and severity of pain and the lack of range of motion in the ED setting. The quality of ED care provided to patients with musculoskeletal shoulder pain is crucial to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common shoulder injuries and conditions in the ED...
January 18, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29345234/current-approaches-to-epistaxis-treatment-in-primary-and-secondary-care
#18
Rafael Beck, Martin Sorge, Antonius Schneider, Andreas Dietz
BACKGROUND: The lifetime prevalence of epistaxis is approximately 60%, and 6-10% of the affected persons need medical care. In rare cases, severe bleeding calls for the rapid initiation of effective treatment. METHODS: This review is based on pertinent articles that were retrieved by a selective search PubMed, and on the authors' clinical experience. RESULTS: There are no German guidelines for the management of epistaxis. The available evidence consists mainly of retro spective analyses and expert opinions...
January 8, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29345224/therapy-interventions-for-children-with-neurodisabilities-a-qualitative-scoping-study
#19
Bryony Beresford, Susan Clarke, Jane Maddison
BACKGROUND: Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015;5:e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29345207/thresholds-and-interpretations-how-clinical-competency-committees-identify-pediatric-residents-with-performance-concerns
#20
Daniel J Schumacher, Catherine Michelson, Sue Poynter, Michelle M Barnes, Su-Ting T Li, Natalie Burman, Daniel J Sklansky, Lynn Thoreson, Sharon Calaman, Beth King, Alan Schwartz, Sean Elliott, Tanvi Sharma, Javier Gonzalez Del Rey, Kathleen Bartlett, Shannon E Scott-Vernaglia, Kathleen Gibbs, Jon F McGreevy, Lynn C Garfunkel, Caren Gellin, John G Frohna
BACKGROUND: Clinical competency committee (CCC) identification of residents with performance concerns is critical for early intervention. METHODS: Program directors and 94 CCC members at 14 pediatric residency programs responded to a written survey prompt asking them to describe how they identify residents with performance concerns. Data was analyzed using thematic analysis. RESULTS: Six themes emerged from analysis and were grouped into two domains...
January 2018: Medical Teacher
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