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https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#1
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28229066/a-case-of-influenza-a-h3n2-complicated-by-community-acquired-pneumonia-and-death-in-a-young-healthy-adult-during-the-2013-2014-season
#2
Lauren F Collins, Benjamin D Anderson, Gregory C Gray
With multiple available vaccines and antivirals, seasonal influenza A is typically a self-limited acutely debilitating illness in young healthy adults. Here, we illustrate unexpected morbidity and mortality in a relatively young and healthy patient seen at a large tertiary care academic medical center for seasonal influenza A (H3N2) complicated by community-acquired pneumonia, hypoxic respiratory failure, septic shock, and death.
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28228138/current-management-practices-for-patients-presenting-with-low-back-pain-to-a-large-emergency-department-in-canada
#3
Matthew L Nunn, Jill A Hayden, Kirk Magee
BACKGROUND: Low back pain (LBP) is one of the leading causes of disability. Presentations to the emergency department (ED) are common and consume significant healthcare resources. However, treatment of patients with LBP is variable and highly physician dependent. Our study objective was to describe the demographic and clinical characteristics of patients presenting to the ED with LBP, the diagnostic strategies employed by ED physicians, and the subsequent management. METHODS: We conducted a retrospective study using clinical and electronic health data at the Queen Elizabeth II Health Science Center's Charles V...
February 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28224111/attributable-cost-of-a-nosocomial-infection-in-the-intensive-care-unit-a-prospective-cohort-study
#4
Binila Chacko, Kurien Thomas, Thambu David, Hema Paul, Lakshmanan Jeyaseelan, John Victor Peter
AIM: To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS: Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#5
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28222415/young-adult-patient-with-headache-fever-and-blurred-vision
#6
Stavroula A Paschou, Konstantinos Tzioras, Vasiliki Trianti, Stavroula Lyra, Vasileios-Arsenios Lioutas, Andreas Seretis, Andromachi Vryonidou
BACKGROUND AND IMPORTANCE: This case highlights the fact that acute pituitary apoplexy may be misdiagnosed due to being confused with other entities exhibiting similar symptoms, such as meningitis or subarachnoid hemorrhage. CLINICAL PRESENTATION: A patient in his late 30s presented with sudden and severe frontal headache, fever, blurred vision, nausea, confusion, as well as oculomotor palsy (CN III) with partial ptosis of the left eyelid, dilated left pupil and left eye globe deviation inferiorly and laterally...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#7
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219188/-change-of-prognosis-and-pathogens-in-adult-patients-with-severe-community-acquired-pneumonia-during-different-periods
#8
L Zhang, P Ning, F Rong, Z C Gao
Objective: To compare the change of prognosis and pathogens of adult patients with severe community-acquired pneumonia (CAP) requiring admission to Respiratory Intensive Care Unit (RICU) during different period, and estimate the risk factors of severe CAP. Methods: The clinical data of 186 patients with severe CAP admission to RICU was collected and assessed the trend in outcomes of these patients during three time periods: Period Ⅰ (January 1 2000 to October 31 2006), Period Ⅱ (November 1 2006 to December 31 2010), and Period Ⅲ (January 1 2011 to December 31 2015), analyzed the risk factors by Cox Proportional Hazards regression, and compared the pathogens detection...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28218011/asymmetric-dimethylarginine-in-the-assessment-of-febrile-neutropenia-in-hematological-patients
#9
Marika Lappalainen, Sari Hämäläinen, Auni Juutilainen, Irma Koivula, Kari Pulkki, Esa Jantunen
Asymmetric dimethylarginine (ADMA) has been recognized as an independent prognostic factor for sepsis mortality in intensive care units. No data are available on kinetics or prognostic value of ADMA in hematological patients. We evaluated the ability of ADMA to act as a predictor for complicated course of febrile neutropenia, defined as bacteremia and/or septic shock in adult hematological patients receiving intensive chemotherapy. This prospective study included 87 adult hematological patients with febrile neutropenia after an intensive chemotherapy for acute myeloid leukemia (AML) or after an autologous stem cell transplantation (ASCT)...
April 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28215136/protocol-and-statistical-analysis-plan-for-the-randomised-evaluation-of-active-control-of-temperature-versus-ordinary-temperature-management-reactor-trial
#10
Paul J Young, Michael J Bailey, Richard W Beasley, Ross C Freebairn, Naomi E Hammond, Frank M P van Haren, Meg L Harward, Seton J Henderson, Diane M Mackle, Colin J McArthur, Shay P McGuinness, John A Myburgh, Manoj K Saxena, Anne Turner, Steve A R Webb, Rinaldo Bellomo
BACKGROUND: Body temperature can be reduced in febrile patients in the intensive care unit using medicines and physical cooling devices, but it is not known whether systematically preventing and treating fever reduces body temperature compared with standard care. OBJECTIVE: To describe the study protocol and statistical analysis plan for the Randomised Evaluation of Active Control of Temperature versus Ordinary Temperature Management (REACTOR) trial. DESIGN, SETTING AND PARTICIPANTS: Protocol for a phase II, multicentre trial to be conducted in Australian and New Zealand ICUs admitting adult patients...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28215056/an-analysis-of-blood-utilization-for-stem-cell-transplant-patients-in-a-tertiary-care-hospital
#11
Natasha Ali
Background and Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Aga Khan University Hospital...
February 28, 2017: International Journal of Stem Cells
https://www.readbyqxmd.com/read/28214758/comparative-analysis-of-viral-shedding-in-pediatric-and-adult-subjects-with-central-nervous-system-associated-enterovirus-infections-from-2013-to-2015-in-switzerland
#12
S Cordey, M Schibler, A G L'Huillier, N Wagner, A R Gonçalves, J Ambrosioni, S Asner, L Turin, K M Posfay-Barbe, L Kaiser
BACKGROUND: Several enterovirus (EV) genotypes can result in aseptic meningitis, but their routes of access to the central nervous system remain to be elucidated and may differ between the pediatric and adult populations. OBJECTIVE: To assess the pattern of viral shedding in pediatric and adult subjects with acute EV meningitis and to generate EV surveillance data for Switzerland. STUDY DESIGN: All pediatric and adult subjects admitted to the University Hospitals of Geneva with a diagnosis of EV meningitis between 2013 and 2015 were enrolled...
February 7, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#13
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#14
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#15
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#16
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28209594/adolescents-and-young-adults-with-acute-lymphoblastic-leukemia-and-acute-myeloid-leukemia-impact-of-care-at-specialized-cancer-centers-on-survival-outcome
#17
Julie Wolfson, Can-Lan Sun, Laura Wyatt, Wendy Stock, Smita Bhatia
Background: Adolescents and young adults (AYA; 15-39 years) with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) experience inferior survival when compared with children. Impact of care at NCI-designated Comprehensive Cancer Centers (CCC) or Children's Oncology Group sites (COG) on survival disparities remains unstudied.Methods: Using the Los Angeles cancer registry, we identified 1,870 ALL or AML patients between 1 and 39 years at diagnosis. Cox regression analyses assessed risk of mortality; younger age + CCC/COG served as the referent group...
February 16, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#18
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28209107/gastro-intestinal-manifestations-in-cystic-fibrosis-patients
#19
REVIEW
S Van Biervliet, C de Clercq, D Declercq, E Van Braeckel, S Van Daele, F De Baets, D De Looze
Cystic fibrosis (CF) is a life-limiting disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR). This defective chloride channel, present in different organ systems such as respiratory system, gastrointestinal tract, reproductive system and sweat glands, disturbs the ion and water transport over the membranes leading to the well known CF symptoms. CF has outgrown paediatric care, as half of CF patients are currently adults. The CF gastrointestinal tract has its own particularities...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28199053/the-effect-of-tonsillectomy-on-the-morbidity-from-recurrent-tonsillitis
#20
C M Douglas, K Lang, W M Whitmer, J A Wilson, K Mackenzie
BACKGROUND: Tonsillitis is a common condition with an incidence in UK general practice of 37 per 1000 population a year(1) . Recurrent tonsillitis results in significant morbidity and impacts on individuals' quality of life. This study assesses the morbidity and quality of life of adults with recurrent tonsillitis, and the impact of surgical intervention on their health state. OBJECTIVES: 1.To describe disease specific and global quality of life for adults with recurrent tonsillitis six months after tonsillectomy, using two instruments: the Health Impact of Throat Problems (HITP) and EuroQol-visual analogue scale (EQ-VAS) questionnaire...
February 15, 2017: Clinical Otolaryngology
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