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Fabrizio Bert, Maria Rosaria Gualano, Paolo Biancone, Valerio Brescia, Elisa Camussi, Maria Martorana, Silvana Secinaro, Roberta Siliquini
INTRODUCTION: Over 2 million people in high-income countries live with HIV. Early diagnosis and treatment present benefits for infected subjects and reduce secondary transmissions. Cost-effectiveness analyses are important to effectively inform policy makers and consequently implement the most cost-effective programmes. Therefore, we conducted a systematic review regarding the cost-effectiveness of HIV screening in high-income countries. METHODS: We followed PRISMA statements and included all papers evaluating the cost-effectiveness of HIV screening in the general population or in specific subgroups...
March 23, 2018: Health Policy
Kendra M Cuffe, Jami S Leichliter, Thomas L Gift
State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.
February 7, 2018: Sexually Transmitted Diseases
Ryan Cramer, Penny S Loosier, Andee Krasner, Jennifer Kawatu
BACKGROUND: Health departments (HDs) cite state laws as barriers to billing third parties for sexually transmitted disease (STD) services, but the association between legal/policy barriers and third party HD billing has not been examined. This study investigates the relationship between laws that may limit HDs' ability to bill, clinic perceptions of billing barriers, and billing practices. METHODS: Two surveys (1) clinic managers [N=246], 2) STD program managers [N=63]) conducted via a multi-regional needs assessment of federally funded HD clinics' capacity to bill for STD services, billing/reimbursement practices, and perceived barriers were combined with an analysis of state laws regarding third party billing for STD services...
February 7, 2018: Sexually Transmitted Diseases
Niall Morris, Rick Body
STUDY OBJECTIVE: This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. METHODS: This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form...
December 2017: Emergency Medicine Journal: EMJ
Jillian McGrath, Michael Barrie, David P Way
INTRODUCTION: The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States...
January 2017: Western Journal of Emergency Medicine
Derek P Chew, Christopher Zeitz, Matthew Worthley, Hugh Grantham, John Beltrame, Margaret Arstall, Penelope Coates, Carolyn Astley, Stephen Quinn, Julie Ratcliffe, Matthew Horsfall, Philip G Aylward
BACKGROUND: High-sensitivity troponin T (hs-TnT) assays promise greater discrimination of evolving myocardial infarction, but the impact of unguided implementation on the effectiveness of care is uncertain. METHODS AND RESULTS: We evaluated the impact of hs-TnT reporting on care and outcome among chest pain patients presenting to 5 emergency departments within a multicenter randomized trial. Patients were allocated to hs-TnT reporting (hs-report) or standard reporting (std-report; Roche Elecys)...
September 2016: Circulation. Cardiovascular Quality and Outcomes
Robert D Kirkcaldy, Alesia Harvey, John R Papp, Carlos Del Rio, Olusegun O Soge, King K Holmes, Edward W Hook, Grace Kubin, Stefan Riedel, Jonathan Zenilman, Kevin Pettus, Tremeka Sanders, Samera Sharpe, Elizabeth Torrone
PROBLEM/CONDITION: Gonorrhea is the second most commonly reported notifiable disease in the United States; 350,062 gonorrhea cases were reported in 2014. Sexually transmitted infections caused by Neisseria gonorrhoeae are a cause of pelvic inflammatory disease in women, which can lead to serious reproductive complications including tubal infertility, ectopic pregnancy, and chronic pelvic pain. Prevention of sequelae and of transmission to sexual partners relies largely on prompt detection and effective antimicrobial treatment...
July 15, 2016: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
Cornelius A Thiels, Matthew C Hernandez, Martin D Zielinski, Johnathon M Aho
INTRODUCTION: Fishing is a common pastime. In the developed world, it is commonly performed as a recreational activity. We aim to determine injury patterns and outcomes among patients injured while ice fishing. METHODS: Data on initial emergency department visits from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) from 2009-2014 were analyzed. All patients with fishing related injuries were included. Primary endpoint was rate of admission or transfer...
July 2016: American Journal of Emergency Medicine
Mihai Dorin Vartolomei, Ovidiu Simion Cotoi, Mihail Alexandru Badea, Calin Bogdan Chibelean, Titiana Cotoi, Violeta Morariu, Cosmin Albu, Silviu Horia Morariu
No abstract text is available yet for this article.
2015: Acta Dermatovenerologica Croatica: ADC
Elissa M Schechter-Perkins, Dareema Jenkins, Laura F White, Patricia M Mitchell
BACKGROUND: The aim of this study was to determine the proportion of patients treated appropriately, both presumptively in the emergency department (ED), and at follow-up, among those patients who ultimately tested positive for either Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT). Secondary aims were to characterize patients who received appropriate presumptive antibiotic treatment of both NG and CT at the time of ED visit and to compare them to patients who did not receive appropriate presumptive therapy...
July 2015: Sexually Transmitted Diseases
Srikala Subramanian, Jennifer S Green
The effects a sexual assault on a survivor can be profound and multifaceted. Some of the aftermath may include bodily and/or anal/genital injury, sexually transmitted infection (STI) or disease (STD), post-traumatic stress disorder (PTSD), depression, suicidal ideation, and pregnancy. There is no typical experience or survivor response. So, if a survivor presents to the Emergency Departments for care, it is imperative for healing that the response is stabilizing, coordinated, and compassionate. Immediate needs of a survivor of sexual assault include: medical and/or psychiatric evaluation and stabilization, activation of community advocacy to the bedside, mandated reporting as directed by state statutes, offering and conducting (if desired by the survivor) the Sexual Assault Forensic Exam (SAFE), collaboration with law enforcement (if desired by the survivor), prophylactic medications for STI and STD, pregnancy risk evaluation and care and safe discharge planning...
May 2015: Missouri Medicine
Colleen E Holley, Thuy Van Pham, Heather M Mezzadra, George C Willis, Michael D Witting
BACKGROUND: Infections with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the most commonly reported sexually transmitted diseases in the United States. OBJECTIVES: The primary objective of this study was to estimate the incidence of overtreatment of GC and CT infections in the emergency department (ED). The secondary objective was to determine if there are clinical variables that predict infection with GC and CT. METHODS: A retrospective medical record review was performed at 2 inner-city hospitals...
September 2015: American Journal of Emergency Medicine
Simon Bordeleau, Julien Poitras, Danièle Marceau, Carolle Breton, Pierre Beaupré, Patrick M Archambault
BACKGROUND: Quick reversal of warfarin anticoagulation is important in life threatening bleeding. The aim of this study is to improve the administration delay when using Prothrombin Complex Concentrate (PCC) for the emergent reversal of warfarin anticoagulation in the emergency department. METHODS: An audit and feedback quality improvement project was conducted in three phases: a retrospective audit phase, an analysis and feedback phase and prospective evaluation phase...
2015: BMC Health Services Research
Ashley F Harbison, Derek M Polly, Megan E Musselman
PURPOSE: Special considerations in pharmacotherapy for infectious diseases in pregnant and lactating women in the emergency department (ED) setting are reviewed. SUMMARY: With many women turning to the ED as a source of primary care, it is essential for pharmacists involved in providing ED services to guide the selection of appropriate antiinfective agents during pregnancy and lactation; this area of practice is complicated by the very limited body of published data on the safety and efficacy of maternal antimicrobial use and potential fetal or neonatal adverse effects...
February 1, 2015: American Journal of Health-system Pharmacy: AJHP
Roxanne P Kerani, Mark R Stenger, Hillard Weinstock, Kyle T Bernstein, Mary Reed, Christina Schumacher, Michael C Samuel, Margaret Eaglin, Matthew Golden
BACKGROUND: Replacing oral treatments with ceftriaxone is a central component of public health efforts to slow the emergence of cephalosporin-resistant Neisseria gonorrhoeae in the United States; US gonorrhea treatment guidelines were revised accordingly in 2010. However, current US gonorrhea treatment practices have not been well characterized. METHODS: Six city and state health departments in Cycle II of the STD Surveillance Network (SSuN) contributed data on all gonorrhea cases reported in 101 counties and independent cities...
January 2015: Sexually Transmitted Diseases
Maria Rita Parisi, Laura Soldini, Gianmarino Vidoni, Chiara Mabellini, Teresa Belloni, Livia Brignolo, Silvia Negri, Karin Schlusnus, Fernanda Dorigatti, Adriano Lazzarin
Over the last few years, hepatitis C virus (HCV) infection has emerged as one of the most significant causes of chronic liver disease worldwide, with an estimated prevalence ranging from 2.2 to 3.0%. In Italy, approximately 2% of subjects are infected with HCV. Considering that acute HCV infection is usually asymptomatic, early diagnosis is rare. Those people who develop chronic infection, even though undiagnosed, may suffer serious liver damage, making chronic HCV infection a major health problem. New initiatives are needed to identify a submerged portion of patients with chronic viral hepatitis and to propose controls and antiviral treatments to avoid the progression to liver cirrhosis or hepatocellular carcinoma (HCC)...
October 2014: New Microbiologica
Enrique Casalino, Christophe Choquet, Agathe Leleu, Romain Hellmann, Mathias Wargon, Gaelle Juillien, Yazdan Yazdanpanah, Elisabeth Bouvet
OBJECTIVE: We aimed to determine the trends in numbers and percentages of sexually exposed persons to HIV (SE) consulting an ED for post-exposure prophylaxis (PEP), as well as predictors of condom use. STUDY DESIGN: We conducted a prospective-observational study. METHODS: We included all SE attendances in our Emergency Department (ED) during a seven-year study-period (2006-2012). Trends were analyzed using time-series analysis. Logistic Regression was used to define indicators of condom use...
2014: PloS One
Eshan U Patel, Melanie A Frank, Yu-Hsiang Hsieh, Richard E Rothman, Amy E O Baker, Chadd K Kraus, Judy Shahan, Charlotte A Gaydos, Gabor D Kelen, Thomas C Quinn, Oliver Laeyendecker
OBJECTIVES: Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted disease, but there is limited data on its epidemiology among urban populations. The urban Emergency Department (ED) is a potential venue for surveillance as it predominantly serves an inner city minority population. We evaluate the seroprevalence and factors associated with HSV-2 infection among patients attending the Johns Hopkins Hospital Adult Emergency Department (JHH ED). METHODS: An identity unlinked-serosurvey was conducted between 6/2007 and 9/2007 in the JHH ED; sera were tested by the Focus HerpeSelect ELISA...
2014: PloS One
Kathleen H Krause, Annie Lewis-O'Connor, Amanda Berger, Teress Votto, Sigal Yawetz, Daniel J Pallin, Lindsey R Baden
BACKGROUND: Comprehensive data that address current HIV nonoccupational postexposure prophylaxis (nPEP) practices in the emergency care of sexual assault patients are limited. The U.S. Centers for Disease Control and Prevention released HIV nPEP guidelines in 2005 and updated guidelines for Sexually Transmitted Disease Treatment in 2006 and 2010, each of which support providing nPEP to sexual assault patients. This study examined the offer, acceptance, and adherence rates of nPEP among sexual assault patients treated at an emergency department (ED)...
July 2014: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Mari-Lynn Drainoni, Meg Sullivan, Shwetha Sequeira, Janine Bacic, Katherine Hsu
BACKGROUND: In the Affordable Care Act era, no-cost-to-patient publicly funded sexually transmitted infection (STI) clinics have been challenged as the standard STI care delivery model. This study examined the impact of removing public funding and instituting a flat fee within an STI clinic under state-mandated insurance coverage. METHODS: Cross-sectional database analysis examined changes in visit volumes, demographics, and payer mix for 4 locations in Massachusetts' largest safety net hospital (STI clinic, primary care [PC], emergency department [ED], obstetrics/gynecology [OB/GYN] for 3 periods: early health reform implementation, reform fully implemented but public STI clinic funding retained, termination of public funding and institution of a US$75 fee in STI clinic for those not using insurance)...
July 2014: Sexually Transmitted Diseases
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