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https://www.readbyqxmd.com/read/29026893/descending-necrotizing-mediastinitis-after-a-trigger-point-injection
#1
Jae Young Choe, Jong Kun Kim, Dong Eun Lee, Kang Suk Seo, Jung Bae Park, Mi Jin Lee, Hyun Wook Ryoo, Jae Yun Ahn, Sungbae Moon
Descending necrotizing mediastinitis (DNM) is a rare form of mediastinal infection. Most cases are associated with esophageal rupture. DNM after a trigger point injection in the upper trapezius has not been described previously. We present a case of DNM after a trigger point injection in the upper trapezius. A 70-year-old man visited the emergency department with chest discomfort and fever after a trigger point injection in the left upper trapezius. Chest computed tomography showed evidence of DNM, and antibiotic therapy was immediately administered intravenously...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29023163/asthma-exacerbations-and-socio-economic-status-in-french-adults-with-persistent-asthma-a-prospective-cohort-study
#2
Katia Mazalovic, Flore Jacoud, Alexandra L Dima, Eric Van Ganse, Maeva Nolin, Didier Cannet, Claire Zabawa
INTRODUCTION: Adults disadvantaged by poor socio-economic status (SES) are more severely affected by asthma compared to those with better SES. We aimed to determine whether the frequency of asthma exacerbations (AEx), as well as aspects related to AEx management, differed based on SES in patients treated with daily treatments. METHODS: This study, part of the prospective observational cohort ASTRO-LAB, included French adult patients with persistent asthma. Patients were considered as low SES if they benefited from publicly funded special health insurance and/or were perceived as low SES by their general practitioner...
October 12, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29022427/confirming-the-timing-of-phase-based-costing-in-oncology-studies-a-case-example-in-advanced-melanoma
#3
Michael Atkins, Anna D Coutinho, Sasikiran Nunna, Komal Gupte-Singh, Michael Eaddy
AIMS: The utilization of health care services and costs among patients with cancer is often estimated by the phase of care: initial, interim, or terminal. Although their durations are often set arbitrarily, we sought to establish data-driven phases of care using joinpoint regression in an advanced melanoma population as a case example. METHODS: A retrospective claims database study was conducted to assess the costs of advanced melanoma from distant metastasis diagnosis to death 01/2010-09/2014...
October 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28988740/health-care-usage-and-suicide-risk-screening-within-1%C3%A2-year-of-suicide-death
#4
Amy R Stuck, Michael P Wilson, Christen E Chalmers, Jonathan Lucas, Andrew Sarkin, Kyle Choi, Kimberly Center
BACKGROUND: Research indicates patients often seek medical care within 1 year of suicide. Health care encounters are a crucial opportunity for health professionals to identify patients at highest risk and provide preventative services. OBJECTIVE: Study aims were to determine the characteristics of persons seeking health care within 12 months of suicide death and evaluate suicide risk screening (SRS) frequency in the emergency department (ED) vs. clinic settings...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28985364/concomitant-pulmonologist-and-primary-care-for-chronic-obstructive-pulmonary-disease-a-population-study
#5
Andrea S Gershon, Erin M Macdonald, Jin Luo, Peter C Austin, Samir Gupta, Khalil Sivjee, Ross Upshur, Shawn D Aaron
Background: Pulmonologists provide quality care, however, their number is not adequate to take care of all the chronic obstructive pulmonary disease (COPD) needs of the population and their services come with a cost. Their optimal role should be defined, ideally based on evidence, to ensure that their abilities are applied most efficiently where needed. Objective: To determine if concomitant pulmonologist and primary care physician care after COPD hospital or emergency department discharge was associated with better health outcomes than primary care services alone...
July 7, 2017: Family Practice
https://www.readbyqxmd.com/read/28973620/effect-of-genotype-guided-warfarin-dosing-on-clinical-events-and-anticoagulation-control-among-patients-undergoing-hip-or-knee-arthroplasty-the-gift-randomized-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Brian F Gage, Anne R Bass, Hannah Lin, Scott C Woller, Scott M Stevens, Noor Al-Hammadi, Juan Li, Tomás Rodríguez, J Philip Miller, Gwendolyn A McMillin, Robert C Pendleton, Amir K Jaffer, Cristi R King, Brandi DeVore Whipple, Rhonda Porche-Sorbet, Lynnae Napoli, Kerri Merritt, Anna M Thompson, Gina Hyun, Jeffrey L Anderson, Wesley Hollomon, Robert L Barrack, Ryan M Nunley, Gerard Moskowitz, Victor Dávila-Román, Charles S Eby
Importance: Warfarin use accounts for more medication-related emergency department visits among older patients than any other drug. Whether genotype-guided warfarin dosing can prevent these adverse events is unknown. Objective: To determine whether genotype-guided dosing improves the safety of warfarin initiation. Design, Setting, and Patients: The randomized clinical Genetic Informatics Trial (GIFT) of Warfarin to Prevent Deep Vein Thrombosis included patients aged 65 years or older initiating warfarin for elective hip or knee arthroplasty and was conducted at 6 US medical centers...
September 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28970260/effectiveness-of-a-financial-incentive-to-physicians-for-timely-follow-up-after-hospital-discharge-a-population-based-time-series-analysis
#7
Lauren Lapointe-Shaw, Muhammad Mamdani, Jin Luo, Peter C Austin, Noah M Ivers, Donald A Redelmeier, Chaim M Bell
BACKGROUND: Timely follow-up after hospital discharge may decrease readmission to hospital. Financial incentives to improve follow-up have been introduced in the United States and Canada, but it is unknown whether they are effective. Our objective was to evaluate the impact of an incentive program on timely physician follow-up after hospital discharge. METHODS: We conducted an interventional time series analysis of all medical and surgical patients who were discharged home from hospital between Apr...
October 2, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28964382/emergency-department-hospital-inpatient-and-mortality-burden-of-atrial-fibrillation-in-the-united-states-2006-to-2014
#8
Sandra L Jackson, Xin Tong, Xiaoping Yin, Mary G George, Matthew D Ritchey
The prevalence of atrial fibrillation (AF) is increasing in the United States as the population ages, but national surveillance is lacking. This cross-sectional study (2006 to 2014) analyzed data from the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample, the National (Nationwide) Inpatient Sample, and the National Vital Statistics System. Event totals were estimated independently for emergency department (ED) visits, hospitalizations, and mortality, and then collectively after applying criteria to identify mutually exclusive events...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28939062/poor-oral-health-affects-survival-in-head-and-neck-cancer
#9
Douglas R Farquhar, Kimon Divaris, Angela L Mazul, Mark C Weissler, Jose P Zevallos, Andrew F Olshan
INTRODUCTION: Poor oral health has emerged as a risk factor for squamous cell carcinoma of the head and neck (HNSCC) but its impact on survival has not been examined. We sought to estimate the impact of oral health indicators on survival in a population-based HNSCC cohort. MATERIALS AND METHODS: Cases (n=1381) and age-, sex- and race-matched controls (n=1396) were participants in the Carolina Head and Neck Cancer Epidemiologic Study (CHANCE). Vital status was determined via linkage with the National Death Index...
October 2017: Oral Oncology
https://www.readbyqxmd.com/read/28893184/the-canadian-hiv-and-aging-cohort-study-determinants-of-increased-risk-of-cardio-vascular-diseases-in-hiv-infected-individuals-rationale-and-study-protocol
#10
Madeleine Durand, Carl Chartrand-Lefebvre, Jean-Guy Baril, Sylvie Trottier, Benoit Trottier, Marianne Harris, Sharon Walmsley, Brian Conway, Alexander Wong, Jean-Pierre Routy, Colin Kovacs, Paul A MacPherson, Kenneth Marc Monteith, Samer Mansour, George Thanassoulis, Michal Abrahamowicz, Zhitong Zhu, Christos Tsoukas, Petronela Ancuta, Nicole Bernard, Cécile L Tremblay
BACKGROUND: With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors...
September 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28890140/-impact-of-the-elderly-patient-in-the-emergency-department
#11
Manuel Bermúdez Menéndez de la Granda, German Guzmán Gutiérrez, María Fernández Fernández, Juan José Solano Jaurrieta
INTRODUCTION: The aging of the population, chronic diseases, and non-urgent visits to the Emergency departments (ED) are considered the reasons for the increase of the demand of care. The aim of this study is to analyse the impact of the older population in the ED, when compared to a younger population. MATERIAL AND METHODS: An observational, descriptive and retrospective study including an analysis of the 92,627 patients that attended the ED in Hospitals from Health Area IV belonging to the Principality of Asturias Health Services during 2009...
September 7, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28885519/preparing-global-trauma-nurses-for-leadership-roles-in-global-trauma-systems
#12
Sol Angelica Muñiz, Richard W Lang, Lisa Falcon, Jasmine Garces-King, Suzanne Willard, Gregory L Peck
Trauma leads to 5.7 million annual deaths globally, accounting for 25%-33% of global unintentional deaths and 90% of the global trauma burden in low- and middle-income countries. The Lancet Commission on Global Surgery and the World Health Organization assert that emergent and essential surgical capacity building and trauma system improvement are essential to address the global burden of trauma. In response, the Rutgers Global Surgery program, the School of Nursing and Medicine, and the Robert Wood Johnson University Hospital faculty collaborated in the first Interprofessional Models in Global Injury Care and Education Symposium in June 2016...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28882638/delayed-onset-of-atrial-fibrillation-and-ventricular-tachycardia-after-an-automobile-lightning-strike
#13
Dorian Drigalla, Shannon E Essler, C Keith Stone
BACKGROUND: Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. CASE REPORT: An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28877241/real-time-surveillance-of-heat-related-morbidity-relation-to-excess-mortality-associated-with-extreme-heat
#14
Robert W Mathes, Kazuhiko Ito, Kathryn Lane, Thomas D Matte
The impact of heat on mortality is well documented but deaths tend to occur after (or lag) extreme heat events, and mortality data is generally not available for timely surveillance during extreme heat events. Recently, systems for near-real time surveillance of heat illness have been reported but have not been validated as predictors of non-external cause of deaths associated with extreme heat events. We analyzed associations between daily weather conditions, emergency medical system (EMS) calls flagged as heat-related by EMS dispatchers, emergency department (ED) visits classified as heat-related based on chief complaint text, and excess non-external cause mortality in New York City...
2017: PloS One
https://www.readbyqxmd.com/read/28874930/prevalence-of-intracranial-hemorrhage-after-blunt-head-trauma-in-patients-on-pre-injury-dabigatran
#15
James A Chenoweth, M Austin Johnson, Laura Shook, Mark E Sutter, Daniel K Nishijima, James F Holmes
INTRODUCTION: Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The prevalence of intracranial hemorrhage after blunt head trauma in patients on dabigatran is currently unknown, complicating adequate ability to accurately compare the risks and benefits of dabigatran to alternative anticoagulants. We aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. METHODS: This is a retrospective observational study of adult patients on dabigatran who presented to a Level I trauma center and received cranial computed tomography (CT) following blunt head trauma...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28851780/mortality-and-risk-of-cardiac-complications-among-immediate-survivors-of-accidental-electric-shock-a-danish-nationwide-cohort-study
#16
Steen Møller Hansen, Sam Riahi, Søren Hjortshøj, Rikke Mortensen, Lars Køber, Peter Søgaard, Christian Torp-Pedersen
OBJECTIVE: Exposure to electric shock has been associated with an increased risk of developing delayed cardiac arrhythmias and cardiac diseases. We examined whether electric shock patients have an increased risk of developing cardiac disease, cardiac arrhythmias or death compared with the general Danish population. DESIGN: Matched cohort study. SETTING: A nationwide study in Denmark from 1994 to 2011. PARTICIPANTS: We identified 11 462 Danish patients who visited an emergency ward or were admitted to a hospital due to electric shock from 1994 to 2011...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28846483/palliative-care-needs-in-an-acute-internal-medicine-ward-in-mexico
#17
Tania Zertuche-Maldonado, Rodrigo Tellez-Villarreal, Antonio Pascual, Salvador B Valdovinos-Chavez, Abel Jesus Barragan-Berlanga, Maria Teresa Sanchez-Avila, Leonardo Bracho-Vela, Adria Tinoco-Aranda, Eduardo Bruera
BACKGROUND: Palliative care is an evolving but underdeveloped practice in Mexico. OBJECTIVE: The primary end point of this prospective observational study was to identify internal medicine inpatients fulfilling advanced criteria within a second-level hospital. Secondary end points were symptom burden, treatment, resource utilization, and one-year survival. DESIGN AND MEASUREMENTS: The 390-sample size calculation was based on previous studies where 15% of inpatients fulfilled palliative care needs...
August 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817755/measuring-toxic-effects-and-time-to-treatment-failure-for-nivolumab-plus-ipilimumab-in-melanoma
#18
Alexander N Shoushtari, Claire F Friedman, Pedram Navid-Azarbaijani, Michael A Postow, Margaret K Callahan, Parisa Momtaz, Katherine S Panageas, Jedd D Wolchok, Paul B Chapman
Importance: Nivolumab plus ipilimumab (nivo + ipi) is a standard treatment of advanced melanoma. Two randomized trials describe high objective response rates by Response Evaluation Criteria in Solid Tumors. The trials assessed toxic effects using the Common Terminology Criteria for Adverse Events (CTCAE), which may underestimate incidence of clinically significant immune-related adverse events (AEs). Objective: To describe detailed toxic effects and time to treatment failure of patients with melanoma treated with nivo + ipi in a prospective cohort...
August 17, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28814285/quality-of-midwife-provided-intrapartum-care-in-amhara-regional-state-ethiopia
#19
Tegbar Yigzaw, Fantu Abebe, Lalem Belay, Yewulsew Assaye, Equlinet Misganaw, Ashebir Kidane, Desalegn Ademie, Jos van Roosmalen, Jelle Stekelenburg, Young-Mi Kim
BACKGROUND: Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS: A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia...
August 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28717776/a-retrospective-study-of-emergency-department-potassium-disturbances-severity-treatment-and-outcomes
#20
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. METHODS: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected...
June 2017: Clinical and Experimental Emergency Medicine
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