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https://www.readbyqxmd.com/read/28229065/foreign-body-aspiration-in-adults-two-unusual-foreign-bodies-knife-and-tube-tracheostomy
#1
Seyed Mozafar Hashemi, Mohsen Kolahdouzan, Shahab Shahabi, Hamid Talebzadeh, Mohammad Taghi Rezaei
INTRODUCTION: Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time. CASE REPORTS: Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X-ray revealed the presence of 5-cm foreign object in the right main bronchus. Rigid bronchoscopy was performed and a knife was removed from the right main bronchus...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28228660/estimating-the-economic-consequences-of-an-increased-medication-adherence-due-to-a-potential-improvement-in-the-inhaler-technique-with-spiromax-%C3%A2-compared-with-turbuhaler-%C3%A2-in-patients-with-moderate-to-severe-chronic-obstructive-pulmonary-disease-in-spain
#2
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas, José Francisco Pascual, Diego Vargas, Adi Bijedic
OBJECTIVE: The objective of this study was to estimate the economic impact of the introduction of DuoResp(®) Spiromax(®), budesonide/formoterol fixed-dose combination (FDC), focusing on an increase in medication adherence due to an enhancement of the inhalation technique for the treatment of COPD patients in Spain and 5 regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the time period of 2015-2018...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28228063/psychiatric-consultation-and-referral-of-persons-who-have-attempted-suicide
#3
Marc Roelands, Reginald Deschepper, Johan Bilsen
BACKGROUND: Persons who have attempted suicide are often admitted to a hospital's emergency department (ED). The risk of them repeating their attempt is lower if they have had access to a psychiatrist in hospital and had been referred to mental health care services. However, the literature suggests this is often lacking. AIMS: To describe perceived barriers to and supportive factors for psychiatric consultation and appropriate referral of suicide attempters in the ED...
February 23, 2017: Crisis
https://www.readbyqxmd.com/read/28220804/impact-of-symptomatic-skeletal-events-on-health-care-resource-utilization-and-quality-of-life-among-patients-with-castration-resistant-prostate-cancer-and-bone-metastases
#4
R McKay, B Haider, M S Duh, A Valderrama, M Nakabayashi, M Fiorillo, L Ristovska, L Wen, P Kantoff
BACKGROUND: Data regarding the impact of symptomatic skeletal events (SSEs) on health economics and patient-reported outcomes in men with castration-resistant prostate cancer (CRPC) and bone metastases from a clinical setting are lacking. Hence, this study aimed to quantify the effects of SSEs on health-care resource utilization (HRU), health-related quality of life (HRQoL) and pain in men with CRPC metastasized to bone. METHODS: This cohort study included men with CRPC and bone metastasis treated at a tertiary center during December 1996-July 2015...
February 21, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28215096/colonic-obstruction-secondary-to-sigmoid-fecaloma-endoscopically-resolved-with-coca-cola%C3%A2
#5
Guillermo Ontanilla Clavijo, Rafael León Montañés, Yolanda Sánchez Torrijos, Teófilo López Ruiz, Juan Manuel Bozada García
BACKGROUND: Colonic obstruction is a relatively common condition in emergency care, with a mortality rate of up to 20%. In 90% of cases it results from colonic or rectal adenocarcinoma, volvulus, or stenosis secondary to diverticular disease. When fecal impaction is the underlying cause, the condition is usually managed conservatively, but may on occasion become complicated and even require surgical intervention. Based on the proven efficacy of Coca-Cola® to dissolve gastric phytobezoars, we report a case of colonic obstruction secondary to sigmoid fecaloma...
February 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28214908/-integrated-patient-centered-care-in-community-health-centers-in-italy-performance-evaluation
#6
Piero Salvadori
In Italy, a "Casa della Salute" (or "House of Health"), translated for the purposes of this article as Community Health Center (CHC), is a public center (of the national public healthcare system), where one can find allocated all primary community healthcare services centered on prevention, treatment and rehabilitation of the citizen in the same physical space, including general practitioner offices, outpatient specialist clinics, and social services. CHCs assure patient-centered primary care services and are the ideal place for applying the Chronic Care Model...
November 2016: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28213305/risk-of-suicide-according-to-the-level-of-psychiatric-contact-in-the-older-people-analysis-of-national-health-insurance-databases-in-taiwan
#7
Shin-Ting Yeh, Yee-Yung Ng, Shiao-Chi Wu
PURPOSE: Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. METHODS: A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence...
February 1, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28211045/walk-in-clinics-versus-physician-offices-and-emergency-rooms-for-urgent-care-and-chronic-disease-management
#8
REVIEW
Connie E Chen, Christopher T Chen, Jia Hu, Ateev Mehrotra
BACKGROUND: Walk-in clinics are growing in popularity around the world as a substitute for traditional medical care delivered in physician offices and emergency rooms, but their clinical efficacy is unclear. OBJECTIVES: To assess the quality of care and patient satisfaction of walk-in clinics compared to that of traditional physician offices and emergency rooms for people who present with basic medical complaints for either acute or chronic issues. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers on 22 March 2016 together with reference checking, citation searching, and contact with study authors to identify additional studies...
February 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28207547/planning-for-operating-room-efficiency-and-faster-anesthesia-wake-up-time-in-open-major-upper-abdominal-surgery
#9
Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chih-Shung Wong, Chen-Hwan Cherng, Zhi-Fu Wu
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28202833/-emergency-decompressive-craniotomy-in-the-emergency-room-was-effective-in-severe-acute-subdural-hematoma-treatment-two-case-reports
#10
Naoto Shiomi, Tadashi Echigo, Hideki Oka, Masahiro Nozawa, Michiko Okada, Shiho Hiraizumi, Fumitaka Kato, Hirokazu Koseki, Yoichi Hashimoto, Akihiko Hino
The outcome of severe acute subdural hematoma is unfavorable. In particular, patients with levels of consciousness of Glasgow Coma Scale(GCS)3 or 4 tend to be refractory to treatment. Decompressive craniotomy should be promptly performed to remove hematoma. However, if an operating room is not immediately available, emergency burr hole surgery is sometimes performed in the emergency room(primary care room)prior to craniotomy. A previous study has reported that the interval from injury to surgery influences the outcome of severe acute subdural hematoma...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28198723/leveraging-telemedicine-infrastructure-to-monitor-quality-of-operating-room-to-intensive-care-unit-handoffs
#11
Mark E Barry, Beth R Hochman, Meghan B Lane-Fall, Denise Zappile, Daniel N Holena, Brian P Smith, Lewis J Kaplan, Ann Huffenberger, Patrick M Reilly, Jose L Pascual
PURPOSE: To analyze in-room video recordings of operating room (OR) to intensive care unit (ICU) handoffs to determine tempo and quality of team interactions on nights and weekends compared with weekdays, and to demonstrate how existing telemedicine technology can be used to evaluate handoffs. METHOD: This prospective observational study of OR-to-ICU bedside handoffs was conducted in the surgical ICU of the Hospital of the University of Pennsylvania in July 2014-January 2015...
February 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28197217/the-effect-of-demographics-and-patient-location-on-the-outcome-of-patients-with-acute-respiratory-distress-syndrome
#12
Haitham El-Haddad, Hyejeong Jang, Wei Chen, Samran Haider, Ayman O Soubani
OBJECTIVE: Outcome of acute respiratory distress syndrome (ARDS) in relation to age, gender, race, pre-Intensive Care Unit (ICU) location, and type of ICU. METHODS: Retrospective cohort study of patients enrolled in the ARDS network randomized controlled trials. RESULTS: A total of 2914 patients were included in these trials. Outcomes were adjusted to baseline covariates including APACHE III score, vasopressor use, cause of lung injury, lung injury score, diabetes, cancer status, body mass index, and study ID...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#13
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28194478/-diagnostic-investigation-in-emergency-medicine-why-case-history-is-crucial
#14
M Mirus, A R Heller
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28188188/locally-advanced-colon-cancer-evaluation-of-current-clinical-practice-and-treatment-outcomes-at-the-population-level
#15
Charlotte E L Klaver, Lieke Gietelink, Willem A Bemelman, Michel W J M Wouters, Theo Wiggers, Rob A E M Tollenaar, Pieter J Tanis
Background: The goal of this study was to evaluate current clinical practice and treatment outcomes regarding locally advanced colon cancer (LACC) at the population level. Methods: Data were used from the Dutch Surgical Colorectal Audit from 2009 to 2014. A total of 34,527 patients underwent resection for non-LACC and 6,918 for LACC, which was defined as cT4 and/or pT4 stage. LACC was divided into those with multivisceral resection (LACC-MV; n=3,385) and without (LACC-noMV; n=1,595). Guideline adherence, treatment strategy, and short-term outcomes were evaluated...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28180119/nonemergent-patients-in-the-emergency-department-an-ethnographic-study
#16
Amir Mirhaghi, Abbas Heydari, Mohsen Ebrahimi, Mohsen Noghani Dokht Bahmani
BACKGROUND: Triage in the interactive atmosphere of the emergency department (ED) has been described as complex and challenging. Nonemergent ED visits have been accompanied by ethical and legal conflicts. OBJECTIVES: The aim of this study was to gain an understanding of ED nurses' practice regarding triage of nonemergent patients. PATIENTS AND METHODS: Focused micro-ethnography based on Spradley's developmental research sequence (DRS) was used...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28176298/what-does-the-u-s-medicare-administrative-claims-database-tell-us-about-initial-antiepileptic-drug-treatment-for-older-adults-with-new-onset-epilepsy
#17
Roy C Martin, Edward Faught, Jerzy P Szaflarski, Joshua Richman, Ellen Funkhouser, Kendra Piper, Lucia Juarez, Chen Dai, Maria Pisu
OBJECTIVE: Disparities in epilepsy treatment are not uncommon; therefore, we examined population-based estimates of initial antiepileptic drugs (AEDs) in new-onset epilepsy among racial/ethnic minority groups of older US Medicare beneficiaries. METHODS: We conducted retrospective analyses of 2008-2010 Medicare administrative claims for a 5% random sample of beneficiaries augmented for minority representation. New-onset epilepsy cases in 2009 had ≥1 International Classification of Diseases, Ninth Revision (ICD-9) 345...
February 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28174559/zika-virus-chikungunya-virus-and-dengue-virus-in-cerebrospinal-fluid-from-adults-with-neurological-manifestations-guayaquil-ecuador
#18
Nathalie Acevedo, Jesse Waggoner, Michelle Rodriguez, Lissette Rivera, José Landivar, Benjamin Pinsky, Hector Zambrano
Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) have been associated with clinical presentations that involve acute neurological complaints. In the current study, we identified ZIKV, CHIKV, and DENV in cerebrospinal fluid (CSF) samples from patients admitted to the Hospital Luis Vernaza (Guayaquil, Ecuador) to the Emergency Room or the Intensive Care Unit, with neurological symptoms and/or concern for acute arboviral infections. Viral RNA from one or more virus was detected in 12/16 patients...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28169438/association-between-parental-access-to-paid-sick-leave-and-children-s-access-to-and-use-of-healthcare-services
#19
Abay Asfaw, Maria Colopy
BACKGROUND: We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. METHODS: We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. RESULTS: Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12...
February 7, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28168987/injury-severity-in-pediatric-all-terrain-vehicle-related-trauma-in-nova-scotia
#20
Samuel Jessula, Nadia Murphy, Natalie L Yanchar
BACKGROUND/PURPOSE: In 2004-2005, legislation restricting all-terrain vehicle (ATV) use by children and an extensive social marketing campaign intended to reduce pediatric ATV-related morbidity. The frequency, nature, and severity of pediatric ATV-associated trauma were compared before and after such interventions. METHODS: A retrospective cohort study was performed for all pediatric ATV-related injuries that presented to the provincial level 1 pediatric trauma center from 1998 to 2014...
January 31, 2017: Journal of Pediatric Surgery
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