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https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#1
Jahan Fahimi, Aaron E Kornblith, Hemal Kanzaria, Andrew Herring, Ralph C Wang
OBJECTIVES: Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. METHODS: This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28815486/staphylococcus-aureus-carriage-in-french-athletes-at-risk-of-ca-mrsa-infection-a-prospective-cross-sectional-study
#2
E Couvé-Deacon, D Postil, O Barraud, C Duchiron, D Chainier, A Labrunie, N Pestourie, P M Preux, B François, M C Ploy
BACKGROUND: Staphylococcus aureus (SA) is a leading cause of infectious diseases in sports teams. In recent decades, community-associated SA (CA-SA) strains have emerged worldwide and have been responsible for outbreaks in sports teams. There are very few data on the prevalence of these strains in France, and none on the carriage among athletes. METHODS: We conducted a cross-sectional study to determine the SA carriage proportion among athletes practicing sports at risk for CA-SA infection in a French county, and determined the methicillin-resistant and/or CA-SA proportion...
August 16, 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28814584/examining-self-reported-and-biological-stress-and-near-misses-among-emergency-medicine-residents-a-single-centre-cross-sectional-assessment-in-the-usa
#3
Bengt B Arnetz, Philip Lewalski, Judy Arnetz, Karen Breejen, Karin Przyklenk
OBJECTIVES: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. DESIGN: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. SETTING: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#4
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28806355/seroprevalence-of-anti-polio-antibodies-in-children-from-polio-high-risk-areas-of-pakistan-a-cross-sectional-survey-2015-2016
#5
Imtiaz Hussain, Ondrej Mach, Atif Habib, Zaid Bhatti, Zamir Suhag, M Steven Oberste, William C Weldon, Roland W Sutter, Sajid B Soofi, Zulfiqar A Bhutta
BACKGROUND: Pakistan is one of the 3 remaining wild poliovirus endemic countries. We collected sera from children to assess the prevalence of poliovirus antibodies in selected high-risk areas for poliovirus transmission. METHODS: Children in 2 age groups (6-11 and 36-48 months) were randomly selected between November 2015 and March 2016 in 6 areas of Pakistan (Sindh Province: Karachi and Kashmore; Khyber Pakhtunkhwa Province: Peshawar, Bannu and Nowshera; Punjab Province: Faisalabad)...
September 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28782539/leveraging-the-medical-context-to-increase-upper-extremity-reconstruction-among-patients-with-tetraplegia-a-qualitative-analysis
#6
Chelsea A Harris, John-Michael Muller, Melissa J Shauver, Kevin C Chung
OBJECTIVES: (1) To characterize patients' medical experiences from initial injury until they become candidates for Upper Extremity Reconstruction (UER). (2) To identify points in this medical context that may be most amenable to interventions designed to increase UER utilization. DESIGN: A qualitative cross-sectional study using grounded theory methodology and constant comparative analysis of data collected through semi-structured individual interviews. SETTING: Community PARTICIPANTS: A sample of individuals with C4-C8 cervical spinal injuries (N=19) who sustained injuries at least one year prior to interview...
August 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28777828/depression-anxiety-and-smartphone-addiction-in-university-students-a-cross-sectional-study
#7
Jocelyne Matar Boumosleh, Doris Jaalouk
OBJECTIVES: The study aims to assess prevalence of smartphone addiction symptoms, and to ascertain whether depression or anxiety, independently, contributes to smartphone addiction level among a sample of Lebanese university students, while adjusting simultaneously for important sociodemographic, academic, lifestyle, personality trait, and smartphone-related variables. METHODS: A random sample of 688 undergraduate university students (mean age = 20.64 ±1.88 years; 53% men) completed a survey composed of a) questions about socio-demographics, academics, lifestyle behaviors, personality type, and smartphone use-related variables; b) 26-item Smartphone Addiction Inventory (SPAI) Scale; and c) brief screeners of depression and anxiety (PHQ-2 and GAD-2), which constitute the two core DSM-IV items for major depressive disorder and generalized anxiety disorder, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28777289/sarcopenia-increases-risk-of-long-term-mortality-in-elderly-patients-undergoing-emergency-abdominal-surgery
#8
Erika L Rangel, Arturo J Rios-Diaz, Jennifer W Uyeda, Manuel Castillo-Angeles, Zara Cooper, Olubode A Olufajo, Ali Salim, Aaron D Sodickson
BACKGROUND: Frailty is associated with poor surgical outcomes in elderly patients but is difficult to measure in the emergency setting. Sarcopenia, or the loss of lean muscle mass, is a surrogate for frailty and can be measured using cross-sectional imaging. We sought to determine the impact of sarcopenia on one-year mortality after emergency abdominal surgery in elderly patients. METHODS: Sarcopenia was assessed in patients ≥70 years old who underwent emergency abdominal surgery at a single hospital from 2006-2011...
August 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28774767/variation-in-the-evaluation-of-testicular-conditions-across-united-states-pediatric-emergency-departments
#9
Lois K Lee, Michael C Monuteaux, Joel D Hudgins, John J Porter, Susan C Lipsett, Florence Bourgeois, Bartley G Cilento, Mark I Neuman
OBJECTIVES: To explore the variation in diagnostic testing and management for males diagnosed with three testicular conditions (testicular torsion, appendix testis torsion, epididymitis/orchitis) using a large pediatric health care database. Diagnostic testing is frequently used in evaluation of the acute scrotum; however, there is likely variability in the use of these tests in the emergency department setting. METHODS: We conducted a cross-sectional study of males with the diagnoses of testicular torsion, appendix testis torsion, and epididymitis/orchitis...
July 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28770185/intensive-nutrition-management-in-a-patient-with-short-bowel-syndrome-who-underwent-bariatric-surgery
#10
MeeRa Kweon, Dal Lae Ju, Misun Park, JiHyeong Choe, Yun-Suhk Suh, Eun-Mi Seol, Hyuk-Joon Lee
Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg...
July 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28762570/streptococcal-toxic-shock-syndrome-occurring-in-the-third-trimester-of-pregnancy-a-case-report
#11
Mohamad Irani, Rodney McLaren, Richard H Savel, Oksana Bogatyryova, Fady Khoury-Collado
Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. We also review the potential preventive measures and treatment modalities for this syndrome. A 29-year-old primigravid presented at 36 weeks' gestation with diarrhea, abdominal pain, fever, and fetal bradycardia. She underwent an emergency cesarean section and was subsequently diagnosed with GAS TSS...
August 1, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28755806/physical-activity-and-blood-pressure-in-10-000-mediterranean-adults-the-epic-florence-cohort
#12
G Masala, B Bendinelli, D Occhini, R M Bruno, S Caini, C Saieva, A Ungar, L Ghiadoni, D Palli
BACKGROUND AND AIMS: The relevant role of physical activity (PA) in cardiovascular risk prevention is widely agreed. We aimed to evaluate, in a large Mediterranean population, the influence of PA on systolic (SBP) and diastolic blood pressure (DBP), taking into account individual characteristics and lifestyle habits. METHODS AND RESULTS: In the Florence section of the European Prospective Investigation into Cancer and Nutrition 10,163 individuals, 35-64 years, without a previous diagnosis of hypertension were recruited...
June 15, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28754586/distress-associated-with-dementia-related-psychosis-and-agitation-in-relation-to-healthcare-utilization-and-costs
#13
Donovan T Maust, Helen C Kales, Ryan J McCammon, Frederic C Blow, Amanda Leggett, Kenneth M Langa
OBJECTIVES: Explore the relationship between behavioral and psychological symptoms of dementia (BPSD; specifically, delusions, hallucinations, and agitation/aggression) and associated caregiver distress with emergency department (ED) utilization, inpatient hospitalization, and expenditures for direct medical care. DESIGN/SETTING/PARTICIPANTS: Retrospective cross-sectional cohort of participants with dementia (N = 332) and informants from the Aging, Demographics, and Memory Study, a nationally representative survey of U...
May 25, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28753633/patient-safety-climate-profiles-across-time-strength-and-level-of-safety-climate-associated-with-a-quality-improvement-program-in-switzerland-a-cross-sectional-survey-study
#14
Anna C Mascherek, David L B Schwappach
Safety Climate has been acknowledged as an unspecific factor influencing patient safety. However, studies rarely provide in-depth analysis of climate data. As a helpful approach, the concept of "climate strength" has been proposed. In the present study we tested the hypotheses that even if safety climate remains stable on mean-level across time, differences might be evident in strength or shape. The data of two hospitals participating in a large national quality improvement program were analysed for differences in climate profiles at two measurement occasions...
2017: PloS One
https://www.readbyqxmd.com/read/28749055/a-failure-to-be-candid
#15
Jennifer McGuirl
I was a second-year neonatal-perinatal fellow in a meeting between other members of the neonatal intensive care team and parents who had just received devastating news about their planned-for and highly desired baby, born after what had been an uncomplicated pregnancy. At home, a little sister was waiting to meet her new brother. These conversations are never easy, but this one I found particularly disturbing. John had been born at term via emergency cesarean section after his mother, Muriel, had come for a routine obstetrical visit and reported decreased fetal movement...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28748772/epidemiology-and-hospital-readmission-associated-with-complications-of-staphylococcus-aureus-bacteremia-in-pediatrics-over-a-25-year-period
#16
J LE, Q Dam, T Tran, A Nguyen, F C Adler-Shohet, S Kim, K Schmidt, J M Lieberman, J S Bradley
We sought to comprehensively assess the prevalence and outcomes of complications associated with Staphylococcus aureus bacteremia (SAB) in children. Secondarily, prevalence of methicillin resistance and outcomes of complications from methicillin-resistant S. aureus (MRSA) vs. methicillin-susceptible S. aureus SAB were assessed. This is a single-center cross-sectional study of 376 patients ⩽18 years old with SAB in 1990-2014. Overall, 197 (52%) patients experienced complications, the most common being osteomyelitis (33%), skin and soft tissue infection (31%), and pneumonia (25%)...
September 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28748771/acute-care-referral-systems-in-liberia-transfer-and-referral-capabilities-in-a-low-income-country
#17
Jimin Kim, Maria Barreix, Christine Babcock, Corey B Bills
Introduction Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes. Problem This study aimed to characterize the referral and transfer systems in the largest county of Liberia...
July 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28743257/longer-travel-time-to-district-hospital-worsens-neonatal-outcomes-a-retrospective-cross-sectional-study-of-the-effect-of-delays-in-receiving-emergency-cesarean-section-in-rwanda
#18
Joseph Niyitegeka, Georges Nshimirimana, Allison Silverstein, Jackline Odhiambo, Yihan Lin, Theoneste Nkurunziza, Robert Riviello, Stephen Rulisa, Paulin Banguti, Hema Magge, Martin Macharia, Regis Habimana, Bethany Hedt-Gauthier
BACKGROUND: In low-resource settings, access to emergency cesarean section is associated with various delays leading to poor neonatal outcomes. In this study, we described the delays a mother faces when needing emergency cesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda. METHODS: This retrospective study included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda...
July 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28742078/longitudinal-changes-in-glucocorticoid-receptor-exon-1f-methylation-and-psychopathology-after-military-deployment
#19
R R Schür, M P Boks, B P F Rutten, N P Daskalakis, L de Nijs, M van Zuiden, A Kavelaars, C J Heijnen, M Joëls, R S Kahn, E Geuze, E Vermetten, C H Vinkers
Several cross-sectional studies have demonstrated the relevance of DNA methylation of the glucocorticoid receptor exon 1F region (GR-1F) for trauma-related psychopathology. We conducted a longitudinal study to examine GR-1F methylation changes over time in relation to trauma exposure and the development of post-deployment psychopathology. GR-1F methylation (52 loci) was quantified using pyrosequencing in whole blood of 92 military men 1 month before and 6 months after a 4-month deployment period to Afghanistan...
July 25, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28738721/the-clinical-value-of-maternal-and-fetal-doppler-parameters-in-low-risk-postdates-pregnancies-%C3%A2-a-prospective-study
#20
Oshrit Lebovitz, Eran Barzilay, Shali Mazaki-Tovi, Itai Gat, Reuven Achiron, Yinon Gilboa
OBJECTIVE: To determine the clinical significance of maternal and fetal ultrasound Doppler flow indices in postdates pregnancies. METHODS: This prospective study comprised 120 low-risk pregnant women beyond 40 weeks of gestation. All participants underwent Doppler assessment including of fetal middle cerebral artery (MCA), umbilical and uterine arteries. Perinatal outcomes were recorded and evaluated for possible associations with Doppler flow values. Adverse perinatal outcomes were defined as umbilical cord arterial pH < 7...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
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