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Emergency room

Maria Isabel de Oliveira, Gislene Mitsue Namiyama, Gabriela Bastos Cabral, João Leandro Ferreira, Noemi Taniwaki, Ana Maria Sardinha Afonso, Isabella Rillo Lima, Luís Fernando Macedo de Brigido
A great variety of viruses which cause exanthema share other clinical manifestations, making the etiologic identification a very difficult task, relying exclusively on the clinical examination. Rubella virus (RV) infection during the early stages of pregnancy can lead to serious birth defects, known as congenital rubella syndrome (CRS). In the present report, we described the presence of Zika virus (ZIKV) particles in urine samples and also ZIKV isolation in SIRC cells from the urine of a patient in acute phase of suspected rubella disease...
2018: Revista do Instituto de Medicina Tropical de São Paulo
Pooya Banapour, George A Abdelsayed, Zoe Bider-Canfield, Peter A Elliott, Patrick S Kilday, Gary W Chien
To compare perioperative outcomes in the three most common partial nephrectomy modalities: robotic (RPN), laparoscopic (LPN), and open (OPN), matched for nephrometry scores. Patients aged 16-85 who underwent RPN, LPN, or OPN from 2007 to 2014 for localized renal carcinoma within our healthcare system were enrolled. Age, sex, body mass index, and Charlson Comorbidity Index (CCI) as well as perioperative outcomes of estimated blood loss (EBL), length of hospital stay (LOS), ischemia time (IT), change in eGFR, positive margin rate, operative time (OT), and emergency room visit rates were compared between RPN, LPN, and OPN using the R...
March 19, 2018: Journal of Robotic Surgery
I Marzi, T Lustenberger, P Störmann, K Mörs, N Wagner, S Wutzler
BACKGROUND: Every year up to 35,000 people in Germany are severely injured in accidents in traffic, during work or leisure activities. The 24-h availability of the trauma room as well as surgical and intensive care unit capacities are essential to provide optimal acute care. This study analyzed the frequency of utilization of the resource trauma room in a level I trauma center in the past. METHODS: Data of a level I trauma center from 2005 to 2016 including trauma room alerts deployed by the rescue coordination center and the number of patients found to be severely injured (ISS ≥ 16) during trauma room diagnostics were analyzed retrospectively...
March 19, 2018: Der Unfallchirurg
Linda Ye, Mingu Kang, Junwei Liu, Felix von Cube, Christina R Wicker, Takehito Suzuki, Chris Jozwiak, Aaron Bostwick, Eli Rotenberg, David C Bell, Liang Fu, Riccardo Comin, Joseph G Checkelsky
The kagome lattice is a two-dimensional network of corner-sharing triangles that is known to host exotic quantum magnetic states. Theoretical work has predicted that kagome lattices may also host Dirac electronic states that could lead to topological and Chern insulating phases, but these states have so far not been detected in experiments. Here we study the d-electron kagome metal Fe3 Sn2 , which is designed to support bulk massive Dirac fermions in the presence of ferromagnetic order. We observe a temperature-independent intrinsic anomalous Hall conductivity that persists above room temperature, which is suggestive of prominent Berry curvature from the time-reversal-symmetry-breaking electronic bands of the kagome plane...
March 19, 2018: Nature
Adam B King, Matthew D Spann, Patrick Jablonski, Jonathan P Wanderer, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions...
February 13, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Wan-Hsuan Lu, Chih-Wan Lin, Chen-Yu Wang, Liang-Kung Chen, Fei-Yuan Hsiao
BACKGROUND: The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. METHODS: Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool...
March 20, 2018: BMC Public Health
Minna M Wieck, Aaron J Cunningham, Brandon Behrens, Erika T Ohm, Bryan G Maxwell, Nicholas A Hamilton, M Christopher Adams, Frederick J Cole, Mubeen A Jafri
BACKGROUND: Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. METHODS: All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Katherine J Karriker-Jaffe, Robin Room, Norman Giesbrecht, Thomas K Greenfield
The emergent and growing body of research on alcohol's harm to others (AHTO), or secondhand effects of drinking, has important implications for prevention, intervention, and policy. Those victimized by other drinkers tend to favor effective alcohol policies more than their nonvictimized peers, but often a community's impulse will be to combat AHTO by targeting and stigmatizing individual heavy drinkers, rather than taking a public health approach to reducing harm. Here we discuss opportunities and challenges in selecting ways of reducing AHTO...
March 2018: Journal of Studies on Alcohol and Drugs
Cumhur Murat Tulay, Sadık Yaldız, Adnan Bilge
PURPOSE: To identify occult pneumothorax with oblique chest X-ray (OCXR) in clinically suspected patients. METHODS: In this retrospective study, we examined 1082 adult multitrauma patients who were admitted to our emergency service between January 2016 and January 2017. Clinical findings that suggest occult pneumothorax were rib fracture, flail chest, chest pain, subcutaneous emphysema, abrasion or ecchymosis and moderate to severe hypoxia in clinical parameters...
March 16, 2018: Annals of Thoracic and Cardiovascular Surgery
Raju Bishwakarma, Wei Zhang, Yu-Li Lin, Yong-Fang Kuo, Victor J Cardenas, Gulshan Sharma
Background: Chronic obstructive pulmonary disease (COPD) is associated with persistent systemic inflammation. Anti-inflammatory therapies have been shown to decrease acute exacerbations of COPD. The antidiabetic medication metformin decreases oxidative stress and inflammation and may benefit patients with COPD. We aimed at investigating the effect of metformin on health care utilizations in patients with coexisting COPD and diabetes mellitus (DM). Methods: We studied 5% Medicare beneficiaries with coexisting COPD and DM prescribed metformin or other antidiabetics during the period 2007-2010...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Amos Lal, Alwyn Rapose
BACKGROUND: Gonococcal infection can present with wide spectrum of symptoms, most commonly involving the genitals. This case highlights a rare presentation of Neisseria gonorrhoeae infection primarily with skin involvement without uro-genital disease. CASE: A 33-year-old male was admitted to the hospital with complaints of painful swelling of his penis. In the emergency room, he underwent incision and drainage of the abscess under local anaesthesia. After microbiological evaluation, he was found to have skin abscess caused by N...
March 16, 2018: Infection
John M Trahanas, Benjamin S Van Boxtel, Steven E Miller, Christopher Irobunda, Susheel K Kodali, Isaac George
There are few case reports in the literature of transcatheter aortic valve replacement used as emergent therapy for aortic insufficiency. We present a case in which transcatheter aortic valve replacement was implemented successfully as a salvage therapy in a hemodynamically unstable patient experiencing aortic insufficiency as a result of a torn bio-prosthetic leaflet during an unrelated abdominal operation. The successful use of this technique in a non-cardiac operating room allowed the patient to be placed on extracorporeal support and ultimately to be discharged home...
March 13, 2018: Annals of Thoracic Surgery
J Russell Hoverman, Marcus A Neubauer, Melissa Jameson, Jad E Hayes, Kathryn J Eagye, Mitra Abdullahpour, Wendy J Haydon, Maria Sipala, Amy Supraner, Michael A Kolodziej, Diana K Verrilli
PURPOSE: Reform of cancer care delivery seeks to control costs while improving quality. Texas Oncology collaborated with Aetna to conduct a payer-sponsored program that used evidence-based treatment pathways, a disease management call center, and an introduction to advance care planning to improve patient care and reduce total costs. METHODS: From June 1, 2013, to May 31, 2016, 746 Medicare Advantage patients with nine common cancer diagnoses were enrolled. Patients electing for patient support services were telephoned by oncology nurses who assessed symptoms and quality of life and introduced advance care planning...
March 16, 2018: Journal of Oncology Practice
Carrie L McCarthy, Richard L Brutchey
Solution processing has emerged as a promising option for the preparation of functional materials with methods that tend to be cheap, less energy intensive, and allow for high throughput and large area deposition. A recently developed method, whereby a binary thiol-amine solvent mixture is used to dissolve bulk oxides, chalcogenides, or elemental materials to yield molecular precursor inks for the deposition of phase pure chalcogenide materials, has recently garnered attention for applications in optoelectronics, thermoelectrics, and electrocatalysis...
March 16, 2018: Dalton Transactions: An International Journal of Inorganic Chemistry
Yan Zhang, Zhongyuan Huang, Letao Wang, Chunming Wang, Changde Zhang, Thomas E Wiese, Guangdi Wang, Kevin Eugene Riley, Zhe Wang
This work aims to face the challenge of monitoring small molecule drugs accurately and rapidly for point-of-care (POC) diagnosis in current clinical settings. Overdose of acetaminophen (AP), a commonly used OTC analgesic drug, has been determined to be a major cause of acute liver failure in the US and the UK. However, there is no rapid and accurate detection method available for this drug in the emergency room. The present study examined an AP sensing strategy that relies on a previously unexplored strong interaction between AP and the arginine (Arg) molecule...
March 15, 2018: Analytical Chemistry
Hadil Ak AlOtair, Abdulaziz H Alzeer, Mohammed A Abdou, Shaden O Qasrawi
Central alveolar hypoventilation is rarely encountered. This case report describes a young woman who was recently diagnosed with hypertension and ischemic heart disease. She presented to the emergency room with hypercapnic respiratory failure, for which she was mechanically ventilated. This was preceded by an acute upper respiratory tract infection. She was initially suspected to have Guillain-Barré syndrome, but further investigations ruled out neuromuscular or autoimmune disorders. Sleep-related hypoventilation was suspected after she experienced recurrent apneas at night that resulted in re-intubation...
March 2018: Saudi Medical Journal
Jarkko Mäntylä, Tuuli Thomander, Auli Hakulinen, Kaarina Kukkonen, Kati Palosuo, Helena Voutilainen, Anna Pelkonen, Paula Kauppi
INTRODUCTION: The standard care of severe food allergy in both adults and children means avoidance of allergens. In recent years promising results of oral immunotherapy (OIT) have been reported in children. In adults, information on OIT in severe food allergy is very limited. OBJECTIVE: We aimed to study if OIT is possible in adults. METHODS: We report OIT results in 10 adult patients with milk OIT, nine adult patients with peanut OIT, and four adult patients with egg OIT...
March 15, 2018: Immunity, Inflammation and Disease
Samin Nobakht, Arash Shirdel, Yasamin Molavi-Taleghani, Mohammad M Doustmohammadi, Hojjat Sheikhbardsiri
INTRODUCTION: Human resource supply is considered as one of the most vital factors in achieving organizational goals, and human resources are the most valuable factor in the production and delivery of services. Labor shortages and surpluses could downgrade the quality of services offered to patients. Considering the seriousness of this issue, this study aimed to investigate the status of human resources in Iran hospitals. METHODS: The narrative review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines...
March 15, 2018: International Journal of Health Planning and Management
William Bullock, E Reed Smith, Craig Heligman
A number of recent incidents in the United States resulted in a large number of citizens reporting to the Emergency Room seeking reassurance that they were okay. These citizens are being referred to in the medical community as the "Worried Well." We conducted a review of a transportation incident involving a chemical release and fire, which resulted in over 100 people reporting to the local emergency room for evaluation. Few, if any of the patients seen in the hospital had a potential exposure to the chemical or combustion byproducts...
January 2018: Journal of Emergency Management: JEM
Gerald Jordan, Miriam Kinkaid, Srividya N Iyer, Ridha Joober, Karen Goldberg, Ashok Malla, Jai L Shah
PURPOSE: To explore the unintended impact of a targeted case identification (TCI) campaign for first episode psychosis (FEP) on people not experiencing FEP ("non-cases") with respect to referral patterns and reasons for being a non-case. METHODS: Sources of referral, reasons for being a non-case, and subsequent referral destinations of non-cases were examined before and after a TCI. RESULTS: Following the TCI, a greater proportion of non-cases lived outside the study catchment area...
March 14, 2018: Social Psychiatry and Psychiatric Epidemiology
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