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https://www.readbyqxmd.com/read/28636092/impact-of-diagnosis-of-von-willebrand-disease-on-patient-outcomes-analysis-of-medical-insurance-claims-data
#1
R F Sidonio, K M Haley, D Fallaize
The inherited bleeding disorder von Willebrand disease (VWD) is challenging to diagnose owing to disease heterogeneity, lack of a definitive laboratory test and variations in diagnostic criteria. We evaluated the impact of diagnosis and diagnostic delay on patient outcomes. The PharMetrics Plus Database was interrogated for medical claims for VWD (ICD-9 286.4) and bleeding events between 1 January 2006 and 30 June 2015. Longitudinal analysis was performed of patients newly diagnosed with VWD (≥9 months' continuous enrolment before first VWD claim) through 24 months following diagnosis...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28636072/using-chief-complaint-in-addition-to-diagnosis-codes-to-identify-falls-in-the-emergency-department
#2
Brian W Patterson, Maureen A Smith, Michael D Repplinger, Michael S Pulia, James E Svenson, Michael K Kim, Manish N Shah
OBJECTIVES: To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. DESIGN: Retrospective electronic record review. SETTING: Academic medical center ED. PARTICIPANTS: Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28635513/evaluation-of-platelet-indices-and-red-cell-distribution-width-as-new-biomarkers-for-the-diagnosis-of-acute-appendicitis
#3
Noha Boshnak, Mohamed Boshnaq, Hatem Elgohary
BACKGROUND: Debate around the value of laboratory tests in establishing the diagnosis of acute appendicitis (AA) still continues. This prospective study aimed to investigate the changes in mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) with the diagnosis of acute appendicitis. METHOD: 200 patients who underwent emergency appendectomy were included. According to postoperative histology, patients were divided into three groups: acute non-complicated, acute complicated appendicitis (positive appendicectomy groups), and negative appendectomy group...
February 16, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28634102/depression-and-asthma-outcomes-in-older-adults-results-from-the-national-health-and-nutrition-examination-survey
#4
Pooja O Patel, Minal R Patel, Alan P Baptist
BACKGROUND: Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults. OBJECTIVE: The objective of this study was to determine the association of depression with asthma outcomes in older adults (age ≥ 55) from the National Health and Nutrition Examination Survey (NHANES)...
June 17, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28633906/respiratory-syncytial-virus-rsv-in-adult-emergency-department-patients-do-emergency-providers-consider-rsv-as-an-admission-diagnosis-a-retrospective-observational-study-carried-out-at-massachusetts-general-hospital-boston-ma
#5
William Binder, Jill Thorsen, Pierre Borczuk
BACKGROUND: Respiratory Syncytial Virus (RSV) has been recognized for over half a century as a cause of morbidity in infants and children. Over the past 20years, data has emerged linking RSV as a cause of illness in adults resulting in 177,000 annual hospitalizations and up to 14,000 deaths among older adults. OBJECTIVE: Characterize clinical variables in a cohort of adult RSV patients. We hypothesize that emergency physicians do not routinely consider RSV in the differential diagnosis (DDx) of influenza like illness...
June 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#6
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633745/carcinoma-hemorrhagiectoides-case-report-of-an-uncommon-presentation-of-cutaneous-metastatic-breast-carcinoma
#7
Roberto Cullen Aravena, Daniella Cullen Aravena, Margarita Jo Velasco, Alejandra Queirolo González, Luis Requena
In most cases, cutaneous metastases develop after the diagnosis of the primary internal malignancy has been established, but sometimes they can be discovered earlier or simultaneously. We describe a case of a 90-year-old woman who presented to the emergency room in poor general condition, with cutaneous lesions characterized by hot, infiltrated, violaceous and erythematous plaques involving the left chest wall. The clinical and histopathological findings were consistent with the recently described variant of inflammatory cutaneous metastatic carcinoma named carcinoma hemorrhagiectoides...
June 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28633126/emergency-incarcerated-obturator-hernia-repair-with-biologic-mesh-in-a-male-patient-after-ipsilateral-hip-disarticulation-a-case-report
#8
Rodolfo J Oviedo, Alexander H W Molinari
INTRODUCTION: An obturator hernia is an uncommon form of abdominal hernia that is difficult to diagnose due to its non-distinct presentation. This case investigates an emergency treatment of an obturator hernia presenting in a patient with an ipsilateral hip disarticulation in a 266-bed community hospital. PRESENTATION OF CASE: A 53-year old man with a history of a left hip disarticulation 3-weeks prior presented to the emergency department with fever, nausea, vomiting, and diarrhea for the past 5-days...
June 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28633044/written-accounts-of-living-with-psychogenic-nonepileptic-seizures-a-thematic-analysis
#9
Gregg H Rawlings, Ian Brown, Brendan Stone, Markus Reuber
PURPOSE: Qualitative studies examining lived experiences of psychogenic nonepileptic seizures (PNES) have predominantly relied on datasets collected using clinical or research interviews. This study pursued a different approach by investigating individuals' written accounts of their condition. METHODS: Participants (n=19) were recruited from membership-led organisations for individuals living with seizures and from a United Kingdom hospital. Participants were instructed to produce four pieces of writing: 1) about their thoughts and feelings about their condition; 2) a letter to their condition; 3) a letter to their younger self; and 4) about a personal value...
June 15, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#10
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28632946/emerging-biomarkers-of-illness-severity-urinary-metabolites-associated-with-sepsis-and-necrotizing-methicillin-resistant-staphylococcus-aureus-pneumonia
#11
Lilliam Ambroggio, Todd A Florin, Samir S Shah, Richard Ruddy, Larisa Yeomans, Julie Trexel, Kathleen A Stringer
STUDY OBJECTIVE: To illustrate the potential of metabolomics to identify novel biomarkers of illness severity in a child with fatal necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Case report with two control groups and a metabolomics analysis. PATIENTS: An infant with fatal MRSA pneumonia, four children with influenza pneumonia (pneumonia control group), and seven healthy children with no known infections (healthy control group)...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28632827/-occult-bacteremia-in-s%C3%A3-tero-del-r%C3%A3-o-hospital-experience-after-pneumococcal-conjugated-vaccine
#12
Isolda Budnik, Alejandra Sandoval, Alejandra Prado, Marcela Labbé, Anamaría Peña, Tamara Viviani
BACKGROUND: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room. OBJECTIVE: describe OB in the era after introduction of pneumococcal vaccine in Chile. PATIENTS AND METHODS: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013. RESULTS: Possible OB was diagnosed on 391 patients...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632748/trimetazidine-therapy-for-diabetic-mouse-hearts-subjected-to-ex-vivo-acute-heart-failure
#13
Emilene Breedt, Lydia Lacerda, M Faadiel Essop
Acute heart failure (AHF) is the most common primary diagnosis for hospitalized heart diseases in Africa. As increased fatty acid β-oxidation (FAO) during heart failure triggers detrimental effects on the myocardium, we hypothesized that trimetazidine (TMZ) (partial FAO inhibitor) offers cardioprotection under normal and obese-related diabetic conditions. Hearts were isolated from 12-14-week-old obese male and female diabetic (db/db) mice versus lean non-diabetic littermates (db/+) controls. The Langendorff retrograde isolated heart perfusion system was employed to establish an ex vivo AHF model: a) Stabilization phase-Krebs Henseleit buffer (10 mM glucose) at 100 mmHg (25 min); b) Critical Acute Heart Failure (CAHF) phase-(1...
2017: PloS One
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#14
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632578/acute-abdominal-pain-recognition-and-management-of-constipation-in-the-emergency-department
#15
Stefania Norbedo, Giulia Bassanese, Francesca Barbieri, Egidio Barbi
OBJECTIVE: The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department. METHODS: This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#16
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632503/the-catastrophic-antiphospholipid-syndrome-in-children
#17
Ellen J L Go, Kathleen M O'Neil
PURPOSE OF REVIEW: To review the difficult syndrome of catastrophic antiphospholipid syndrome, emphasizing new developments in the diagnosis, pathogenesis and treatment. RECENT FINDINGS: Few recent publications directly address pediatric catastrophic antiphospholipid syndrome (CAPS). Most articles are case reports or are data from adult and pediatric registries. The major factors contributing to most pediatric catastrophic antiphospholipid syndrome include infection and the presence of antiphospholipid antibodies, but complement activation also is important in creating diffuse thrombosis in the microcirculation...
June 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28631894/serpini1-pathogenic-variants-an-emerging-cause-of-childhood-onset-progressive-myoclonic-epilepsy
#18
Emmanuelle Ranza, Stephanie Garcia-Tarodo, Konstantinos Varvagiannis, Michel Guipponi, Johannes A Lobrinus, Armand Bottani, Ilse Kern, Mary Kurian, Marie-Pascale Pittet, Stylianos E Antonarakis, Joel Fluss, Christian M Korff
Progressive myoclonic epilepsies are rare neurodegenerative diseases with a wide spectrum of clinical presentations and genetic heterogeneity that render their diagnosis perplexing. Discovering new imputable genes has been an ongoing process in recent years. We present two pediatric cases of progressive myoclonic epilepsy with SERPINI1 pathogenic variants that lead to a severe presentation; we highlight the importance of including this gene, previously known as causing an adult-onset dementia-epilepsy syndrome, in the genetic work-up of childhood-onset progressive myoclonic epilepsies...
June 20, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28631775/-innovations-in-the-treatment-of-ovarian-cancer-analysis-of-the-therapeutic-development-from-platinum-to-immunotherapy
#19
Gesuino Angius, Pierangela Sepe, Anselmo Papa, Silverio Tomao, Federica Tomao
Ovarian cancer is the seventh most common cancer in women. The therapeutic approach provides for an appropriate integration between surgery and chemotherapy. Surgery is an important step for diagnosis, staging and therapy, aiming at the complete cytoreduction of all macroscopic visible disease. At the moment, adjuvant and first-line chemotherapy has as a standard the carboplatin-paclitaxel combination. Further, the addition of bevacizumab in the advanced stage (IIIB-IV) is strongly recommended. Despite the initial effectiveness, however, 70-80% of patients develop relapsed disease within the first two years and require subsequent treatment lines that have palliative, rather than curative purposes and that seek to reach a chronic state for the disease...
June 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28631451/accuracy-of-transcutaneous-laryngeal-ultrasound-for-detecting-vocal-cord-paralysis-in-the-immediate-postoperative-period-after-total-thyroidectomy
#20
Marcos de Miguel, Eva M Peláez, Enric Caubet, Óscar González, Mercedes Velasco, Lidia Rigual
BACKGROUND: Transcutaneous laryngeal ultrasound (TLUS) has emerged as a promising imaging tool for vocal cord examination in patients undergoing thyroid surgery. The focus of this prospective, double-blind study was to assess the accuracy of TLUS in the diagnosis of vocal cord paralysis in the immediate postoperative period following total thyroidectomy. METHODS: The study included 93 patients undergoing total thyroidectomy and assessed by videostrobolaryngoscopy (VSL) and TLUS...
June 14, 2017: Minerva Anestesiologica
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