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https://www.readbyqxmd.com/read/29664808/trends-in-pharmacological-emergency-treatment-of-patients-suffering-from-schizophrenia-over-a-16-year-observation-period
#1
Monika Edlinger, Anna-Sophia Welte, Nursen Yalcin-Siedentopf, Georg Kemmler, Felix Neymeyer, W Wolfgang Fleischhacker, Alex Hofer
Patients suffering from schizophrenia are often treated in locked psychiatric units because of psychomotor agitation, hostility and aggressive behavior, or suicidality. Because of legal conditions, investigations on these acutely ill patients are difficult, and many studies do not represent 'real-life psychiatry'. This retrospective survey was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Medical University, Innsbruck, Austria. Data were collected from the records of all adult inpatients suffering from a schizophrenia spectrum disorder according to the International Classification of Diseases, 10th ed...
April 16, 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29628184/the-two-bag-method-for-treatment-of-diabetic-ketoacidosis-in-adults
#2
Nathan L Haas, Roma Y Gianchandani, Kyle J Gunnerson, Benjamin S Bassin, Arun Ganti, Christopher Hapner, Caryn Boyd, James A Cranford, Sage P Whitmore
BACKGROUND: The "two-bag method" of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant. OBJECTIVE: We aimed to evaluate the feasibility and potential benefits of this strategy in adult emergency department (ED) patients with DKA. METHODS: This is a before-and-after comparison of a protocol using the two-bag method operationalized in our adult ED in 2015...
April 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29623242/the-impact-of-a-case-of-ebola-virus-disease-on-emergency-department-visits-in-metropolitan-dallas-fort-worth-tx-july-2013-july-2015-an-interrupted-time-series-analysis
#3
Noelle-Angelique M Molinari, Tanya Telfair LeBlanc, William Stephens
Background: The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US. Methods: This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth--, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI)...
March 20, 2018: PLoS Currents
https://www.readbyqxmd.com/read/29619807/-recommendations-for-the-care-of-patients-with-community-acquired-pneumonia-in-the-emergency-department
#4
A Julián-Jiménez, I Adán Valero, A Beteta López, L M Cano Martín, O Fernández Rodríguez, R Rubio Díaz, M A Sepúlveda Berrocal, J González Del Castillo, F J Candel González
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29614996/more-to-gain-dietary-energy-density-is-related-to-smoking-status-in-us-adults
#5
R Ross MacLean, Alexandra Cowan, Jacqueline A Vernarelli
BACKGROUND: Given the current prevalence of both cigarette use and obesity in the United States, identification of dietary patterns that reduce mortality risk are important public health priorities. The objective of the present study was to evaluate the correlation between cigarette use and dietary energy density, a marker for diet quality, in a population of current smokers, former smokers, and never smokers. METHODS: Data from a nationally representative sample of 5293 adults who participated in the 2013-2014 National Health and Nutrition Examination Surveys (NHANES) were analyzed...
April 4, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29584659/is-what-low-income-brazilians-are-eating-in-popular-restaurants-contributing-to-promote-their-health
#6
Alinne de Paula Carrijo, Raquel Braz Assunção Botelho, Rita de Cássia Coelho de Almeida Akutsu, Renata Puppin Zandonadi
This study evaluates the healthfulness of the meals offered to and consumed by low-income Brazilians in Popular Restaurants (PR). It is a cross-sectional, exploratory study. The final sample includes 36 PRs, respecting the stratification criteria for each of the five Brazilian regions. To identify the quantity and quality of food consumption, consumers' meals are evaluated. The sample calculation uses a minimum of 41 consumers in each PR. Consumption evaluation is carried out by weighing and direct observation of the meal that each consumer served to his plate...
March 27, 2018: Nutrients
https://www.readbyqxmd.com/read/29573904/causes-of-emergency-department-overcrowding-and-blockage-of-access-to-critical-services-in-beijing-a-2-year-study
#7
Zhen Wang, Xiaying Xiong, Shuang Wang, Junguo Yan, Martin Springer, R P Dellinger
BACKGROUND: Emergency department (ED) overcrowding is a serious issue worldwide. OBJECTIVES: This study was done to evaluate the degree of overcrowding in local "teaching hospitals" in Beijing, and to ascertain the apparent root causes for the pervasive degree of overcrowding in these EDs. METHODS: This is a multicenter cross-sectional study. The studied population included all ED patients from 18 metropolitan teaching hospital EDs in Beijing for calendar years 2013 and 2014...
March 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29572091/effects-on-short-term-outcome-of-non-invasive-ventilation-use-in-the-emergency-department-to-treat-patients-with-acute-heart-failure-a-propensity-score-based-analysis-of-the-eahfe-registry
#8
Òscar Miró, Gemma Martínez, Josep Masip, Víctor Gil, Francisco Javier Martín-Sánchez, Pere Llorens, Pablo Herrero-Puente, Carolina Sánchez, Fernando Richard, Javier Lucas-Invernón, José Manuel Garrido, Alexandre Mebazaa, José Ríos, W Frank Peacock, Judd E Hollander, Javier Jacob
OBJECTIVE: To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes. METHODS: Patients from the EAHFE Registry (a multicenter, observational, multipurpose, cohort-designed database including consecutive AHF patients in 41 Spanish EDs) were grouped based on NIV treatment (NIV+ and NIV-groups). Using propensity score (PS) methodology, we identified two subgroups of patients matched by 38 covariates and compared regarding 30-day survival (primary outcome)...
March 20, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29570120/mortality-associated-with-emergency-department-boarding-exposure-are-there-differences-between-patients-admitted-to-icu-and-non-icu-settings
#9
Martin A Reznek, Benjavan Upatising, Samantha J Kennedy, Natassia T Durham, Richard M Forster, Sean S Michael
BACKGROUND: Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS: We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of adult patients admitted from the ED. We used Kaplan-Meier estimation and Cox Proportional Hazards regression to describe differences in boarding time among patients who died during hospitalization versus those who survived, controlling for covariates that could affect mortality risk or boarding exposure, and separately evaluating patients admitted to ICUs versus non-ICU settings...
May 2018: Medical Care
https://www.readbyqxmd.com/read/29569323/real-world-observational-results-from-a-database-of-48-million-men-in-the-united-states-relationship-of-cardiovascular-disease-diabetes-mellitus-and-depression-with-age-and-erectile-dysfunction
#10
Irwin Goldstein, Richard Chambers, WingYu Tang, Vera Stecher, Tarek Hassan
AIMS: To evaluate the relationship of comorbidities (cardiovascular disease [CVD], diabetes mellitus [DM] and depression) with erectile dysfunction (ED) and age using real-world claims data from 48 million men in the United States. METHODS: This was a cross-sectional, non-interventional study in men aged ≥18 years using data from the Truven Health MarketScan® and Medicare Supplemental Research Databases from January 2010 to December 2015, with an observational period of January 2011 to December 2014 to allow for 12 months pre- and post-index...
March 22, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29562151/a-randomized-trial-of-high-flow-oxygen-therapy-in-infants-with-bronchiolitis
#11
RANDOMIZED CONTROLLED TRIAL
Donna Franklin, Franz E Babl, Luregn J Schlapbach, Ed Oakley, Simon Craig, Jocelyn Neutze, Jeremy Furyk, John F Fraser, Mark Jones, Jennifer A Whitty, Stuart R Dalziel, Andreas Schibler
BACKGROUND: High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. METHODS: In this multicenter, randomized, controlled trial, we assigned infants younger than 12 months of age who had bronchiolitis and a need for supplemental oxygen therapy to receive either high-flow oxygen therapy (high-flow group) or standard oxygen therapy (standard-therapy group)...
March 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29560059/emergency-department-ed-ed-observation-day-hospital-and-hospital-admissions-for-adults-with-sickle-cell-disease
#12
David M Cline, Susan Silva, Caroline E Freiermuth, Victoria Thornton, Paula Tanabe
Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC), such as a day hospital (DH) or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) VOC, we prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) DH, and 4) hospital admission, of two different patient cohorts with SCD presenting to our two study sites...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29560048/emergency-department-experience-with-novel-electronic-medical-record-order-for-referral-to-food-resources
#13
Marc L Martel, Lauren R Klein, Kurt A Hager, Diana B Cutts
Introduction: Food insecurity is a significant issue in the United States and is prevalent in emergency department (ED) patients. The purpose of this study was to report the novel use of an integrated electronic medical record (EMR) order for food resources, and to describe our initial institutional referral patterns after focused education and implementation of the order. Methods: This was a retrospective, observational study, describing food-bank referral patterns before and after the implementation of dedicated ED education on the novel EMR order for food resources...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29560046/implementation-of-a-rapid-protocol-based-tia-management-pathway
#14
Susann J Jarhult, Melissa L Howell, Isabelle Barnaure-Nachbar, Yuchiao Chang, Benjamin A White, Mary Amatangelo, David F Brown, Aneesh B Singhal, Lee H Schwamm, Scott B Silverman, Joshua N Goldstein
Introduction: Our goal was to assess whether use of a standardized clinical protocol improves efficiency for patients who present to the emergency department (ED) with symptoms of transient ischemic attack (TIA). Methods: We performed a structured, retrospective, cohort study at a large, urban, tertiary care academic center. In July 2012 this hospital implemented a standardized protocol for patients with suspected TIA. The protocol selected high-risk patients for admission and low/intermediate-risk patients to an ED observation unit for workup...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29550098/evaluating-the-emergency-department-observation-unit-for-the-management-of-hyperglycemia-in-adults
#15
Colin J Crilly, Amy J Allen, Teresa M Amato, Allison Tiberio, Rifka C Schulman, Robert A Silverman
OBJECTIVE: To determine whether hyperglycemic patients can be successfully managed in the Emergency Department Observation Unit (EDOU), as determined by the frequency of inpatient admission following their EDOU stay. METHODS: This was a retrospective chart review of patients≥18years presenting to an academic tertiary care ED between May 1, 2014 and May 31, 2016, found to have a glucose≥300mg/dL, and selected for EDOU admission. Patient demographic information, lab results including an HbA1c, disposition, and hospital revisits within 30days of discharge were recorded...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29549922/comparison-of-clinical-practice-in-the-emergency-department-female-versus-male-emergency-physicians
#16
Kuo-Chen Huang, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, I-Min Chiu, Chao-Jui Li
BACKGROUND: There are fewer female emergency physicians (EPs) than male ones. This study attempted to analyze the differences in clinical practice between female and male EPs in the emergency department (ED). MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across 4 EDs in the largest healthcare system in Taiwan. A total of 199,757 adult patients without trauma treated by 76 EPs (9 females and 67 males) were included in the study. The clinical practice of female and male EPs was compared...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29543941/utilization-of-ophthalmologist-consultation-for-emergency-care-at-a-university-hospital
#17
Sophia Y Wang, Mariam S Hamid, David C Musch, Maria A Woodward
Importance: Nearly 2 million patients visit emergency departments (EDs) because of eye concerns annually in the United States. How hospitals currently assign these patients to treatment is important for designing systems that equitably allocate resources for eye care in urgent settings. Objective: To investigate factors associated with ophthalmology consultation for eye-related adult ED encounters to assess possible disparities by sex, race/ethnicity, language preference, or residential distance from the medical center...
March 15, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29524340/creation-and-implementation-of-an-outpatient-pathway-for-atrial-fibrillation-in-the-emergency-department-setting-results-of-an-expert-panel
#18
Christopher W Baugh, Carol L Clark, Jason W Wilson, Ian G Stiell, Abraham G Kocheril, Krista K Luck, Troy D Myers, Charles V Pollack, Steven K Roumpf, Gery F Tomassoni, James M Williams, Brian B Patel, Fred Wu, Jesse M Pines
Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States (US). Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways...
March 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29523426/in-hospital-sepsis-mortality-rates-comparing-tertiary-and-non-tertiary-hospitals-in-washington-state
#19
Gail G Salvatierra, Bernice G Gulek, Baran Erdik, Deborah Bennett, Kenn B Daratha
BACKGROUND: More than a million people a year in the United States experience sepsis or sepsis-related complications, and sepsis remains the leading cause of in-hospital deaths. Unlike many other leading causes of in-hospital mortality, sepsis detection and treatment are not dependent on the presence of any technology or services that differ between tertiary and non-tertiary hospitals. OBJECTIVE: To compare sepsis mortality rates between tertiary and non-tertiary hospitals in Washington State...
March 6, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29502499/biophysics-model-of-heavy-ion-degradation-of-neuron-morphology-in-mouse-hippocampal-granular-cell-layer-neurons
#20
Murat Alp, Francis A Cucinotta
Exposure to heavy-ion radiation during cancer treatment or space travel may cause cognitive detriments that have been associated with changes in neuron morphology and plasticity. Observations in mice of reduced neuronal dendritic complexity have revealed a dependence on radiation quality and absorbed dose, suggesting that microscopic energy deposition plays an important role. In this work we used morphological data for mouse dentate granular cell layer (GCL) neurons and a stochastic model of particle track structure and microscopic energy deposition (ED) to develop a predictive model of high-charge and energy (HZE) particle-induced morphological changes to the complex structures of dendritic arbors...
March 2018: Radiation Research
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