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https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#1
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#2
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28811121/emergency-department-use-in-the-perinatal-period-an-opportunity-for-early-intervention
#3
Saloni Malik, Catherine Kothari, Colleen MacCallum, Michael Liepman, Shama Tareen, Karin V Rhodes
STUDY OBJECTIVE: We characterize emergency department (ED) utilization among perinatal women and identify differences in risk factors and outcomes between women who use versus do not use the ED during the perinatal period. METHODS: This is a retrospective cross-sectional study comparing patients who used the ED versus did not use the ED during the perinatal period. Patient data were collected from medical chart review and postpartum interviews. RESULTS: Of the 678 participants, 218 (33%) had at least 1 perinatal ED visit...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28810975/adaptation-of-screening-brief-intervention-referral-to-treatment-to-active-duty-military-personnel-in-an-emergency-department-findings-from-a-formative-research-study
#4
Megan Holt, Mark Reed, Susan I Woodruff, Gerard DeMers, Michael Matteucci, Suzanne L Hurtado
BACKGROUND: The transient nature of military life coupled with environmental and psychosocial stressors increase the risk for alcohol misuse and abuse among active duty (AD) military service members and recent epidemiological studies demonstrate high rates of heavy drinking among AD personnel. Over the past decade, Department of Defense health care systems have observed increases in the utilization of substance use services among military personnel demobilizing from Operation Enduring Freedom and Operation Iraqi Freedom...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28809587/severe-asthma-emergency-care-patient-driven-solutions
#5
Karen Newell, Chris Corrigan, Geoffrey Punshon, Alison Leary
Purpose Patients with severe asthma were choosing not to use the emergency department (ED) in extremis and were self-medicating when experiencing severe asthma, putting their lives at risk. This local issue reflected a nationwide situation. The purpose of this paper is to better understand the reasons behind patients' reluctance to attend ED and to consider practical solutions in a structured way. Design/methodology/approach Systems thinking (soft systems methodology) was used to examine the issues resulting in this reluctance to attend the ED...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28807486/gender-social-networks-and-stroke-preparedness-in-the-stroke-warning-information-and-faster-treatment-study
#6
Tracy E Madsen, Eric T Roberts, Heather Kuczynski, Emily Goldmann, Nina S Parikh, Bernadette Boden-Albala
BACKGROUND AND PURPOSE: The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset. METHODS: As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center...
August 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28807069/a-pilot-project-demonstrating-that-combat-medics-can-safely-administer-parenteral-medications-in-the-emergency-department
#7
Steven G Schauer, Cord W Cunningham, Andrew D Fisher, Robert A DeLorenzo
Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28806942/impact-of-inpatient-care-in-emergency-department-on-outcomes-a-quasi-experimental-cohort-study
#8
Aisha Lateef, Soo Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H Phan, Reshma A Merchant
BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#9
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#10
Jingjing Qian, Saranrat Wittayanukorn, Richard A Hansen
This study estimated patterns and trends in all-cause (any reason, including psychiatry related) and psychiatric emergency department (ED) utilization among Medicare beneficiaries under 65 who were residing in community settings (i.e., noninstitutionalized or in their own homes). Medicare beneficiaries under the age of 65 enrolled in Medicare for Social Security Disability Insurance (SSDI) due to permanent physical or mental disabilities are a population with poor health conditions and high utilization of health services; however, this vulnerable population has received limited attention from researchers and policymakers compared to the Medicare beneficiaries 65 years and older...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28802541/opioid-doses-and-acute-care-utilization-outcomes-for-adults-with-sickle-cell-disease-emergency-department-versus-acute-care-unit
#11
Robert E Molokie, Chariz Montminy, Corissa Dionisio, Muhammad Ahmen Farooqui, Michel Gowhari, Yingwei Yao, Marie L Suarez, Miriam O Ezenwa, Judith M Schlaeger, Zaijie J Wang, Diana J Wilkie
BACKGROUND: Acute care units (ACUs) with focused sickle cell disease (SCD) care have been shown to effectively address pain and limit hospitalizations compared to emergency departments (ED), the reason for differences in admission rates is understudied. Our aim was compare effects of usual care for adult SCD pain in ACU and ED on opioid doses and discharge pain ratings, hospital admission rates and lengths of stay. METHODS: In a retrospective, comparative cohort, single academic tertiary center study, 148 adults with sickle cell pain received care in the ED, ACU or both...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#12
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28801485/identifying-discordance-between-senior-physicians-and-trainees-on-the-root-cause-of-ed-revisits
#13
Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur
OBJECTIVE: Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities. METHODS: Questionnaire-based observational study conducted in an urban academic paediatric ED...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801399/a-randomised-controlled-pilot-trial-evaluating-feasibility-and-acceptability-of-a-computer-based-tool-to-identify-and-reduce-harmful-and-hazardous-drinking-among-adolescents-with-alcohol-related-presentations-in-canadian-pediatric-emergency-departments
#14
Amanda S Newton, Nadia Dow, Kathryn Dong, Eleanor Fitzpatrick, T Cameron Wild, David W Johnson, Samina Ali, Ian Colman, Rhonda J Rosychuk
OBJECTIVE: This study piloted procedures and obtained data on intervention acceptability to determine the feasibility of a definitive randomised controlled trial (RCT) of the effectiveness of a computer-based brief intervention in the emergency department (ED). DESIGN: Two-arm, multi-site, pilot RCT. SETTING AND PARTICIPANTS: Adolescents aged 12-17 years presenting to three Canadian pediatric EDs from July 2010 to January 2013 for an alcohol-related complaint...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800799/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-2-special-psychiatric-populations-and-considerations
#15
REVIEW
Al Alam, James Rachal, Veronica Theresa Tucci, Nidal Moukaddam
Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800416/the-enigma-of-male-eating-disorders-a-critical-review-and-synthesis
#16
REVIEW
Stuart B Murray, Jason M Nagata, Scott Griffiths, Jerel P Calzo, Tiffany A Brown, Deborah Mitchison, Aaron J Blashill, Jonathan M Mond
Historically, male presentations of eating disorders (EDs) have been perceived as rare and atypical - a perception that has resulted in the systematic underrepresentation of males in ED research. This underrepresentation has profoundly impacted clinical practice with male patients, in which i) stigmatization and treatment non-engagement are more likely, ii) a distinct array of medical complexities are faced, and iii) symptom presentations differ markedly from female presentations. Further, the marginalization of males from ED research has hindered the assessment and clinical management of these presentations...
August 2, 2017: Clinical Psychology Review
https://www.readbyqxmd.com/read/28798798/the-protective-effect-of-salidroside-on-hypoxia-induced-corpus-cavernosum-smooth-muscle-cell-phenotypic-transformation
#17
Xiang Zhang, Jian-Feng Zhao, Fan Zhao, Jun-Feng Yan, Fan Yang, Xiao-Jun Huang, Gang Chen, Hui-Ying Fu, Bo-Dong Lv
Salidroside, a major active ingredient isolated from Rhodiola rosea, has a long application in Chinese medical history. It has widely demonstrated effects on fatigue, psychological stress, and depression and exhibits potential antihypoxia activity. Emerging evidence shows that hypoxia is an important independent risk factor for erectile dysfunction (ED). The aim of this study was to clarify the effect of salidroside on hypoxia-induced phenotypic transformation of corpus cavernosum smooth muscle cells (CCSMCs)...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28795285/polypharmacy-and-potential-drug-drug-interactions-in-emergency-department-patients-in-the-caribbean
#18
Darren Dookeeram, Satesh Bidaisee, Joanne F Paul, Paula Nunes, Paula Robertson, Vidya Ramcharitar Maharaj, Ian Sammy
Background Potential Drug-Drug Interactions (DDI) account for many emergency department visits. Polypharmacy, as well as herbal, over-the-counter (OTC) and combination medication may compound this, but these problems are not well researched in low-and-middle-income countries. Objective To compare the incidence of drug-drug interactions and polypharmacy in older and younger patients attending the Emergency Department (ED). Setting The adult ED of a tertiary teaching hospital in Trinidad. Methods A 4 month cross sectional study was conducted, comparing potential DDI in older and younger patients discharged from the ED, as defined using Micromedex 2...
August 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28793090/prevalence-of-erectile-dysfunction-oral-drugs-use-in-a-city-of-southern-brazil
#19
Daniel Vanti Duarte, María Clara Restrepo-Méndez, Mariângela Freitas da Silveira
The last decade has seen a breakthrough in the treatment of erectile dysfunction (ED) with the advent of phosphodiesterase-5 inhibitors. There are few population-based observational studies on the prevalence of use of these drugs. We conducted a cross-sectional population-based study in the city of Pelotas (Brazil). Our sample comprised 1,082 men aged 20 years or older who answered a confidential and self-administered questionnaire. Prevalence of EDD use was 5% (IC95% = 4%;7%). ED and advanced age were strongly associated with a higher prevalence of EDD use...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#20
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
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