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https://www.readbyqxmd.com/read/28636421/analysis-of-origins-of-admission-for-solid-tumor-oncology-inpatients-disease-severity-and-outcomes
#1
Christopher E Wee, Lindsey M Goodman, Leticia Varella, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn H Best, James P Stevenson
PURPOSE: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes. METHODS: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics...
June 21, 2017: Journal of Oncology Practice
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/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#3
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#4
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/28631746/prevalence-of-androgen-deficiency-in-chronic-spinal-cord-injury-patients-suffering-from-erectile-dysfunction
#5
M Behnaz, Z Majd, M Radfar, H Ajami, M Qorbani, A Kokab
STUDY DESIGN: Retrospective cross-sectional study. OBJECTIVES: To estimate the prevalence of biochemical androgen deficiency in Iranian spinal cord injured men suffering from erectile dysfunction (ED) and to determine factors related to this problem. SETTING: An andrology clinic of a teaching hospital in Tehran. METHODS: Men, 18 years of age and older, with chronic (>2 years) spinal cord injury (SCI) suffering from ED were recruited...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28631577/the-impact-of-opioid-medications-on-subsequent-fractures-in-discharged-emergency-department-patients-with-peripheral-vertigo
#6
Keerat Grewal, Peter C Austin, Moira K Kapral, Hong Lu, Clare L Atzema
BACKGROUND: Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids. OBJECTIVES: To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period...
June 20, 2017: CJEM
https://www.readbyqxmd.com/read/28630844/multifocal-septic-arthritis-secondary-to-infective-endocarditis-a-rare-case-report
#7
Pavandeep Soor, Nikhil Sharma, Chandra Rao
INTRODUCTION: Infective endocarditis (IE) is a rare cause of septic arthritis. We report a patient who presented with multifocal septic arthritis as a result of IE, which is an extremely rare condition. CASE REPORT: This 69-year-old gentleman presented to the emergency department (ED) with a 3-day history of acute right knee pain. Initial investigations demonstrated chondrocalcinosis on knee radiographs, acute renal failure with rhabdomyolysis and a CRP of 520. After treatment with intravenous fluid rehydration and analgesia, the knee aspiration grew a Group B Streptococcus, and the patient underwent arthroscopic washout...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630774/lead-poisoning-can-be-easily-misdiagnosed-as-acute-porphyria-and-nonspecific-abdominal-pain
#8
Ming-Ta Tsai, Shi-Yu Huang, Shih-Yu Cheng
Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28628525/assessing-sensitivity-and-specificity-of-the-manchester-triage-system-in-the-evaluation-of-acute-coronary-syndrome-in-adult-patients-in-emergency-care-a-systematic-review
#9
Fernanda Ayache Nishi, Flávia de Oliveira Motta Maia, Itamar de Souza Santos, Dina de Almeida Lopes Monteiro da Cruz
BACKGROUND: Triage is the first assessment and sorting process used to prioritize patients arriving in the emergency department (ED). As a triage tool, the Manchester Triage System (MTS) must have a high sensitivity to minimize the occurrence of under-triage, but must not compromise specificity to avoid the occurrence of overtriage. Sensitivity and specificity of the MTS can be calculated using the frequency of appropriately assigned clinical priority levels for patients presenting to the ED...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28625532/emergency-department-do-not-resuscitate-order-in-patients-with-spontaneous-intracerebral-hemorrhage
#10
Ju-Sing Fan, Hsien-Hao Huang, Yen-Chia Chen, Chorng-Kuang How, David Hung-Tsang Yen
OBJECTIVES: To explore the determinant factors and prognostic significance of emergency department do-not-resuscitate (ED-DNR) orders for patients with spontaneous intracerebral hemorrhage (SICH). METHODS: Consecutive adult SICH patients treated in our ED from January 1, 2012 to December 31, 2016 were selected as the eligible cases from our hospital's stroke database. Patients' information was comprehensively reviewed from the database and medical and nursing charts...
June 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28625215/assessing-coagulation-by-rotational-thromboelastometry-rotem-in-rivaroxaban-anticoagulated-blood-using-hemostatic-agents
#11
Jonathan Bar, Alexa David, Tarek Khader, Mary Mulcare, Christopher Tedeschi
Introduction The use of direct oral anticoagulants (DOACs) such as rivaroxaban (Xarelto) is increasingly common. However, therapies for reversing anticoagulation in the event of hemorrhage are limited. This study investigates the ability of hemostatic agents to improve the coagulation of rivaroxaban-anticoagulated blood, as measured by rotational thromboelastometry (ROTEM). Hypothesis/Problem If a chitosan-based hemostatic agent (Celox), which works independently of the clotting cascade, is applied to rivaroxaban-anticoagulated blood, it should improve coagulation by decreasing clotting time (CT), decreasing clot formation time (CFT), and increasing maximum clot firmness (MCF)...
June 19, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28625000/mechanical-restraint-in-an-emergency-department-a-consecutive-series-of-593-cases
#12
Nicolas Beysard, Bertrand Yersin, Pierre-Nicolas Carron
The objective is to describe the characteristics of mechanically restrained patients in the emergency department (ED) of a university hospital and to evaluate the quality of restraint documentation that was filled out according to the dedicated protocol with respect to the law on restraint. All adult patients (≥16 years) who were admitted to the ED from January 2009 to December 2010 and were mechanically restrained were included. We assessed medical and demographic characteristics, the completeness of the dedicated protocol, and the concomitant use of chemical sedation...
June 17, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28624376/orthorexia-nervosa-and-eating-disorder-symptoms-in-registered-dietitian-nutritionists-in-the-united-states
#13
Kaylee Tremelling, Lona Sandon, Gloria L Vega, Carrie J McAdams
BACKGROUND: Registered dietitian nutritionists are trained to identify optimal food choices for clients based on medical state and lifestyle. Orthorexia nervosa (ON) is a proposed disorder related to obsessions about eating healthfully. Eating disorders (EDs) are serious mental illnesses with symptoms related to eating, body image, and self-esteem. Both ON and EDs are more common among RDNs than the general population. OBJECTIVE: This study examined the prevalence of ON and EDs in RDNs in the United States and, among this sample, assessed whether the presence of ON symptoms related to symptoms of EDs, including weight, shape, eating, and restraint...
June 14, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28624064/assessing-written-communication-during-interhospital-transfers-of-emergency-general-surgery-patients
#14
Felicity N R Harl, Megan C Saucke, Caprice C Greenberg, Angela M Ingraham
BACKGROUND: Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. METHODS: We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622813/evaluation-of-drug-use-and-medication-compliance-in-adolescents-admitted-to-a-psychiatric-facility-from-the-pediatric-emergency-department
#15
George Sam Wang, Genie Roosevelt, Amy Becker, Lina Brou, Jeffrey L Galinkin
OBJECTIVES: Knowledge of drug use and medication compliance during mental health evaluation can help guide evaluation and treatment. The objective was to evaluate drug use and medication compliance in a pediatric emergency department (PED) psychiatric population by comparing medical history, standard urine drug screen (EIA), and expanded urine drug screen (HPLC-MS/MS). METHODS: A prospective cohort study of admitted psychiatric patients ≥13years and ≤18years in a tertiary-care children's hospital psychiatric ED from January 31, 2013 through April 16, 2014...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28617790/clinical-management-and-patient-persistence-with-antibiotic-course-in-suspected-group-a-streptococcal-pharyngitis-for-primary-prevention-of-rheumatic-fever-the-perspective-from-a-new-zealand-emergency-department
#16
Jeremy J Mathan, Jozsef Ekart, Anthony Houlding, Gary Payinda, Clair Mills
AIM: Rates of acute rheumatic fever in the Northland region are historically among the highest in New Zealand, impacting disproportionately on Māori children and youth. The primary aim of this study was to determine patient persistence to antibiotic treatment for group A streptococcus (GAS) pharyngitis in patients presenting with sore throat to the Whangarei Hospital Emergency Department. Secondarily, this study sought to determine prescriber adherence to the national antibiotic guideline for sore throat management...
June 16, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28615932/expanding-the-inspired-copd-outreach-program%C3%A2-to-the-emergency-department-a-feasibility-assessment
#17
Darcy Gillis, Jillian Demmons, Graeme Rocker
BACKGROUND: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28615465/emergency-department-urinary-antibiograms-differ-by-specific-patient-groups
#18
S Jorgensen, M Zurayk, S Yeung, J Terry, M Dunn, P Nieberg, A Wong-Beringer
Background: Patients presenting to the ED represent a heterogeneous population comprised of all ages, from the community and skilled-nursing facilities (SNF), and at varying risk for resistant pathogens. The aim of this study was to compare patient group-specific urinary antibiograms in ED.Methods: Adults presented to ED with an ICD 9/10 UTI diagnosis during 7/15 - 6/16 were randomly selected (n=500) to extract relevant demographic, laboratory, and clinical data from the medical record. Urinary E. coli antibiograms were compared between: institutional vs...
June 14, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28611901/a-comparison-of-urolithiasis-in-the-presence-and-absence-of-microscopic-hematuria-in-the-emergency-department
#19
Jason M Mefford, Robert M Tungate, Leila Amini, Dongjin Suh, Craig L Anderson, Scott E Rudkin, Megan Boysen-Osborn
INTRODUCTION: Urolithiasis is a common medical condition that accounts for a large number of emergency department (ED) visits each year and contributes significantly to annual healthcare costs. Urinalysis is an important screening test for patients presenting with symptoms suspicious for urolithiasis. At present there is a paucity of medical literature examining the characteristics of ureteral stones in patients who have microscopic hematuria on urinalysis versus those who do not. The purpose of this study was to examine mean ureteral stone size and its relationship to the incidence of clinically significant hydronephrosis in patients with and without microscopic hematuria...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611900/replacement-of-dislodged-gastrostomy-tubes-after-stoma-dilation-in-the-pediatric-emergency-department
#20
Shiloni Bhambani, Tammy H Phan, Lance Brown, Andrea W Thorp
INTRODUCTION: A dislodged gastrostomy tube (GT) is a common complaint that requires evaluation in the pediatric emergency department (ED) and, on occasion, will require stoma dilation to successfully replace the GT. The objective of this study was to describe the frequency that stoma dilation is required, the success rate of replacement, complications encountered, and the techniques used to confirm placement of the GT after dilation. METHODS: We conducted a retrospective medical record review of children 0-18 years who presented to the pediatric ED from February 2013 through February 2015 with a dislodged GT that required stoma dilation by pediatric emergency physicians with serially increasing Foley catheter sizes prior to successful placement of the GT...
June 2017: Western Journal of Emergency Medicine
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