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Emergency department operations

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https://www.readbyqxmd.com/read/28647770/ct-value-of-the-intestine-is-useful-predictor-for-differentiate-irreversible-ischaemic-changes-in-strangulated-ileus
#1
Atsushi Kohga, Akihiro Kawabe, Kiyoshige Yajima, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Kenji Suzuki, Katsuaki Muramatsu
PURPOSE: To determine the differential points of strangulated ileus with and without irreversible ischaemic changes, especially on preoperative computed tomography (CT) images. METHODS: Seventy patients with strangulated ileus underwent emergency operations between January 2009 and July 2016 in our department. Of these patients, 57 met the study requirements, including 30 patients who had irreversible ischaemic changes (ischaemic group; n = 30) and 27 patients who had reversible ischaemic changes during laparotomy (non-ischaemic group; n = 27)...
June 24, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28647716/bilateral-recurrent-pyosalpinx-in-a-sexually-inactive-12-year-old-girl-secondary-to-rare-variant-of-mullerian-duct-anomaly
#2
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647650/quick-sequential-organ-failure-assessment-compared-to-systemic-inflammatory-response-syndrome-for-predicting-sepsis-in-emergency-department
#3
Hyun Kyung Park, Won Young Kim, Myung Chun Kim, Woong Jung, Byuk Sung Ko
PURPOSE: It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department (ED). METHODS: A retrospective observational study was conducted in an ED during a 9-year period...
June 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28647048/-resident-as-teacher-in-pediatric-surgery-innovation-is-overdue-in-central-europe
#4
REVIEW
S Zundel, M Stocker, P Szavay
PURPOSE: We set out to evaluate how residents in pediatric surgery learn and how they teach. We hypnotized that European residents learn as much from their peers and teach as much as their fellows worldwide, but that they receive comparably less educational training. METHODS: An online questionnaire was distributed to the participants of the combined annual meeting for German, Swiss and Austrian residents in pediatric surgery. Participants were asked whom they learn from in different workplace environments (ward, operating room, emergency department), how, when and why they adopt the role of teacher and how they were prepared for this role...
June 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28643568/process-mining-based-method-of-designing-and-optimizing-the-layouts-of-emergency-departments-in-hospitals
#5
Farhood Rismanchian, Young Hoon Lee
OBJECTIVE: This article proposes an approach to help designers analyze complex care processes and identify the optimal layout of an emergency department (ED) considering several objectives simultaneously. These objectives include minimizing the distances traveled by patients, maximizing design preferences, and minimizing the relocation costs. BACKGROUND: Rising demand for healthcare services leads to increasing demand for new hospital buildings as well as renovating existing ones...
July 2017: HERD
https://www.readbyqxmd.com/read/28639959/3d-printing-current-use-in-facial-plastic-and-reconstructive-surgery
#6
Tsung-Yen Hsieh, Raj Dedhia, Brian Cervenka, Travis T Tollefson
PURPOSE OF REVIEW: To review the use of three-dimensional (3D) printing in facial plastic and reconstructive surgery, with a focus on current uses in surgical training, surgical planning, clinical outcomes, and biomedical research. To evaluate the limitations and future implications of 3D printing in facial plastic and reconstructive surgery. RECENT FINDINGS: Studies reviewed demonstrated 3D printing applications in surgical planning including accurate anatomic biomodels, surgical cutting guides in reconstruction, and patient-specific implants fabrication...
July 20, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#7
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28637583/the-revised-trauma-score-plus-serum-albumin-level-improves-the-prediction-of-mortality-in-trauma-patients
#8
Seong Chun Kim, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Daesung Lim
INTRODUCTION: The Revised Trauma Score (RTS) is used worldwide in prehospital practice and in the emergency department (ED) settings to triage trauma patients. The main purpose of this study was to evaluate the value of the RTS plus serum albumin (RTS-A) and to compare it with other existing trauma scores as well as to compare the predictive performance of the Trauma and Injury Severity Score with the RTS-A (TRISS-A) with the original TRISS. METHODS: This was a single center, trauma registry based observational cohort study...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633905/short-and-long-term-mortality-of-patients-presenting-with-bleeding-events-to-the-emergency-department
#9
Alberto Conti, Noemi Renzi, Daniele Molesti, Simone Bianchi, Irene Bogazzi, Giada Bongini, Giuseppe Pepe, Fabiana Frosini, Alessio Bertini, Massimo Santini
BACKGROUND: Death of patients presenting with bleeding events to the Emergency Department still represent a major problem. We sought to analyze clinical characteristics associated with worse outcomes including short- and long-term death, beyond antithombotic treatment strategy. METHODS: Patients presenting with any bleeding events during 2016-2017years were enrolled. Clinical parameters, site of bleeding, major bleeding, ongoing anti-thrombotic treatment strategy and death were collected...
June 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633903/internal-validation-of-a-scoring-system-to-evaluate-the-probability-of-ureteral-stones-the-chokai-score
#10
Hiroki Fukuhara, Osamu Ichiyanagi, Shinichi Midorikawa, Hiroshi Kakizaki, Hisashi Kaneko, Norihiko Tsuchiya
OBJECTIVE: The CHOKAI and STONE scores are prediction models for ureteral stones. The aims of the present study were to evaluate the diagnostic performance, to examine the optimal cut-off value, and to compare the diagnostic performance of each model. METHODS: Patients who presented to our emergency department with renal colic were considered for this prospective study. We analyzed the predictive performance of both STONE and CHOKAI scores at their optimal cut-off values, using receiver operating characteristic (ROC) curve and area under the curve (AUC), as well as sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) at the optimal cut-off value...
June 13, 2017: American Journal of Emergency Medicine
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
#11
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/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#12
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#13
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28624030/emergency-department-length-of-stay-in-critical-nonoperative-trauma
#14
Anaar Siletz, Kexin Jin, Marilyn Cohen, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
BACKGROUND: Prolonged emergency department (ED) stays correlate with negative outcomes in critically ill nontrauma patients. This study sought to determine the effect of ED length of stay (LOS) on trauma patients. MATERIALS AND METHODS: Two hundred forty-one trauma patients requiring direct intensive care unit (ICU) admission were identified. Patients requiring immediate operative intervention were excluded. Odds ratios (ORs) of outcomes for patients transferred to ICU in ≤90 min were compared with patients transferred in >90 min, adjusting for Injury Severity Score (ISS)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623244/it-s-a-cod-finding-nemo-impacted-fishbone-in-the-emergency-department
#15
Aileen McCabe, Andrew Patton, Nigel Salter
A 23-year-old woman presented to the emergency department (ED) with a sensation of a 'fish bone' stuck in her throat after eating cod. On physical examination, while she reported an uncomfortable sensation in her throat, no airway compromise was evident. Clinical examination, including ear, nose and throat (ENT) and oropharyngeal assessment, was unremarkable. A linear opacity consistent with a fishbone was visualised on a soft tissue lateral neck X-ray anterior to the vertebral body of C4-6. One attempt to visualise the fishbone on direct laryngoscopy failed in the ED...
June 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28621799/clinical-guideline-for-the-management-of-odontogenic-infections-in-the-tertiary-setting
#16
Sushma Vytla, Dieter Gebauer
BACKGROUND: Odontogenic infections are a common presentation to Emergency Departments of Australian hospitals. Due to the limited training in diagnosis and treatment of dental conditions, these patients can present a challenge for the medical practitioner. The objective of this study was to provide an evidence-based approach to the management of odontogenic infections in adults presenting to Royal Perth Hospital. METHODS: A literature search was conducted to identify evidence based guidelines for the management of odontogenic infections in the tertiary hospital setting...
June 16, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#17
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28617206/utilization-patterns-at-a-specialized-children-s-comprehensive-psychiatric-emergency-program
#18
Ruth Gerson, Jennifer Havens, Mollie Marr, Amy Storfer-Isser, Mia Lee, Carolena Rojas Marcos, Michelle Liu, Sarah McCue Horwitz
OBJECTIVE: Most youths experiencing a psychiatric crisis present to emergency departments (EDs) that lack the specialized staff to evaluate them, so youths are often discharged without appropriate mental health assessment or treatment. To better understand the needs of this population, this study described clinical details and disposition associated with visits for psychiatric emergencies to a specialized ED staffed 24/7 by child psychiatrists. METHODS: Through retrospective chart review, 1,180 visits to the ED during its first year of operation were reviewed for clinical characteristics, prior service utilization, and demographic characteristics...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28616619/a-case-of-late-diagnosis-of-chronic-subdural-hematoma-following-spinal-anesthesia
#19
Ali Aygun, Hava Semra Vuran, Nurhak Aksut, Yunus Karaca, Ozgur Tatli
Intracranial subdural hematoma developing following spinal anesthesia is a rare but serious complication. We describe a case of subdural hematoma developing following spinal anesthesia and diagnosed late. A female patient receiving spinal anesthesia for cesarean delivery 45 days prior to arrival at the emergency department presented to our hospital with non-severe headache persisting for 45 days after discharge. Computerized tomography (CT) of the brain performed due to long-term persisting headache resistant to medical treatment and a history of spinal intervention revealed a hypodense chronic subdural hematoma in the left frontoparietal area and a shift from left to right in midline structures...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28616616/lipoprotein-associated-phospholipase-a2-activity-and-its-diagnostic-potential-in-patients-with-acute-coronary-syndrome-and-acute-ischemic-stroke
#20
Sedat Kocak, Birsen Ertekin, Abdullah Sadik Girisgin, Zerrin Defne Dundar, Mehmet Ergin, Idris Mehmetoglu, Said Bodur, Basar Cander
BACKGROUND: The study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. METHODS: The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups...
June 2017: Turkish Journal of Emergency Medicine
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