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https://www.readbyqxmd.com/read/28328838/development-and-validation-of-a-risk-prediction-nomogram-for-in-hospital-mortality-in-adults-poisoned-with-drugs-and-nonpharmaceutical-agents-an-observational-study
#1
Catalina Lionte, Victorita Sorodoc, Elisabeta Jaba, Alina Botezat
Acute poisoning with drugs and nonpharmaceutical agents represents an important challenge in the emergency department (ED).The objective is to create and validate a risk-prediction nomogram for use in the ED to predict the risk of in-hospital mortality in adults from acute poisoning with drugs and nonpharmaceutical agents.This was a prospective cohort study involving adults with acute poisoning from drugs and nonpharmaceutical agents admitted to a tertiary referral center for toxicology between January and December 2015 (derivation cohort) and between January and June 2016 (validation cohort)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328730/partial-occlusion-conversion-from-thoracotomy-undelayed-but-shorter-occlusion-resuscitative-endovascular-balloon-occlusion-of-the-aorta-strategy-in-japan
#2
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a viable alternative to resuscitative thoracotomy (RT) in refractory hemorrhagic patients. We evaluated REBOA strategies using Japanese multi-institutional data. PATIENTS AND METHODS: The DIRECT-IABO investigators registered trauma patients requiring REBOA from 18 hospitals. Patients' characteristics, outcomes, and time in initial treatment were collected and analyzed. RESULTS: From August 2011 to December 2015, 106 trauma patients were analyzed...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28325679/children-treated-for-lawn-mower-related-injuries-in-us-emergency-departments-1990-2014
#3
Karen S Ren, Thiphalak Chounthirath, Jingzhen Yang, Laura Friedenberg, Gary A Smith
OBJECTIVE: Investigate the epidemiology of lawn mower-related injuries to children in the US. METHODS: A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. RESULTS: An estimated 212,258 children <18years of age received emergency treatment for lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#4
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28320790/patient-experience-of-different-regional-models-of-urgent-and-emergency-care-a-cross-sectional-survey-study
#5
Conor Foley, Elsa Droog, Maria Boyce, Orla Healy, John Browne
OBJECTIVES: To compare user experiences of 8 regional urgent and emergency care systems in the Republic of Ireland, and explore potential avenues for improvement. DESIGN: A cross-sectional survey. SETTING: Several distinct models of urgent and emergency care operate in Ireland, as system reconfiguration has been implemented in some regions but not others. The Urgent Care System Questionnaire was used to explore service users' experiences with urgent and emergency care...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28316308/where-we-fail-location-and-timing-of-failure-to-rescue-in-trauma
#6
Jennifer J Chung, Emily C Earl-Royal, M Kit Delgado, Jose L Pascual, Patrick M Reilly, Douglas J Wiebe, Daniel N Holena
Failure to rescue (FTR) is an outcome metric that reflects a center's ability to prevent mortality after a major complication. Identifying the timing and location of FTR events could help target efforts to reduce FTR rates. We sought to characterize the timing and location of FTR occurrences at our center, hypothesizing that FTR rates would be highest early after injury and in settings of lower intensity of care. We used data, prospectively collected from 2009 to 2013, on patients ≥16 years old with minimum Abbreviated Injury Score ≥2 from a single institution...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28296829/ovarian-torsion-in-the-normal-ovary-a-diagnostic-challenge-in-postmenarchal-adolescent-girls-in-the-emergency-department
#7
Erbil Karaman, Burhan Beger, Orkun Çetin, Mehmet Melek, Yasemin Karaman
BACKGROUND Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. MATERIAL AND METHODS A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed...
March 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28295429/urinary-timp-2-%C3%A2-%C3%A3-%C3%A2-igfbp7-for-risk-prediction-of-acute-kidney-injury-in-decompensated-heart-failure
#8
Moritz Schanz, Jing Shi, Christoph Wasser, Mark Dominik Alscher, Martin Kimmel
BACKGROUND: In acute decompensated heart failure (ADHF) the risk of acute kidney injury (AKI) is high. Early detection of patients at risk for AKI is important. We tested urinary [TIMP-2] × [IGFBP7], a new US Food and Drug Administration-cleared test to assess AKI risk, in a cohort of hospitalized ADHF patients. HYPOTHESIS: In patients with ADHF, urinary [TIMP-2] × [IGFBP7] is associated with moderate to severe AKI and related to increased mortality. METHODS: We enrolled 400 patients in the emergency department at Robert-Bosch Hospital, Stuttgart, Germany...
March 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28292390/penile-incarceration-by-metallic-ring
#9
(no author information available yet)
Application of constricting objects over penis for auto-erotic purpose can lead to dangerous results. A variety of metallic and non-metallic objects are used. The removal of these objects is a great challenge. We report a case of a young man who placed a hard metallic ring around his penis for sexual pleasure. A 22-year old man presented in emergency department with complain of painful swelling of his penis since 4 hours. Physical examination revealed part of penis distal to ring as congested and markedly tender with decreased sensation...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291547/remote-cerebellar-haemorrhage-after-placement-of-an-external-ventricular-drainage-for-acute-hydrocephalus-a-case-report
#10
I Caldeira, J Lavrador, G Basílio, R Sousa, S Reimão
INTRODUCTION: Remote cerebellar haemorrhage (RCH) is a rare complication following a craniotomy. This generally benign phenomenon is an identifiable complication of supratentorial craniotomies and should not be mistaken with other pathologies. The most common presenting symptom is a decrease in the level of consciousness but in some cases the RCH may be asymptomatic and accidentally discovered in follow-up CT scans. CASE REPORT: A 70-year-old man was admitted to our emergency department with sudden mental status deterioration...
March 10, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28291498/emergency-department-wounds-managed-by-combat-medics-a-case-series
#11
Steven G Schauer, James A Pfaff
BACKGROUND: Combat medics are an integral part of their unit helping to conserve the fighting strength. Minor wounds are a common problem in the deployed settings that affect a soldier's ability to partake in operations. While the medics often manage wound care, there is very little data on the outcomes. METHODS: Cases were acquired as part of a quality assurance project providing training feedback to medics on wound management. Laceration management is delegated to the medic at the direction of the provider...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#12
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#13
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28286841/diagnostic-accuracy-of-abdominal-wall-ultrasonography-and-local-wound-exploration-in-predicting-the-need-for-laparotomy-following-stab-wound
#14
Ali Vafaei, Kamran Heidari, Afshin Saboorizadeh, Amin Shams Akhtari
INTRODUCTION: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU) and local wound exploration (LWE) in this regard. METHODS: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286840/comparing-the-quality-and-complications-of-tube-thoracostomy-by-emergency-medicine-and-surgery-residents-a-cohort-study
#15
Parvin Kashani, Sepideh Harati, Ali Shirafkan, Alireza Amirbeigi, Hamid Reza Hatamabadi
INTRODUCTION: Tube thoracostomy complications depend on the operator's skill, patients' general condition and the place in which the procedure is done. The present study aimed to compare the quality and complications of tube thoracostomy carried out by emergency medicine residents (EMRs) and surgery residents (SRs). METHODS: This cohort study was conducted on 18-60 years old trauma patients in need of tube thoracostomy presenting to two academic emergency departments...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286827/doing-pre-operative-investigations-in-emergency-department-a-clinical-audit
#16
Muhammad Salman Rafiq, Maria Rafiq, Muhammad Imran Rafiq, Seema Gul Salman, Sania Hafeez
INTRODUCTION: Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria. METHODS: A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#17
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28283919/preventing-returns-to-the-emergency-department-followingbariatric-surgery
#18
Jennwood Chen, Justin Mackenzie, Yan Zhai, James O'Loughlin, Rebecca Kholer, Ellen Morrow, Robert Glasgow, Eric Volckmann, Anna Ibele
BACKGROUND: Unnecessary emergency department (ED) visits following bariatric surgery represent a significant source of inefficient resource utilization. This study aimed to identify potential strategies aimed at preventing unnecessary returns to the ED following bariatric surgery. The study was conducted in University Hospital, USA. METHODS: The electronic medical records of all patients who underwent bariatric surgery at our institution between January 2011 and October 2015 were retrospectively reviewed...
March 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28282078/-problematic-substance-abuse-and-history-of-suicidal-behavior-in-female-patients-in-an-acute-mental-health-service
#19
Sebastián Camino, Ramiro Expósito, Demián Rodante
Current publications that analyze operational and epidemiologic variables in the Argentinian Mental Health System are scarce. Several international studies have found a correlation between substance abuse and suicidal behavior. However, to our knowledge, there are no local studies that verify this association, especially in hospitalized female patients. The aim of this study is to verify this association in a population of female patients hospitalized in a Mental Health Hospital between august 2007 and july 2013...
July 2016: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/28279312/the-role-of-post-resuscitation-electrocardiogram%C3%A2-in-patients-with%C3%A2-st-segment%C3%A2-changes-in-the-immediate%C3%A2-post-cardiac-arrest-period
#20
Youn-Jung Kim, Sun-Yang Min, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Hui Jai Lee, Jonghwan Shin, Byuk Sung Ko, Shin Ahn, Gi-Byoung Nam, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. BACKGROUND: The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial...
March 13, 2017: JACC. Cardiovascular Interventions
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