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https://www.readbyqxmd.com/read/28228898/disseminated-coccidioidomycosis-with-multifocal-musculoskeletal-disease-involvement
#1
Michael F McConnell, Ann Shi, Todd M Lasco, Luke Yoon
We report a rare case of disseminated coccidioidomycosis with multifocal musculoskeletal involvement. The patient presented to the emergency department with left shoulder pain and swelling. Magnetic resonance imaging of the left shoulder revealed enhancing soft tissue masses, bony lesions, and fluid collections in and around the glenohumeral joint with involvement of the proximal humerus, glenoid, and rotator cuff musculature. Multiple additional areas of involvement were subsequently discovered. Fungal cultures confirmed coccidioidomycosis infection at all surgical sites with superimposed polymicrobial bacterial infection in the left shoulder...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228875/traumatic-nonanastomotic-axilloprofundal-ptfe-bypass-rupture-a-case-report
#2
Borna K Barth, Fabian Hässler, Oliver Graubitz
A 76-year-old male patient was admitted to our emergency department with painful swelling of the right lateral chest after a fall. Imaging revealed a hematoma, secondary to rupture of a synthetic axilloprofundal bypass. In an emergency surgical procedure, the spelled hematoma was evacuated and the graft legs were successfully ligated. The patient was discharged after an uneventful hospital stay. Traumatic bypass rupture because of blunt trauma is an exceedingly rare event; however, it must be taken into consideration in a patient with bypass surgery in his/her history...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28225742/review-of-military-and-civilian-trauma-registries-does-consensus-matter
#3
Thijs T C F van Dongen, Johan de Graaf, Eelco P Huizinga, Howard R Champion, Rigo Hoencamp, Luke P H Leenen
BACKGROUND: Structural collection of data from combat injuries is important to improve provided care and the outcome of (combat) casualties. Trauma registries are used in civilian and military health care systems for systematic administration of injury data. However, these registries often use different methods of data management, compromising international comparison of trauma systems. The aim of this review is to aid in reaching international (coalition-wide) consensus for compatible data collection methods with uniform definitions, which is needed for transnational research and subsequent improvement of medical support organizations...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#4
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220246/treatment-of-open-fractures-of-the-hand-in-the-emergency-department
#5
Nofar Ben Basat, Raviv Allon, Ahmad Nagmi, Ronit Wollstein
Current guidelines suggest early surgical treatment of open fractures. This rule in open hand fractures is not well supported and may be unpractical. Furthermore, desirable debridement and washout can be obtained in the emergency department (ED). The purpose of this study was to evaluate the relationship between the level of contamination, quality of washout in the emergency room, and the development of infection. Sixty-one patients with open fractures of the hand were retrospectively reviewed for demographic and fracture characteristics, and other complications...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#6
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28217583/profile-of-trauma-patients-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#7
Kundavaram Paul Prabhakar Abhilash, Nilanchal Chakraborthy, Gautham Raja Pandian, Vineet Subodh Dhanawade, Thomas Kurien Bhanu, Krishna Priya
BACKGROUND: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216700/a-retrospective-study-of-transfusion-practices-in-a-tertiary-care-institute
#8
Babita Raghuwanshi, N K Pehlajani, Mithilesh K Sinha, Swagata Tripathy
BACKGROUND AND AIMS: Excessive requests for cross matching blood which is more than the blood required for transfusion are usually based on worst case assumptions leading to overestimation of blood usage. We investigated the blood ordering pattern and transfusion practices so as to incorporate a blood ordering schedule for streamlining the use of blood in various hospital departments. METHODS: The study was conducted over a period of 19 months in a 350 bedded tertiary teaching hospital...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#9
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#10
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209449/maxillofacial-and-concomitant-serious-injuries-an-eight-year-single-center-experience
#11
Fausto Fama, Marco Cicciu, Alessandro Sindoni, Enrico Nastro-Siniscalchi, Roberto Falzea, Gabriele Cervino, Francesca Polito, Francesco De Ponte, Maria Gioffre-Florio
PURPOSE: Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#12
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28196439/surgical-site-infection-after-hand-surgery-outside-the-operating-theatre-a-systematic-review
#13
N A Jagodzinski, S Ibish, D Furniss
: We carried out a systematic review to determine the incidence of infection for hand surgery done in settings other than the operating theatre. Databases were searched and a PRISMA chart created by three independent reviewers. From 1200 studies identified, 46 full text articles were reviewed and six were included (two Level 3 studies and four Level 4). In three studies there were no infections after surgery in an office, procedure room or emergency department. Two studies with a combined number of 1962 procedures reviewed carpal tunnel decompressions and reported identical infection rates of 0...
March 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28195896/contributing-factors-for-complications-and-outcomes-in-patients-with-snakebite-experience-in-a-medical-center-in-southern-taiwan
#14
Yu-Hsuan Hsieh, Jung-Hua Hsueh, Wen-Chung Liu, Kuo-Chung Yang, Kuei-Chang Hsu, Cheng-Ta Lin, Yen-Yi Ho, Lee-Wei Chen
OBJECTIVES: Snakebite usually results in various complications, such as significant soft tissue damage, infection, hematological, and neurological deficit. Surgical intervention, usually, is indicated in patients with tissue necrosis, infection, and compartment syndrome. To identify the contributing factors for complications and outcomes in different patients with snakebite so that outcomes can be evaluated and treatment of such patients can be initiated at the earliest. METHODS: Information was collected regarding age, sex, underlying disease, species of snake, and the course of treatment of the victims of snakebite who visited the emergency department of a medical center in southern Taiwan between 2004 and 2014...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28194327/dysuria-an-uncommon-presentation-in-emergency-department-following-bladder-neck-disruption
#15
Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell
Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications...
February 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28193080/inappropriate-packed-rbc-transfusion-in-a-tertiary-care-center
#16
Anahita Sadeghi, Safieh Belali, Ali Ali Asgari, Zahra Morovat, Reza Malekzadeh, Ashkan Emadi
INTRODUCTION: Transfusion of packed red blood cells (pRBC) with appropriate indications is not only important for patient safety and well-being but is also crucial for proper utilization of resources and health care-related cost reduction. We aimed to investigate the clinical appropriateness of blood transfusion in Shariati Hospital, one of the largest academic medical centers in Tehran. METHODS: In this prospective observational study, 1000 transfusions of allogenic pRBCs from April 1st to October 31st, 2015 were included...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28190431/posterior-reversible-encephalopathy-in-the-intensive-care-unit
#17
M Toledano, J E Fugate
Posterior reversible encephalopathy syndrome (PRES) is increasingly diagnosed in the emergency department, and medical and surgical intensive care units. PRES is characterized by acute onset of neurologic symptoms in the setting of blood pressure fluctuations, eclampsia, autoimmune disease, transplantation, renal failure, or exposure to immunosuppressive or cytotoxic drugs, triggers known to admit patients to the intensive care unit (ICU). Although the exact pathophysiology remains unknown, there is growing consensus that PRES results from endothelial dysfunction...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28181109/a-retrospective-review-of-farm-injuries-presenting-to-an-irish-hospital-emergency-department-in-2013
#18
A Abdulkarim, P Carroll, P Coffey, E Sheehan
BACKGROUND: The agricultural and equestrian businesses are an important source of employment in the Midlands. This is a retrospective study examining the demographics, characteristics, and outcomes of agricultural and equestrian related injuries presenting to the Midland Regional Hospital, Tullamore, Co. Offaly. There were a total of 30,700 attendances to the Emergency Department for 2013. AIMS: This study is an epidemiological review of agricultural injuries, their mechanisms, and consequences presenting to a rural regional hospital over a 1 year period...
February 8, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#19
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28169205/evaluating-organizational-factors-associated-with-postoperative-bariatric-surgery-readmissions
#20
Ryan Macht, Ruth Cassidy, Howard Cabral, Lewis E Kazis, Amir Ghaferi
BACKGROUND: Several patient and surgical characteristics have been identified as risk factors for readmission after bariatric surgery, but there is a paucity of information on how organizational factors influence this metric. OBJECTIVE: To evaluate the association between readmissions and several organizational factors, including compliance with best practices to reduce unplanned hospital visits, major complication rates, and the emergency department-sourced readmission (EDSR) rate...
January 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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