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https://www.readbyqxmd.com/read/29245179/hot-off-the-press-sgem-196-gastroparesis-i-feel-like-throwing-up
#1
Corey Heitz, Justin Morgenstern, William K Milne
This randomized controlled trial compared haloperidol along with conventional therapy to placebo along with conventional therapy for gastroparesis in the emergency department. The primary outcomes of pain and nausea scores at 1 hour were significantly improved in the haloperidol group, but not in the placebo group. In this summary, we discuss a quality assessment of the article and summarized the social media commentary from the blog post/podcast. This article is protected by copyright. All rights reserved.
December 15, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29244964/outpatient-negative-pressure-dressing-therapy-for-pretibial-lacerations-in-a-patient-with-high-anaesthetic-risk-a-case-study
#2
L Sutton, D Edwards, M McColl
Pretibial lacerations are a common cause of presentation to accident and emergency departments. The management of these wounds is contentious with a variation in practise between individual institutions. We present the case of a 49-year-old female with a background of pulmonary atresia and associated pulmonary hypertension, who underwent successful outpatient negative pressure wound therapy (NPWT) for three pretibial lacerations. We would propose that this therapy is an effective option for the management of these wounds in independently mobile patients who are at high-risk when under anaesthetic...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29244694/failure-of-patellar-plating-with-mini-fragment-implants-a-case-report
#3
Daniel T Miles, Matthew L Graves, Clay A Spitler, Patrick F Bergin
CASE: A 40-year-old woman presented to the emergency department with a comminuted fracture of the patella with separation of the bone fragments. The patient underwent an open reduction and osteosynthesis using medial and lateral 2.0-mm nonlocking plates, which subsequently led to pain in the anterior and posterior aspects of the knee. CONCLUSION: In this patient, bicolumnar nonlocking plating was unable to adequately resist the tensile forces of the extensor mechanism...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244659/intra-articular-patellar-dislocation-a-technique-for-closed-reduction-a-case-report-and-review-of-the-literature
#4
Lachlan Wight, Dugal James
CASE: An 87-year-old man fell onto a flexed knee and sustained a closed intra-articular patellar dislocation. A closed reduction was performed under intravenous sedation by flexing the knee to 90°, applying an anterior drawer force to the tibia, and applying pressure to the inferior pole of the patella. The day after reduction, weight-bearing was begun in a hinged brace set at 0° to 90°. Full function was regained by 6 weeks postreduction. CONCLUSION: Intra-articular patellar dislocation may present as an unusual cause of a locked knee...
December 13, 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29243937/long-term-coarse-pm-exposure-is-associated-with-asthma-among-children-in-medicaid
#5
Corinne A Keet, Joshua P Keller, Roger D Peng
RATIONALE: Short and long-term fine particulate matter (PM2.5) pollution is associated with asthma development and morbidity, but there is little data on the effects of long-term exposure to coarse PM (PM10-2.5) on respiratory health. OBJECTIVES: To understand the relationship between long-term fine and coarse PM exposure and asthma prevalence and morbidity among children. METHODS: A semi-parametric regression model that incorporated PM2.5 and PM10 monitor data and geographic characteristics was developed to predict two-year average PM2...
December 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29243880/review-article-best-practice-management-of-common-knee-injuries-in-the-emergency-department-part-3-of-the-musculoskeletal-injuries-rapid-review-series
#6
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Knee injuries are a common presentation to the ED and are often difficult to assess and definitively diagnose due to the patient's acute pain, effusion and guarding. The quality of ED care provided to patients with fractures or soft tissue injuries of the knee is critical to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common knee injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites...
December 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29243193/comparison-between-two-point-and-three-point-compression-ultrasound-for-the-diagnosis-of-deep-vein-thrombosis
#7
Rona Zuker-Herman, Irit Ayalon Dangur, Ron Berant, Elinor Cohen Sitt, Libbi Baskin, Yossi Shaya, Shachaf Shiber
Lower extremity deep vein thrombosis (DVT) is a frequent cause of admission to the emergency departments (ED). Although the gold standard for diagnosis is the Duplex ultrasound examination, the current study used for diagnosis of DVT in the ED by emergency physicians is the point-of-care compression ultrasound (POCUS). To compare the sensitivity and specificity of the two-point and three-point compression ultrasound (2PCUS and 3PCUS respectively) for diagnosis of lower extremity DVT in an ED management. We prospectively recruited outpatients who were admitted to the ED with suspected lower extremity DVT...
December 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29243077/pulmonary-embolus-as-cause-of-death-in-an-adolescent-demonstration-on-postmortem-ct
#8
Mary P Harty, H Theodore Harcke, Sharon W Gould, Adrienne Sukula-Perlman
Computed tomography (CT) is widely accepted in adult forensic death investigations (determination of cause and manner of death) but is only beginning to play a larger role in the cause of death determination in infants and children. We present a case of an adolescent with nephrotic syndrome who sustained cardiac arrest and died in the emergency department. A postmortem CT was requested by the state Office of the Medical Examiner as part of the medicolegal death investigation. Postmortem CT showed a saddle pulmonary embolus that was confirmed on conventional autopsy, demonstrating a natural manner of death...
December 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29242141/molecular-and-epidemiological-evidence-of-patient-to-patient-hepatitis-c-virus-transmission-in-a-scottish-emergency-department
#9
I Johannessen, J Danial, D B Smith, J Richards, L Imrie, A Rankin, L J Willocks, C Evans, C Leen, P Gibson, P Simmonds, D Goldberg, A McCallum, K Roy
BACKGROUND: Transmission of hepatitis C virus (HCV) in the health care setting is rare. Routine infection prevention and control (IPC) measures mean this should be a preventable never event. This paper investigates the diagnosis of acute healthcare associated HCV infection. METHODS: Epidemiological and molecular investigation of a case of acute HCV infection associated with nosocomial exposure. RESULTS: Detailed investigation of the treatment history of a patient with acute HCV infection identified transmission from a co-attending patient in an Emergency Department as the likely source; this possibility was confirmed by virus sequence analysis...
December 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29242091/association-between-microcephaly-zika-virus-infection-and-other-risk-factors-in-brazil-final-report-of-a-case-control-study
#10
Thalia Velho Barreto de Araújo, Ricardo Arraes de Alencar Ximenes, Demócrito de Barros Miranda-Filho, Wayner Vieira Souza, Ulisses Ramos Montarroyos, Ana Paula Lopes de Melo, Sandra Valongueiro, Maria de Fátima Pessoa Militão de Albuquerque, Cynthia Braga, Sinval Pinto Brandão Filho, Marli Tenório Cordeiro, Enrique Vazquez, Danielle di Cavalcanti Souza Cruz, Claudio Maierovitch Pessanha Henriques, Luciana Caroline Albuquerque Bezerra, Priscila Mayrelle da Silva Castanha, Rafael Dhalia, Ernesto Torres Azevedo Marques-Júnior, Celina Maria Turchi Martelli, Laura Cunha Rodrigues
BACKGROUND: A Zika virus epidemic emerged in northeast Brazil in 2015 and was followed by a striking increase in congenital microcephaly cases, triggering a declaration of an international public health emergency. This is the final report of the first case-control study evaluating the potential causes of microcephaly: congenital Zika virus infection, vaccines, and larvicides. The published preliminary report suggested a strong association between microcephaly and congenital Zika virus infection...
December 11, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29242012/outcomes-of-immunocompetent-children-presenting-with-fever-and-neutropenia
#11
Osnat Wittmann, Ayelet Rimon, Dennis Scolnik, Miguel Glatstein
BACKGROUND: Neutropenia may alarm clinicians and prompt extensive evaluation in children with fever, even in immunocompetent patients. OBJECTIVE: Our aim was to determine outcomes in previously healthy febrile children presenting to the emergency department with severe neutropenia. METHODS: We reviewed data from infants and children aged 3-36 months with fever and severe neutropenia, defined as a peripheral neutrophil count <500 × 103/μL, at our institution between January 1, 2012 and December 31, 2015...
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29242010/heart-rate-variability-analysis-in-patients-who-have-bradycardia-presenting-to-the-emergency-department-with-chest-pain
#12
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Heart rate variability (HRV) is a noninvasive method to measure the function of the autonomic nervous system. It has been used to risk stratify patients with undifferentiated chest pain in the emergency department (ED). However, bradycardia can have a modifying effect on HRV. OBJECTIVE: In this study, we aimed to determine how bradycardia affected HRV analysis in patients who presented with chest pain to the ED. METHODS: Adult patients presenting to the ED at Singapore General Hospital with chest pain were included in the study...
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29241835/the-impact-of-a-statewide-mandatory-prescription-drug-monitoring-program-on-opioid-prescribing-by-emergency-medicine-providers-across-15-hospitals-in-a-single-health-system
#13
Brian Suffoletto, Michael Lynch, Charissa B Pacella, Donald M Yealy, Clifton W Callaway
Prescription drug monitoring programs (PDMP) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the impact of a state-mandated PDMP on opioid prescribing by Emergency Medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 Emergency Departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time-series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law mandated PDMP use on August 25th, 2016...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29241809/chemotherapy-use-end-of-life-care-and-costs-of-care-among-patients-diagnosed-with-stage-iv-pancreatic-cancer
#14
Yuhua Bao, Renee C Maciejewski, Melissa M Garrido, Manish A Shah, Paul K Maciejewski, Holly G Prigerson
CONTEXT: For patients with metastatic cancer and limited life-expectancy, potential benefits of chemotherapy must be balanced against harms to quality-of-life near death and increased out-of-pocket costs of care. OBJECTIVES: To evaluate the association between chemotherapy use by patients with Stage IV pancreatic cancer and health care use and Medicare and out-of-pocket costs in the last 30 days of life. METHODS: We conducted a retrospective, cohort study of 3,825 patients 66 years or older when diagnosed with Stage IV pancreatic cancer in 2006-2011, using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data...
December 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29241516/factors-affecting-self-care-behavior-in-koreans-with-copd
#15
Soo Kyung Park
BACKGROUND: Despite the importance of self-care in people with COPD, little is known about the effect of symptoms and symptom clusters on self-care behavior in people with exacerbated COPD. This study was designed to describe their level of self-care and to examine factors associated with self-care behavior, including symptoms and symptom clusters. METHODS: For this cross-sectional descriptive study, the researcher recruited Koreans with exacerbated COPD (N=71) from three tertiary care hospitals...
December 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29241463/-myocardial-contusion-following-trauma
#16
R T Stolmeijer, H Lameijer
BACKGROUND: Myocardial contusion is a potentially life threatening condition, which should be considered in patients with a compatible thoracic trauma. Guidelines for diagnosis and determination of management are non-existent. CASE DESCRIPTION: A 51-year-old man arrived at the accident and emergency department with thoracic trauma after being knocked down by a bus. A myocardial contusion was diagnosed based on the ECG and elevated high-sensitivity (hs) troponin levels...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241339/a-novel-model-for-a-hub-and-spoke-spinal-service-and-improvements-in-the-treatment-of-spinal-pathology-in-a-rural-hospital-setting
#17
Erden Ali, Andrew Macdowell, Thomas Pagonis
INTRODUCTION:   We present a unique pathway for care aimed specifically at spinal patients. As a result of the shift of the spoke direction from the existing hub-and-spoke model, patient care is being redirected successfully with great benefit to a rural department. Within the rural community, it is the spoke that is the main locality to which patients present and at which they are treated. Subspecialty procurement is often more central and located in tertiary referral centres outside of a rural position...
December 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29241305/serum-glutamine-levels-as-a-potential-diagnostic-biomarker-in-sepsis-following-surgery-for-peritonitis
#18
Chun-Ju Yang, Ting-Shuo Huang, Tung-Liang Lee, Kang-Chung Yang, Shin-Sheng Yuan, Ruey-Hwa Lu, Chung-Ho Hsieh, Yu-Chiau Shyu
Few diagnostic biomarkers for sepsis after emergency peritonitis surgery are available to clinicians, and, thus, it is important to develop new biomarkers for patients undergoing this procedure. We investigated whether serum glutamine and selenium levels could be diagnostic biomarkers of sepsis in individuals recovering from emergency peritonitis surgery. From February 2012 to March 2013, patients who had peritonitis diagnosed at the emergency department and underwent emergency surgery were screened for eligibility...
December 15, 2017: Chinese Journal of Physiology
https://www.readbyqxmd.com/read/29241303/body-fluid-status-assessment-by-bio-impedance-analysis-in-patients-presenting-to-the-emergency-department-with-dyspnea
#19
Chan Soon Park, Sang-Eun Lee, Hyun-Jai Cho, Yong-Jin Kim, Hyun-Jae Kang, Byung-Hee Oh, Hae-Young Lee
Background/Aims: Fluid retention occurs in patients with heart failure, accounting for dyspnea. We investigated the diagnostic implication of body fluid status, assessed by bio-impedance analysis (BIA), in acute heart failure (AHF) among patients who presented with dyspnea. Methods: A total of 100 patients who presented with dyspnea and suspected with AHF were analyzed in this study. We enrolled 50 AHF and 50 non-AHF patients discriminated through echocardiographic analysis and Framingham criteria and were matched by age and sex...
December 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29241242/automated-screening-of-emergency-department-notes-for-drug-associated-bleeding-adverse-events-occurring-in-older-adults
#20
Richard D Boyce, Jeremy Jao, Taylor Miller, Sandra L Kane-Gill
No abstract text is available yet for this article.
October 2017: Applied Clinical Informatics
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