369,553 results match your criteria Emergency Medicine News [Journal]


The Association Between Telemedicine and Emergency Department (ED) Disposition: A Stepped Wedge Design of an ED-Based Telemedicine Program in Critical Access Hospitals.

J Rural Health 2019 Apr 23. Epub 2019 Apr 23.

Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa.

Purpose: To study the relationship between the availability and activation of emergency department-based telemedicine (teleED) and patient disposition in Critical Access Hospitals (CAHs).

Methods: A non randomized stepped wedge design examined 133,396 ED visits in 15 CAHs that subscribe to a single teleED provider. Data were available for at least 12 months prior to teleED implementation and at least 12 months of post-implementation. Read More

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http://dx.doi.org/10.1111/jrh.12370DOI Listing

Translating science into recommendations: The development of NCRP Report 180.

Authors:
Donald Cool

J Radiol Prot 2019 Apr 23. Epub 2019 Apr 23.

Radiaton Safety, Electric Power Research Institute, Palo Alto, California, UNITED STATES.

The development of new recommendations for radiological protection is a complex process of translating scientific knowledge of radiation risks into a coherent system for protection, using experience and ethical values. From 2014 to 2019, the U.S. Read More

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http://dx.doi.org/10.1088/1361-6498/ab1b98DOI Listing

Do Electronic Health Record Prompts Increase Take-Home Naloxone Administration for Emergency Department Patients After an Opioid Overdose?

Addiction 2019 Apr 23. Epub 2019 Apr 23.

Department of Emergency Medicine, University of Pittsburgh School of Medicine.

Background And Aims: Distribution of take-home-naloxone (THN) to emergency department (ED) patients who have survived an opioid overdose could reduce future opioid mortality but is not commonly performed. We examined whether electronic health record (EHR) prompts provided to ED physicians when discharging a patient after an opioid overdose could improve THN distribution.

Design: Interrupted time series analysis to compare the percentage of OD patients who received THN during the 11 months before and after implementation of an EHR prompt on June 18, 2017. Read More

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http://dx.doi.org/10.1111/add.14635DOI Listing

The cost impact of PCT-guided antibiotic stewardship versus usual care for hospitalised patients with suspected sepsis or lower respiratory tract infections in the US: A health economic model analysis.

PLoS One 2019 23;14(4):e0214222. Epub 2019 Apr 23.

Panaxea B.V., Amsterdam, the Netherlands.

Background: Procalcitonin is a biomarker that supports clinical decision-making on when to initiate and discontinue antibiotic therapy. Several cost (-effectiveness) analyses have been conducted on Procalcitonin-guided antibiotic stewardship, but none mainly based on US originated data.

Objective: To compare effectiveness and costs of a Procalcitonin-algorithm versus standard care to guide antibiotic prescription for patients hospitalized with a diagnosis of suspected sepsis or lower respiratory tract infection in the US. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214222PLOS

Opening Pandora's Box - Presumed ST Segment Elevation Myocardial Infarction with Symptomatic Ventricular Tachycardia is Cured by Resection of a Huge Left Ventricular Aneurysm.

Heart Surg Forum 2019 Apr 16;22(2):E170-E171. Epub 2019 Apr 16.

Cardioangiologisches Centrum Bethanien (CCB), Frankfurt am Main, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany.

A 76-year-old male patient with history of hypertension, type 2 diabetes, and smoking was admitted to the emergency department with chest pain. The patient reported severe and sudden chest pain accompanied by cold sweating, dizziness, and palpitations. Read More

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http://dx.doi.org/10.1532/hsf.2287DOI Listing

Hospital nurse-staffing models and patient- and staff-related outcomes.

Cochrane Database Syst Rev 2019 Apr 23;4:CD007019. Epub 2019 Apr 23.

Faculty of Science and Health, Dublin City University, Collins Avenue, Glasnevin, Dublin, Ireland, Dublin 9.

Background: Nurses comprise the largest component of the health workforce worldwide and numerous models of workforce allocation and profile have been implemented. These include changes in skill mix, grade mix or qualification mix, staff-allocation models, staffing levels, nursing shifts, or nurses' work patterns. This is the first update of our review published in 2011. Read More

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http://dx.doi.org/10.1002/14651858.CD007019.pub3DOI Listing

Effect of Addition of an Intimate Partner Violence Intervention to a Nurse Home Visitation Program on Maternal Quality of Life: A Randomized Clinical Trial.

JAMA 2019 Apr;321(16):1576-1585

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Importance: Intimate partner violence (IPV) is a public health problem with significant adverse consequences for women and children. Past evaluations of a nurse home visitation program for pregnant women and first-time mothers experiencing social and economic disadvantage have not consistently shown reductions in IPV.

Objective: To determine the effect on maternal quality of life of a nurse home visitation program augmented by an IPV intervention, compared with the nurse home visitation program alone. Read More

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http://dx.doi.org/10.1001/jama.2019.3211DOI Listing

Chronic Traumatic Encephalopathy: A Clinical Perspective.

J Neuropsychiatry Clin Neurosci 2019 ;31(2):170-172

From the Departments of Neurology, Psychiatry, Physical Medicine and Rehabilitation, and Emergency Medicine, University of Colorado School of Medicine, Aurora, Colo. (Filley, Arciniegas, Brenner, Anderson, Kelly); the Behavioral Neurology Section, University of Colorado School of Medicine, Aurora, Colo. (Filley, Arciniegas, Anderson, Kelly); and Rocky Mountain Mental Illness, Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Marcus Institute for Brain Health, Aurora, Colo. (Filley, Arciniegas, Brenner, Anderson, Kelly).

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http://dx.doi.org/10.1176/appi.neuropsych.18100223DOI Listing
January 2019

[DHEAS/cortisol index as a marker of stress-induced premature aging.]

Klin Lab Diagn 2019 ;64(3):140-144

Federal State Budgetary Institution "The Nikiforov Russian Center of Emergency and Radiation Medicine", the Ministry of the Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters, 194044, Saint-Petersburg, Russia.

The detection of stress-induced premature aging with the aim of correcting damaging adaptive effects seems to be actual today. The article discusses the use of the DHEAS / cortisol index as a screening marker for accelerating the rate of biological aging in people exposed to stress. Read More

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http://dx.doi.org/10.18821/0869-2084-2019-64-3-140-144DOI Listing
January 2019

Emergency Department Risk Stratification after Opiate Overdose is Just the Beginning.

Acad Emerg Med 2019 Apr 23. Epub 2019 Apr 23.

Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA.

The January 2019 edition of Academic Emergency Medicine reported on the Hospital Observation Upon Reversal (HOUR) with Naloxone Study. This study examined the ability of emergency medicine providers to use clinical judgment, a decision rule or both to evaluate patients for safe discharge from the emergency department (ED) one hour after naloxone administration for suspected opiate overdose.  The topic of safe and timely discharge is important for the practice of emergency medicine, but not nearly as important as what comes next for our patients. Read More

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http://dx.doi.org/10.1111/acem.13772DOI Listing

Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital.

Neth J Med 2019 Apr;77(3):109-115

Departments of Medical Microbiology, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.

Background: The seasonal influenza epidemic poses a significant burden on hospitals, both in terms of capacity and costs. Beds that are occupied by isolated influenza patients result in hospitals temporary being closed to admissions and elective operations being cancelled. Improving hospital and emergency department (ED) patient flow during the influenza season could solve these problems. Read More

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Cost implications of adverse drug event-related emergency department visits - a multi-center study in South Korea.

Expert Rev Pharmacoecon Outcomes Res 2019 Apr 23. Epub 2019 Apr 23.

a School of Pharmacy , Sungkyunkwan University , Suwon , Korea.

Objectives: Adverse drug reactions (ADRs) increase healthcare resource utilization, including that for emergency department (ED) visits. However, cost analyses of ADRs resulting in ED visits are scarce. Therefore, we aimed to estimate the direct medical costs before and after ADR occurrence and analyzed the cost-driving factors. Read More

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http://dx.doi.org/10.1080/14737167.2019.1608825DOI Listing

Treatment Works, So Who's Afraid of PNES?

Authors:
Jay Salpekar

Epilepsy Curr 2019 Mar-Apr;19(2):1535759719841354

Adherence With Psychotherapy and Treatment Outcomes for Psychogenic Nonepileptic Seizures Tolchin B, Dworetzky BA, Martino S, et al. Neurology. 2019;92(7):e675-e679. Read More

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http://dx.doi.org/10.1177/1535759719841354DOI Listing

Clinical use of cryopoor plasma continuous rate infusion in critically ill, hypoalbuminemic dogs.

J Vet Emerg Crit Care (San Antonio) 2019 Apr 22. Epub 2019 Apr 22.

The Emergency and Critical Care Service, The Ohio State University Veterinary Medical Center Veterinary Clinical Sciences, Columbus, OH.

Objective: To investigate the impact of cryopoor plasma (CPP) continuous rate infusion (CRI) on albumin concentration and colloid osmotic pressure (COP) in critically ill dogs with hypoalbuminemia.

Design: Retrospective study between 2013 and 2015 with a 90-day follow-up on survivors.

Setting: University teaching hospital. Read More

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http://dx.doi.org/10.1111/vec.12834DOI Listing

Sugammadex in Ontario hospitals: Access and institutional policies.

J Eval Clin Pract 2019 Apr 22. Epub 2019 Apr 22.

Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.

Rationale And Aims: Sugammadex is a novel neuromuscular blockade reversal agent which rapidly reverses the effects of rocuronium and vecuronium. Compared with the first-generation neuromuscular blockade reversal agent, neostigmine, sugammadex has a number of superior properties; however, sugammadex is significantly more expensive per dose compared with neostigmine (~CAD$95 vs $4). Given the high cost of sugammadex, many Ontario hospitals either do not stock the drug or have specific policies on when the drug can be administered. Read More

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http://dx.doi.org/10.1111/jep.13151DOI Listing

The bicuspid aortic valve: Is it an immunological disease process?

J Card Surg 2019 Apr 23. Epub 2019 Apr 23.

Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, UK.

Bicuspid aortic valves (BAVs) are the most common congenital cardiac condition and are characterized by a structural abnormality whereby the aortic valve is composed of two leaflets instead of being trileaflet. It is linked to an increased risk for a variety of complications of the aorta, many with an immunological pathogenesis. The aim of this study is to review and analyze the literature regarding immunological processes involving BAVs, associated common pathologies, and their incidence in the population. Read More

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http://dx.doi.org/10.1111/jocs.14050DOI Listing

The roles of dispositional coping style and social support in helping people with respiratory disease cope with a breathlessness crisis.

J Adv Nurs 2019 Apr 22. Epub 2019 Apr 22.

IMPACCT, Faculty of Health, University of Technology, Sydney.

Aim: To explore the role of coping moderators in self-management of breathlessness crises by people with advanced respiratory disease.

Design: A secondary analysis of semi-structured interview data.

Methods: Interviews with patients who had advanced respiratory disease, chronic breathlessness and at least one experience where they considered presenting to Emergency but self-managed instead (a 'near miss'). Read More

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http://dx.doi.org/10.1111/jan.14039DOI Listing

An intervention including the national early warning score improves patient monitoring practice and reduces mortality: a cluster randomised controlled trial.

J Adv Nurs 2019 Apr 22. Epub 2019 Apr 22.

Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.

Aims: To investigate the impact of the national early warning score on the frequency and the quality of vital sign registration and to study the association between protocol compliance and patient mortality.

Design: We conducted a post-hoc data analysis of a stepped wedge cluster randomised controlled trial in six hospitals.

Methods: All adult, non-pregnant patients admitted to 24 wards were included. Read More

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http://dx.doi.org/10.1111/jan.14034DOI Listing

A storytelling intervention reduces childhood caries risk behaviors among American Indian and Alaska Native mothers in Northern California.

J Public Health Dent 2019 Apr 23. Epub 2019 Apr 23.

Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.

Objectives: To evaluate a storytelling intervention targeting the oral health beliefs, knowledge, and behaviors of AIAN pregnant women and mothers.

Methods: Fifty-three adult AIAN women from three tribal communities in Northern California participated. The intervention story delivered oral health messaging using a traditional storytelling format. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/jphd.12318
Publisher Site
http://dx.doi.org/10.1111/jphd.12318DOI Listing
April 2019
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Red blood cell transfusion in critically ill patients with traumatic brain injury: an international survey of physicians' attitudes.

Can J Anaesth 2019 Apr 22. Epub 2019 Apr 22.

CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit, Traumatology - Emergency - Critical Care Medicine, CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), 1401, 18e rue, Québec City, QC, G1J 1Z4, Canada.

Introduction: Restrictive transfusion strategies have been advocated in critically ill patients. Nevertheless, considerable uncertainty exists regarding optimal transfusion thresholds in traumatic brain injury (TBI) patients because the injured brain is susceptible to hypoxemic damage. We aimed to identify the determinants of red blood cell (RBC) transfusion and the perceived optimal transfusion thresholds in adult patients with moderate-to-severe TBI. Read More

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http://dx.doi.org/10.1007/s12630-019-01369-wDOI Listing

Dynamics of in Vivo Metabolites Concentrations in Posttraumatic Period of Human Brain. H MRS Study.

Dokl Biochem Biophys 2019 May 22;484(1):25-28. Epub 2019 Apr 22.

Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, 119334, Moscow, Russia.

For the first time the intracellular concentrations of N-acetylaspartate (NAA), aspartate (Asp), and glutamate (Glu) were measured in human brain in vivo, and the effect of severe traumatic brain injury on NAA synthesis in acute and remote posttraumatic phases was revealed. In non-damaged (MRI-negative) lobes the next day after injury, Asp and Glu decreased by 45% and 35%, respectively, while NAA decreased only by 16%. A negative correlation between NAA and Asp/Glu ratio was found. Read More

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http://dx.doi.org/10.1134/S1607672919010071DOI Listing

Subspecialization in radiology: effects on the diagnostic spectrum of radiologists and report turnaround time in a Swiss university hospital.

Radiol Med 2019 Apr 22. Epub 2019 Apr 22.

Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.

Purpose: To analyze the changes in the work profiles of radiologists and the reporting time after the implementation of professional subspecialization in the radiology department of a Swiss university hospital.

Methods: In a retrospective analysis, the overall number of different radiologic examinations performed in the department of radiology of the largest Swiss university hospital was documented for 2014 and 2016 before and after the implementation of subspecialized reporting (subspecialities: abdominal, musculoskeletal, cardiothoracic, emergency, and pediatric imaging) in May 2015. For six selected radiologists, the number and types of reported examinations as well as the related radiology report turnaround times (RTATs) were analyzed in detail and compared between the two 1-year periods. Read More

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http://dx.doi.org/10.1007/s11547-019-01039-3DOI Listing

How Often Do Systematic Reviews Exclude Articles Not Published in English?

J Gen Intern Med 2019 Apr 22. Epub 2019 Apr 22.

Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan.

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http://dx.doi.org/10.1007/s11606-019-04976-xDOI Listing

Fundamentals of Enterprise Photodocumentation: Connecting the Clinical and Technical-a Review of Key Concepts.

J Digit Imaging 2019 Apr 22. Epub 2019 Apr 22.

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 7775 Thistle Lane, Novelty, OH, 44072, USA.

Photodocumentation is an invaluable tool in many specialties, including dermatology, facial plastic and reconstructive surgery, and wound management. As digital cameras and camera-enabled smartphones have become omnipresent in our society, they have brought photodocumentation to all corners of healthcare organizations including the emergency department as well as family medicine and pediatrics. Simultaneously, enterprise imaging programs have evolved enabling access to all medical images for all providers throughout these organizations. Read More

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http://dx.doi.org/10.1007/s10278-019-00212-4DOI Listing

Supplementation with Lactobacillus reuteri ATCC PTA 4659 in patients affected by acute uncomplicated diverticulitis: a randomized double-blind placebo controlled trial.

Int J Colorectal Dis 2019 Apr 22. Epub 2019 Apr 22.

Università Cattolica del Sacro Cuore, Rome, Italy.

Introduction: Acute uncomplicated diverticulitis (AUD) is an inflammation of the colon diverticulum. We tested the efficacy of Lactobacillus reuteri 4659 (L. reuteri) in treating AUD. Read More

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http://dx.doi.org/10.1007/s00384-019-03295-1DOI Listing

Implementation of an electronic medical record tool for early detection of deep vein thrombosis in the ambulatory oncology setting.

Res Pract Thromb Haemost 2019 Apr 28;3(2):226-233. Epub 2019 Jan 28.

Department of Hematology and Medical Oncology Taussig Cancer Institute Cleveland Clinic Cleveland Ohio.

Background: Venous thromboembolism (VTE) is a major cause of morbidity, mortality, and hospitalization in cancer patients.

Objectives: To evaluate the feasibility of an electronic alert to identify and screen at-risk individuals and gather rates of early detection of deep vein thrombosis (DVT).

Patients/methods: An alert was built into the electronic medical record based on a validated risk tool (Khorana Score [KS]) and outcomes evaluated in an initial silent phase. Read More

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http://dx.doi.org/10.1002/rth2.12176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462749PMC

Qatar experience on One Health approach for middle-east respiratory syndrome coronavirus, 2012-2017: A viewpoint.

One Health 2019 Jun 4;7:100090. Epub 2019 Apr 4.

Ministry of Public of Health, Doha, Qatar.

The emergence of the Middle East Respiratory Syndrome Corona Virus (MERS-CoV) in the Middle East in 2012 was associated with an overwhelming uncertainty about its epidemiological and clinical characteristics. Once dromedary camels () was found to be the natural reservoir of the virus, the public health systems across the Arabian Peninsula encountered an unprecedented pressure to control its transmission. This view point describes how the One Health approach was used in Qatar to manage the MERS-CoV outbreak during the period 2012-2017. Read More

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http://dx.doi.org/10.1016/j.onehlt.2019.100090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462540PMC

Isolated ureteral injury following a stab wound: A case report.

Trauma Case Rep 2019 Jun 12;21:100197. Epub 2019 Apr 12.

Department of Surgery, Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Republic of Korea.

Ureteral injuries reportedly occur in 2-5% of gunshot wounds to the abdomen, and are even rarer in abdominal stab wounds. Ureteral injuries are usually silent and produce no early signs or symptoms. An unrecognized or mismanaged ureteral injury can lead to significant morbidity and mortality. Read More

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http://dx.doi.org/10.1016/j.tcr.2019.100197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463216PMC

Using Ketamine and Propofol for Procedural Sedation of Adults in the Emergency Department: A Systematic Review and Meta-Analysis.

Adv Pharm Bull 2019 Feb 21;9(1):5-11. Epub 2019 Feb 21.

Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Ketamine-propofol combination (ketofol) is being used to provide a safe and effective procedural sedation (PS) in emergency department (ED) and may theoretically have beneficial effects since using lower doses of each drug may result in a reduction of the adverse events of both agents while maintaining optimal conditions for performing procedures. This systematic review was conducted to evaluate the efficacy, advantages and disadvantages of these two drugs for PS. The PRISMA statement was used for this systematic review. Read More

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https://apb.tbzmed.ac.ir/Abstract/apb-22985
Publisher Site
http://dx.doi.org/10.15171/apb.2019.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468222PMC
February 2019

Misplaced Ventricular Lead via an Atrial Septal Defect-Percutaneous Extraction.

Thorac Cardiovasc Surg Rep 2019 Jan 19;8(1):e8-e10. Epub 2019 Apr 19.

Department of Cardiac Surgery, University Clinic Oldenburg, European Medical School Oldenburg-Groningen, Oldenburg, Germany.

 Necessity for lead removal in this case was after 12 years due to mitral valve regurgitation caused by retraction of the posterior leaflet by the inadvertently misplaced lead.  This history describes a 45-year-old woman with history of multiple cardiac operations at young age with an abandoned defibrillator lead via a patent atrial septal defect. Lead extraction was performed with first described use of rotational dilating sheaths to reduce emboli risk, hoping to avoid a fourth surgical procedure with high risk. Read More

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http://dx.doi.org/10.1055/s-0039-1687821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474773PMC
January 2019

A Rare Case of Neurosyphilis with Ocular Involvement in a Patient with HIV Infection and New Onset Syphilis.

Cureus 2019 Feb 7;11(2):e4034. Epub 2019 Feb 7.

Internal Medicine, St. Barnabas Hospital, Bronx, USA.

Neurosyphilis (NS) is more frequently seen in patients with human immunodeficiency virus (HIV) infection, especially those not on antiretroviral therapy or with a low CD4 cell count. Ocular syphilis is an unusual and early form of neurosyphilis. Lumbar puncture should be considered in all HIV infected patients who present with neurologic or ocular disease. Read More

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http://dx.doi.org/10.7759/cureus.4034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456285PMC
February 2019

Acute ST-segment Elevation Myocardial Infarction as the First Manifestation of Essential Thrombocytosis.

Cureus 2019 Feb 7;11(2):e4032. Epub 2019 Feb 7.

Oncology, Florida Cancer Specialists, Atlantis, USA.

A 36-year-old female with no significant past medical history presented with sudden onset of crushing substernal chest pain. When the emergency medical services (EMS) arrived, she had a cardiac arrest requiring defibrillation two times in the field prior to arriving at the hospital. In the emergency department (ED), the electrocardiogram (ECG) was significant for ST-elevation that suggested acute anterolateral infarct. Read More

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http://dx.doi.org/10.7759/cureus.4032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456283PMC
February 2019

Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia.

Case Rep Obstet Gynecol 2019 18;2019:2893149. Epub 2019 Mar 18.

Obstetrics and Gynaecology, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Rd, London SE1 7EH, UK.

A 28-year-old, 9 and a half weeks pregnant (spontaneous conception) multigravida presented with abdominal pain and vaginal bleeding. On examination, her abdomen was diffusely tender, particularly in the right iliac fossa, though guarding was absent. Transabdominal and transvaginal ultrasonography demonstrated a viable intrauterine pregnancy and large-volume intraperitoneal haemoperitoneum; the right ovary could not be identified. Read More

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http://dx.doi.org/10.1155/2019/2893149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442437PMC

A Rare Cause of Thrombotic Thrombocytopenia Purpura- (TTP-) Like Syndrome, Vitamin B12 Deficiency: Interpretation of Significant Pathological Findings.

Case Rep Hematol 2019 18;2019:1529306. Epub 2019 Mar 18.

Department of Hematology-Oncology, University of Arizona Cancer Center, Tucson, AZ, USA.

Thrombotic thrombocytopenia purpura (TTP) is a hematological emergency that requires rapid assessment followed by prompt initiation of therapy due to high mortality associated with delayed treatment. TTP has many causes including heritable syndromes, ADAMTS13 deficiency, and drugs-related etiologies. Profound vitamin B12 deficiency can, in rare cases, mimic TTP in presentation, and since plasmapheresis can be of limited benefit, prompt diagnosis is necessary for accurate treatment with B12. Read More

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http://dx.doi.org/10.1155/2019/1529306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442445PMC

Gastric Emphysema in a Critically Ill Patient Successfully Treated without Surgery.

Case Rep Crit Care 2019 18;2019:1824101. Epub 2019 Mar 18.

Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Japan.

Gastric emphysema is a relatively rare clinical entity caused by injury to the gastric mucosa. A 62-year-old Japanese male with a history of heavy alcohol consumption and smoking was admitted to the emergency intensive care unit due to severe hypercapnic respiratory acidosis. His body mass index was only 12. Read More

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http://dx.doi.org/10.1155/2019/1824101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442441PMC

Does Interhospital Transfer Influence the Outcomes of Patients Receiving Surgery for Acute Type A Aortic Dissection? Type A Aortic Dissection: Is Transfer Hazardous or Beneficial?

Emerg Med Int 2019 18;2019:5692083. Epub 2019 Mar 18.

Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Taoyuan, Taiwan.

Introduction: The progression of acute type A aortic dissection may cause immediate death, such that, in the event of its diagnosis, emergency surgery is indicated. Relatedly, an interhospital transfer may prolong the time from diagnosis to surgery. This study therefore investigated how interhospital transfers impact surgical outcomes for acute type A aortic dissection. Read More

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https://www.hindawi.com/journals/emi/2019/5692083/
Publisher Site
http://dx.doi.org/10.1155/2019/5692083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442438PMC

Urinary catheters in the emergency department: a prospective audit to improve quality control.

Cent European J Urol 2019 22;72(1):62-65. Epub 2019 Jan 22.

Tallaght University Hospital, Department of Urology, Dublin, Ireland.

Introduction: The best way to prevent urinary catheter related complications is to avoid unnecessary insertions of catheters and removing the catheters when they are no longer necessary. Previous studies have shown 47% documentation rate of urinary catheter (UC) insertion in the Emergency Department (ED) and have found one-sixth of patients in the ED have no indication for UC insertion. The aim of this audit was to record the indications and documentation of UC insertion in the ED and to propose an intervention to improve the quality of these processes. Read More

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http://dx.doi.org/10.5173/ceju.2019.1731DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469012PMC
January 2019

Multiple subacute bilateral cerebral infarcts in a 9-year-old Nigerian male: a case of childhood primary angiitis of the central nervous system.

Pan Afr Med J 2018 10;31:99. Epub 2018 Oct 10.

Children's Emergency Room (CHER), Ward 12 (children's in-patient ward) and the Paediatric Neurology Clinic, Federal Medical Centre, Owerri, Nigeria.

A Primary Angiitis of the Central Nervous System (PACNS) is ill-defined, complex and rare in children. Clinical presentation is variable, diagnosis is challenging and it is life-threatening but treatable. The index case is a 9-year old male who presented with progressively slurred speech, progressive weakness of the limbs, hemifacial weakness and vomiting. Read More

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http://dx.doi.org/10.11604/pamj.2018.31.99.13898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462305PMC
October 2018

An algorithm to improve the accuracy of emergency weight estimation in obese children.

Pan Afr Med J 2018 5;31:90. Epub 2018 Oct 5.

Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Introduction: During medical emergencies in children, accurate and appropriate weight estimations may ultimately influence the outcome by facilitating the delivery of safe and effective doses of medications. Children at the extremes of habitus, especially obese children, are more at risk of an inaccurate weight estimation and therefore may be more at risk of medication errors. The objective was therefore to develop an algorithm to guide accurate emergency weight estimation in obese children. Read More

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http://dx.doi.org/10.11604/pamj.2018.31.90.13821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461967PMC
October 2018

Hepatic rupture from haematomas in patients with pre-eclampsia/eclampsia: a case series.

Pan Afr Med J 2018 4;31:86. Epub 2018 Oct 4.

Department of Obstetrics and Gynaecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.

Hepatic rupture from haematomas is a rare complication of severe preeclampsia/eclampsia especially when complicated with the haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome. It is associated with poor maternal and foetal outcomes as demonstrated by three cases we describe. The first case had eclampsia at 31 weeks gestation with features of abruptio placentae and at caesarean section we found haemoperitoneum of 1. Read More

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http://dx.doi.org/10.11604/pamj.2018.31.86.15975DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462150PMC
October 2018

[Acute medullary infarct: a still little know diagnosis with a poor prognosis].

Pan Afr Med J 2018 4;31:85. Epub 2018 Oct 4.

Service de Neurologie, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc.

Medullary infarct is still little known influencing the short-term vital and functional prognosis of patients. Medullary vascularization is one of the most complex in the body due to the significant number of arteries that contribute to it. Our knowledge is still limited due to the scarcity of vascular medullary accidents and to low accessibility of medullary vessels during assessments. Read More

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http://dx.doi.org/10.11604/pamj.2018.31.85.16854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461969PMC
October 2018

Gallbladder Metastases: A Report of Two Cases.

Case Rep Oncol 2019 Jan-Apr;12(1):235-240. Epub 2019 Mar 19.

Virginia Tech Carilion School of Medicine, Division of Gastroenterology and Hepatology, Roanoke, Virginia, USA.

Introduction: Metastasis to the gallbladder is not common and usually manifests an advanced stage of malignancy. Herein, we report a case of triple negative high grade invasive ductal carcinoma of breast with a metastatic lesion to the gallbladder.

Case Presentation: The patient is a 52-year-old female diagnosed with invasive ductal carcinoma treated with mastectomy and chemotherapy. Read More

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https://www.karger.com/Article/FullText/497818
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http://dx.doi.org/10.1159/000497818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465751PMC

Chronic functional constipation is strongly linked to vitamin D deficiency.

World J Gastroenterol 2019 Apr;25(14):1729-1740

Department of Gastroenterology and Digestive Endoscopy, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte (Bari) 70013, Italy.

Background: Few studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not well-defined.

Aim: To investigate the relationship between serum 25-hydroxyvitamin D levels and functional chronic constipation associated to intestinal motility disorders.

Methods: We performed a prospective case-control study, from May-June to November 2017. Read More

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http://dx.doi.org/10.3748/wjg.v25.i14.1729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465937PMC

Acute Care for Elders (ACE) Team Model of Care: A Clinical Overview.

Geriatrics (Basel) 2018 Aug 6;3(3). Epub 2018 Aug 6.

Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama, Birmingham, AL 35294, USA.

The Institute of Medicine (IOM) Reports of and have called for more interprofessional and coordinated hospital care. For over 20 years, Acute Care for Elders (ACE) Units and models of care that disseminate ACE principles have demonstrated outcomes in-line with the IOM goals. The objective of this overview is to provide a concise summary of studies that describe outcomes of ACE models of care published in 1995 or later. Read More

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http://dx.doi.org/10.3390/geriatrics3030050DOI Listing

Illness Representation and Self-Care Ability in Older Adults with Chronic Disease.

Geriatrics (Basel) 2018 Jul 31;3(3). Epub 2018 Jul 31.

Department of Nursing, Mayo Clinic, Rochester, MN 55905, USA.

Chronic illness affects >50% of adults in the United States and accounts for >80% of healthcare spending. The purpose of this study was to determine whether beliefs about one's chronic disease (illness representation) are associated with self-care activation, emergency department (ED) visits, or hospitalizations. Using a cross-sectional design, we recruited older adults with heart failure, chronic obstructive pulmonary disease (COPD), and chronic kidney disease. Read More

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http://www.mdpi.com/2308-3417/3/3/45
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http://dx.doi.org/10.3390/geriatrics3030045DOI Listing

Prediction of Emergency Department Re-Visits in Older Patients by the Identification of Senior at Risk (ISAR) Screening.

Geriatrics (Basel) 2018 Jun 21;3(3). Epub 2018 Jun 21.

Emergency Department, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.

The "Identification of Seniors at Risk" (ISAR) screening is a tool to identify seniors at risk of adverse outcomes. We investigated whether seniors with a positive ISAR screening have an increased risk of Emergency Department (ED) re-visits and health-service costs. In a pilot project, we enrolled 96 ED patients (≥70 years) who received an ISAR screening in the ED. Read More

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http://dx.doi.org/10.3390/geriatrics3030033DOI Listing

Epilepsy: a cross-sectional study of paediatricians and general practitioners on their experiences, knowledge and handling of the disease.

Epileptic Disord 2019 Apr 23. Epub 2019 Apr 23.

University Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig, University Hospital for Children and Adolescents, Neuropaediatrics, Rostock, Germany.

Epilepsy is a life-changing disease, and patients with epilepsy may face a number of issues. Paediatricians and general practitioners are often the first to be asked for advice. This cross-sectional study was performed to gain information on the knowledge and experiences of paediatricians and general practitioners on epilepsy. Read More

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http://dx.doi.org/10.1684/epd.2019.1048DOI Listing