4,208 results match your criteria referral delay


Delays during emergency obstetric care and their determinants among mothers who gave birth in South Gondar zone hospitals, Ethiopia. A cross-sectional study design.

Glob Health Action 2021 Jan;14(1):1953242

Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity.

Objective: This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. Read More

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January 2021

Delineating the genotypic and phenotypic spectrum of -related neurodevelopmental disorders.

J Med Genet 2021 Jul 28. Epub 2021 Jul 28.

GeneDx, Gaithersburg, Maryland, USA.

Background: Variants in have recently been reported to cause a neurodevelopmental disorder with hypotonia, seizures and impaired language; however, only six variants have been reported and the clinical characteristics have only broadly been defined.

Methods: Molecular and clinical data were collected from clinical and research cohorts. Massive parallel sequencing was performed and identified individuals with a related neurodevelopmental disorder. Read More

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Strengths and weaknesses in the diagnostic process of endometriosis from the patients' perspective: a focus group study.

Diagnosis (Berl) 2021 Jul 28. Epub 2021 Jul 28.

Department of Gynecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands.

Objectives: Endometriosis is characterized by a long interval between onset of symptoms and diagnosis. Detailed information about the patients' perspective on the diagnostic delay of endometriosis is scarce. The aim of this study was to identify strengths and weaknesses in the diagnostic process of endometriosis from the patients' perspective. Read More

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Differential perceptions regarding personal protective equipment use during the COVID-19 pandemic by NHS healthcare professionals based on ethnicity, sex and professional experience.

Infect Prev Pract 2021 Sep 12;3(3):100141. Epub 2021 Jun 12.

University Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.

Objectives: To capture perceptions regarding personal protective equipment (PPE) among healthcare professionals during the COVID-19 pandemic, including staff subgroups at high risk for severe COVID-19, such as black and minority ethnic (BAME) groups.

Design: Electronically distributed survey with semi-quantitative analysis. Survey distributed at a major academic NHS tertiary referral centre in the West Midlands with a diverse medical workforce to medically qualified staff who completed COVID-19 redeployment trainingN=121; 47% female; 49% of BAME background; 26% international medical graduates). Read More

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September 2021

Variability in Neuropsychological Phenotypes in Patients with 22Q11.2 Deletion Syndrome: Case Series.

Dev Neuropsychol 2021 Jul 27:1-12. Epub 2021 Jul 27.

Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, TX.

Children with 22q11.2 deletion syndrome (22q11.2DS) have diverse neurodevelopmental and mental health profiles involving cognitive impairments and behavioral symptomatology that evolve over the lifespan. Read More

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Frequency and Risk Factors of Severe Postoperative Bleeding After Proctological Surgery: A Retrospective Case-Control Study.

Ann Coloproctol 2021 Jul 27. Epub 2021 Jul 27.

Proctologic Surgery, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.

Purpose: The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment.

Methods: All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Read More

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The impact of the COVID-19 pandemic on diagnostic delay of skin cancer: a call to restart screening activities.

J Eur Acad Dermatol Venereol 2021 Jul 26. Epub 2021 Jul 26.

1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Athens, Greece.

The COVID-19 pandemic has led to delays in diagnosis and treatment of patients with skin cancer: presentational delay of patients to the physician, diagnostic referral delay due to restrictions of diagnostic capacities, and/or treatment delay (decision to defer treatment due to increased risk of COVID-19 transmission or health policy restrictions to treatment capacities). Read More

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Retinopathy of prematurity screening and retinal hemorrhages - Our experience among Indian babies.

Indian J Ophthalmol 2021 Aug;69(8):2147-2150

Minto Regional Institute of Ophthalmology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

Purpose: To evaluate the clinical characteristics of intraocular hemorrhages among babies screened for retinopathy of prematurity (ROP) and thereby their additional risk to the progression of ROP.

Methods: A descriptive study was conducted at a tertiary referral hospital, which included 108 eyes of 60 neonates who were discovered to have retinal hemorrhages on retinal screening of 540 babies at risk for ROP. Maternal, obstetric, and neonatal risk factors were assessed in neonates with retinal hemorrhages. Read More

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Endoscopic Management of Bariatric Surgery Complications According to a Standardized Algorithm.

Obes Surg 2021 Jul 23. Epub 2021 Jul 23.

Unité d'Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Générale de Santé, 8 Place de l'Abbé G. Hénocque, 75013, Paris, France.

Background And Aims: Endoscopy is effective in management of bariatric surgery (BS) adverse events (AEs) but a comprehensive evaluation of long-term results is lacking. Our aim is to assess the effectiveness of a standardized algorithm for the treatment of BS-AE.

Patients And Methods: We retrospectively analyzed 1020 consecutive patients treated in our center from 2012 to 2020, collecting data on demographics, type of BS, complications, and endoscopic treatment. Read More

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Axial Spondyloarthritis in the Chiropractic Care Setting: A Systematic Literature Review.

J Clin Rheumatol 2021 Jul 21. Epub 2021 Jul 21.

From the Oregon Health & Science University, Portland, OR Equilibrium, Portland, OR.

Abstract: Diagnosis of axial spondyloarthritis (axSpA), an immune-mediated inflammatory disease, is commonly associated with chronic inflammatory back pain (IBP) and often occurs years after initial onset of clinical symptoms. Recognition of IBP is important for timely referral of patients with suspected axSpA to a rheumatologist. Patients with all types of back pain are treated in chiropractic care, but the proportion of patients with undiagnosed axSpA is unknown. Read More

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Clinical and Paraclinical Characteristics of Non-Classic Phenylketonuria.

Iran J Child Neurol 2021 ;15(3):131-138

Pediatric Resident Endocrinology and Metabolism, Mofid Children's Hospital, Shahid Beheshti Unversity of Medical Sciences, Tehran, Iran.

Objective: Phenylketonuria (PKU) is one of the most common inherited metabolic diseases, which is classified into classic and non-classic types. It is estimated that 2% of children with PKU develop a severe and progressive neurological disease, called non-classic (malignant) PKU. This study aimed to demonstrate the clinical features, laboratory findings, and diagnostic/therapeutic characteristics of non-classic PKU patients referred to a tertiary referral center for children in Tehran, Iran. Read More

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January 2021

Early diagnosis of kala-azar in Bangladesh: Findings from a population based mixed methods research informing the post-elimination era.

Parasitol Int 2021 Jul 17;85:102421. Epub 2021 Jul 17.

National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia.

Background: Global annual reports of visceral leishmaniasis or kala-azar ("black fever") reduced from 200,000 cases in 2012 to 23,804 in 2015. India, Bangladesh and Nepal reported 80% of the global cases in 2012, but 39% in 2015. We sought to identify major amenable barriers to early diagnosis of kala-azar in peripheral areas of Mymensingh district, an area of Bangladesh that was highly endemic for kala-azar. Read More

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The COVID-19 survey pandemic: a critical approach.

J BUON 2021 May-Jun;26(3):654-655

School of Human and Health Sciences. University of Huddersfield, HD1 3DH, UK.

COVID-19 pandemic has obviously affected patients' behavior towards seeking medical help as well as physicians' decision in the management of emergencies. Our recent experience as surgeons at a COVID-19 referral hospital revealed cases which share an alerting characteristic: the delay in appropriate management. Unfortunately for COVID-19 negative patients a "coronacentric" health system has been adopted. Read More

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Factors associated with length of stay and treatment outcome of Ebola patients treated at an Ebola treatment center in Sierra Leone during the peak period of the West African Ebola outbreak 2013-2016.

Arch Public Health 2021 Jul 12;79(1):131. Epub 2021 Jul 12.

Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.

Background: The World Health Organization (WHO) declared the West Africa Ebola epidemic as a Public Health Emergency of International Concern in August 2014. During the outbreak period, there were calls for the affected countries to construct Ebola treatment centres and reliable diagnostic laboratories closer to areas of transmission in order to improve the quality care of Ebola Virus Disease (EVD) patients. Delay in seeking treatment has been reported to have led to poor treatment outcome of EVD patients. Read More

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Clinical profile, long-term follow-up and outcome of juvenile systemic scleroderma: 25 years of clinical experience from North-West India.

Clin Exp Rheumatol 2021 Jul-Aug;39 Suppl 131(4):149-156. Epub 2021 Jul 6.

Allergy Immunology Unit, Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Objectives: To describe the clinical profile, long-term follow-up and outcome of juvenile systemic scleroderma (JSSc) from a tertiary care referral hospital in North-West India.

Methods: A review of case records was performed and children with JSSc (disease onset <14 years of age) were analysed. Diagnosis was based on the Paediatric Rheumatology European Society/American College of Rheumatology/European League against Rheumatism provisional classification criteria for JSSc. Read More

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Cecal volvulus in an adult male: A rare cause of intestinal obstruction: A case report.

Int J Surg Case Rep 2021 Jul 8;85:106186. Epub 2021 Jul 8.

Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda; Department of Surgery, Jinja Regional Referral Hospital, Jinja, Uganda.

Introduction And Importance: Cecal volvulus is uncommon cause of intestinal obstruction. It affects the ascending colon and the terminal part of the ileum which are twisted around the mesenteric pedicle.

Case Presentation: We report the case of 37-year-old male who underwent emergency laparotomy for intestinal obstruction and found a twisted cecum with ileal knotting and anterior part of cecum necrosed. Read More

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Assessment of the cochlear implant pathway for newborn hearing screening referrals.

Cochlear Implants Int 2021 Jul 7:1-8. Epub 2021 Jul 7.

Cambridge University Hospitals Foundation trust, Addenbrooke's Hospital, Cambridge, UK.

Objective: To evaluate the cochlear implant (CI) assessment pathway for children referred through the newborn hearing screening programme (NHSP) and identify potential reasons for delay in CI surgery at a large UK centre.

Methods: Retrospective analysis of electronic notes of children referred through NHSP from 2016 to 2019. Key points in the assessment pathway from referral to switch-on were assessed. Read More

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Delay in liver transplantation referral for adolescents with biliary atresia transitioning to adult care: a slippery slope.

Br J Surg 2021 Jul 6. Epub 2021 Jul 6.

Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

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Relationship between oral cancer stage and elapsed time from the onset of signs and symptoms to diagnosis and treatment.

Cancer Treat Res Commun 2021 Jun 24;28:100428. Epub 2021 Jun 24.

Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address:

Background: Oral cancer includes a variety of diagnoses of malignancies that manifest in the oral tissues. Prognosis and treatment depend on the site of involvement, the time of diagnosis, and the stage of the tumor. Early diagnosis of oral mucosal lesions facilitates the early detection of cancer, which is a key step for treatment. Read More

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Door-to-antibiotic Time and In-hospital Mortality of Elder Patients Presenting to Emergency Department with Sepsis; a Cross-Sectional Study.

Arch Acad Emerg Med 2021 11;9(1):e44. Epub 2021 Jun 11.

Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

Introduction: The current international sepsis guideline recommends that administration of intravenous broad-spectrum antibiotics should be initiated within 1 hour of emergency department (ED) arrival for sepsis patients. This study aimed to evaluate the association between door-to-antibiotic time and in-hospital mortality of these patients.

Methods: In this retrospective cross-sectional study, elderly patients (age ≥65 years) diagnosed with sepsis in the ED of a tertiary referral and academic hospital from January to December 2019 were enrolled. Read More

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The effect of coronavirus (COVID-19) pandemic on medical sciences education in Iran.

J Educ Health Promot 2021 20;10:136. Epub 2021 May 20.

Department of Emergency Medicine, Clinical Research Development Unit, Yasuj University of Medical Sciences, Yasuj, Iran.

Background: COVID-19 has a great impact on medical sciences education. Some researches have been conducted on the effects of the COVID-19 pandemic on medical sciences education in the world. The aim of this study was to identify the effects of this disease on medical sciences education in Iran. Read More

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Prenatal cerebellar growth is altered in congenital diaphragmatic hernia on ultrasound.

Prenat Diagn 2021 Jul 3. Epub 2021 Jul 3.

Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven University of Leuven, Leuven, Belgium.

Objective: Children with congenital diaphragmatic hernia (CDH) are at risk for neurodevelopmental delay. Herein we report on prenatal changes in biometry and brain perfusion in fetuses with isolated CDH.

Study Design: This retrospective study evaluated fetuses with isolated, left-sided CDH in three European referral centers. Read More

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Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care.

BMJ Open Qual 2021 Jul;10(3)

NHS Central London Clinical Commissioning Group, London, UK.

Objectives: The largest proportion of general practitioner (GP) magnetic resonance imaging (MRI is musculoskeletal (MSK), with consistent annual growth. With limited supporting evidence and potential harms from early imaging overuse, we evaluated practice to improve pathways and patient safety.

Methods: Cohort evaluation of routinely collected diagnostic and general practice data across a UK metropolitan primary care population. Read More

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Developmental dysplasia of the hip screening during the lockdown for COVID-19: experience from Northern Italy.

J Child Orthop 2021 Jun;15(3):248-254

Pediatric Orthopedic and Traumatology Unit, San Raffaele Hospital, Milan, Italy.

Purpose: Developmental dysplasia of the hip (DDH) ultrasound screening (USS), which is usually performed in Italy as an outpatient, was halted for an indefinite period in most centres during lockdown. The aim of this study was to analyze the effect of COVID-19 on DDH-USS, in two paediatric orthopaedic centres in one of the most critical areas of the western World.

Methods: An academic teaching hospital and paediatric trauma centre (T) and a University hospital and DDH referral centre (H), classified as national COVID-19 hubs, were involved. Read More

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Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years.

Stem Cells Int 2021 9;2021:9921015. Epub 2021 Jun 9.

The Regenerative Clinic, 18-22 Queen Anne Street, London, UK.

Background: Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life. Access to this intervention can be limited for a number of reasons including rationing of care, lack of healthcare provision in austere environments, and more recently, due to the cessation of elective orthopaedic care as a result of the COVID pandemic. Read More

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Improving Referrals to Preschool Special Education in Pediatric Primary Care.

J Pediatr Health Care 2021 Jun 28. Epub 2021 Jun 28.

Introduction: The American Academy of Pediatrics created evidence-based guidelines that encourage early identification and referral for children with developmental delays. Although pediatric primary care providers are poised to link 3-to-5-year-old children to school-based services, there are gaps in making referrals.

Method: Educational dissemination of streamlined referral packets was introduced. Read More

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Prevalence and risk factors for maternal mortality at a tertiary care centre in Eastern Nepal- retrospective cross sectional study.

BMC Pregnancy Childbirth 2021 Jul 1;21(1):471. Epub 2021 Jul 1.

Department of Obstetrics and Gynecology, Maharajgunj Medical Campus, TUTH, Kathmandu, Nepal.

Background: The maternal mortality ratio is a significant public health indicator that reflects the quality of health care services. The prevalence is still high in developing countries than in the developed countries. This study aimed to determine the MMR and identify the various risk factors and causes of maternal mortality. Read More

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Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung's Disease in Suspected Pediatric Patients.

Healthcare (Basel) 2021 Jun 4;9(6). Epub 2021 Jun 4.

Department of Surgery, Division of Pediatric Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chiangmai 50200, Thailand.

The diagnosis of Hirschsprung's disease (HSCR) relies on history, physical examination, and investigations. Some of investigation modalities could not be done in primary hospital. This study was aimed to develop the clinical score model for diagnosing and early referrals of HSCR, especially in areas where investigations were not available. Read More

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Non-GH Agents and Novel Therapeutics in the Management of Short Stature.

Indian J Pediatr 2021 Jul 1. Epub 2021 Jul 1.

Division of Pediatric Endocrinology, Department of Pediatrics, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, USA.

Short stature is one of the most common reasons for referral to pediatric endocrinologists. The vast majority of short children do not have growth hormone (GH) deficiency or another pathologic process that is interfering with normal growth. While GH has been approved in the US for several etiologies of non-GH deficient short stature, its high cost and need for daily injections represent barriers for many families. Read More

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Digestive Oncology in the COVID-19 Pandemic Era.

GE Port J Gastroenterol 2021 Mar 22;579:1-8. Epub 2021 Mar 22.

Department of Gastroenterology, Hospital Garcia de Orta, Almada, Portugal.

Introduction: Since the rise of the COVID-19 pandemic there has been widespread concern regarding the possible delay in the diagnosis/treatment of cancer patients. We aimed to assess the impact of the COVID-19 pandemic on the diagnosis, treatment, and outcome of patients with digestive cancer.

Methods: This was a retrospective study including patients with an inaugural digestive cancer diagnosis discussed for the first time at our center during the weekly digestive oncology reunion (DOR) meeting. Read More

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