检索结果-南通市图书馆

community emergency medicine:Benefits and challenges of screening for elder abuse in the emergency department of a developing country

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2015年第4期6卷 261-264页

作者： Muhammad Akbar Baig Asad Mian Erfaan Hussain Shahan Waheed department of emergency medicine Aga Khan University Hospital departments of emergency medicine Aga Khan University Hospital Adult Critical Care Services Aga Khan University Hospital

As people live longer and fewer babies are born,the elderly became the fastest and largest growing population of the world,expected to increase further from 86 million in 2005 to 394 million in 2050 worldwide.Older patients represent a large bulk of the population arriving in emergency departments(EDs)all over the world.^([1])They use hospitals more frequently than younger patients。

关键词： community emergency medicine

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2017年第3期8卷 214-222页

作者： Salima Kerai Omrana Pasha Uzma Khan Muhammad Islam Nargis Asad Junaid Razzak Epidemiology and Biostatistics Community Health Sciences Department Aga Khan University community Health Sciences department Aga Khan University Psychiatry department Aga Khan University emergency medicine department Johns Hopkins University School of Medicine

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

关键词： emergency medical service Karachi Pakistan Post-traumatic stress disorder Stress Work performance

Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2020年第4期11卷 206-215页

作者： Hai-jiang Zhou Tian-fei Lan Shu-bin Guo emergency medicine Clinical Research Center Beijing Chao-yang HospitalCapital Medical University&Beijing Key Laboratory of Cardiopulmonary Cerebral ResuscitationBeijingChina department of Allergy Beijing Shijitan HospitalCapital Medical UniversityBeijingChina

BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,Pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in emergency department Sepsis[MEDS])and admission lactate level.METHODS:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were enrolled.Demographic characteristics were collected.The primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation use.Outcome prediction value of parameters above was compared using receiver operating characteristics(ROC)curves.Cox regression analyses were carried out to determine the risk factors for the 28-day mortality.Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS.RESULTS:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical ventilation.Among single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission.CONCLUSIONS:NEWS could be a valuable predictor in septic patients with CAP in emergency departments.Admission lactate did not predict well t

关键词： community-acquired pneumonia Sepsis National Early Warning Score(NEWS) Intensive care unit emergency departments

Light chain cardiac amyloidosis in a nonagenarian

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2022年第1期19卷 83-89页

作者： Koji Takahashi Mina Yamashita Tomoki Sakaue Daijiro Enomoto Shigeki Uemura Takafumi Okura Shuntaro Ikeda Takanori Senba Akira Saijo Nobuhisa Yamamura Sohei Kitazawa Department of Community Emergency Medicine Ehime University Graduate School of MedicineEhimeJapan department of Cardiology Yawatahama City General HospitalEhimeJapan department of Hematology Yawatahama City General HospitalEhimeJapan department of Clinical Pathology Yawatahama City General HospitalEhimeJapan department of Molecular Pathology Ehime University Graduate School of MedicineEhimeJapan

Cardiac amyloidosis is an infiltrative and restrictive cardiomyopathy caused by the extracellular deposition of amyloid fib-rils within the heart as systemic amyloidosis,lead-ing to heart failure,reduced quality of life,and death.[1]There are two major amyloid fibril proteins that af-fect the heart:amyloid immunoglobulin light chain(AL)and amyloid transthyretin(ATTR).The latter is further subdivided into wild-type ATTR and variant types based on the presence of a mutation in the transthyretin gene.

关键词： amyloid death. cardiomyopathy

emergency department operations and management education in emergency medicine training

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2012年第2期3卷 98-101页

作者： Bret A Nicks Darrell Nelson department of emergency medicine Wake Forest Baptist Medical Center department of emergency medicine Forsyth Medical Center

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based emergency medicine Residency programs.METHODS:Residency program directors at all US-based emergency medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

关键词： Core measures Operations management emergency medicine residency Resident education

An unusual case of severe pneumonia caused by Tropheryma whipplei combined with Legionella pneumophila

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2023年第6期14卷 492-494页

作者： Zhenfeng Lu Aiping Zhang Jingsheng Guo Haibin Ni department of emergency medicine Affiliated Hospital of Integrated Traditional Chinese and Western MedicineNanjing University of Chinese MedicineNanjing 210046China

community-acquired pneumonia is a common disease caused by a variety of pathogens.Tropheryma whipplei (T.whipplei) is a rare pathogenic bacterium,few cases have been reported.George Hoyt Whipple described Whipple’s d... 详细信息

关键词： pneumonia Whipple

emergency department presentation changes due to the coronavirus disease pandemic in Nova Scotia,Canada

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2023年第1期14卷 62-64页

作者： Tara Dahn Patrick T.Fok Hana Wiemer Daniel J.Dutton Valancy Cole David Lewis Tong Liu Keith R.Brunt Robert Hanlon Jacqueline Fraser Chris Vaillancourt Paul Atkinson department of emergency medicine Dalhousie UniversityHalifax B3H 3A7Canada department of community Health and Epidemiology Dalhousie UniversitySaint John E2K 5E2Canada Dalhousie medicine New Brunswick Saint John E2L 4L5Canada department of emergency medicine Level One Saint John Regional HospitalSaint John E2L 4L2Canada department of emergency medicine Horizon Health NetworkSaint John E2L 4L2Canada

Multiple studies have reported decreased emergency department(ED)patient volumes during the coronavirus disease(COVID-19)pandemic,[1-6]including areas most affected by the virus.[7]Most existing studies have investigated general trends in ED presentations and have not examined the impact of COVID-19 on different types of EDs,specific ED patient groups,or illness presentations.

关键词： Canada department patient

Analysis of risk factors contributing to road traffic accidents in a tertiary care hospital. A hospital based cross-sectional study

在线全文

学校读者我要写书评

暂无评论

Chinese Journal of Traumatology 2020年第3期23卷 159-162页

作者： Sandip Kumar Mahima Dhiraj Kumar Srivastava Pradip Kharya Neha Sachan K.Kiran department of community medicine UPUMSSaifaiEtawah206130India

Purpose: Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them.Methods: During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward.Results: In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motor-cyclists (54.2%) followed by pedestrian (25.1%).Conclusion: There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.

关键词： Road traffic accidents Risk factors Tertiary care hospital

Unfamiliar waveforms spanning from the ST to TP segments only observed in certain limb leads of the standard 12-lead electrocardiogram due to Aslanger’ s sign

在线全文

学校读者我要写书评

暂无评论

老年心脏病学杂志:英文版 2023年第9期20卷 693-696页

作者： Koji Takahashi Nobuhisa Yamamura Mako Yoshino Daijiro Enomoto Hiroe Morioka Shigeki Uemura Takafumi Okura Tomoki Sakaue Shuntaro Ikeda Department of Community Emergency Medicine Ehime University Graduate School of MedicineEhimeJapan department of Cardiology Yawatahama City General HospitalEhimeJapan department of Clinical Pathology Yawatahama City General HospitalEhimeJapan

Aslanger’s sign,also known as the arterial pulse tapping artifact or electromechanical association artifact,is an electrocardiographic artifact caused by arterial pulsation at the site where the limb leads of the standard 12-lead electrocardiogram near the radial or posterior tibial arteries are positioned,particularly in hyperdynamic states.[1–8]It occurs in every cardiac cycle with a constant coupling interval between the QRS complex and artifact.This synchronization with the underlying heart rhythm makes it less likely to be recognized as an artifact compared to unsynchronized artifacts,such as those caused by limb movement and inadequate contact between the electrode and skin.[1,2,7,8]Almost all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one of the standard 12-lead electrocardiogram.This sign is often confused with an electrocardiographic finding commonly observed during acute coronary events.

关键词： electrocardiogram arterial likely