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31.
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Maryam Boumezrag Sormeh Harounzadeh Hamza Ijaz Angeline Johny Lorna Richards Yan Ma Maxine A. Le Saux Paige Kulie Caitlin Davis Andrew C. Meltzer 《The American journal of emergency medicine》2019,37(2):304-307
Study objectives
The primary objective of this study was to compare Emergency Department patients with first-time versus recurrent acute pancreatitis.Methods
This study was a retrospective chart review of patients with a diagnosis of acute pancreatitis who presented to a single academic urban emergency department from 2012 to 2016. Criteria for inclusion were clinical symptoms of pancreatitis, age greater than or equal to 18?years, ED diagnosis of acute pancreatitis, and an abdominal CT scan within 24?h of triage. Exclusion criteria were traumatic mechanism and pregnancy. Charts were reviewed by a minimum of two trained abstractors using structured data collection sheets and discrepancies were resolved by a third abstractor. Patients with first time acute pancreatitis versus recurrent acute pancreatitis were compared to determine differences in characteristics, management and disposition.Results
250 patients were included in the study. Of these, 165 patients had first-time acute pancreatitis and 85 patients had recurrent acute pancreatitis. Demographics, vital signs and initial lab values were the same in both groups. Patients with recurrent acute pancreatitis were more likely to have significant findings on CT (Modified CT Severity Index, 2.09 versus 1.43, p?<?0.05), more likely to require IV opiates (96% versus 75%, p?<?0.001) and less likely to need ICU admission (8% versus 19%, p?=?0.03).Conclusion
ED patients with recurrent acute pancreatitis demonstrated more significant findings on CT compared to patients with first-time acute pancreatitis but were less likely to require ICU admission. 相似文献33.
34.
Tonya J.H. White 《Journal of the American Academy of Child and Adolescent Psychiatry》2019,58(11):1042-1050
35.
Tau Ming Liew 《Journal of the American Medical Directors Association》2019,20(8):1054.e11-1054.e20
ObjectivesEarly diagnosis of cognitive impairment is increasingly emphasized in the literature to facilitate timely preventive interventions. Although bedside cognitive tests such as the Montreal Cognitive Assessment (MoCA) are widely used for such early diagnostic purposes, they may not have comparable performance to a full neuropsychological battery (FNB) in diagnosing early cognitive impairment. This study investigated whether a small subset of neuropsychological tests can be added on to MoCA to match its performance to that of the FNB in discriminating mild cognitive impairment and dementia (MCI/dementia) from normal cognition.DesignCross-sectional diagnostic study.SettingAlzheimer's Disease Centers across the United States.ParticipantsOlder participants (≥50 years) who completed MoCA and the FNB (N = 9187).MeasuresThe study sample was split into two: the derivation sample (n = 1837) was used to develop a brief neuropsychological battery that best discriminated MCI/dementia (using the best-subset approach with 10-fold cross-validation); while the validation sample (n = 7350) verified its actual performance in discriminating MCI/dementia.ResultsA 3-item neuropsychological battery was identified, comprising MoCA, Benson Complex Figure Recall, and Craft Story 21 Delayed Recall. It had excellent performance in discriminating MCI/dementia from normal cognition (area under the receiver operating characteristic curve [AUROC] 90.0%, 95% confidence interval [CI] 89.2%-90.7%), which was comparable to that of the FNB (AUROC 88.4%, 95% CI 87.6%-89.2%). By contrast, MoCA alone had significantly worse AUROC (86.9%, 95% CI 86.0%-87.7%) than that of the FNB.Conclusions/ImplicationsUsing rigorous methods, this study developed a brief neuropsychological battery that maintained the brevity of a bedside cognitive test, while rivaling the diagnostic performance of an FNB in early cognitive impairment. This brief battery offers a viable alternative when the FNB is needed but cannot be feasibly administered in nonspecialty clinics. It can have a wider health systems effect of improving patients’ access to accurate diagnosis in early cognitive impairment and facilitating timely interventions to delay the progression of cognitive impairment. 相似文献
36.
《中国现代医生》2020,58(26):168-170+175
目的 探讨集束化护理在心内科危重患者压力性损伤管理中的应用效果。方法 选取2019年7~12月在心内科住院并病情危重的患者70例作为研究对象,分为对照组与观察组,每组各35例,其中对照组给予常规护理,观察组给予集束化护理,并比较分析两组患者压力性损伤的发生率、压力性损伤发生程度、压力性损伤发生时间以及压力性损伤护理满意度的情况。结果 集束化护理管理的观察组压疮发生率要低于常规护理的对照组的压力性损伤发生率(P0.05),观察组患者压力性损伤程度好于对照组(P0.05),观察组患者压力性损伤的发生时间长于对照组患者的压力性损伤发生时间(P0.05),观察组患者经过集束化护理后满意度要高于对照组,差异有统计学意义(P=0.039)。结论 对心内科危重患者进行集束化护理管理措施,能够有效降低心内科患者压力性损伤的发生率及严重程度,同时还延缓了压力性损伤的发生时间,并提升了患者的护理满意度,具有较好的应用效果。 相似文献
37.
Stephen Sze Shing Teo Ed Oakley Jane Stanford Jane Cichero 《Emergency medicine Australasia : EMA》2019,31(4):676-679
The Paediatric Acute Care Conference (PACC) is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre‐hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The PACC 2018 was held in Hobart, Tasmania. We provide a summary of some of the presentations. 相似文献
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39.
BackgroundEmergency department personnel are exposed to high risk of workplace violence (WPV) and nurses are the main victims. Few researchers have investigated the effects of WPV on job satisfaction and turnover intention among nurses.AimsTo describe WPV, job satisfaction and turnover intention of emergency nurses and clarify the relationship between them.MethodsA cross-sectional study was used to collect data on WPV, job satisfaction and turnover intention among 385 nurses working in emergency department in 13 general hospitals in Beijing. Structural equation modeling was used to test the relationship between them.ResultsAmong them, 89.9% had experienced WPV in the previous year. WPV had short-term and long-term impacts on over 80% of them. The score of job satisfaction and turnover intention was 2.48 ± 0.49, 2.75 ± 0.58 respectively. WPV had significant direct effect on turnover intention (β = 0.105) and job satisfaction (β = −0.161). Job satisfaction had a significant negative effect on turnover intention (β = −0.604) and it mediated the relationship between WPV and turnover intention.ConclusionEmergency nurses in China are at great risk of WPV. Their job satisfaction is low and turnover intention is high. Job satisfaction plays the mediator role between WPV and turnover intention among emergency nurses. 相似文献
40.