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Itay Zmora Yonit Wiener-Well Evan Avraham Alpert 《The American journal of emergency medicine》2019,37(5):1006.e5-1006.e7
Background
Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.Case report
An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.Why should an emergency physician be aware of this?
Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage. 相似文献3.
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Feasibility and Diagnostic Potential of Pulmonary Transit Time Measurement by Contrast Echocardiography: A Pilot Study 
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下载免费PDF全文 5.
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Daniel J. Snyder Thomas R. Kroshus Aakash Keswani Evan B. Garden Karl M. Koenig Kevin J. Bozic David S. Jevsevar Jashvant Poeran Calin S. Moucha 《The Journal of arthroplasty》2019,34(4):613-618
Background
Nursing Home Compare (NHC) ratings, created and maintained by Medicare, are used by both hospitals and consumers to aid in the skilled nursing facility (SNF) selection process. To date, no studies have linked NHC ratings to actual episode-based outcomes. The purpose of this study was to evaluate whether NHC ratings are valid predictors of 90-day complications, readmission, and bundle costs for patients discharged to an SNF after primary total joint arthroplasty (TJA).Methods
All SNF-discharged primary TJA cases in 2017 at a multihospital academic health system were queried. Demographic, psychosocial, and clinical variables were manually extracted from the health record. Medicare NHC ratings were then collected for each SNF. For patients in the Medicare bundle, postacute and total bundle cost was extracted from claims.Results
Four hundred eighty-eight patients were discharged to a total of 105 unique SNFs. In multivariate analysis, overall NHC rating was not predictive of 90-day readmission/major complications, >75th percentile postacute cost, or 90-day bundle cost exceeding the target price. SNF health inspection and quality measure ratings were also not predictive of 90-day readmission/major complications or bundle performance. A higher SNF staffing rating was independently associated with a decreased odds for >75th percentile 90-day postacute spend (odds ratio, 0.58; P = .01) and a 90-day bundle cost exceeding the target price (odds ratio = 0.69; P = .02) but was similarly not predictive of 90-day readmission/complications.Conclusion
Results of our study suggest that Medicare's NHC tool is not a useful predictor of 90-day costs, complications, or readmissions for SNFs within our health system. 相似文献7.
Lee Mi Jung Romero Sergio Velozo Craig A. Gruber-Baldini Ann L. Shulman Lisa M. 《Quality of life research》2019,28(6):1595-1603
Quality of Life Research - This study investigated the PROMIS Self-Efficacy Measure for Managing Chronic Conditions (PROMIS-SE) domain distributions and examined the factor structure of the... 相似文献
8.
Interaction effects between the 5‐hydroxy tryptamine transporter‐linked polymorphic region (5‐HTTLPR) genotype and family conflict on adolescent alcohol use and misuse 下载免费PDF全文
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