The American journal of emergency medicine
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Violence and aggressive behaviors among youth are a leading cause of Emergency Department (ED) mental health (MH) encounters. A consistent method is needed for public health research, to identify ED encounters associated with aggression. The aim of this study was to develop such a screening procedure. ⋯ This paper presents a screening method for identifying ED encounters related to aggression. A replication study will be necessary to validate the method prior to applying to large claims data. If validated, it will support future research on this important population.
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Case Reports
Acute venous thromboembolism after initiation of voxelotor for treatment of sickle cell disease.
Sickle Cell Disease (SCD) is the most common genetic disease in the United States. Symptoms result from formation of sickle hemoglobin (HbS), which polymerizes and obstructs vasculature. Voxelotor, a HbS polymerization inhibitor, was granted accelerated approval by the Food and Drug Administration in 2019 for chronic treatment of SCD. ⋯ Although listed as an AE on its drug label, the only reports of voxelotor-associated VTE are in the results of clinical trials. To our knowledge, we present the first case of VTE likely provoked by voxelotor. While voxelotor offers a promising therapeutic option for SCD, emergency medicine physicians should be aware of severe AEs that may necessitate ED visits.
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Patients over the age of 65 who present to the Emergency Department (ED) are more likely to be admitted to the hospital and, if admitted, often have a longer length of stay (LOS) in the hospital than younger patients. ⋯ Patients who were assessed by the GEMA team were more likely to be discharged directly from the ED, and if admitted, hospital LOS was reduced by over 24 h. This indicates that a targeted intervention in the ED can help reduce hospital LOS in geriatric patients and therefore provide cost savings.
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The AZD1222 is one of the vaccines used against coronavirus disease 2019 (COVID-19), which is currently being used in many countries worldwide. Some important neurological side effects have been reported in association with this vaccine, but aseptic meningitis has not yet been reported. Herein, we report a case of aseptic meningitis in a 26-year-old health care worker, following the first dose of the AZD1222 vaccine.