Articles: emergency-department.
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JNMA J Nepal Med Assoc · Jan 2023
Hand Injury among Patients Visiting Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
The hand is a complex organ responsible for activities of daily living, making it susceptible to injuries and accidents. Hand injuries can result in significant functional impairment and it occurs in a younger productive age group. Therefore, it is important to understand the prevalence and patterns of hand injuries. The aim of the study was to find out the prevalence of hand injuries among patients visiting the emergency department of a tertiary care centre. ⋯ finger injuries; hand injuries; occupational injuries.
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Point-of-care focused vascular ultrasound (FOVUS), an assessment of carotid artery plaque, predicts coronary artery disease in outpatients referred for coronary angiography. Our primary objective was to determine the diagnostic accuracy of sonographer-performed FOVUS to predict major adverse cardiac events (MACE) within 30 days among patients with suspected cardiac ischemia in the emergency department (ED). ⋯ This study was registered at clinicaltrials.gov (NCT02947360).
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Sex differences in clinical presentation and mortality in emergency department patients with sepsis.
There is growing awareness that sex differences are associated with different patient outcomes in a variety of diseases. Studies investigating the effect of patient sex on sepsis-related mortality remain inconclusive and mainly focus on patients with severe sepsis and septic shock in the intensive care unit. We therefore investigated the association between patient sex and both clinical presentation and 30-day mortality in patients with the whole spectrum of sepsis severity presenting to the emergency department (ED) who were admitted to the hospital. ⋯ Females with sepsis presenting to the ED had fewer comorbidities, lower disease severity, less often thrombocytopenia and fever and were more likely to have a urinary tract infection. Females had a lower in-hospital and 30-day mortality compared to males, but sex was not an independent predictor of 30-day mortality. The lower mortality in female patients may be explained by differences in comorbidity and clinical presentation compared to male patients.KEY MESSAGESOnly limited data exist on sex differences in sepsis patients presenting to the emergency department with the whole spectrum of sepsis severity.Female sepsis patients had a lower incidence of comorbidities, less disease severity and a different source of infection, which explains the lower 30-day mortality we found in female patients compared to male patients.We found that sex was not an independent predictor of 30-day mortality; however, the study was probably underpowered to evaluate this outcome definitively.
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Mild traumatic brain injury (mTBI), or concussion, is the most common presentation of TBI in the emergency department (ED), but a diagnosis of mTBI may be missed in patients presenting with other acute injuries after a motor vehicle collision (MVC). ⋯ Patients presenting to the ED following an MVC have a high prevalence of mTBI. Patients whose diagnosis of mTBI is missed end up with significantly more severe postconcussion symptoms. While all patients included in this study were either referred or being treated for chronic pain after an MVC, they all also went on to develop PCS and disability following their accident, suggesting that better screening for mTBI after an MVC might identify those who may require more follow-up or rehabilitation therapy. In particular, those presenting with loss of consciousness, an altered mental state, posttraumatic amnesia, or postinjury headache are at increased risk of PCS.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsDiagnostic Overlap of Brain Abscess Symptoms with Methamphetamine Withdrawal Symptoms.
From the perspective of forensic medicine, substance abuse is an important topic due to its nature and consequences. The usage of methamphetamine is a significant public health problem with deleterious side effects, one of the most serious of which is mimicking central nervous system infection. A 40-year man was brought to the emergency department with complaints of headache, vomiting, fever, and loss of consciousness. ⋯ A diagnosis of brain abscess and ventriculitis was made. The aim of this report is to draw physicians attention to substance abstinence symptoms that may mask more serious diseases. Key Words: Brain abscess, Methamphetamine withdrawal, Sinusitis.