scholarly journals Evaluation and management of wilderness injuries and acute illness in Iceland during the years 2017-2018

2021 ◽  
Vol 107 (11) ◽  
pp. 515-521
Author(s):  
Ragna Sif Árnadóttir ◽  
◽  
Hjalti Már Björnsson ◽  
Keyword(s):  
Significant Proportion ◽  
Final Diagnosis ◽  
Search And Rescue ◽  
Lower Extremity Injury ◽  
Health Clinic ◽  
Medical Illness ◽  
Cardiac Symptoms ◽  
Minor Injuries ◽  
National Emergency ◽  
Provide Health Care

INTRODUCTION: In Iceland, wilderness search and rescue services are provided by volunteer members of the Icelandic association for search and rescue (ICE-SAR). The rescue teams respond to about 1200 calls every year, with a significant proportion of them involving injured and sick individuals. No previous studies have been done on the service provided by ICE-SAR teams. The aim of this study was to obtain information about the health services provided by ICE-SAR in Iceland. MATERIAL AND METHODS: Data was obtained from the ICE-SAR‘s and the National emergency call service‘s (112) databases. Cases that occurred during the years 2017 and 2018 that required transfer and treatment at a health clinic or hospital were included in the study. All cases with no involvement of sick or injured and minor injuries managed on scene without tranport were excluded. Treatment on scene and during transport and preliminary diagnosis made by ICE-SAR teams was reviewed. The medical report at each treating medical facility in Iceland was reviewed for treatment provided and final diagnosis. RESULTS: A total of 189 operations with 239 individuals were included in the study. A majority of the operations were recorded in the South region of Iceland. The average age of individuals was 44,4 years, just over half of cases involving men. Accidents accounted for 86% of all cases where the most common incident was a fall resulting in lower extremity injury. Cardiac disease was the most common cause for acute medical illness. On-scene treatment and use of equipment was not recorded in over 70% of cases. CONCLUSION: The ICE-SAR teams provide health care on regular basis, most commonly after accidents involving the lower extremities. Illness treated by the ICE-SAR volunteers most commonly involves cardiac symptoms. Documentation of on-site treatment and equipment use is incomplete.

scholarly journals Pre-diagnostic drop out of presumptive TB patients and its associated factors at Bugembe Health Centre IV in Jinja, Uganda

2020 ◽  
Vol 20 (2) ◽  
pp. 633-640
Author(s):  
Godfrey Ekuka ◽  
Ismael Kawooya ◽  
Edward Kayongo ◽  
Ronald Ssenyonga ◽  
Frank Mugabe ◽  
...  
Keyword(s):  
Associated Factors ◽  
Health Centre ◽  
Significant Proportion ◽  
Final Diagnosis ◽  
Drop Out ◽  
Population Characteristics ◽  
Dropping Out ◽  
Keywords Tuberculosis ◽  
Male Patients ◽  
The Individual

Background: Drop out of presumptive TB individuals before making a final diagnosis poses a danger to the individual and their community. We aimed to determine the proportion of these presumptive TB drop outs and their associated factors in Bugembe Health Centre, Jinja, Uganda. Methods: We used data from the DHIS2, presumptive and laboratory registers of Bugembe Health Centre IV for 2017. Descriptive statistics were used to summarize the population characteristics. A modified Poisson regression model via the generalized linear model (GLM) with log link and robust standard errors was used for bivariate and multivariate analysis. Results: Among the 216 registered presumptive TB patients who were less than 1% of patients visiting the outpatients’ department, 40.7% dropped out before final diagnosis was made. Age and HIV status were significantly associated with pre-diagnostic drop out while gender and distance from the health center were not. Conclusion: A high risk to individuals and the community is posed by the significant proportion of presumptive TB pa- tients dropping out before final diagnosis. Health systems managers need to consider interventions targeting young persons, male patients, HIV positive persons. Keywords: Tuberculosis (TB); Pre-diagnostic drop out; Presumptive TB; SORT IT.

Abstract 4069: Refusal to Seek Medical Care for Symptoms Prior to Sudden Cardiac Death

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Anne G Rosenfeld ◽  
Mohamud Daya ◽  
Vivian Christensen ◽  
Rebecca Rawson
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Sudden Cardiac Death ◽  
Medical Care ◽  
Cardiac Death ◽  
Significant Proportion ◽  
Heart Association ◽  
Qualitative Description ◽  
Cardiac Symptoms ◽  
History Of

Sudden cardiac death (SCD) is accompanied by preceding symptoms in a significant proportion of victims, with a median duration of up to 2 hours in some cases. The purpose of this study was to describe the characteristics of SCD victims with heralding symptoms who refused medical care. We conducted a secondary data analysis of interview data from witnesses of 99 cases of out-of-hospital presumed myocardial infarction death with known symptoms. Qualitative description methods were used to analyze qualitative data. Logistic regression was used to test the influence of type of symptoms (chest pain vs. non-chest pain), history of heart disease, and age on refusal of medical care. Categorization as refusal of medical care required conversation with someone where refusal was expressed verbally by the victim. There were 19 cases (19%) that refused medical care; their mean age was 72. The majority were male (16/19, 84%). Fifteen cases involved persistent refusal, defined as refusing care until collapse (range of <15 minutes to 60 hours). Four victims initially refused care and then permitted access to medical care. The suggestion for seeking medical care came from someone else in all but one case, and usually included multiple attempts. The care options offered but refused included calling 911 or a doctor, as well as going to the hospital, emergency department or a doctor’s office. Reasons for refusal of medical care (more than one reason in some cases) included stating the symptoms were due to something not urgent (n=10), other obligations (n=3), expressed dislike of hospitals or doctors (n=4), or recent medical reassurance of health status (n=7). Controlling for age, victims with chest pain vs. non-chest pain symptoms were more likely (OR = 3.56, p = .036, 95% CI = 1.09 –11.66) to refuse medical care and those with a history of heart disease were less likely (OR = .16, p = .004, 95% CI = .05–.55) to refuse medical care. Patients with chest pain and no history of heart disease are more likely to refuse advice to seek medical care. Public health messages about how to respond to cardiac symptoms should include strategies to overcome the reasons people refuse medical care. This research has received full or partial funding support from the American Heart Association, AHA Pacific/Mountain Affiliate (Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Oregon, Washington & Wyoming).

Correlates of cognitive functioning in independent elderly patients discharged home from the emergency department after a minor injury

2016 ◽  
Vol 28 (8) ◽  
pp. 1313-1322 ◽  
Author(s):  
Marie-Christine Ouellet ◽  
Marie-Josée Sirois ◽  
Simon Beaulieu-Bonneau ◽  
Marie-Ève Gagné ◽  
Jacques Morin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Elderly Patients ◽  
Cognitive Functioning ◽  
Significant Proportion ◽  
Minor Injury ◽  
Memory Problems ◽  
Lower Baseline ◽  
Minor Injuries ◽  
A Minor ◽  
Trajectory Of Care

ABSTRACTBackground:The objective of this study was to explore correlates of cognitive functioning of older adults visiting the emergency department (ED) after a minor injury.Methods:These results are derived from a large prospective study in three Canadian EDs. Participants were aged ≥ 65 years and independent in basic activities of daily living, visiting the ED for minor injuries and discharged home within 48 hours (those with known dementia, confusion, and delirium were excluded). They completed the Montreal Cognitive Assessment (MoCA). Potential correlates included sociodemographic and injury variables, and measures of psychological and physical health, social support, mobility, falls, and functional status.Results:Multivariate analyses revealed that male sex, age ≥ 85 years, higher depression scores, slower walking speed, and self-reported memory problems were significantly associated with lower baseline MoCA scores.Conclusions:These characteristics could help ED professionals identify patients who might need additional cognitive evaluations or follow-ups after their passage through the ED. Obtaining information on these characteristics is potentially feasible in the ED context and could help professionals alter favorably elderly's trajectory of care. Since a significant proportion of elderly patients consulting at an ED have cognitive impairment, the ED is an opportunity to prevent functional and cognitive decline.

Pre-participation health evaluation in adolescent athletes competing at Youth Olympic Games: proposal for a tailored protocol

2018 ◽  
Vol 53 (17) ◽  
pp. 1111-1116 ◽  
Author(s):  
Paolo Emilio Adami ◽  
Maria Rosaria Squeo ◽  
Filippo Maria Quattrini ◽  
Fernando Maria Di Paolo ◽  
Cataldo Pisicchio ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Olympic Games ◽  
Significant Proportion ◽  
Sports Participation ◽  
Final Diagnosis ◽  
Health Evaluation ◽  
Adolescent Athletes ◽  
Wide Range ◽  
Periodic Health Evaluation ◽  
Guidelines And Recommendations

ObjectiveTo promote sports participation in young people, the International Olympic Committee (IOC) introduced the Youth Olympic Games (YOG) in 2007. In 2009, the IOC Consensus Statement was published, which highlighted the value of periodic health evaluation in elite athletes. The objective of this study was to assess the efficacy of a comprehensive protocol for illness and injury detection, tailored for adolescent athletes participating in Summer or Winter YOG.MethodsBetween 2010 and 2014, a total of 247 unique adolescent elite Italian athletes (53% females), mean age 16±1,0 years, competing in 22 summer or 15 winter sport disciplines, were evaluated through a tailored pre-participation health evaluation protocol, at the Sports Medicine and Science Institute of the Italian Olympic Committee.ResultsIn 30 of the 247 athletes (12%), the pre-participation evaluation led to the final diagnosis of pathological conditions warranting treatment and/or surveillance, including cardiovascular in 11 (4.5%), pulmonary in 11 (4.5%), endocrine in five (2.0%), infectious, neurological and psychiatric disorders in one each (0.4%). Based on National and International Guidelines and Recommendations, none of the athletes was considered at high risk for acute events and all were judged eligible to compete at the YOG. Athletes with abnormal conditions were required to undergo a periodic follow-up.ConclusionsThe Youth Pre-Participation Health Evaluation proved to be effective in identifying a wide range of disorders, allowing prompt treatment, appropriate surveillance and avoidance of potential long-term consequences, in a significant proportion (12%) of adolescent Italian Olympic athletes.

scholarly journals PRECISION IN HEALTH CARE FOR DEMENTIA: DO CARE PARTNERS KNOW WHAT THEY DON’T KNOW?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S595-S595
Author(s):  
Tatiana Sadak ◽  
Emily Ishado ◽  
Soo Borson
Keyword(s):  
Health Care ◽  
Objective Assessment ◽  
Cognitive Status ◽  
Multiple Chronic Conditions ◽  
Medical Illness ◽  
Medical Conditions ◽  
Care Recipients ◽  
People With Dementia ◽  
Care Partners ◽  
Provide Health Care

Abstract Clinicians rely on care partners to provide health care at home for people with dementia, who typically have multiple chronic conditions in addition to progressive cognitive decline. We examined the accuracy of care partners’ knowledge of care recipients’ medical conditions and medications, using a benchmark of ≥ 80% match. Of 100 care partners of people with dementia who were recently hospitalized for a major medical illness, nearly all rated their knowledge as high, but about half did not correctly identify care recipients’ medical conditions or know medications, and one fourth did not understand the purpose for which medications were given. A key predictor of poor objective knowledge was care partners’ cognitive status. These findings highlight the importance of objective assessment of care partner knowledge and skills by clinicians who provide health care and advance care planning for people with dementia.

A comparison of telemedicine with face-to-face consultations for trauma management

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 178-181 ◽  
Author(s):  
Sapal Tachakra ◽  
Maria Lynch ◽  
Roger Newson ◽  
Alistair Stinson ◽  
Alganandan Sivakumar ◽  
...  
Keyword(s):  
Good Accuracy ◽  
Weight Bearing ◽  
Colour Change ◽  
Severity Of Illness ◽  
Final Diagnosis ◽  
Joint Movement ◽  
Face To Face ◽  
Minor Injuries ◽  
Treatment And Diagnosis ◽  
Made In

We compared the accuracy of teleconsultations for minor injuries with face-to-face consultations. Two hundred patients were studied. Colour change, swelling, decreased movement, tenderness, instability, radiological examination, severity of illness, treatment and diagnosis were recorded for both telemedicine and face-to-face consultations. Colour change showed an accuracy of 97%, presence of swelling or deformity of 98%, diminution of joint movement of 95%, presence of tenderness of 97%, weight bearing and gait of 99%, and radiological diagnosis of 98%. The severity of illness or injury was overestimated in one case and underestimated in five cases. Treatment was over-prescribed in one case and under-prescribed in three cases. The final diagnosis was correct in all but the two cases in which mistakes were made in the teleradiology. Overall, there was good accuracy using teleconsultations.

scholarly journals High prevalence of coinfection of azithromycin-resistant Mycoplasma genitalium with other STIs: a prospective observational study of London-based symptomatic and STI-contact clinic attendees

2020 ◽  
pp. sextrans-2019-054356
Author(s):  
Claire E Broad ◽  
Martina Furegato ◽  
Mark A Harrison ◽  
Marcus J Pond ◽  
NgeeKeong Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Proportion ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
Health Clinic ◽  
High Prevalence ◽  
Potential Benefits ◽  
Patient Groups ◽  
Sex With Men ◽  
Associated Risk Factors

ObjectivesAzithromycin treatment of Chlamydia trachomatis (CT) may not be adequate to treat concomitant Mycoplasma genitalium (MG) infection, and particularly if MG has macrolide resistance-associated mutations (MG-MRAMs). We estimated prevalence of coinfections of CT with MG carrying MRAM, and risk factors for MG-MRAM among a sexual health clinic population.Study design and settingAmong symptomatic and STI-contact clinic attendees in London, prevalence of CT-MG coinfection and MG-MRAM were estimated using nucleic acid amplification testing and Sanger sequencing, respectively, and their associated risk factors analysed using logistic regression.ResultsMG prevalence was 7.5% (23/307), 17.3% (30/173), and 11.4% (8/70) in females, men who have sex with women (MSW) and men who have sex with men (MSM), respectively; MG coinfection in CT-infected participants represented 28.0% (7/25), 13.5% (5/37), 0.0% (0/0), respectively. Presence of MG-MRAM was 39.1% (9/23) in female swabs, 70.0% (21/30) in MSW urine and 83.3% (5/6) in MSM rectal swabs. In multivariate analyses, coinfection with another STI was strongly associated with MG-MRAM (OR: 7.19; 95% CI: 2.4 to 21.5).ConclusionA significant proportion of participants in our study of symptomatic patients and STI contacts were infected with macrolide-resistant MG, suggesting that testing for MG and MRAM, for MG positives, might be clinically useful. The findings also suggest services explore potential benefits of testing CT positive samples for MG in these patient groups. Where MG testing is not available, potential high rates of MG coinfection should be borne in mind when considering azithromycin in the treatment of CT among STI contacts and symptomatic patients.

scholarly journals Retrospective analysis of older travellers attending a specialist travel health clinic

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Milad Darrat ◽  
Gerard T. Flaherty
Keyword(s):  
Medical Condition ◽  
Travel Medicine ◽  
Significant Proportion ◽  
Antihypertensive Agents ◽  
Health Clinic ◽  
Travel Health ◽  
Wide Range ◽  
Health Advice ◽  
Visiting Friends And Relatives ◽  
The Mean

Abstract Background Older people represent a significant proportion of overseas travellers. The epidemiology of older international travellers is not well described in the literature. This study aims to identify demographics, travel characteristics and the medical profile of older travellers seeking pre-travel health advice in a specialist travel medicine clinic. Methods Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential analysis of data was performed. Results A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic. Conclusions This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.

A novel optimal route planning algorithm for searching on the sea

2021 ◽  
pp. 1-19
Author(s):  
Y. Yang ◽  
Y. Mao ◽  
R. Xie ◽  
Y. Hu ◽  
Y. Nan
Keyword(s):  
Optimal Algorithm ◽  
Route Planning ◽  
Search And Rescue ◽  
Search Rate ◽  
Planning Problem ◽  
Optimal Route ◽  
Planning Algorithm ◽  
Discrete Programming ◽  
Maritime Search And Rescue ◽  
National Emergency

ABSTRACT Emergency search and rescue on the sea is an important part of national emergency response for marine perils. Optimal route planning for maritime search and rescue is the key capability to reduce the searching time, improve the rescue efficiency, as well as guarantee the rescue target’s safety of life and property. The main scope of the searching route planning is to optimise the searching time and voyage within the constraints of missing search rate and duplicate search rate. This paper proposes an optimal algorithm for searching routes of large amphibious aircraft corresponding to its flight characteristics and sea rescue capability. This algorithm transforms the search route planning problem into a discrete programming problem and applies the route traceback indexes to satisfy the duplicate search rate and missing search rate.

An adolescent with chronic giardiasis mimicking anorexia nervosa

2014 ◽  
Vol 26 (2) ◽  
pp. 293-295 ◽  
Author(s):  
Lewis J. Thomas IV ◽  
Alex P. Zweig ◽  
Aneesh K. Tosh
Keyword(s):  
Anorexia Nervosa ◽  
Celiac Disease ◽  
Outpatient Care ◽  
Preliminary Investigation ◽  
Final Diagnosis ◽  
Health Clinic ◽  
Gastrointestinal Disorders ◽  
Antigen Test ◽  
Negative Results ◽  
Inflammatory Bowel

Abstract A 13-year-old Hispanic female presented with symptoms of abdominal pain, amenorrhea, and unintentional weight loss of 11 kg. Preliminary investigation yielded no immediate causes, and an initial differential included inflammatory bowel disease (IBD), celiac disease, as well as viral, bacterial, or parasitic gastrointestinal infection. Evaluation of these potential diagnoses yielded negative results; thus, the team thought that the patient may be suffering from anorexia nervosa. The patient was discharged to outpatient care, and was treated in our adolescent health clinic, where repeat laboratory testing yielded a positive Giardia-antigen test. The patient was placed on metronidazole, rapidly gained weight, and resumed menstruation soon after. The final diagnosis was chronic giardiasis. Chronic giardiasis is a rare and enigmatic disease that presents with many symptoms similar to chronic gastrointestinal disorders (e.g. IBD and celiac disease) and anorexia nervosa. Practitioners involved in the diagnosis and treatment of anorexia nervosa should be aware of this disorder and include it in differential diagnoses of patients presenting with anorexia nervosa symptoms.

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