Analysis of emergency department admissions of a chest diseases hospital during the early period of SARS-CoV-2 outbreak

Background and Purpose— The prehospital setting is a promising site for therapeutic intervention in stroke, but current stroke screening tools do not account for the evolution of neurological symptoms in this early period. We developed and validated the Paramedic Global Impression of Change (PGIC) Scale in a large, prospective, randomized trial. Methods— In the prehospital FAST-MAG (Field Administration of Stroke Therapy-Magnesium) randomized trial conducted from 2005 to 2013, EMS providers were asked to complete the PGIC Scale (5-point Likert scale values: 1-much improved, 2-mildly improved, 3-unchanged, 4-mildly worsened, 5-much worsened) for neurological symptom change during transport for consecutive patients transported by ambulance within 2 hours of onset. We analyzed PGIC concurrent validity (compared with change in Glasgow Coma Scale, Los Angeles Motor Scale), convergent validity (compared with National Institutes of Health Stroke Scale severity measure performed in the emergency department), and predictive validity (of neurological deterioration after hospital arrival and of final 90-day functional outcome). We used PGIC to characterize differential prehospital course among stroke subtypes. Results— Paramedics completed the PGIC in 1691 of 1700 subjects (99.5%), among whom 635 (37.5%) had neurological deficit evolution (32% improvement, 5.5% worsening) during a median prehospital care period of 33 (IQR, 27–39) minutes. Improvement was associated with diagnosis of cerebral ischemia rather than intracranial hemorrhage, milder stroke deficits on emergency department arrival, and more frequent nondisabled and independent 3-month outcomes. Conversely, worsening on the PGIC was associated with intracranial hemorrhage, more severe neurological deficits on emergency department arrival, more frequent treatment with thrombolytic therapy, and poor disability outcome at 3 months. Conclusions— The PGIC scale is a simple, validated measure of prehospital patient course that has the potential to provide information useful to emergency department decision-making. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT00059332.

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Evaluating Unscheduled Readmission to Emergency Department in the Early Period

Balkan Medical Journal ◽

10.5152/balkanmedj.2015.15917 ◽

2016 ◽

Vol 33 (1) ◽

pp. 72-79 ◽

Cited By ~ 4

Author(s):

Abdullah Cuneyt Hocagil ◽

Fikret Bildik ◽

Isa Kilicaslan ◽

Hilal Hocagil ◽

Hasan Karabulut ◽

...

Keyword(s):

Emergency Department ◽

Early Period

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EVALUATION OF THE CHARACTERISTICS OF REVISITS TO AN ADULT EMERGENCY DEPARTMENT WITHIN 72 HOURS

Romanian Journal of Emergency Surgery ◽

10.33695/rojes.v2i1.19 ◽

2020 ◽

Vol 2 (1) ◽

pp. 12-19

Author(s):

Nedim Uzun ◽

Ertuğrul Altinbilek ◽

M. Yaşar Sever ◽

Mustafa Çalik

Keyword(s):

Emergency Department ◽

Early Period ◽

Information Management System ◽

Initial Presentation ◽

Upper Respiratory Tract ◽

Unexplained Pain ◽

Common Diagnosis ◽

Significant Difference ◽

Upper Respiratory ◽

Hospital Information Management System

The objective of this study was to determine revisits of the patients discharged from the adult emergency department of our hospital in the early period (72 hours) between January 2016 and December 2016, and to evaluate characteristics of these revisits. In this study, records of the patients discharged from the adult emergency department in 2016 were retrospectively screened from the hospital information management system. Of the 361,413 patients, 7,800 (2.1%) met the inclusion criteria. The most common cause of the initial presentation was unexplained pain with 890 (11.4%) patients, while the most common diagnosis in revisits was acute upper respiratory tract infection with 642 (8.2%) patients. It was found that 18 patients (2.23%) died in the emergency department. No significant difference was found between triage scores of the emergency department presentations, while 161 patients with green area triage in the initial presentation presented to the red area and 134 of these patients were discharged. In our study, the revisit rate was similar with the studies in the literature. It was observed that the majority of the patients who revisited were discharged after the initial visit and they presented to the emergency department again upon their complaints continued. It was thought that revisits can be largely prevented with correct prescription and providing better information to patients.

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Sleep and intrusive memories immediately after a traumatic event in emergency department patients

SLEEP ◽

10.1093/sleep/zsaa033 ◽

2020 ◽

Vol 43 (8) ◽

Cited By ~ 2

Author(s):

Kate Porcheret ◽

Lalitha Iyadurai ◽

Michael B Bonsall ◽

Guy M Goodwin ◽

Sally A Beer ◽

...

Keyword(s):

Emergency Department ◽

Sleep Duration ◽

Traumatic Event ◽

Real Life ◽

Early Period ◽

Psychological Trauma ◽

Clinical Feature ◽

Depression Symptoms ◽

Intrusive Memories ◽

The Impact

Abstract Study objectives Intrusive memories of psychological trauma are a core clinical feature of posttraumatic stress disorder (PTSD), and in the early period post-trauma may be a potential target for early intervention. Disrupted sleep in the weeks post-trauma is associated with later PTSD. The impact of sleep and intrusive memories immediately post-trauma, and their relation to later PTSD, is unknown. This study assessed the relationship between sleep duration on the first night following a real-life traumatic event and intrusive memories in the subsequent week, and how these might relate to PTSD symptoms at 2 months. Methods Patients (n = 87) recruited in the emergency department completed a sleep and intrusive memory diary from the day of their trauma and for the subsequent week, with optional actigraphy. PTSD, anxiety, and depression symptoms were assessed at 1 week and 2 months. Results A U-shaped relationship was observed between sleep duration on the first night and intrusive memories over the subsequent week: sleeping “too little” or “too much” was associated with more intrusive memories. Individuals who met Clinician-Administered PTSD Scale (CAPS) criteria for PTSD at 2 months had three times more intrusive memories in the first week immediately post-trauma than those who did not (M = 28.20 vs 9.96). Post hoc analysis showed that the absence of intrusive memories in the first week post-trauma was only observed in those who did not meet CAPS criteria for PTSD at 2 months. Conclusions Monitoring intrusive memories and sleep in the first week post-trauma, using a simple diary, may help identify individuals more vulnerable to later psychopathology.

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A Fifteen Year Analysis of Rare Isolated Fallopian Tube Torsions in Adolescent Children: A Case Series

10.20944/preprints201907.0343.v1 ◽

2019 ◽

Author(s):

Cengiz Güney ◽

Abuzer Coskun

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Fallopian Tube ◽

Acute Abdominal Pain ◽

Case Series ◽

Early Period ◽

Lower Abdominal Quadrant ◽

Laparoscopic Intervention ◽

The Mean ◽

Abdominal Quadrant

Isolated fallopian tube torsions presenting to the emergency department are a very rare cause of childhood acute abdominal pain. Since the diagnosis to be made in the early period is of importance in terms of affecting tubal damage and fertility, it was aimed to evaluate the cases in the light of literature. Materials and Methods: This study included 10 patients under 18 years of age presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5±1.43 years (range: 12-17years). The demographic characteristics, surgical findings, and methods, concomitant pathology results of these patients were retrospectively evaluated. Results: The reason for admitting to the emergency department of 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 hours in 7 patients (70%) and was more than 24 hours in three patients (30%). Of the patients, 9 (90%) had tenderness in the lower abdominal quadrant, 5 (5%) had the defense, and 3 (30%) had a rebound. Nausea, vomiting, and leucocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Of the patients, 8 (80%) underwent open surgery and 2 (20%) underwent laparoscopic intervention. Detorsion was performed in 5 (50%) and salpingectomy was performed in 5 (50%) cases. Conclusion: Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the maintenance of fertility.

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Neuron-glia relationship during the early postembryonic development of the nervous system in some oligochaetes

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100083874 ◽

1978 ◽

Vol 36 (2) ◽

pp. 600-601

Author(s):

Wiktor Djaczenko ◽

Carmen Calenda Cimmino

Keyword(s):

Nervous System ◽

Glial Cells ◽

Early Period ◽

Postembryonic Development ◽

Ruthenium Red ◽

The Body ◽

Tubifex Tubifex ◽

Growth Stages ◽

Cell Processes ◽

Cytoplasmic Processes

The simplicity of the developing nervous system of oligochaetes makes of it an excellent model for the study of the relationships between glia and neurons. In the present communication we describe the relationships between glia and neurons in the early periods of post-embryonic development in some species of oligochaetes.Tubifex tubifex (Mull. ) and Octolasium complanatum (Dugès) specimens starting from 0. 3 mm of body length were collected from laboratory cultures divided into three groups each group fixed separately by one of the following methods: (a) 4% glutaraldehyde and 1% acrolein fixation followed by osmium tetroxide, (b) TAPO technique, (c) ruthenium red method.Our observations concern the early period of the postembryonic development of the nervous system in oligochaetes. During this period neurons occupy fixed positions in the body the only observable change being the increase in volume of their perikaryons. Perikaryons of glial cells were located at some distance from neurons. Long cytoplasmic processes of glial cells tended to approach the neurons. The superimposed contours of glial cell processes designed from electron micrographs, taken at the same magnification, typical for five successive growth stages of the nervous system of Octolasium complanatum are shown in Fig. 1. Neuron is designed symbolically to facilitate the understanding of the kinetics of the growth process.

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Image quality vs data obtainment in biological electron microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100141950 ◽

1986 ◽

Vol 44 ◽

pp. 42-43

Author(s):

J. E. Johnson

Keyword(s):

Electron Microscopy ◽

Endoplasmic Reticulum ◽

Electron Beam ◽

Image Quality ◽

High Speed ◽

Early Period ◽

Early Years ◽

Fluorescent Screen ◽

Embedding Medium

In the early years of biological electron microscopy, scientists had their hands full attempting to describe the cellular microcosm that was suddenly before them on the fluorescent screen. Mitochondria, Golgi, endoplasmic reticulum, and other myriad organelles were being examined, micrographed, and documented in the literature. A major problem of that early period was the development of methods to cut sections thin enough to study under the electron beam. A microtome designed in 1943 moved the specimen toward a rotary “Cyclone” knife revolving at 12,500 RPM, or 1000 times as fast as an ordinary microtome. It was claimed that no embedding medium was necessary or that soft embedding media could be used. Collecting the sections thus cut sounded a little precarious: “The 0.1 micron sections cut with the high speed knife fly out at a tangent and are dispersed in the air. They may be collected... on... screens held near the knife“.

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