scholarly journals The Management of Community Acquired Pneumonia

2008 ◽  
Vol 7 (1) ◽  
pp. 3-10
Author(s):  
Tania Syed ◽  
◽  
Mark Woodhead ◽  
Keyword(s):  
Hospital Admission ◽  
Effective Treatment ◽  
Correct Diagnosis ◽  
Community Acquired Pneumonia ◽  
Common Cause ◽  
Diagnosis And Management

Community acquired pneumonia (CAP) is a common cause of hospital admission. The first 24–48 hours are crucial in the correct diagnosis and management of CAP. In this article we highlight the pitfalls in diagnosis and the important management steps. The correct assessment of severity with CURB65 scoring, proper supportive measures and appropriate antibiotics are key to effective treatment of CAP.

scholarly journals Serotonin Syndrome: An unusual cause of acute confusion and fever in the elderly

2011 ◽  
Vol 10 (4) ◽  
pp. 206-208
Author(s):  
Gary Peter Misselbrook ◽  
◽  
Raj Shekhar ◽  
Keyword(s):  
Elderly Patients ◽  
Hospital Admission ◽  
Serotonin Syndrome ◽  
The Elderly ◽  
Common Cause ◽  
Diagnosis And Management ◽  
Acute Confusion

Delirium is a common cause for hospital admission among elderly patients. Although infection is the most common explanation, there is a large number of other potential causes. We present a case of acute delirium due to serotonin syndrome, precipitated by concomitant prescription of clarithromycin and fluoxetine. The symptoms improved following treatment with a benzodiazepine and discontinuation of the fluoxetine. The diagnosis and management of serotonin syndrome is discussed.

scholarly journals The effect of air temperature on hospital admission of adults with community acquired pneumonia in Baotou, China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wenfang Guo ◽  
Letai Yi ◽  
Peng Wang ◽  
Baojun Wang ◽  
Minhui Li
Keyword(s):  
Hospital Admission ◽  
Air Temperature ◽  
Meteorological Data ◽  
Community Acquired Pneumonia ◽  
Adult Patients ◽  
Distributed Lag ◽  
Specific Effects ◽  
Lower Temperature Range ◽  
Lower Temperature ◽  
Inner Mongolia Autonomous Region

AbstractThe relationship between air temperature and the hospital admission of adult patients with community-acquired pneumonia (CAP) was analyzed. The hospitalization data pertaining to adult CAP patients (age ≥ 18 years) in two tertiary comprehensive hospitals in Baotou, Inner Mongolia Autonomous Region, China from 2014 to 2018 and meteorological data there in the corresponding period were collected. The exposure–response relationship between the daily average temperature and the hospital admission of adult CAP patients was quantified by using a distributed lag non-linear model. A total of 4466 cases of adult patients with CAP were admitted. After eliminating some confounding factors such as relative humidity, wind speed, air pressure, long-term trend, and seasonal trend, a lower temperature was found to be associated with a higher risk of adult CAP. Compared to 21 °C, lower temperature range of 4 to –12 °C was associated with a greater number of CAP hospitalizations among those aged ≥ 65 years, and the highest relative risk (RR) was 2.80 (95% CI 1.15–6.80) at a temperature of − 10 °C. For those < 65 years, lower temperature was not related to CAP hospitalizations. Cumulative lag RRs of low temperature with CAP hospitalizations indicate that the risk associated with colder temperatures appeared at a lag of 0–7 days. For those ≥ 65 years, the cumulative RR of CAP hospitalizations over lagging days 0–5 was 1.89 (95% CI 1.01–3. 56). In brief, the lower temperature had age-specific effects on CAP hospitalizations in Baotou, China, especially among those aged ≥ 65 years.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

Acetaminophen Overdose: Incidence, Diagnosis, and Management in 416 Patients

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5s) ◽  
pp. 898-903
Author(s):  
Barry H. Rumack ◽  
Robert G. Peterson
Keyword(s):  
Effective Treatment ◽  
Old Age ◽  
Open Study ◽  
Blood Levels ◽  
Age Group ◽  
Reye's Syndrome ◽  
Acetaminophen Overdose ◽  
Diagnosis And Management

Acetaminophen overdose was studied in 416 patients as part of a nationwide multiclinic open study. Twenty-seven percent of the patients were toxic by plasma acetaminophen level. The 12- to 21-year-old age group had the highest incidence of toxic blood levels (47%). Children under age 5 had the mildest toxicity of any age group; only two of 16 patients had toxic blood levels. No relationship to subsequent Reye's syndrome could be demonstrated. Acetylcysteine is a safe, effective treatment if administered within the first ten hours; it has some efficacy with no toxicity if used after ten hours. Acetylcysteine has advantages over both cysteamine and methionine. All patients in this study recovered with no sequelae.

scholarly journals Bile acid diarrhoea: from diagnosis to treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 36-41
Author(s):  
V.P. Novikova ◽  
◽  
L.N. Belousova ◽  
Keyword(s):  
Bile Acid ◽  
Bile Duct ◽  
Bile Acids ◽  
Enterohepatic Circulation ◽  
Diet Therapy ◽  
Diagnostic Methods ◽  
Chronic Diarrhoea ◽  
Common Cause ◽  
Diagnosis And Management

Bile acid diarrhoea is a common cause of chronic diarrhoea associated with disturbance of the enterohepatic circulation: either excessive biosynthesis/secretion of bile acids or disordered absorption of bile acids in the ileum. At the same time bile acid diarrhoea is an insufficiently studied, frequently underestimated condition, and the questions remain concerning its diagnosis and management. The work discusses the main groups of causes of this pathology, modern diagnostic methods and the difficulties of a differential search. Also, the article offers information about the diet therapy of bile duct diarrhoea and the main groups of administered medications, in particular, modern enterosorbents.

Diagnostic statements: a linguistic analysis of how clinicians communicate diagnosis

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maria R. Dahm ◽  
Carmel Crock
Keyword(s):  
Diagnostic Accuracy ◽  
Correct Diagnosis ◽  
Linguistic Analysis ◽  
Diagnostic Error ◽  
The Other ◽  
Personal Knowledge ◽  
History Taking ◽  
High Stakes ◽  
Diagnosis And Management

Abstract Objectives To investigate from a linguistic perspective how clinicians deliver diagnosis to patients, and how these statements relate to diagnostic accuracy. Methods To identify temporal and discursive features in diagnostic statements, we analysed 16 video-recorded interactions collected during a practice high-stakes exam for internationally trained clinicians (25% female, n=4) to gain accreditation to practice in Australia. We recorded time spent on history-taking, examination, diagnosis and management. We extracted and deductively analysed types of diagnostic statements informed by literature. Results Half of the participants arrived at the correct diagnosis, while the other half misdiagnosed the patient. On average, clinicians who made a diagnostic error took 30 s less in history-taking and 30 s more in providing diagnosis than clinicians with correct diagnosis. The majority of diagnostic statements were evidentialised (describing specific observations (n=24) or alluding to diagnostic processes (n=7)), personal knowledge or judgement (n=8), generalisations (n=6) and assertions (n=4). Clinicians who misdiagnosed provided more specific observations (n=14) than those who diagnosed correctly (n=9). Conclusions Interactions where there is a diagnostic error, had shorter history-taking periods, longer diagnostic statements and featured more evidence. Time spent on history-taking and diagnosis, and use of evidentialised diagnostic statements may be indicators for diagnostic accuracy.

Non-gonococcal urethritis and mucopurulent cervicitis

2019 ◽  
pp. 161-168
Keyword(s):  
Antibiotic Resistance ◽  
Chlamydia Trachomatis ◽  
Clinical Features ◽  
Mycoplasma Genitalium ◽  
Common Cause ◽  
Urethral Discharge ◽  
Separate Section ◽  
Diagnosis And Management ◽  
Gonococcal Urethritis

Non-gonococcal urethritis (NGU) is caused by Chlamydia trachomatis in 11–50% of cases, but Mycoplasma genitalium is being increasingly recognized as a common cause. Mycoplasma genitalium is not as well understood, and experience with treatment is limited; however, antibiotic resistance is already a problem. Asymptomatic in up to 20% of men, symptoms include dysuria and urethral discharge. Mucopurulent cervicitis is the female equivalent, but is less well defined. This chapter describes the aetiology, clinical features, complications, and investigations and management of NGU, and mucopurulent cervicitis. Management of recurrent and persistent urethritis is also covered, including a separate section for diagnosis and management of Mycoplasma genitalium.

scholarly journals Current diagnosis and management of blunt traumatic rupture of the thoracic aorta

2007 ◽  
Vol 6 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Vishal Bansal ◽  
Jeanne Lee ◽  
Raul Coimbra
Keyword(s):  
Mortality Rate ◽  
Thoracic Aorta ◽  
High Mortality ◽  
Aortic Injury ◽  
Traumatic Rupture ◽  
Trauma Systems ◽  
Endovascular Stenting ◽  
Common Cause ◽  
Diagnosis And Management ◽  
Diagnostic Modalities

The diagnosis and management of aortic lacerations has been gradually improving. Historically, aortic lacerations were a common cause of exsanguination with extremely high mortality rate. However, in modern trauma systems with advanced resuscitation and rapid radiology imaging, the diagnosis of an aortic injury is improving with an emphasis on preventing the progression of intimal flaps and pseudoaneurysms to frank dissection or rupture. Both diagnostic modalities and the paradigm of immediate operative intervention have changed. The evolution of endovascular stenting may play a future role in definitive care.

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