Search results for " Emergency department"

showing 10 items of 10 documents

Polypharmacy in people with dementia: Associations with adverse health outcomes

2018

Polypharmacy has been linked to higher risks of hospitalisation and death in community samples. It is commonly present in people with dementia but these risks have rarely been studied in this population. We aimed to investigate associations between polypharmacy and emergency department attendance, any and unplanned hospitalisation, and mortality in patients with dementia. Using a large mental health care database in South London, linked to hospitalisation and mortality data, we assembled a retrospective cohort of patients diagnosed with dementia. We ascertained number of medications prescribed at the time of dementia diagnosis and conducted multivariate Cox regression analyses. Of 4668 pati…

MaleAgingmedicine.medical_specialtyDatabases FactualPopulationBiochemistry03 medical and health sciences0302 clinical medicineEndocrinologyRisk FactorsLondonDementia; Emergency department; Hospitalisation; Mortality; Pharmacoepidemiology; PolypharmacyGeneticsmedicineHospitalisationDementiaHumans030212 general & internal medicineMortalityeducationMolecular BiologyAgedRetrospective StudiesPolypharmacyAged 80 and overeducation.field_of_studyProportional hazards modelbusiness.industryEmergency departmentPharmacoepidemiologyHazard ratioAttendanceRetrospective cohort studyCell BiologyEmergency departmentmedicine.diseaseSurvival AnalysisHospitalizationEmergency medicineMultivariate AnalysisPolypharmacyFemaleDementiabusinessEmergency Service Hospital030217 neurology & neurosurgery
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Advances in survival analysis: applications and extensions of the "standard" competing risks model

2023

Overcrowding in Emergency DepartmentSettore SECS-S/05 - Statistica SocialeBiostatisticsCompeting risksSurvival AnalysisCovid-19 In-hospital mortalitySettore MED/01 - Statistica Medica
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The violence of men against women: Medico-legal and psychological issues

2019

Violence against women breaches women’s human rights and is a global public health issue that can cause devastating life-long damage. This study considers the characters of victims, abusers and traumatic bonding in heterosexual couples from a medico-legal and psycological standpoint. After considering the devastating effects on women’s health, and with the objective of preventing future violence, it illustrates the weaknesses and strengths of new Italian guidelines related to violence against women in emergency departments including the use of “Brief Risk Assessment for IPV in the Emergency Department – DA5”.

MaleEmergency Medical Servicesmedicine.medical_specialtymedia_common.quotation_subjectIntimate Partner ViolencePoison controlGuidelines as Topicbrief risk assessment Intimate partner violence Italian guidelines for emergency department physical–psychological violence women’s healthCriminologySuicide preventionOccupational safety and health03 medical and health sciences0302 clinical medicineInjury preventionmedicineHumans0501 psychology and cognitive sciences030212 general & internal medicinemedia_commonHuman rightsPublic health05 social sciencesHuman factors and ergonomicsGeneral MedicinehumanitiesItalyDomestic violenceFemalePsychology050104 developmental & child psychologyMedico-Legal Journal
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Neurological vertigo in the emergency room in pediatric and adult age: systematic literature review and proposal for a diagnostic algorithm.

2022

AbstractNeurological vertigo is a common symptom in children and adults presenting to the emergency department (ED) and its evaluation may be challenging, requiring often the intervention of different medical specialties. When vertigo is associated with other specific symptoms or signs, a differential diagnosis may be easier. Conversely, if the patient exhibits isolated vertigo, the diagnostic approach becomes complex and only through a detailed history, a complete physical examination and specific tests the clinician can reach the correct diagnosis. Approach to vertigo in ED is considerably different in children and adults due to the differences in incidence and prevalence of the various c…

Adultdifferentialemergency servicediagnosisEmergency departmentadulthood; childhood; emergency department; vertigo; adult; algorithms; child; diagnosis differential; humans; physical examination; emergency service; hospitalGeneral MedicineAdulthoodChildhoodDiagnosis DifferentialVertigoHumanshospitalChildEmergency Service HospitalPhysical ExaminationAlgorithmsItalian journal of pediatrics
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The impact of SARS-COV2 pandemic on the management oF IPF patients: Our narrative experience

2021

Abstract Background The SARS-CoV-2 pandemic has changed the health-care systems around the world in a remarkable way. We describe the strategies adopted to cope with the limitations imposed by the pandemic to the access to health care by patients diagnosed with idiopathic Pulmonary Fibrosis (IPF). Material and methods We conducted a retrospective observational analysis including IPF patients under antifibrotic drugs (nintedanib and pirfenidone) that accessed to the Outpatient clinic of the University of Palermo, Italy. Patients received a phone number and an email address in case of any urgency and a virtual meeting was settled up monthly. Results 40 patients (M/F: 30/10) were followed up, …

Pulmonary and Respiratory Medicinemedicine.medical_specialtyPyridonesCOVID-19 IPF Pulmonary fibrosis SARS-CoV-2DiseaseSettore MED/10 - Malattie Dell'Apparato RespiratorioSARS-CoV-2 severe acute respiratory syndrome coronavirus 2ArticlePulmonary fibrosis03 medical and health sciencesIdiopathic pulmonary fibrosischemistry.chemical_compound0302 clinical medicineED Emergency departmentInternal medicinePulmonary fibrosisPandemicmedicineOutpatient clinicHumansPharmacology (medical)030212 general & internal medicineIPF Idiopathic Pulmonary FibrosisPandemicsRetrospective StudiesCOVID-19 Coronavirus disease 2019business.industrySARS-CoV-2Biochemistry (medical)ARDS adult respiratory distress syndromeCOVID-19Emergency departmentPirfenidonemedicine.diseaseIdiopathic Pulmonary FibrosisIPF030228 respiratory systemchemistryHRCT High-resolution chest tomographyRNA ViralNintedanibbusinessPulmonary fibrosimedicine.drug
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High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol f…

2019

Background Noninvasive ventilation (NIV) is indicated to treat respiratory acidosis due to exacerbation of chronic obstructive pulmonary disease (COPD). Recent nonrandomized studies also demonstrated some physiological effects of high-flow nasal therapy (HFNT) in COPD patients. We designed a prospective, unblinded, multicenter, randomized controlled trial to assess the noninferiority of HFNT compared to NIV with respect to the reduction of arterial partial pressure of carbon dioxide (PaCO2) in patients with hypercapnic acute respiratory failure with mild-to-moderate respiratory acidosis. Methods We will enroll adult patients with acute hypercapnic respiratory failure, as defined by arterial…

Chronic ObstructiveTime FactorsExacerbationRespiratory ratemedicine.medical_treatmentMedicine (miscellaneous)Equivalence Trials as TopicAcute respiratory failurelaw.inventionPulmonary DiseaseHypercapnia03 medical and health sciencesPulmonary Disease Chronic ObstructiveStudy Protocol0302 clinical medicineAcute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilation; Acute Disease; Equivalence Trials as Topic; Humans; Hypercapnia; Italy; Lung; Multicenter Studies as Topic; Oxygen Inhalation Therapy; Prospective Studies; Pulmonary Disease Chronic Obstructive; Respiratory Insufficiency; Time Factors; Treatment Outcome; Noninvasive VentilationRandomized controlled triallawHigh-flow oxygen therapy through nasal cannulamedicineHumansMulticenter Studies as TopicPharmacology (medical)Intensive care unit030212 general & internal medicineProspective StudiesLungTidal volumeMechanical ventilationCOPDlcsh:R5-920business.industryEmergency departmentChronic obstructive pulmonary diseaseOxygen Inhalation Therapymedicine.diseaseIntensive care unitRespiratory acidosisTreatment OutcomeItalyCarbon dioxideAnesthesiaAcute DiseasebusinessRespiratory Insufficiencylcsh:Medicine (General)Acute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilationNoninvasive ventilation030217 neurology & neurosurgeryTrials
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Evolution of Pediatric Migraine Patients Admitted at an Emergency Department after a 10-Year Follow-Up

2023

Background: Despite its high prevalence, the clinical course of pediatric migraine has not been fully understood, and previous studies present conflicting results. We present here the findings of a 10-year follow-up study involving children with severe migraine pain admitted to our emergency department. Furthermore, all studies were carried out on selected outpatient clinical case studies. Our aim was to evaluate a population of migraine children admitted to an emergency department because of increased severity or frequency of pain or even because of very anxious parents concerning their child’s headache in order to describe their long-term outcomes, whether it differed from that of o…

children emergency department follow-up headache migraine sleepmigraine; children; follow-up; emergency department; headache; sleep; headacheGeneral MedicineSettore MED/39 - Neuropsichiatria InfantileJournal of Clinical Medicine; Volume 12; Issue 7; Pages: 2475
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Managing adult patients with infectious diseases in emergency departments: international ID-IRI study.

2021

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 +/- 0.74. Sepsis (qSOFA >= 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 +/- 0.963) compared to upper-middle (0.17 +/- 0.482) and high-income (0.36 +/- 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respirator…

0301 basic medicinePoint prevalence surveymedicine.medical_specialtyUrologic NeoplasmsReferralinternational ID-IRI study- JOURNAL OF CHEMOTHERAPY 2021 [Erdem H. Hargreaves S. ANKARALI H. ÇAŞKURLU H. Ceviker S. A. Bahar-Kacmaz A. Meric-Koc M. ALTINDİŞ M. Yildiz-Kirazaldi Y. Kizilates F. et al. -Managing adult patients with infectious diseases in emergency departments]medicine.drug_classOrgan Dysfunction Scores030106 microbiologyAntibioticsPractice Patternsemergency ; antibiotic ; elderly ; infection ; sepsis ; treatmentGlobal HealthelderlyCommunicable Diseasestreatment.SepsisHospital03 medical and health sciences0302 clinical medicineantibioticSepsismedicineHumansPharmacology (medical)Practice Patterns Physicians'Developing CountriesRespiratory Tract InfectionsPharmacologyEmergency ServicePhysicians'Adult patientstreatmentbusiness.industryPatient AcuityAntimicrobialmedicine.diseasehumanitiesinfectionDrug UtilizationAnti-Bacterial AgentsInfectious DiseasesOncology030220 oncology & carcinogenesisEmergency medicineEmergencysepsibusinessEmergency Service HospitalJournal of chemotherapy (Florence, Italy)
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Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

2020

Abstract Background Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements. Methods Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results Seventy-two percent of patients admitted to …

MaleMetabolic diseaseHospitalization rateCongenital skeletal conditionHospitalization rateChildren with special health care needs; Congenital skeletal condition; Emergency department; Hospitalization rate; Isolated CNS malformation; Metabolic diseases; Multiple AED therapy; Neuromuscular diseases; Syndromic disorders; True isolated microcephaly0302 clinical medicineClinical historyMedicineChildeducation.field_of_studyNeuromuscular diseaseSettore MED/38Disabled ChildrenHospitalizationNeuromuscular diseasesSettore MED/38 - PEDIATRIA GENERALE E SPECIALISTICAItalyChild PreschoolFemaleChildren with special health care needEmergency Service Hospitalmedicine.medical_specialtyAdolescentPopulationTriage CodeChildren with special health care needsSyndromic disordersChildren with special health care needs03 medical and health sciencesPharmacotherapy030225 pediatricsHumansMedical prescriptioneducationRetrospective StudiesHealth Services Needs and DemandSyndromic disorderEmergency departmentTrue isolated microcephalybusiness.industryResearchInfant NewbornInfantMetabolic diseases030208 emergency & critical care medicineEmergency departmentChildren with special health care needs Congenital skeletal conditionsEmergency department Hospitalization rate Isolated CNS malformation Metabolic diseases Multiple AED therapy Neuromuscular diseases Syndromic disorders True isolated microcephalyFamily medicineChronic DiseaseMultiple AED therapyIsolated CNS malformationbusinessFacilities and Services UtilizationItalian Journal of Pediatrics
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Diagnosis and therapeutic management of primary headache in an emergency setting

2013

Introduction and aim: Much headachers are under or mis-diagnoses and data regarding the proportion of patients attending an emergency department (ED) because of headache are still few. We conducted a retrospective observational study in an ED with the following aims: (a) estimate the proportion of headache attending to an ED (b) to estimate and describe the therapeutic management of primary headache and (c) to assessment the exam most frequently requested. Materials and methods: We collected data regarding patients diagnosed with headache consecutively attending the ED of the University of Palermo between September 2011 and March 2012. The study was approved by the ethics committee. Results: Between the semester evaluated 25110 subjects were admitted to ED headache suffers were equal to 1.6 %. Of these 263 (63.1 %) were woman and 154 (36.9 %). Mean age was 44.2 (DS ± 18.4) years (p = 0.068).According to ED registry headache admission was as follow assigned: 76.5 % with a diagnosis of headache 22.8 % with a secondary headache 0.7 % with Trigeminal Autonomic Cephalgias (TACs). Among those with a primary headache about 36 % of patient did not received a pharmacological treatment. Monotherapy was prescribed less frequently than combination therapy (19.1 vs 44.5 %).In monotherapy the most frequent medication were NSAIDs (28.3 %) benzodiazepines (26.7 %) and dopamine antagonists (11.7 %). Among those with a primary headache a CT scan was performed in the 124 subjects and 111 (34.8 %) had a neurologist consultation. Discussion: Our data are in line with the one previously reported in literature. The most frequently medication in the Italian ED were NSAIDs benzodiazepines dopamine antagonists and steroids. Neverless our data unlikely can be compared to other study give a snapshot. We believe that much more can be done to improve treatment of primary headache in ED.Settore MED/26 - Neurologia
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