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Ablation Surgery for Atrial Fibrillation: "Freeze it or Buzz it; Just do it and Cure it"  [cached]
Patwardhan AM
Indian Pacing and Electrophysiology Journal , 2005,
Abstract: Patients in normal sinus rhythm have lesser stroke rate, better functional class and quality of life than those in atrial fibrillation. Adding a surgical procedure to cure atrial fibrillation in patients needing correction of structural heart disease has been shown to be a safe option, which benefits the majority in restoration of sinus rhythm. Age is no bar to implement this option. The same does not hold true for lone atrial fibrillation. The affirm trial has shown that there is need for improved treatment strategies for patients in atrial fibrillation, although young patients were not represented in sizable proportion. There is need to develop curative treatment for patients with lone atrial fibrillation. And there are technological advances in the form of ablative energy sources and hardware for applying these with minimal invasion. “Between tomorrow’s dream and yesterday’s regret is today’s opportunity”. Let’s make the best of it!
Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study
Stefan Russmann, Emmilia A Dowlatshahi, Gert Printzen, Susanne Habicht, Jürg Reichen, Heinz Zimmermann
BMC Gastroenterology , 2007, DOI: 10.1186/1471-230x-7-5
Abstract: Cross-sectional study in patients admitted to the emergency room of a university hospital. No formal exclusion criteria. Determination of anti-HBs, anti-HCV, transferrin saturation, alanine aminotransferase, and obtaining answers from a study-specific questionnaire.The study included 5'036 patients, representing a 14.9% sample of the target population during the study period. Prevalence of anti-HBc and anti-HCV was 6.7% (95%CI 6.0% to 7.4%) and 2.7% (2.3% to 3.2%), respectively. Factors independently associated with positive anti-HBc were intravenous drug abuse (OR 18.3; 11.3 to 29.7), foreign country of birth (3.4; 2.6 to 4.4), non-white ethnicity (2.7; 1.9 to 3.8) and age ≥60 (2.0; 1.5 to 2.8). Positive anti-HCV was associated with intravenous drug abuse (78.9; 43.4 to 143.6), blood transfusion (1.7; 1.1 to 2.8) and abdominal pain (2.7; 1.5 to 4.8). 75% of all participants were not vaccinated against hepatitis B or did not know their vaccination status. Among anti-HCV positive patients only 49% knew about their infection and 51% reported regular alcohol consumption. Transferrin saturation was elevated in 3.3% and was associated with fatigue (prevalence ratio 1.9; 1.2 to 2.8).Emergency rooms should be considered as targets for public health programs that encourage vaccination, patient education and screening of high-risk patients for liver disease with subsequent referral for treatment if indicated.Worldwide, about 350 million persons have chronic hepatitis B virus (HBV) infection, and about 125 million have been infected with hepatitis C virus (HCV), putting viral hepatitis B and C amongst the world's greatest infectious disease health problems [1-3]. Many patients are not aware of their chronic disease, and this is also true for another chronic liver disease, namely hereditary haemochromatosis, which is the most common autosomal recessive genetic disorder in Europe [4]. Viral hepatitis B and C, and haemochromatosis have in common that they may lead to liver cirrh
First clinical experience with IVR-CT system in the emergency room: Positive impact on trauma workflow  [cached]
Wada Daiki,Nakamori Yasushi,Yamakawa Kazuma,Fujimi Satoshi
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-52
Abstract: Recently, computed tomography (CT) has gained importance in the early diagnostic phase of trauma care in the emergency room. We implemented a new trauma workflow concept with CT in our emergency room that allows emergency therapeutic intervention without relocating the patient. Times from patient arrival to CT initiation, CT end, and definitive intervention were significantly shorter with our new protocol than were those with the conventional CT protocol. Our new workflow concept, which provides faster time to definitive intervention, appears to be effective.
Occupational Injuries Admitted to the Emergency Department  [cached]
Bekir Da?l?,Mustafa Serinken
Journal of Academic Emergency Medicine , 2012,
Abstract: Objective: In trauma patients who were admitted to the emergency services, occupational accidents have a significant place because of the social problems and high costs effects.Materials and Methods: This 18-month period study on patients who were admitted to the Emergency Services in Pamukkale University Hospital were evaluated prospectively.Results: During the study 538 occupational accident cases appliedand these cases composed 1.6% of applications to emergency services. The frequency of accidents in the age group 25-34 in male workers was determined and the maximum occurs between 08:00-10:00 hours, Monday (21.0%) and Saturday (17.8) was determined to increase the frequency. The most commonly physically affectedarea was the upper extremity (hand and fingers 65.3%) injuries, and cutting, penetrating and abrasion types injuries were most commonly determined Both workers and the workplace source were noted as reasons for the occupational accidents (62.5%), workers are sourced due to negligence, while the workplace was the source due to not providing protective measures in the first place. Conclusion: Most of the injuries associated with occupational accidents result in presentation to Emergency Departments. The data in Emergency Departments may help reveal details of occupational injuries and prevent workplace-related accidents.
Customer satisfaction in the observation unit of the Emergency Room
Monica Cirone,Fiorella Robba,Guglielmo Lagorio,Grazia Guiddo
Emergency Care Journal , 2009, DOI: 10.4081/ecj.2009.2.19
Abstract: An investigation on the customer satisfaction is not of easy application in an emergency department. The application of an appropriate procedure implies several problems, which are mainly related to the short time hospitalization of some patients, the severity of some clinical conditions and the differences in the knowledge of heath problems between patients. The Authors report the results of a simple questionnaire that was submitted for a three-months period to patients admitted to the Observation Unit of the Emergency Room. Patients’s comments are considered and discussed by nurses and physicians which are in charge of the Observation Unit.
'Just Enough' Ontology Engineering  [PDF]
P. Di Maio
Computer Science , 2011,
Abstract: This paper introduces 'just enough' principles and 'systems engineering' approach to the practice of ontology development to provide a minimal yet complete, lightweight, agile and integrated development process, supportive of stakeholder management and implementation independence.
Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma  [cached]
Abdulkadir Akturk,Akkan Avci,Muge Gulen,Mehmet Oguzhan Ay
Cukurova Medical Journal , 2013,
Abstract: Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the patients such as, age, gender, date of application and as well as the causes of trauma, physical examination findings and outcome situation in the emergency department were evaluated. The study was performed prospectively. SPSS V.20 was used for statistical analysis of the data obtained. Results: Total 175 patients were included to the study, 74 were male (42.28%) and 101 were female (57.72%). The mean age of male patients were 75.01 ± 6.557 while the mean age of female patients were 76.10 ± 7.353. The most common cause of trauma in both gender was falls. This rate was 91.1% in female and 8.9% in male patients. 40.6% of the female patients and 27% of the male patients were admitted to the hospital before because of any trauma. The most common form of trauma according to exposed body localization in both gender was extremity traumas. It was seen in 51.5% of the females and 56.8% of the males. 30 female patients (29.7%) and 13 male patients (17.6%) had fracture in limbs. 78.3% of all patients were discharged from the emergency department and 21.7% of the patients were hospitalised. None of the patients were died in emergency department and none of the patients were referred to another institution from the emergency department. Total 38 patients were hospitalised, 32 of them were discharged, 2 of them were referred to another institution, and 4 of them were died. 26 of 38 hospitalised patients had undergone surgery while 20 of them were orthopedic surgeries. Conclusions: Most of the geriatric trauma patients constitute of traffic accidents and falls from height. These injuries can lead to serious morbidity and mortality in elderly people, and these problems can be prevented significantly by giving information and education to family members and caregivers in terms of preventive measures. [Cukurova Med J 2013; 38(4.000): 687-695]
Evaluation of the behavior of the preschool one just admitted in the unit of pediatrics and the use of the therapeutic toy  [PDF]
Mariana Coelho Campos,Karen Cristina S. Rodrigues,Marcia Carla Morete Pinto
Einstein (S?o Paulo) , 2010,
Abstract: Objective: To evaluate the behavior of children before and after a therapeutic play session. Methods: A quantitative and descriptive study was carried out in a major hospital of the city of Santos, State of S o Paulo, involving 30 preschool children recently admitted to a pediatric ward. A behavior scale was applied before and after a therapeutic play session. This scale comprises six categories: moving, gazing, expressing feelings, talking, playing, and not responding to stimuli or requests. Each category is scored from 1 to 3, the lowest score representing the least interaction. Results: Before therapeutic play sessions, children showed no interest and were scored 1 and 2: moving parts of their bodies and expressing emotions, such as seriousness, and gazing rapidly to a place as if expecting something. After therapeutic play, the children progressed to level 3: changing position, moving with a purpose, observing attentively to what they saw, and expressing emotions such as joy. Conclusion: Children interact well with the toys, representing home and hospital situations, and expressing feelings of anger and love. We also observed that therapeutic play improved the interactions of children with this new situation, making it easier for them to accept treatment and perceiving hospitalization as less aggressive and painful.
Reconstrucción torácica primaria con material protésico en trauma torácico extenso
MU?OZ C,CéSAR; MORALES G,JUAN LUIS; ARRIAGADA H,RENATO; MONDACA V,ALEJANDRA; VERDUGO M,LUIS; RIVERA G,ALEN; MU?OZ C,MARIA JOSé;
Revista chilena de cirugía , 2007, DOI: 10.4067/S0718-40262007000600012
Abstract: we report a 21 years old woman that was admitted in the emergency room due to a extensive chest trauma caused by a gunshot. the patient was subjected to an emergency thoracotomy. a right lung lower and middle lobectomy, partial hepatectomy, diaphragmatic suture and mastectomy were performed. a primary chest closure was done, using a marlex prosthesis covered by a cutaneous flap. during the postoperative period, the patient had a surgical wound infection, that was treated conservatively and was discharged 42 days after surgery
Ethnography in an emergency room: evaluating patients with alcohol consumption
Mondragón,Liliana; Romero,Martha; Borges,Guilherme;
Salud Pública de México , 2008, DOI: 10.1590/S0036-36342008000400009
Abstract: objective:to present an ethnographic description of the treatment of patients with excessive alcohol consumption in an emergency room, how they are evaluated by doctors, and the various contextual aspects surrounding this condition. material and methods: the ethnographic work was carried out over a period of two months, with researchers working 24 hours a day, seven days a week from january 9 to march 15, 2002 in the emergency room (er) at general hospital, mexico city. results: patients that had consumed alcohol and were admitted to the er had to wait longer than others to be treated for their intoxication to wear off and for their sometimes aggressive attitude to become calm. the rejection of the alcoholized patients was expressed through scolding to persuade alcohol-dependent patients or those that abused alcohol to reduce their consumption. conclusion: the theoretical and methodological approach of the ethnographic observation enables reflection on the social and cultural mechanisms related to this health problem.
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