The purpose of this study was to evaluate the impact of nursing telephone triage on the appropriateness of emergency department (ED) use among 563 patients at a military hospital by comparing 286 ED patients referred by the Tel-a-Nurse Line (TAN) with 277 non-TAN-referred patients from October 2000 to November 2000. When controlling for confounding factors, TAN-referred patients had less appropriate ED use than non-TAN-referred patients, although this was not statistically significant (odds ratio = 0.87, p = 0.452). After excluding TAN patients with a primary clinic disposition but who were directed to the ED because no clinic appointments were available, TAN-referred patients had more appropriate referrals than non-TAN patients, although this was also not significant (odds ratio = 1.19, p = 0.401). TAN patients directed to the ED because of clinic appointment unavailability contributed significantly to inappropriate ED use with 62% having low acuity. This finding underscores the need to evaluate clinic availability for the TAN line and possibly for all patients as well.
Download full-text PDF |
Source |
---|
Importance: The effectiveness of different approaches to dementia care is unknown.
Objective: To determine the effectiveness of health system-based, community-based dementia care, and usual care for persons with dementia and for caregiver outcomes.
Design, Setting, And Participants: Randomized clinical trial of community-dwelling persons living with dementia and their caregivers conducted at 4 sites in the US (enrollment June 2019-January 2023; final follow-up, August 2023).
Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
Int J Surg
January 2025
Department of Gastrointestinal Surgery, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China.
Background: Preoperative neoadjuvant chemoradiotherapy (nCRT) is considered to be the standard treatment strategy for locally advanced rectal cancer (LARC); however, the risk of adverse events and postoperative recurrence remains significant. This study aimed to evaluate the non-inferiority of neoadjuvant chemotherapy (nCT) compared with nCRT in patients with LARC and to assess the possibility of eliminating radiotherapy on the basis of guaranteed efficacy.
Materials And Methods: We searched the PubMed, Embase, and Cochrane Library databases to identify randomized controlled trials (RCTs) comparing the efficacy of nCRT and nCT for LARC.
Cureus
December 2024
Orthopaedic Surgery, Ng Teng Fong General Hospital, Singapore, SGP.
This case report describes a 70-year-old male presenting with limb weakness, urinary retention and tandem cervical and lumbar spinal stenosis with complicating white cord syndrome, a rare reperfusion injury post decompression surgery. Initially admitted following an unwitnessed fall, the patient's neurological examination indicated that progressive weakness of the limbs and sensory loss etiology is cervical and lumbar spondylosis with severe spinal canal stenosis, confirmed by imaging. Due to rapid deterioration, he underwent C5 corpectomy, cervical decompression and fusion.
View Article and Find Full Text PDFIDCases
January 2025
Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia.
We report a first case of ceftazidime-resistant pediatric melioidosis involving a previously healthy seven-year-old boy who presented with right lobar pneumonia complicated with a 5-cm lung abscess. Ceftazidime was initiated on Day-6 of admission when (ceftazidime-susceptible, minimum inhibitory concentration [MIC] 1.0 mcg/mL) was isolated from blood.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!