Background: A small proportion of patients use an excessively large amount of emergency care resources which often results in emergency department (ED) overcrowding, decreased quality of care and efficiency. There is a need to better identify these patients in order to target those who will benefit most from interventions adapted to their specific needs. We aimed to identify the predictive factors of short-term frequent use of ED (over a 1-year period) and chronic frequent use of ED (over a multiple-year period) and to highlight recurring characteristics in patients.
Methods: A scoping review was performed of all relevant articles found in Medline published between 1979 and 2015 (Ovid). This scoping review included a total of 20 studies, of these, 16 articles focussed on frequent ED users and four others on chronic frequent ED users.
Results: A majority of articles confirm that patients who frequently visit the ED are persons of low socioeconomic status. Both frequent and chronic frequent ED users show high levels of health care use (other than the ED) and suffer from multiple physical and mental conditions.
Conclusions: This research highlights which individual factors predict frequent emergency department use. Further research is needed to better characterize and understand chronic frequent users as well as the health issues and unmet medical needs that lead to chronic frequent ED use.
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http://dx.doi.org/10.1186/s12913-016-1852-1 | DOI Listing |
J Med Virol
February 2025
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
The determinants of varicella-zoster virus (VZV)-associated central nervous system (CNS) infection have not been fully elucidated. This study aimed to investigate the incidence and risk factors, including immunosuppression, for different manifestations of VZV-associated CNS infection. Patient registers were used to include adults diagnosed with VZV-associated CNS infections between 2010 and 2019 in Sweden.
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January 2025
Department of Surgical Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy; Department of Neuroscience, Psychology Unit, University of Pisa Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.
Insomnia disorder is a frequent sleep disorder leading to significant health and economic consequences. It has been proposed that individuals with insomnia may experience compromised deactivation systems of arousal, leading to a chronic state of hyperactivation of arousal known as hyperarousal, along with instability in the flip-flop system. Such disruptions may have a primarily impact on the sleep homeostatic drive process.
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January 2025
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
Obstructive sleep apnea syndrome (OSAS) significantly affects the sleep-wake circadian rhythm through intermittent hypoxia and chronic sleep fragmentation. OSAS patients often experience excessive daytime sleepiness, frequent awakenings, and sleep fragmentation, leading to a disrupted circadian rhythm and altered sleep-wake cycle. These disruptions may exacerbate OSAS symptoms and contribute to neurodegenerative processes, particularly through the modulation of clock gene expression such as CLOCK, BMAL1, and PER.
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January 2025
Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, United States.
Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a multifactorial, chronic syndrome involving urinary frequency, urgency, and bladder discomfort. These IC/BPS symptoms can significantly impact individuals' quality of life, affecting their mental, physical, sexual, and financial well-being. Individuals sometimes rely on peer-to-peer support to understand the disease and find methods of alleviating symptoms.
View Article and Find Full Text PDFCancer Genet
January 2025
Cincinnati Children's Hospital Medical Center, Division of Oncology, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address:
Introduction: POT1 tumor predisposition (POT1-TPD) is an autosomal dominant disorder characterized by increased lifetime malignancy risk. Melanoma, angiosarcoma, and chronic lymphocytic leukemia are the most frequently reported malignancies [1]. Protection of telomeres protein 1 (POT1) is part of the shelterin protein complex to maintain/protect telomeres [2].
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