Severe hemophilia A is defined by factor VIII level of <1%. Limited research and case series show that these patients are at the highest risk for bleeding complications, the most common being hemarthrosis and muscle hematoma, respectively.1 While rare, iliopsoas hematoma carries significant morbidity, mortality, and requires prompt intervention in hemophiliac patients. As such, it is essential the emergency providers evaluate for this condition in this unique patient population. We present the case of 21-year-old male with severe hemophilia A who presented with one day of right groin pain after going without his prophylactic factor VIII infusions for one week, with subsequent diagnosis and initial treatment of iliopsoas hematoma made in the ED.
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http://dx.doi.org/10.1016/j.ajem.2017.12.035 | DOI Listing |
Alzheimers Dement
December 2024
Yale School of Medicine, New Haven, CT, USA.
Background: Over 15 million informal caregivers provide assistance to persons living with dementia. Despite increasing emergency department (ED) use within the population, little is known regarding the support required of older adults seeking acute care with varying degrees of cognitive impairment. Our objectives were to quantify the daily care hours that informal caregivers provide to older ED patients with diagnosed dementia, undiagnosed cognitive impairment, and intact cognition.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Yale University, New Haven, CT, USA.
Background: Elder abuse (EA) is a major public health problem and older people living with dementia (PLWD) are not likely to self-report EA. As a result, identification of EA remains low, and providers often miss the opportunity to identify EA during Emergency Department (ED) visits. We present a pilot study on adapting an evidence-informed intervention to motivate PLWD to self-report abuse despite existing cognitive challenges.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Wisconsin Madison School of Medicine & Public Health, Madison, WI, USA.
Background: People living with dementia (PLWD) are high utilizers of acute illness and emergency care, with over 50% of the more than 6 million people with Alzheimer's disease and Alzheimer's disease related dementia (ADRD) visiting an emergency department (ED) annually. While the ED plays an important role meeting the urgent and acute needs of PLWD and their caregivers, presence of ADRD is often not well recognized and ED visits are associated with significant adverse outcomes for PLWD. Despite these factors, research on the emergency care needs of PLWD is extremely limited.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Background: The United States faces a growing challenge with over 6.5 million people living with dementia (PLwD). PLwD and their caregivers struggle with cognitive, functional, behavioral, and psychosocial issues.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Washington University School of Medicine, Saint Louis, MO, USA.
Implementation of amyloid-lowering treatments in clinical care for early symptomatic Alzheimer disease (AD) raises many challenges. The Memory Diagnostic Center (MDC), the dementia specialty practice associated with Barnes-Jewish Hospital/Washington University School of Medicine (BJH/WUSM), has 16 clinicians (12 physicians and 4 advanced practice providers) who see over 2,000 patients with memory disorders per year. BJH is the academic flagship of BJC HealthCare (BJC), an integrated health system in St.
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