Background: Meeting time goals for patients with time-sensitive conditions can be challenging in rural emergency departments (EDs), and adopting policies is critical. ED-based telemedicine has been proposed to improve quality and timeliness of care in rural EDs.
Introduction: The objective of this study was to test the hypothesis that diagnostic testing in telemedicine-supplemented ED care for patients with myocardial infarction (MI) and stroke would be faster than nontelemedicine care in rural EDs.
Materials And Methods: This observational cohort study included all ED patients with MI or stroke in 19 rural critical access hospitals served by a single real-time contract-based telemedicine provider in the upper Midwest (2007-2015). The primary outcome for the MI cohort was time-to-electrocardiogram (EKG) and for the stroke cohort was time-to-head computed tomography (CT) interpretation. To measure the relationship between telemedicine and timeliness parameters, generalized estimating equations models were used, clustering on presenting hospital.
Results: Of participating ED visits, 756 were included in the MI cohort (29% used telemedicine) and 140 were included in the stroke cohort (30% used telemedicine). Time-to-EKG did not differ when telemedicine was used (1% faster, 95% confidence interval [CI] -4% to 7%), or after telemedicine was implemented (4% faster, 95% CI -3% to 10%). Head CT interpretation was faster for telemedicine cases (15% faster, 95% CI 4-26%). No differences were observed in time to reperfusion therapy.
Conclusions: Telemedicine implementation was associated with more timely head CT interpretation for rural patients with stroke, but no difference in early MI care. Future work will focus on the specific manner in which telemedicine changes ED care processes and ongoing professional education.
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http://dx.doi.org/10.1089/tmj.2018.0013 | DOI Listing |
Vision Res
January 2025
Department of Clinical Neuroscience, Division of Eye and Vision, Karolinska Institute, St Erik Eye Hospital, Eugeniavägen 12 SE 171 64, Stockholm, Sweden. Electronic address:
High prevalences of visual dysfunction and reading-related symptoms have been found in patients with rehabilitation needs after COVID-19 infection. The purpose of this study was to study the effects of coloured overlays on reading speed and reading experience. Twenty-nine patients (45.
View Article and Find Full Text PDFObjective: This study aimed to compare the effects of intranasal (IN) and IM administration of medetomidine on cardiac size and sedation variables in cats.
Methods: This study included 14 male tabby cats, aged 1 to 3 years, with American Society of Anesthesiologists status of 1 to 2. The cats were randomly assigned to 2 groups (IN and IM; n = 7 cats/group) and received 0.
Matern Child Health J
January 2025
Department of Public Health Nursing, Department of Nursing, Faculty of Health Science, Pamukkale University, Pamukkale, Campus Denizli, 20160, Turkey.
Background: During the first 6 weeks after birth, women often encounter problems and seek answers to their questions. This period is also crucial in terms of technology use.
Aim: The aim of this study was to examine the digital motherhood approach to self-care and infant care in the 6-week postpartum period, and its association with different variables.
Postgrad Med
January 2025
Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China.
Purpose: Limited studies have examined the relationship between plasma aldosterone concentration (PAC) and arterial stiffness progression. This study aimed to investigate the longitudinal association between baseline PAC and arterial stiffness progression in hypertensive patients.
Patients And Methods: This was a longitudinal study conducted at the Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region between April 2020 and October 2023.
Neurology
February 2025
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Background And Objectives: Lipid metabolism in older adults is affected by various factors including biological aging, functional decline, reduced physiologic reserve, and nutrient intake. The dysregulation of lipid metabolism could adversely affect brain health. This study investigated the association between year-to-year intraindividual lipid variability and subsequent risk of cognitive decline and dementia in community-dwelling older adults.
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