Medical call centres can evaluate and refer patients to an emergency department (ED), a physician or provide guidance for self-care. Our aim was (1) to determine parental adherence to an ED orientation after being referred by the nurses of a call centre, (2) to observe how adherence varies according to children's characteristics and (3) to assess parents' reasons for non-adherence. This was a prospective cohort study set in the Lausanne agglomeration, Switzerland. From 1 February to 5 March 2022, paediatric calls (<16 years old) with an ED orientation were selected. Life-threatening emergencies were excluded. Parental adherence was then verified in the ED. All parents were contacted by telephone to respond to a questionnaire regarding their call. Parental adherence to the ED orientation was 75%. Adherence decreased significantly with increasing distance between the place the call originated and the ED. The child's age, sex and health complaints within calls had no effect on adherence. The three major reasons for non-adherence to telephone referral were: improvement in the child's condition (50.7%), parents' decision to go elsewhere (18.3%) and an appointment with a paediatrician (15.5%). Our results offer new perspectives to optimise the telephone assessment of paediatric patients and decrease barriers to adherence.
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http://dx.doi.org/10.3390/children10020179 | DOI Listing |
Endocrinol Diabetes Metab
January 2025
Department of Endocrinology and Metabolism, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Objective: This study investigates the relationship between the albumin-to-creatinine ratio and diabetic retinopathy (DR) in US adults using NHANES data from 2009 to 2016. This study assesses the predictive efficacy of the urinary serum albumin-to-creatinine ratio (UACR/SACR Ratio) against traditional biomarkers such as the serum albumin-to-creatinine ratio (SACR) and urinary albumin-to-creatinine ratio (UACR) for evaluating DR risk. Additionally, the study explores the potential of these biomarkers, both individually and in combination with HbA1c, for early detection and risk stratification of DR.
View Article and Find Full Text PDFIndian J Pediatr
January 2025
Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Objectives: To evaluate the predictive ability of furosemide stress test (FST), serum and urine cystatin-C in identifying progressive acute kidney injury (AKI) and the need for kidney replacement therapy (KRT).
Methods: Children aged one month to 18 y admitted in the pediatric intensive care unit (PICU) with Kidney Diseases Improving Global Outcomes (KDIGO) stage-1/2 AKI were enrolled. FST and serum and urine cystatin-C levels were performed and analyzed.
J Occup Rehabil
January 2025
Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Purpose: This qualitative study investigated the needs, barriers, and facilitators that affect primary care providers' involvement in supporting patients' stay-at-work and return-to-work following injury or illness. It also aims to understand the lived experiences of primary care providers who participated in the Extension for Community Healthcare Outcomes training program for Occupational and Environmental Medicine (ECHO OEM). By examining both the structural and experiential aspects of the program, this study seeks to provide insights into how ECHO OEM influences providers' approaches to occupational health challenges.
View Article and Find Full Text PDFLangenbecks Arch Surg
January 2025
Department of Trauma Surgery, University Hospital Zurich, Rämistrasse 100, CH - 8091, Zurich, Switzerland.
Introduction: Blunt traumatic aortic injury (TAI) is a critical condition and a leading cause of mortality in trauma patients, often resulting from high-speed accidents. Thoracic endovascular aortic repair (TEVAR) has developed into the preferred therapeutic approach due to its minimally invasive nature and promising outcomes. This study evaluates the safety and efficacy of TEVAR for managing TAI over a 10-year period at a Level-1 trauma center.
View Article and Find Full Text PDFCancer Chemother Pharmacol
January 2025
Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
Purpose: Patients with partial or complete DPD deficiency have decreased capacity to degrade fluorouracil and are at risk of developing toxicity, which can be even life-threatening.
Case: A 43-year-old man with moderately differentiated rectal adenocarcinoma on capecitabine presented to the emergency department with complaints of nausea, vomiting, diarrhea, weakness, and lower abdominal pain for several days. Laboratory findings include grade 4 neutropenia (ANC 10) and thrombocytopenia (platelets 36,000).
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