Objective: To determine Inpatient Rehabilitation Facility (IRF) treatment effect on modified Rankin Scale (mRS) scores at 90 days in acute ischemic stroke (AIS) patients.
Materials And Methods: This prospective cross-sectional study included 738 AIS patients admitted 1/1/2018-12/31/2020 to a Comprehensive Stroke Center with a Stroke Rehabilitation program. We compared outcomes for patients who went directly home versus went to IRF at hospital discharge: (1) acute care length of stay (LOS), (2) National Institutes of Health Stroke Scale (NIHSS) score, (3) mRS score at hospital discharge and 90 days, (4) the proportion of mRS scores ≤ 2 from hospital discharge to 90 days.
Results: Among 738 patients, 499 went home, and 239 went to IRF. IRF patients were more likely to have increased acute LOS (10.7 vs 3.9 days; t-test, P<0.0001), increased mean NIHSS score (7.8 vs 4.8; t-test, P<0.0001) and higher median mRS score (3 vs 1, t-test, P<0.0001) compared to patients who went home. At 90 days, ischemic stroke patients who received IRF care were more likely to progress to a mRS ≤ 2 (18.7% increase) compared to patients discharged home from acute care (16.3% decrease). Home patients experienced a one-point decrease in mRS at 90 days compared to those who received IRF treatment (median mRS of 3 vs. 2, t-test, P<0.05).
Conclusions: In ischemic stroke patients, IRF treatment increased the likelihood of achieving mRS ≤ 2 at 90 days indicating the ability to live independently, and decreased the likelihood of mRS decrease, compared with patients discharged directly home after acute stroke care.
Introduction: Trauma and orthopedics departments have traditionally used face-to-face (FTF) fracture clinics for non-operative fractures. Developed in 2011, the virtual fracture clinic (VFC) was fully implemented at an institution during the COVID-19 pandemic to reduce in-person interactions.
Aims: First, the study aims to measure the percentage of non-operative patients triaged through the VFC when this was optional and re-audit after implementing a COVID-19-related policy change mandating VFC triage.
A 79-year old Caucasian male with metastatic hormone refractory prostate cancer and bilateral nephrostomy was admitted to the emergency department due to 4-day bloody urethral discharge, weakness and dizziness. The patient was treated with the luteinizing hormone-releasing hormone-antagonist and abiraterone acetate plus prednisone, dabigatran 150 mg bid (for atrial fibrillation and coronary heart disease) and 5-aminosalicylic acid for the management of mild ulcerative colitis. Imaging revealed bladder overdistention and blood analysis low levels of hematocrit (HCT) and hemoglobin (HGB) (HCT, 22%; HGB, 7.
Introduction: The incidence of foreign bodies within the human body is uncommon, with thermometers representing an exceptionally rare subset of such cases. The management of these cases is particularly challenging due to the fragility of mercury thermometers and the toxic nature of their contents.
Case Description: A 16-year-old male adolescent presented with a three-month history of persistent, dull pain localized to the right inguinal region.
Objective: To evaluate the differences in the antenatal and neonatal courses of maternal-infant dyads within a homeless population as compared to the general hospital population.
Design: This was a retrospective observational study.
Setting: A large single tertiary maternity hospital (8500 deliveries/year) in Ireland.
Aim: Aiming to offer a diagnostic tool to aid examiners with correct hip typing and decision-making about patient management, members of the Board of the International Interdisciplinary Consensus Committee on DDH Evaluation (ICODE - https://www.icode.expert), introduced the cross-platform mobile application (Android and iOS) called "ICODE Hip US Calculator".
