Prognostic Impact of Hospital Discharge After Heart Failure Admission Without Structured Heart Failure Follow-Up.

The aim was to evaluate the risk of new exacerbations of heart failure (HF) in patients discharged from hospital emergency departments (EDs) without a structured HF follow-up. This prospective, single-center cohort study included patients discharged from the ED following hospital admission for acute HF. The study analyzed the profile of patients seen in the ED and assessed their risk of new ED visits or HF-related hospitalizations within 12 months of discharge.

Dynamic PK/PD Infection Models for the Development and Optimisation of Antimicrobial Regimens: A Narrative Review.

The antimicrobial concentration-time profile in humans affects antimicrobial activity, and as such, it is critical for preclinical infection models to simulate human-like dynamic concentration-time profiles for maximal translatability. This review discusses the setup, principle, and application of various dynamic PK/PD infection models commonly used in the development and optimisation of antimicrobial treatment regimens. It covers the commonly used dynamic infection models, including the one-compartment model, hollow fibre infection model, biofilm model, bladder infection model, and aspergillus infection model.

Threats to the Dignity of People with Advanced Illness Who Are Treated in Emergency Departments: A Qualitative Study.

Background: Dignity is a key element in end-of-life care. Patients with advanced illness attend the emergency department to seek symptom relief but may find their dignity under threat in these services.

Objective: The purpose of the study was to explore the threats to dignity perceived by people with advanced illnesses who are treated in emergency departments.

Metoprolol vs diltiazem for atrial fibrillation with rapid ventricular rate: Systematic review and meta-analysis of adverse events.

Background: Intravenous (IV) diltiazem and metoprolol are commonly used to achieve rate control for atrial fibrillation with RVR (Afib with RVR), and are both recommended as first-line by current guidelines. While prior studies investigated the efficacy of these medications, there is little evidence available regarding the risk of adverse events (AEs) with their use.

Methods: We identified randomized controlled trials (RCT) and observational studies reporting rates of AEs following administration of IV diltiazem and metoprolol for Afib with RVR by searching PubMed, SCOPUS, EMBASE, and Cochrane Library.

Tracking Survivors With Long COVID: Method, Implementation, and Results of an Observational Study.

While the coronavirus disease 2019 (COVID-19) pandemic has declined, many survivors continue to suffer debilitating symptoms, such as fatigue, pain, and foggy thoughts. Sustained COVID-19 symptoms, or Long COVID, challenge health care resources and economic recovery. This article describes the methodology, implementation, and results of an observational study investigating how time since diagnosis may affect lingering symptoms among the adult COVID-19 population.

Paramedic assessment of suspected or confirmed COVID-19 patients in the out-of-hospital environment: a scoping review protocol.

Objective: The objective of this review is to develop a comprehensive collection of information about the current processes for paramedics assessing and referring suspected or confirmed COVID-19 patients in the out-of-hospital environment.

Introduction: Patients with COVID-19 are frequently encountered by paramedics and ambulance service clinicians. Increased demand on ambulance services has resulted in many of these services developing alternative referral pathways to avoid unnecessary conveyance to emergency departments.

High Intensity Physician-Based Service Use for Mental Health Concerns in a General-Population Sample of Children and Youth: Utilisation des services de haute intensité dispensés par des médecins pour les problèmes de santé mentale dans un échantillon d'enfants et de jeunes de la population générale.

Objective: To examine factors associated with high intensity physician-based mental health care services in a population-based sample of children and youth in Ontario, Canada.

Methods: Data from the 2014 Ontario Child Health Study (OCHS) were linked at the person-level to longitudinal health administrative databases containing physician contacts in outpatient settings, emergency departments and hospitals. Our analytical sample (15.

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts.

Purpose: Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

Methods:  Participants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.

Navigating performance measures for ambulatory antimicrobial stewardship: a review of HEDIS® and other metrics the steward should know.

Ambulatory antimicrobial stewardship can be challenging due to disparities in resource allocation across the care continuum, competing priorities for ambulatory prescribers, ineffective communication strategies, and lack of incentive to prioritize antimicrobial stewardship program (ASP) initiatives. Efforts to monitor and compare outpatient antibiotic usage metrics have been implemented through quality measures (QM). Healthcare Effectiveness Data and Information Set (HEDIS®) represent standardized measures that examine the quality of antibiotic prescribing by region and across insurance health plans.

Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study.

Background: Preliminary data suggests that the burden of acute coronary syndrome (ACS) is high in Tanzania. After efforts to improve ACS care, we sought to describe ACS diagnosis rates, care processes, and outcomes in a Tanzanian Emergency Department (ED).

Methods: Adults presenting to a northern Tanzanian ED with acute chest pain or shortness of breath were enrolled from November 2020 to January 2023.

Cerebral Venous Sinus Thrombosis as a Unique Initial Presentation of Thyroid Storm.

Introduction: Thyrotoxicosis is associated with a hypercoagulable state, increasing the risk of thrombotic events like CVST. Literature review reveals thyroid hormone's role in promoting prothrombotic abnormalities, impacting coagulation factors and platelet function.

Case Report: This study explores the rare occurrence of thyroid storm complicated by deep cerebral venous sinus thrombosis (CVST) in a young male with no prior history of thyroid disease.

Emergency department ophthalmoscopy: physician confidence and clinical practices.

Objectives: Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians' practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.

Perspectives of older patients on the preventability of their unplanned emergency department return visit within 30 days in the Netherlands: a multicentre mixed methods study.

Objective: Older adults are prone to unplanned emergency department (ED) return visits (URVs). Knowledge about patient perspectives on the preventability and reasons for these URVs is limited and lacks a representable ED study population. This study aims to determine the proportion of URVs and to explore the preventability and underlying causes as perceived by a wide range of older adults and their caregivers.

Adopting the human factors analysis and classification system into emergency medicine morbidity and mortality rounds: a quality improvement initiative.

Objectives: This initiative assessed the integration of the Human Factors Analysis and Classification System, adapted from aviation, into emergency medicine morbidity and mortality rounds. The objective was to determine whether incorporating the Human Factors Analysis and Classification System could lead to a perceived increase in the overall quality of morbidity and mortality presentations through the standardization of classifying cause factors of medical errors.

Methods: This study involved eight emergency medicine residents who applied the adapted Human Factors Analysis and Classification System framework to their morbidity and mortality case presentations over 6 months.

Development of a reference standard to assign bacterial versus viral infection etiology using an all-inclusive methodology for comparison of novel diagnostic tool performance.

Background: Diagnostic test evaluation requires a reference standard. We describe an approach for creating a reference standard for acute infection using unrestricted adjudication and apply it to compare biomarker tools.

Methods: Adults and children with suspected acute infection enrolled in three prospective studies at emergency departments and urgent cares were included.

Optimizing Management of Febrile Young Infants Without Serum Procalcitonin.

Background: Febrile young infants are at risk of invasive bacterial infections (IBIs; bacteremia or bacterial meningitis). American Academy of Pediatrics (AAP) guidelines recommend that when procalcitonin testing is unavailable, C-reactive protein (CRP), absolute neutrophil count (ANC) and temperature should be used to identify low-risk infants. We sought to determine the optimal combination of these inflammatory markers to predict IBI when procalcitonin is unavailable.

Issuing of albumin solutions to Danish public hospitals-A nationwide, retrospective, observational study based on pharmacy data from 2022.

Background: Intravenous albumin is used for resuscitation and substitution but is not supported by high-certainty evidence. As clinical practice likely varies, we aimed to describe the issuing of albumin solutions across Danish public hospitals.

Methods: We assessed issuing of intravenous albumin solutions (5% and 20%) to all Danish public hospitals in 2022.

Fight or Flight: Emergency Health Care Workers' Willingness to Work during Crises and Disasters. A Cross-Sectional Multicenter Study in the Netherlands.

Objective: Expanding staff levels is a strategy for hospitals to increase their surge capacity. The aim of this study was to evaluate whether emergency health care workers (HCWs) are willing to work during crises or disasters, and which working conditions influence their decisions.

Methods: HCWs in the emergency departments (EDs) and intensive care units (ICUs) of 5 Dutch hospitals were surveyed about various disaster scenarios.

Major Internal Fires in Dutch Hospitals: A Scoping Review.

Objectives: Fires are among the most feared incidents that can occur in a hospital. Hospital fires will disrupt care continuity, may require the evacuation of patients and have the potential to result in injuries or even deaths. The aim of this study is to gain insight into hospital fires in the Netherlands over a 20-year period.

A novel acute basic palliation concept for patients without specialised palliative needs.

Introduction: Among all Danish dying patients, 80% rely on non-specialised palliative care, an area lacking national and international guidelines. In this pilot study, we developed and tested an acute basic palliation concept (ABPC), a structured end-of-life (EOL) care plan for patients discharged from the emergency department to die at home compared with standard care.

Methods: This study compared symptom scores and EOL care statement scores during a standard care period with an ABPC period using unvalidated questionnaires.

National Institute of Neurological Disorders and Stroke Clinical Trials Methodology Course: Summary and Accomplishments 2014-2023.

The Clinical Trials Methodology Course (CTMC), given from 2014 to 2023, was conducted to educate early-career clinical investigators from various backgrounds in neurosciences in the design of clinical trials and to provide mentorship to enhance academic careers and retention plus improve research productivity and the likelihood of successful grant applications. This summary describes the rationale, history, structure, and trainee outcomes of the CTMC. The course used small groups, consisting of 1-2 clinical faculty advisor(s), 1 faculty biostatistician, and 2-4 trainees who met remotely approximately weekly over 12 weeks.

Urinary Cytology: The DxU-850 Iris automaton versus Microscopic Examination.

Introduction: The use of urine cytobacteriological examination is a common and essential practice in medicine which helps guide therapeutic management in case of urinary tract infection. The cytological examination of urine samples can be done using the manual (microscopic) or automated technique. The automated approach, which involves the use of artificial intelligence, is faster, more reliable, and more efficient for laboratories.