Does early ED CT scanning of afebrile patients with first episodes of acute pancreatitis ever change management?

Rising utilization of computed tomography (CT) imaging early in the course of acute pancreatitis (AP) has been recently reported. However, radiographic demonstration of the degree of necrosis or the presence of complications is not fully apparent within the first days of an acute attack. The objective of this study was to examine if CT scanning early in the course of disease (<48 h of symptoms) in afebrile patients with an emergency department (ED) diagnosis of first episode of AP revealed any unanticipated pathology that altered clinical management.

Profile of diabetes mellitus among immigrants from Guyana: epidemiology and implications for community action.

Objective: Prompted by anecdotal evidence of a higher rate of type 2 diabetes, we set out to investigate the prevalence of diabetes, its risk factors, and co-morbidities among immigrant Guyanese patients being treated in a family medicine health center in Schenectady, New York.

Methods: Patients were ascertained from a registration database of all patients aged > or = 30 years who were treated from 2004 to 2006. We then conducted a detailed retrospective chart review of all Guyanese, Caucasian, African American, and Hispanic patients with diabetes and randomly selected non-diabetic controls.

High rates of perinatal group B Streptococcus clindamycin and erythromycin resistance in an upstate New York hospital.

The objective of this study was to evaluate the rates of clindamycin and erythromycin resistance among group B Streptococcus (GBS)-positive isolates cultured from pregnant women in an upstate New York community hospital. All GBS-positive perinatal rectovaginal cultures obtained from January 2010 through October 2011 were tested for resistance to erythromycin and clindamycin. Among the 688 GBS-positive cultures, clindamycin resistance was found in 38.

Exertional rhabdomyolysis--when should we start worrying? Case reports and literature review.

Exertional rhabdomyolysis (ER) is a serious medical issue usually seen in individuals or patients after engaging in heavy exertion and physical activity. The incidence, natural course, and recurrence of ER are, by and large, unknown. Given the lack of rigorous scientific data that are specific for ER, most of the patients with ER receive treatment in an inpatient setting even with only a mild elevation of creatine phosphokinase (CPK) level.

The Pulmonary Embolism Rule-Out Criteria rule in a community hospital ED: a retrospective study of its potential utility.

Background: The Pulmonary Embolism Rule-Out Criteria (PERC) rule identifies patients who can be safely discharged from the emergency department (ED) without undergoing laboratory or radiological investigation for possible pulmonary embolism (PE). It was shown to be 99% sensitive in a large validation series. Our objective was to assess the PERC rule's performance in a representative US community hospital.

Doctor-patient relations in Nazi Germany and the fate of psychiatric patients.

German psychiatrists actively engaged in the forced sterilization and killing of psychiatrically disabled children and adult patients. Academic psychiatrists embraced the Nazi philosophy and led the way in the "final solution" for psychiatric patients. This took place in a climate of widespread racism, virulent anti-Semitism, disillusionment with utopian social reforms, loss of medical confidentiality, devaluation of autonomy, intoxication with collectivism, injured national pride, and economic crisis.

Flight to Los Angeles. Crisis at 30,000 feet.

1. Using therapeutic communication, the nurse can begin to assess the individual in crisis, establish rapport, and evaluate the crisis situation. 2.

Tibial artery false aneurysm: uncommon result of blunt injury occurring during athletics.

Two young men presented with symptoms following lower extremity injuries sustained in the normal course of participation in sports. One played baseball while the other competed in Tae Kwon Do. One case presented with digital ischemia, the other developed a pulsating hematoma.

Horticultural therapy: the garden benefits everyone.

Horticulture therapy (HT) is an applied adjuctive therapy, using plants and gardening materials, to help the client with mental illness to improve social skills, self-esteem, and use of leisure time. HT provides a nonthreatening context for the development of a therapeutic alliance between client and nursing student. HT provides a group experience for the student nurse, allowing the promotion of therapeutic community, assessment of patient status, and management of a therapy session from start to finish via the nursing process.