scholarly journals Thunderstorm-asthma, two cases observed in Northern Italy

2020 ◽  
Vol 15 ◽  
Author(s):  
Maria Francesca Spina ◽  
Paolo Innocente Banfi ◽  
Antonello Nicolini
Keyword(s):  
Emergency Department ◽  
Rare Event ◽  
Evidence Base ◽  
Northern Italy ◽  
Medical Team ◽  
Nature Frequency ◽  
Thunderstorm Asthma

Thunderstorm asthma is a rare event: in this letter we describe two cases observed during the same month of 2018 at an Italian Emergency department, assessed by the same medical team and according to the same methodology and approach. Given the infrequency of such a phenomenon and the debate around its nature, frequency, and - at times - existence, we strongly believe it is important for all specialists who observe such cases to report them, building an evidence base to expand its knowledge and understanding.

scholarly journals Spatial distance between sites of sampling associated with genetic variation among Neospora caninum in aborted bovine foetuses from northern Italy

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Luca Villa ◽  
Pavlo Maksimov ◽  
Christine Luttermann ◽  
Mareen Tuschy ◽  
Alessia L. Gazzonis ◽  
...  
Keyword(s):  
Genetic Distance ◽  
Neospora Caninum ◽  
Geographic Distance ◽  
Rare Event ◽  
Northern Italy ◽  
Spatial Distance ◽  
Italian Regions ◽  
Bovine Abortion

Abstract Background Neospora caninum, a coccidian protozoan, represents an important cause of bovine abortion. Available N. caninum strains show considerable variation in vitro and in vivo, including different virulence in cattle. To which extent sexual recombination, which is possible in the intestines of domestic dogs and closely related carnivores as definitive hosts, contributes to this variation is not clear yet. Methods Aborted bovine foetuses were collected between 2015 and early 2019 from Italian Holstein Friesian dairy herds suffering from reproductive problems. A total of 198 samples were collected from 165 intensive farms located in Lombardy, northern Italy. N. caninum samples were subjected to multilocus-microsatellite genotyping using ten previously established microsatellite markers. In addition to our own data, those from a recent study providing data on five markers from other northern Italian regions were included and analysed. Results Of the 55 samples finally subjected to genotyping, 35 were typed at all or 9 out of 10 loci and their individual multilocus-microsatellite genotype (MLMG) determined. Linear regression revealed a statistically significant association between the spatial distance of the sampling sites with the genetic distance of N. caninum MLMGs (P < 0.001). Including data from this and a previous North Italian study into eBURST analysis revealed that several of N. caninum MLMGs from northern Italy separate into four groups; most of the samples from Lombardy clustered in one of these groups. Principle component analysis revealed similar clusters and confirmed MLMG groups identified by eBURST. Variations observed between MLMGs were not equally distributed over all loci, but predominantly observed in MS7, MS6A, or MS10. Conclusions Our findings confirm the concept of local N. caninum subpopulations. The geographic distance of sampling was associated with the genetic distance as determined by microsatellite typing. Results suggest that multi-parental recombination in N. caninum is a rare event, but does not exclude uniparental mating. More comprehensive studies on microsatellites in N. caninum and related species like Toxoplasma gondii should be undertaken, not only to improve genotyping capabilities, but also to understand possible functions of these regions in the genomes of these parasites.

scholarly journals Comprehensive geriatric assessment in the emergency department

2020 ◽  
Vol 49 (6) ◽  
pp. 936-938 ◽  
Author(s):  
Siobhan Harding
Keyword(s):  
Emergency Department ◽  
Secondary Care ◽  
Evidence Base ◽  
Community Dwelling ◽  
Multiple Sources ◽  
National Guidelines ◽  
Post Discharge ◽  
Post Intervention ◽  
Quasi Experimental ◽  
The Impact

Abstract Completing comprehensive geriatric assessments (CGA) for frail patients admitted to acute hospitals has well-established benefits and is advocated by national guidelines. There is high-quality evidence demonstrating an association between inpatient CGAs and the patient being alive and community-dwelling at 12-month follow-up. However, less well-known is the effectiveness of CGAs conducted within the emergency department (ED), with the primary purpose of facilitating admission avoidance, on reducing 30-day reattendance or readmission. This commentary provides an overview of five studies that measure the impact of conducting an ED-CGA on subsequent secondary care attendance. Two randomised-controlled trials, one case-matched cohort study and two quasi-experimental pre- and post-intervention studies were reviewed. The studies reported variable success in preventing subsequent secondary care use. No studies meeting the criteria had been conducted within the UK, affecting generalisability of the findings. There is no clear evidence that conducting a CGA within ED reduced reattendances or admissions 30 days post-discharge. The existing evidence base is methodologically and clinically heterogeneous and is vulnerable to multiple sources of bias. Further research is needed to understand whether screening to identify target populations or whether increased intensity of interventions delivered improves outcomes. ED-CGA may not have a beneficial effect on cost improvement or service delivery metrics, but it may have positive outcomes that are of high importance to the patients. This warrants further study.

scholarly journals Flowchart for non-invasive ventilation support in COVID-19 patients from a northern Italy Emergency Department

2020 ◽  
Vol 15 (5) ◽  
pp. 767-771 ◽  
Author(s):  
Daniele Privitera ◽  
Laura Angaroni ◽  
Nicolò Capsoni ◽  
Elisa Forni ◽  
Federico Pierotti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Northern Italy ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Ventilation Support

scholarly journals Frequency and Management of Acute Poisoning Among Children Attending an Emergency Department in Saudi Arabia

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 189
Author(s):  
Mansour Tobaiqy ◽  
Bandar A. Asiri ◽  
Ahmed H. Sholan ◽  
Yahya A. Alzahrani ◽  
Ayed A. Alkatheeri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Evidence Base ◽  
Acute Poisoning ◽  
Chi Square ◽  
Jeddah City ◽  
Policy And Strategy ◽  
Poisoning In Children

Background: Acute poisoning is one of the common medical emergencies in children that leads to morbidity and mortality. Medications and chemical agents play a major role in these adverse events resulting in social, economic, and health consequences. Aims of the study: This study aimed to evaluate the frequency and management of acute poisoning among children attending the emergency room at East Jeddah Hospital, Jeddah city, Saudi Arabia. Methods: This study was a retrospective chart review of all acute pediatric poisoning incidences in children (0–16 years of age) from October-21-2016 to March-03-2020 who were attending the emergency department. Data were analyzed via SPSS software. Results: A total of 69 incidences of acute poisoning in children who attended the emergency department at East Jeddah Hospital; males (n = 38, 55.1%). Most children were aged 5 years or younger (n = 41, 59.4%). Unintentional poisoning occurred among 56.5% of observed cases of which 52.2% occurred in children younger than 5 years; 7.20% (n = 5) of patients were 12 to 16 years of age and had deliberate self-poisoning. The association between type of poisoning and age groups was statistically significant (chi-square = 28.5057, p = 0.0001). Most incidences occurred at home (n = 64, 92.8%). Medicines were the most common cause of poisoning (n = 53, 76.8%). An excessive dose of prescribed medicine poisoning accidents was reported in 10.1% cases. Analgesics such as paracetamol were the most documented medication associated with poisoning (39.1%) followed by anticonvulsants and other central nervous system acting medicines (18.8%). The most common route of poisoning was oral ingestion (81.2%). One mortality case was documented. Conclusion: Although not common, accidental and deliberate acute poisoning in children does occur. More can be done to educate parents on safe storage of medicines, household cleaning and other products associated with acute poisoning in children. Likewise, children can be taught more about the risks of poisoning from an early age. As importantly, clinicians need to include more detailed notes in the electronic medical records (EMR) or the system needs to be improved to encourage completeness to more accurately inform the research evidence-base for future service design, health policy and strategy.

scholarly journals Emergency Department Violence: a Local Scene

2003 ◽  
Vol 10 (1) ◽  
pp. 24-29 ◽  
Author(s):  
CH Chung
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Great Majority ◽  
Verbal Abuse ◽  
Mental Condition ◽  
High Risk Factors ◽  
Survey Form ◽  
Nature Frequency ◽  
Victims Of Violence ◽  
Epidemiological Characteristics

Objectives To study the nature, frequency and magnitude of violence in a local emergency department. Design Prospective epidemiological study in a three-month period, during which involved staff filled in a survey form immediately after violence incidents. Setting Accident & Emergency Department of a public general hospital in the northeastern New Territories. Population Assailants and victims of violence in the emergency department. Main outcome measures Nature of violence, frequency, cause, morbidity, epidemiological characteristics of assailants and victims. Results There were 25 incidents with 26 assailants in the three-month period. The great majority was verbal abuse only (64%). No weapon was involved. Long waiting time (36%), deranged mental condition (28%) and dissatisfaction with service (20%) were the leading causes of violence. Assailants showed a predominance of male (69%) and age between 21–50 years. They were either patients (69%) or accompanying persons (31%). Nurses (59%) and to a lesser extent doctors (23%), were the main victims. Conclusion The incidence of emergency department violence (0.08%) was low and the majority was verbal abuse only. Nurses bore the brunt of the violence. Long waiting time, confused patients and dissatisfied patients were high risk factors.

scholarly journals A rare case of isolated gall bladder perforation in blunt trauma abdomen: a case report

2020 ◽  
Vol 8 (2) ◽  
pp. 754
Author(s):  
Omesh K. Meena ◽  
Monish Raj
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Early Diagnosis ◽  
Gall Bladder ◽  
Blunt Trauma ◽  
Rare Case ◽  
Clinical Presentation ◽  
Rare Event ◽  
Gallbladder Perforation ◽  
New Delhi

Blunt trauma abdomen leading to gallbladder perforation is a rare event usually recognized on evaluation and treatment of other visceral injuries during laparotomy. The gallbladder is relatively a well-protected organ. Isolated gallbladder perforation is extremely rare. The clinical presentation is variable, early diagnosis and treatment is of extreme importance to reduce morbidity and mortality associated with gallbladder perforation. We report a case of a patient who sustained isolated gallbladder injury following blunt trauma abdomen to emergency department in Safdarjung Hospital, New Delhi.

scholarly journals Pott’s Puffy Tumour: a rare but sinister cause of facial swelling

2021 ◽  
Vol 20 (2) ◽  
pp. 144-147
Author(s):  
S Birks ◽  
◽  
L Peart ◽  
Keyword(s):  
Emergency Department ◽  
Mr Imaging ◽  
Allergic Reaction ◽  
Epidural Space ◽  
Frontal Sinus ◽  
Surgical Intervention ◽  
Medical Team ◽  
Intravenous Antibiotics ◽  
Facial Swelling ◽  
Uncommon Condition

A 27 year old female presented to the emergency department with intermittent central forehead swelling over several months associated with a headache. She was admitted under the medical team as having had a suspected allergic reaction but the diagnosis of a Pott’s Puffy Tumour was quickly made and confirmed through CT and MR imaging. This uncommon condition is related to sinusitis leading to localised abscess formation with osteomyelitis and a subsequent swollen appearance over the affected facial sinus. This patient’s sinus abscess extended into the epidural space and caused destruction of the anterior and posterior walls of the frontal sinus. The patient was managed with intravenous antibiotics, analgesia and referral to the local ENT team for surgical intervention.

scholarly journals Access in New Zealand to antidotes for accidental and intentional drug poisonings

2012 ◽  
Vol 4 (2) ◽  
pp. 100 ◽  
Author(s):  
Victoria Abbott ◽  
Michaela Creighton ◽  
Janelle Hannam ◽  
Timothy Vincent ◽  
Carolyn Coulter
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
New Zealand ◽  
Health Professionals ◽  
Rare Event ◽  
Morbidity And Mortality ◽  
Common Reason ◽  
Drug Poisoning ◽  
Prior Use ◽  
Hospital Pharmacies

INTRODUCTION: Access to antidotes for the treatment of drug poisonings can impact on morbidity and mortality. Treatment for drug poisonings usually occurs at the nearest emergency department; however, health professionals working in primary care are often the first point of contact for patients. As New Zealand has a small, diffuse population, and poisonings are a rare event, it can be difficult to anticipate what antidotes are required. AIM: The aim of the study was to determine what antidotes are frequently used and stocked in hospital pharmacies. METHODS: A survey was sent out to all 25 hospital pharmacies, excluding private and satellite hospitals. The survey contained questions about the stocking, and prior use, of over 30 antidotes. Also included were open-ended questions asking about reasons for not stocking antidotes and procedures for procuring antidotes in an emergency. RESULTS: Twenty out of 25 hospital pharmacies completed the survey. Most hospital pharmacies were found to stock large quantities of commonly used antidotes and low quantities of uncommonly used antidotes—but in sufficient quantity to treat one to two patients. A low number of poisonings was the most common reason cited for not stocking antidotes, followed by high cost. Most hospitals had clear guidelines for procuring and lending antidotes in an emergency. DISCUSSION: New Zealand hospital pharmacies stock adequate quantities of most antidotes, including antidotes that are expensive and rarely required, but which may be needed urgently. Hospital pharmacies also have clear procurement procedures for obtaining other antidotes in an emergency. KEYWORDS: Antidote stocking; access to antidotes; drug poisoning

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