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Fortschritte Der Neurologie-Psychiatrie Feb 2020Acute psychotic disorders (APS) are characterized by an acute onset as well as a wide array of symptoms including affective, psychotic, and psychomotor symptoms. They... (Review)
Review
Acute psychotic disorders (APS) are characterized by an acute onset as well as a wide array of symptoms including affective, psychotic, and psychomotor symptoms. They occur independently of substance use or organic disorders. In most cases, patients recover fully and without residues within a short period of time. However, APS tend to show a relapsing course, and transitions into other psychiatric disorders (schizophrenia, bipolar disorder) may occur.
Topics: Acute Disease; Bipolar Disorder; Humans; Psychotic Disorders; Recurrence; Schizophrenia
PubMed: 32102104
DOI: 10.1055/a-1008-7510 -
Pediatrics Jun 2020
Review
Topics: Acute Disease; Child; Female; Home Care Services; Hospitalization; Humans; Male; Patient Discharge; Pediatrics
PubMed: 32467093
DOI: 10.1542/peds.2019-0074 -
PloS One 2015Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the...
BACKGROUND
Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.
METHODS AND FINDINGS
Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.
CONCLUSIONS
This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region.
Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Emergency Medical Services; Female; Humans; Infections; Madagascar; Male; Mental Health; Referral and Consultation; Wounds and Injuries; Young Adult
PubMed: 25738300
DOI: 10.1371/journal.pone.0119029 -
Seminars in Neurology Aug 2018Acute neurologic (and potentially disability prone) conditions are rarely taught and, if so, at the bedside and usually after the fact. Simulation training offers a... (Review)
Review
Acute neurologic (and potentially disability prone) conditions are rarely taught and, if so, at the bedside and usually after the fact. Simulation training offers a realistic environment to teach rapid-fire decision making, how to take charge, and how best to approach a deteriorating, acutely ill neurologic patient.Simulating acute neurology is a newly emerging educational program. Proven principles of simulation, which may include teaching technical skills, can be applied to acute neurology (and neurointensive care). Communication skills pertaining to catastrophic neurologic injury with all its ethical ramifications can be taught and practiced. There is a growing need for well-designed, tested teaching scenarios and a need to validate this approach. This review provides an overview of the potential opportunities available in medical institutions with a simulation center.
Topics: Acute Disease; Education, Medical; Humans; Neurology; Simulation Training
PubMed: 30125901
DOI: 10.1055/s-0038-1666986 -
Therapeutische Umschau. Revue... Jan 2015
Topics: Acute Disease; Emergency Medical Services; Humans; Switzerland; Wounds and Injuries
PubMed: 25533246
DOI: 10.1024/0040-5930/a000628 -
Nutrition in Clinical Practice :... Aug 2019
Topics: Acute Disease; Deficiency Diseases; Humans; Micronutrients
PubMed: 31306543
DOI: 10.1002/ncp.10369 -
American Journal of Therapeutics 2018
Review
Topics: Acute Disease; Aged; Diuretics; Female; Heart Failure; Hemodynamics; Hospitalization; Humans; Male; Survival Rate; Time Factors; Treatment Outcome; Vascular Diseases
PubMed: 29985826
DOI: 10.1097/MJT.0000000000000791 -
European Journal of Internal Medicine Aug 2011
Review
Topics: Acute Disease; Humans; Intensive Care Units; Internal Medicine; United Kingdom
PubMed: 21767750
DOI: 10.1016/j.ejim.2011.05.016 -
Annual Review of Nursing Research 1997In this chapter, the research on uncertainty in acute illness is reviewed and critiqued. Both qualitative and quantitative studies are included. The review considers the... (Review)
Review
In this chapter, the research on uncertainty in acute illness is reviewed and critiqued. Both qualitative and quantitative studies are included. The review considers the cause and consequences of uncertainty from research on adults and from research on parents of acutely ill children.
Topics: Acute Disease; Adaptation, Psychological; Adult; Child; Family Health; Humans; Models, Psychological; Risk Factors; Stress, Psychological
PubMed: 9262787
DOI: No ID Found -
JAMA Internal Medicine Nov 2016Determining innovative approaches that better align health needs to the appropriate setting of care remains a key priority for the transformation of US health care;... (Review)
Review
IMPORTANCE
Determining innovative approaches that better align health needs to the appropriate setting of care remains a key priority for the transformation of US health care; however, to our knowledge, no comprehensive assessment exists of alternative management strategies to hospital admission for acute medical conditions.
OBJECTIVE
To examine the effectiveness, safety, and cost of managing acute medical conditions in settings outside of a hospital inpatient unit.
EVIDENCE REVIEW
MEDLINE, Scopus, CINAHL, and the Cochrane Database of Systematic Reviews (January 1995 to February 2016) were searched for English-language systematic reviews that evaluated alternative management strategies to hospital admission. Two investigators extracted data independently on trial design, eligibility criteria, clinical outcomes, patient experience, and health care costs. The quality of each review was assessed using the revised AMSTAR tool (R-AMSTAR) and the strength of evidence from primary studies was graded according to the Oxford Centre for Evidence-Based Medicine.
FINDINGS
Twenty-five systematic reviews (representing 123 primary studies) met inclusion criteria. For outpatient management strategies, several acute medical conditions had no significant difference in mortality, disease-specific outcomes, or patient satisfaction compared with inpatient admission. For quick diagnostic units, the evidence was more limited but did demonstrate low mortality rates and high patient satisfaction. For hospital-at-home, a variety of acute medical conditions had mortality rates, disease-specific outcomes, and patient and caregiver satisfaction that were either improved or no different compared with inpatient admission. For observation units, several acute medical conditions were found to have no difference in mortality, a decreased length of stay, and improved patient satisfaction compared to inpatient admission; results for some conditions were more limited. Across all alternative management strategies, cost data were heterogeneous but showed near-universal savings when assessed.
CONCLUSIONS AND RELEVANCE
For low-risk patients with a range of acute medical conditions, evidence suggests that alternative management strategies to inpatient care can achieve comparable clinical outcomes and patient satisfaction at lower costs. Further study and application of such opportunities for health system redesign is warranted.
Topics: Acute Disease; Ambulatory Care Facilities; Chest Pain; Evidence-Based Medicine; Health Care Costs; Hospitalization; Humans; Inpatients; Meta-Analysis as Topic; Patient Admission; Patient Satisfaction; Randomized Controlled Trials as Topic; United States
PubMed: 27695822
DOI: 10.1001/jamainternmed.2016.5974