Infectious disease
Mojtaba Miladinia; Farhad Abolnezhadian; Joachim G. Voss; Kourosh Zarea; Naser Hatamzadeh; Mandana Ghanavati
Volume 8, Issue 2 , July 2022, , Pages 90-94
Abstract
Objective: Final patient triage determines which patients can be home-isolated andwhich patients require hospitalization on the basis to predict the patient’s prognosismost accurately. Final triage is an important link in the clinical management chain of thecoronavirus disease 2019 (COVID-19) pandemic, ...
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Objective: Final patient triage determines which patients can be home-isolated andwhich patients require hospitalization on the basis to predict the patient’s prognosismost accurately. Final triage is an important link in the clinical management chain of thecoronavirus disease 2019 (COVID-19) pandemic, and a comprehensive review of variouspatient triage methods is very important to guide decision making and triage efficiency.Decision by clinicians about hospitalization or home-discharge is one of the main challengesin places with limited hospital facilities compared to the high volume of COVID-19 patients.This review was designed to guide clinicians on how to address this challenge.Methods: In this mini review we searched scientific databases to obtain the final triagemethods of COVID-19 patients and the important criteria in each method. In order toconducted searches a period from December 2019 to July 2020 was considered. All searcheswere done in electronic databases and search engines.Results: Findings revealed four current methods for final triage (decision-making regardinghome-isolation or hospitalization of COVID-19 patients). These methods included 1)demographic and background information, 2) clinical information, 3) laboratory indicatorsand 4) initial chest CT-scan. Each of the aforementioned methods encompassed significantcriteria according to which decisions on the patient’s prognosis and final triage were made.Finally, by evaluating each final triage method, we found that each method had somelimitations.Conclusion: An effective and quick final triage requires simultaneous complementary useof all four methods to compensate for each other’s weaknesses and add to each other’sstrengths. It is therefore suggested to assure that clinicians are trained in all four COVID-19patient’s triage methods and their useful criteria in order to achieve evidence-basedperformance for better triage (decision between home-isolation versus hospitalization).
Emergency medicine
Vahid Abbasi; Abolfazl Atalu; Afshan Sharghi; Fatemeh Taghvatalab
Volume 5, Issue 2 , July 2019, , Pages 47-50
Abstract
Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA).Methods: This cross-sectional prospective ...
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Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA).Methods: This cross-sectional prospective study was conducted on 30 patients with cerebral ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) >5. Data such as demographic information, signs and symptoms, medical history, risk factors, focused neurological examination, and the NIHSS were collected for all patients. Then, all patients received 0.9 mg/kg of rt-PA as intravenous bolus doses and intravenous infusion under close monitoring in the emergency department. All patients were checked for necessary outcomes and also disability at the admission time, 7 days later and after three months all patients were checked again. All collected data were analyzed by appropriate tests using SPSS version 22.Results: Of all patients, 63.3% were males and 36.7% were females. The mean age of the patients was 62.37 ± 12.62 years with a range of 40-91 years. The mean of NIHSS was 12.46 ± 4.28 at admission time, in day seven it was 8.06 ± 3.72 and in month three after treatment it was 3.62 ± 2.31. There was a significant relationship between age, place of residence and NIHSS. Thirty percent of patients had NIHSS more than 15 at admission time and after 7 days this rate reached to 10% and three months later it declined to 6.7%. These differences were statistically significant.Conclusion: Intravenous thrombolytic therapy is associated with proper short term results in most patients with ischemic stroke.
Emergency medicine
Payman Moharamzadeh; Kavous Shahsavari Nia; Mohammadhossein Somi; Mahboub Pouraghaei; Akbar Fadaeihaghi; Farzad Rahmani
Volume 4, Issue 1 , January 2018, , Pages 34-38
Abstract
Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis.
Methods: ...
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Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis.
Methods: This was a descriptive analytical study performed on 100 patients with acute pancreatitis in the emergency department of Imam Reza hospital of Tabriz University of Medical Sciences. In this study, the primary level of RDW in patients with acute pancreatitis presenting to the emergency ward was collected and after patients’ admission we followed them. Also, the admission outcome (mortality or discharge) of patients was registered, and finally we evaluated the predictive value of RDW in determining the patient’s outcome in hospital.
Results: In our study, 47 patients were male, and 53 patients were female. Mean RDW in patients was 13.82 ± 1.69. Five patients died during the study. Mean RDW in dead patients and other patients was 16.44 ± 4.22 and 13.68 ± 1.37, respectively (P < 0.001). The cut-off point of 14.55 for RDW with 80% sensitivity and 85% specificity was determined for predicting mortality in patients.
Conclusion: Based on our study results, the initial RDW level is an independent factor for predicting in-hospital mortality in pancreatitis but not for determining the need for surgery or admission to the intensive care unit (ICU).
Emergency medicine
Mustafa Bolatkale; Çağdaş Can; Ahmet Çağdaş Acara
Volume 3, Issue 2 , July 2017, , Pages 71-72
Abstract
Arterial ischemic stroke (AIS) in adults is considered a serious health threat and requires urgent medical treatment. Prompt diagnosis allows the therapeutic option of thrombolysis within the time window of 3 to 6 hours after first symptoms. Alternatively, early anti-platelet therapy is effective in ...
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Arterial ischemic stroke (AIS) in adults is considered a serious health threat and requires urgent medical treatment. Prompt diagnosis allows the therapeutic option of thrombolysis within the time window of 3 to 6 hours after first symptoms. Alternatively, early anti-platelet therapy is effective in improving the outcome after stroke. The incidence of pediatric AIS range from 2 to 5 per 100 000 children/year. Pediatric AIS has severity and long-term outcomes similar to those in young adults. Two-thirds of children sustaining AIS have neurological deficits that may result in life-long disability, thus critically impacting their potential development. On the other hand 10%-30% of the causes of acute strokes are of unknown reasons, therefore careful structural, metabolic and genetic risk factors, requiring more specific treatment, should also be considered in any cases of stroke in children. The diagnosis and treatment should be conducted on the basis of a multidisciplinary approach, including pediatric cardiology, hematology, neurology, neurosurgery and neuroradiology.