The American journal of emergency medicine
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Multicenter Study
Underrecognition of cervical Neisseria gonorrhoeae and Chlamydia trachomatis infections in pregnant patients in the ED.
The purposes of this study were to (1) quantify the frequency of underrecognized Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infections in pregnant women tested in the emergency department (ED), (2) describe the characteristics of those not treated during the initial visit, and (3) determine how many pregnant women with acute cervicitis were lost to follow-up. ⋯ Further study is warranted to enhance point-of-contact testing and identify better mechanismsfor contact and follow-up after ED discharge and more liberal policies to treat less symptomatic patients empirically.
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Acute pancreatitis remains a common intraabdominal disease with a complex pathophysiology. The overall outcome has improved, but specific treatment remains elusive. The challenge is the early identification and treatment of patients who will develop severe acute pancreatitis. Therefore, the aim of the present study is to investigate plasma levels of copeptin in the initial phase of predicted severe acute pancreatitis. ⋯ Copeptin plasma concentrations were significantly higher in patients with acute pancreatitis when compared with healthy controls. Copeptin plasma concentrations in severe pancreatitis patients were significantly higher than in mild pancreatitis patients.
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Acute pancreatitis (AP) is a common cause for hospitalization worldwide. Identification of patients at risk for mortality early in the course of AP is an important step in improving outcome. Red cell distribution width (RDW) is reflective of systemic inflammation. The objective of this study was to investigate the association between RDW and mortality in patients with AP. ⋯ Red cell distribution width on admission is a predictor of mortality in patients with AP.
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Patients with colorectal cancer (CRC) who present to the emergency department (ED) reportedly have poorer prognoses than other referral sources. The purpose of this study was to compare the clinical presentations and outcomes of patients referred to the hospital from the ED and those referred from non-ED facilities. ⋯ The ED played a pivotal role in the clinical and diagnostic evaluations of patients with CRC at our institution. Emergency department physicians provided timely diagnoses of CRC because the stage at diagnosis and 2-year mortality rate of ED patients were not compromised compared with that of patients referred from non-ED sources. Efforts should be made to reduce the numbers of patients with late presentations and acute complications associated with in-hospital mortality.