Swiss medical weekly
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Swiss medical weekly · Jan 2013
Thrombocytopenia as a mortality risk factor in acute respiratory failure in H1N1 influenza.
A small proportion of patients with influenza H1N1 rapidly develop acute respiratory failure and are a problem for intensive care units (ICUs). Although certain clinical risk factors have been identified, few measurable biochemical/haematological markers able to predict poor outcome have been reported. The aims of the present report are to show which variables on and during admission are associated with increased in-hospital mortality in patients admitted to the ICU with acute respiratory failure due to H1N1 influenza. ⋯ Thrombocytopenia could be valuable marker of in-hospital mortality in patients with respiratory failure due to H1N1 influenza in the ICU scenario.
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Swiss medical weekly · Jan 2013
Feasibility and safety of passive cooling in a cohort of asphyxiated newborn infants.
Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia. Active cooling with whole body surface or head cooling is complex, expensive and often associated with initial hypothermic overshoot. We speculated that passive cooling might suffice to induce and maintain hypothermia. ⋯ Passive cooling for asphyxiated newborns appears to be feasible for induction and maintenance of hypothermia with a lower risk of overshoot.
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To evaluate the patient characteristics and natural history of pubic rami fractures in geriatric patients, with a special focus on the frequency of concomitant posterior pelvic ring lesions and the percentage of secondarily operated patients as a result of conservative treatment failure. ⋯ Pubic rami fractures are frequently associated with concomitant posterior pelvic ring injuries, making these injuries more unstable than generally assumed. Based on this fact and the long duration of hospital stay, more aggressive management of these injuries may be considered. The principle aims in this patient population are satisfying pain management, early mobilisation, conservation of independence and return to previous place of residence.
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Emergency department crowding is a growing international problem. One possible reason for crowding might be the rising number of "walk-in" patients presenting with "non-urgent" health complaints. ⋯ In the emergency unit of the University Hospital Zurich, the prevalence of "non-urgent" medical encounters was substantial with one out three patients presenting with minor health complaints. Young age and non-Swiss origin were associated with increased use of the emergency unit for "non-urgent" conditions. A simple triage tool did not effectively divert "non-urgent" cases to alternates sites of primary care.
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Swiss medical weekly · Jan 2013
Patients leaving the emergency department without being seen by a physician: a retrospective database analysis.
To describe characteristics of patients leaving the emergency department (ED) before being seen by a physician and to identify factors associated with a greater risk of leaving the ED too early. ⋯ LWBS patients share some characteristics and a better understanding of these characteristics as well as time and logistic issues could ease to implement strategies to reduce premature leaving from the ED.