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Stress, cognitive blend as well as comorbid depressive and also anxiety symptomatology throughout dementia parents.
Copyright © 2020, Chaudhry et al.Introduction Quality improvement projects can help improve clinical practice in an emergency department (ED). However, it is difficult to measure outcomes in rare clinical conditions. We used a simulation program to evaluate a new protocol and workflow in the emergency blood transfusion process as well as provide additional trauma training. To determine if implementing a trauma simulation would help improve the self-reported understanding of the emergency blood transfusion process by both the ED and laboratory staff. Methods Emergency medicine residents and nursing staff participated in a high-fidelity trauma simulation. ED nursing and hospital laboratory staff used the simulation to test a new process for notification and transport of blood within the hospital. All of the participants were provided a four-item Likert scale questionnaire immediately after the training to evaluate their understanding of the ED blood process. Results There was a significant improvement in overall scores based on paired t-tests in the full group (pre 15.0 versus post 17.6, p = 0.0005) and ED group (pre 14.7 versus post 17.8, p = 0.0007) but not in the lab group (pre 15.8 versus post 17.2, p = 0.296). Conclusion Simulation appears to be helpful to evaluate and implement a new ED protocol or workflow. Copyright © 2020, Comp et al.Introduction Close outpatient follow-up with a specialist or family physician post-discharge from the emergency department (ED) has been shown to increase adherence to antihypertensive medications, decrease mortality in heart failure, and reduce the odds of myocardial infarction or death after ED presentation for chest pain. A Canadian study demonstrated that 21% of patients who left the ED with a new diagnosis of atrial fibrillation, heart failure, or hypertension were not seen by a physician within 30 days. There is a paucity of research investigating why this follow-up does not occur. This study aimed to elucidate factors that are associated with outpatient follow-up by a family physician clinic following discharge from a local Canadian community emergency department. Methods A retrospective chart review of patients rostered to a family physician who presented to the community ED in the past two years was conducted. The primary outcome examined was a documented follow-up visit with any physician at the cli specific discharge instructions to follow-up increased the odds that patients followed up with their family physician after discharge from the ED. ED physicians may consider giving explicit instructions to patients to improve monitoring of ongoing clinical issues. More research needs to be conducted on how to improve transitions of care. Countries with different healthcare models may have other barriers to appropriate follow-up. VT107 Copyright © 2020, Lien et al.Vitamin K antagonists are being used in the last five decades as an effective anticoagulant. However, for the past few years, new oral anticoagulants (NOACs) have been introduced as newer anticoagulant agents, which are gradually replacing the previously used vitamin K antagonist. Yet, these agents have not fully replaced the use of warfarin and heparin. NOACs have few advantages over the vitamin K antagonist as they act on a specific factor of coagulation cascade rather than inhibiting the whole vitamin K synthesis. In this article, all the data has been searched electronically on PubMed and PRISMA guidelines were not followed. Instead, we used MOOSE statements and the data searched on PubMed was from articles published in the last five years. A total of 12,269 patients were observed;,out of which 64.19% had active cancer and 35.80% was observed as a control group comprised of both male or female participants. Approximately 61.14% were using NOACs, 42.83% were on warfarin, and 2.72% were on low-molecular-wei al.Caffeine is the most widely consumed psychoactive substance, with recommendations from health associations and regulatory bodies for limiting caffeine consumption during pregnancy being increasingly common. Prenatal exposure to caffeine has been shown to increase the risk of developing abnormalities in lipid metabolism in adult life. We further investigated the effect of prenatal caffeine exposure (PCE) (20 mg/kg of body weight) on the metabolic "reserve" of male Sprague Dawley offspring fed on a high fructose diet in adult life. Male adult PCE offspring were assigned to four groups; Nw and Nf offspring of control mothers (N group of mothers), having received tap water or high fructose water respectively; Cw and Cf offspring exposed to caffeine during gestation (C group of mothers) and receiving tap water or a high fructose water solution, respectively. Cf rats presented increased serum triglyceride level, as well as raised systolic and diastolic blood pressure levels, together with extensive renal tissue oedema in adulthood, compared to the other groups (p less then 0.05 for all comparisons). These findings show further evidence for potential detrimental metabolic effects of prenatal caffeine exposure during adulthood in this animal model. Copyright © 2020, Mastroleon et al.Background Multiple sclerosis (MS) is a serious chronic autoimmune disorder of the central nervous system of unknown etiology. MS-related depression is a common mood disorder recognized within the medical community. However, their association is ambiguous, underdiagnosed, undertreated and less reported. Objectives The study aimed to estimate the point prevalence and severity of depression among multiple sclerosis patients in Saudi Arabia. Materials and methods We conducted an observational cross-sectional study among multiple sclerosis patients in Riyadh region, Saudi Arabia. Patients filled demographic data and Patient Health Questionnaire-9 (PHQ-9) to determine depression. Those who did not meet the age, disease duration, and regular follow-up eligibility criteria were excluded from the study. Results We enrolled 238 MS patients in the study, male patients represented 39.1% (n = 93) while females accounted for 60.9% (n = 145) (malefemale ratio 0.64). The mean age of the study population was 32.07 ± 7.93 years.
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