This study examines the accuracy of initial and subsequent serum procalcitonin (PCT) levels in predicting positive blood cultures, in-hospital mortality, and development of septic shock in emergency department (ED) patients with severe sepsis. This study includes all patients who presented to our ED with an admission diagnosis of severe sepsis over a period of nine months. The median initial PCT was 0.58 ng/mL, interquartile range (IQR) 0.16-5.39. The median subsequent serum PCT was 2.1 ng/mL, with an IQR of 0.3-11.1. The PCT trend over the initial three hours increased in 67% of the study population. Blood cultures were positive in 38% of the cohort. The median maximum PCT in those with a negative blood culture was 1.06 ng/mL compared to 4.19 ng/mL in those with a positive blood culture (p=0.0116). Serum PCT levels >2.0 ng/mL display significant correlation with positive blood cultures, in-hospital mortality, and development of septic shock and as such may serve as a biomarker for more serious infections.
Background Nontraumatic intracranial hemorrhages (ICH) are serious cerebrovascular events with high morbidity and mortality. They occur in about two million people a year worldwide. While ICH continues to be a focus of research in the medical community, there is little data on the differences in outcomes by gender. We aimed to further investigate these differences in our study. Methods This analysis involves a de-identified dataset of all adult patients who presented to one of our hospital system's emergency departments with ICHs as one of the top three discharge diagnoses. This study was considered exempt by our medical school's Institutional Review Board (IRB). Our hospital system comprises over 176 hospitals in the United States with over 8.6 million emergency department visits annually. Logistic regression analyses were performed using JMP 14.1. Outcome variables included the length of stay, mortality, and disposition.
Background/Objective First discovered by Alois Alzheimer in 1906, Alzheimer’s disease (AD) has become a growing global health concern with numerous implications for individuals and modern society. As patients’ symptoms of dementia continue to worsen, they gradually grow more limited in their independence. As a result, family members and close acquaintances often become caregivers for the patient and become more involved in maintaining the patient’s lifestyle. The authors of this research sought to study what motivates caregivers to look after AD patients and the impact of AD on their lifestyles and physical, mental, and social health. Methods The authors crafted a survey of fourteen questions and collected data from 200 caregivers regarding AD’s impact on their physical, emotional, and social health along with their key demographic and background information (e.g. whether or not they are a caregiver for a patient with AD). Results The results indicate that most AD caregivers are family members (78%). AD often strains the caregiver’s relationship with the patient (47.5%), and 58% of participating caregivers report extreme stress levels while 65% realize it is incredibly difficult to take care of a patient. Because of the increased levels of stress, 47% of participating caregivers sleep less; 43% feel more isolated from their family; and, 35.5% did not try to get help from others. Love and a strong sense of duty seem to be the primary motivation for caregivers to take care of a patient. Worry for the patient (50%), financial worries (12.5%), lack of medical experience (10.5%), and their own health (10.5%) seem to be the primary stressors for caregivers. Caregivers rely on numerous support systems and coping mechanisms, with physical activity (54.5%) and increased alcohol and marijuana usage (35.5%) the most frequent. Conclusions Although caregivers have support systems and found coping methods that would alleviate their burden of caring for a patient with AD, the clear negative impact AD has on caregivers affects their physical, mental, and social health. As there is currently no cure for AD, compassion and greater support for caregivers are necessary.
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