The Utility of Point-of-Care Ultrasound (POCUS) in the Emergency Department: A Systematic Review

Point-of-Care Ultrasonography (POCUS) has increasingly become a pivotal tool in emergency medicine, offering significant improvements in diagnostic accuracy and patient care. This systematic review aims to evaluate the utility of POCUS in emergency settings, focusing on its impact on diagnostic accuracy, patient management, and the implications of POCUS training for emergency medicine residents. Following PRISMA guidelines, a comprehensive search across major databases, primarily PubMed, was conducted in November 2023. The review included clinical trials, observational studies, and controlled clinical trials, focusing on the utility of POCUS in emergency departments. Out of 305 articles identified, 8 studies met the inclusion criteria and were analyzed. The review encompassed diverse studies with a total of 1203 participants, demonstrating the effectiveness of POCUS in various emergency scenarios. Key findings include the improvement of diagnostic accuracy for conditions like acute dyspnea and Acute Decompensated Heart Failure (ADHF), the utility of POCUS in pediatric emergency care, and its role in ocular emergencies. POCUS was also found to influence patient care decisions significantly, changing diagnostic impressions and management plans. Additionally, POCUS training for emergency medicine residents led to increased ultrasound usage and improved patient management efficiency. POCUS has emerged as a transformative tool in emergency medicine, enhancing diagnostic accuracy, guiding clinical decision-making, and improving patient care outcomes. Its applications range from general emergency scenarios to specialized pediatric and ocular emergencies. The integration of POCUS training in emergency medicine residency programs is crucial for harnessing its full potential. As technology advances, POCUS is poised to continue revolutionizing patient care in emergency settings, affirming its indispensable role in modern medical practice

Examine the Perceived Risk of Falls Among Patients Receiving Acute Care

Purpose: In an effort to lower the number of falls that occur among hospitalized patients, several facilities have begun introducing various fall prevention programs. However, the efficacy of fall prevention programs is diminished if patients do not consider themselves to be at risk for falls and do not follow recommended procedures. The goal of this study was to characterize how patients in four different acute care specialist services felt about their risk of falling while in the hospital. Methods: One hundred patients admitted to the study hospital with a Morse Fall Scale score of 45 or higher were given the Patient Perception Questionnaire, a tool designed to assess a patient's perception of their own fall risk, fear of falling, and motivation to take part in fall prevention efforts. Scores on the Morse Fall Scale were gathered through a historical assessment of medical records. Descriptive statistics, Pearson's correlation coefficients, and independent sample t tests were used to examine the data. Results: The average age was 65, and around half (52%) were men and half (48%) were women. Based on their ratings on the Morse Fall Scale, all 100 participants were classified as being at high risk for falls. However, only 55.5% of the individuals agreed with this assessment. The likelihood that a patient would seek assistance and the degree to which they feared falling both declined as their faith in their mobility improved. Patients hospitalized after a fall exhibited considerably lower confidence scores and greater fear scores than patients who had not been injured in a fall. Conclusions: Patients who have a high fall risk assessment score may not believe they are at risk for falls and may not take any steps to reduce their risk. The prevalence of falls in hospitals might be mitigated by the creation of a fall risk assessment technique that takes into account both objective and subjective factors

Giant coronary artery aneurysms in juvenile polyarteritis nodosa: a case report

Juvenile polyarteritis nodosa (PAN) is a rare, necrotizing vasculitis, primarily affecting small to medium-sized muscular arteries. Cardiac involvement amongst patients with PAN is uncommon and reports of coronary artery aneurysms in juvenile PAN are exceedingly rare. We describe a 16 year old girl who presented with fever, arthritis and two giant coronary artery aneurysms, initially diagnosed as atypical Kawasaki disease and treated with IVIG and methylprednisolone. Her persistent fevers, arthritis, myalgias were refractory to treatment, and onset of a vasculitic rash suggested an alternative diagnosis. Based on angiographic abnormalities, polymyalgia, hypertension and skin involvement, this patient met criteria for juvenile PAN. She was treated with six months of intravenous cyclophosphamide and high dose corticosteroids for presumed PAN related coronary vasculitis. Maintenance therapy was continued with azathioprine and the patient currently remains without evidence of active vasculitis. She remains on anticoagulation for persistence of the aneurysms. This case illustrates a rare and unusual presentation of giant coronary artery aneurysms in the setting of juvenile PAN

Food advertisements on UK television popular with children: a content analysis in relation to dental health.

Objective To quantify the prevalence of advertising for foods and beverages potentially detrimental to dental health on UK television watched by children.Design Content analysis of pre-recorded television advertisements (adverts).Materials and methods Three hundred and fifty-two hours of television were recorded (one weekday and one weekend day, 6 am - 10 pm) from the main commercial channel (ITV1). All adverts were coded using pre-defined criteria.Setting UK television recorded between January and December 2012.Results Of 9,151 adverts, foods and beverages were the second most commonly advertised products (16.7%; n = 1,532). Nearly two-thirds of food adverts were for items that are potentially harmful to dental health (61%; n = 934). Of these, 96.6% were cariogenic and 11% were acidogenic foods. During peak children's viewing hours, the proportion of foods that are potentially harmful to dental health was significantly higher than for non-harmful foods (65.9% vs. 34.1%; p = 0.011). Adverts for foods potentially harmful to dental health were rare around children's programmes, but significantly more frequent during other programmes watched by children (p <0.001).Conclusion UK children are exposed to a particularly high proportion of advertisements for foods that are potentially detrimental to their dental health during their peak viewing hours and around the programmes they watch the most

Examine the Perceived Risk of Falls Among Patients Receiving Acute Care

&lt;p&gt;Purpose: In an effort to lower the number of falls that occur among hospitalized patients, several facilities have begun introducing various fall prevention programs. However, the efficacy of fall prevention programs is diminished if patients do not consider themselves to be at risk for falls and do not follow recommended procedures. The goal of this study was to characterize how patients in four different acute care specialist services felt about their risk of falling while in the hospital. Methods: One hundred patients admitted to the study hospital with a Morse Fall Scale score of 45 or higher were given the Patient Perception Questionnaire, a tool designed to assess a patient's perception of their own fall risk, fear of falling, and motivation to take part in fall prevention efforts. Scores on the Morse Fall Scale were gathered through a historical assessment of medical records. Descriptive statistics, Pearson's correlation coefficients, and independent sample t tests were used to examine the data. Results: The average age was 65, and around half (52%) were men and half (48%) were women. Based on their ratings on the Morse Fall Scale, all 100 participants were classified as being at high risk for falls. However, only 55.5% of the individuals agreed with this assessment. The likelihood that a patient would seek assistance and the degree to which they feared falling both declined as their faith in their mobility improved. Patients hospitalized after a fall exhibited considerably lower confidence scores and greater fear scores than patients who had not been injured in a fall. Conclusions: Patients who have a high fall risk assessment score may not believe they are at risk for falls and may not take any steps to reduce their risk. The prevalence of falls in hospitals might be mitigated by the creation of a fall risk assessment technique that takes into account both objective and subjective factors.&lt;/p&gt

OVERVIEW ON PREVALENCE OF DEPRESSION AMONG ADULT OBESE PATIENTS

Obesity and depression are both common public health problems, however research on their association is conflicting. Some evidence point to strong links between depression and obesity, as well as the linked prevalence of both conditions. Depression is becoming more common, which predisposes people to considerable functional impairment as well as an increased risk of suicide and concomitant physical health problems. BMI and depression are thought to be related; however, the impacts of depression on body image have not been established from the standpoint of socioeconomic position, which has been regarded a key risk factor for the development of depression. Many epidemiological studies, clinical studies, and meta-analyses support the link between mood disorders and obesity in relation to various conditions such as depression severity, obesity severity, gender, socioeconomic status, genetic susceptibility, environmental influences, and adverse experiences. Immune and endocrine systems, as well as psychological and social factors, are thought to be involved in the two illnesses. As a result, the study was developed to assess the prevalence of depression in adult obese individuals