Prevalence of Pulmonary Embolism in Patients with Syncope

Importance:Sparse data and conflicting evidence exist on the prevalence of pulmonary embolism (PE) in patients with syncope. Objective:To estimate the prevalence of PE among patients presenting to the emergency department (ED) for evaluation of syncope. Design, Setting, and Participants:This retrospective, observational study analyzed longitudinal administrative data from 5 databases in 4 different countries (Canada, Denmark, Italy, and the United States). Data from all adult patients (aged 6518 years) who presented to the ED were screened to identify those with syncope codes at discharge. Data were collected from January 1, 2000, through September 30, 2016. Main Outcomes and Measures:The prevalence of PE at ED and hospital discharge, identified using codes from the International Classification of Diseases, was considered the primary outcome. Two sensitivity analyses considering prevalence of PE at 90 days of follow-up and prevalence of venous thromboembolism were performed. Results: A total of 1\u202f671\u202f944 unselected adults who presented to the ED for syncope were included. The prevalence of PE, according to administrative data, ranged from 0.06% (95% CI, 0.05%-0.06%) to 0.55% (95% CI, 0.50%-0.61%) for all patients and from 0.15% (95% CI, 0.14%-0.16%) to 2.10% (95% CI, 1.84%-2.39%) for hospitalized patients. The prevalence of PE at 90 days of follow-up ranged from 0.14% (95% CI, 0.13%-0.14%) to 0.83% (95% CI, 0.80%-0.86%) for all patients and from 0.35% (95% CI, 0.34%-0.37%) to 2.63% (95% CI, 2.34%-2.95%) for hospitalized patients. Finally, the prevalence of venous thromboembolism at 90 days ranged from 0.30% (95% CI, 0.29%-0.31%) to 1.37% (95% CI, 1.33%-1.41%) for all patients and from 0.75% (95% CI, 0.73%-0.78%) to 3.86% (95% CI, 3.51%-4.24%) for hospitalized patients. Conclusions and Relevance: Pulmonary embolism was rarely identified in patients with syncope. Although PE should be considered in every patient, not all patients should undergo evaluation for PE

Memory and meaning in the search for Chinese Australian families

Over the past twenty-five years there has been tremendous interest in researching ChineseAustralian family history. This includes documenting the experiences of Chinese migrantsand their descendants in Australia from the nineteenth century onwards, as well as seekingto understand their pre-migration lives in China and patterns of return migration. For manyChinese Australian family historians, however, there remains a major difficulty in tracingtheir Chinese ancestry – not knowing their ancestor’s name in Chinese or their precise placeof origin beyond the ubiquitous ‘Canton’. This essay discusses the endeavours of familyhistorians to uncover their Cantonese roots, including by visiting the qiaoxiang (homevillage) districts of the Pearl River Delta region in Guangdong province. We reflect on this‘roots tourism’ and the practice of personal memory-making in the wake of national andfamilial forgetting

Students’ perception of classroom inter-professional learning activity among pharmacy, dietetics and medical students in IMU

Not Availabl

Etiology of acute lower respiratory tract infection in Central Australian aboriginal children

Background. Aboriginal children in central Australia have attach rates for acute lower respiratory tract infection (ALRI) that are similar to those in developing countries. Although mortality rates are much lower than in developing countries, morbidity is high and ALRI is still the leading cause of hospitalization. However, there are no data on the etiology of ALRI in this population. Methods. We prospectively studied 322 cases of ALRI in 280 Aboriginal children admitted to the hospital. Blood, urine and nasopharyngeal aspirate samples were examined for evidence of bacterial, viral and chlamydial infection. Results. The combination of blood culture, viral studies and chlamydial serology provided at least 1 etiologic agent in 170 of 322 (52.5%) cases. Assays for pneumolysin immune complex and pneumolysin antibody increased etiologic diagnosis to 219 (68.0%). Blood cultures were positive in 6% but pneumolysin immune complex and pneumolysin antibody studies were positive in one-third of cases. Evidence of viral infection was present in 155 (48%) of cases compared with 12% in controls (P < 001). There were only 7 possible cases and 2 definite cases of Chlamydia trachomatis and 3 cases of Chlamydia pneumoniae. Coinfection was common in these children. Conclusion. These findings have implications for both standard treatment protocols and vaccine strategies, The high rate of coinfection may make it difficult to develop simple clinical predictors of bacterial infection. In the setting of a developed country with efficient patient evacuation services, management algorithms that focus on disease severity and need for hospital referral will be most useful to health staff in remote. communities. Pneumococcal conjugate vaccines will be required to reduce the high attach rate of pneumococcal disease

Innovative Wege fuer die Handlungsunterstuetzung des Facharbeiters an Werkzeugmaschinen (InnovatiF) Abschlussbericht

Available from TIB Hannover: F98B1379+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Maintaining the strategic edge: the defence of Australia in 2015

The recent and continuing changes in Southeast Asia - the economic calamity in 1997-98, the overthrow of President Soeharto's New Order and the tenuous establishment of democracy, and the horrific circumstances of East Timor's independence - have disturbed Australia's security situation more seriously than anything since the 1960s, when Australia was at war (albeit covertly) with Indonesia in Borneo and had a task force in Vietnam. The rate of technological change is also unprecedented, especially in the area of information technology (IT) and its manifold applications, promising a revolution in military affairs (RMA), some aspects of which are very attractive for Australian defence planning. At the same time, the Australian Defence Force (ADF) faces the imminent prospect of 'block obsolescence' - when major platforms such as the F/A-18 Hornet multi-role fighter aircraft, the F-111 strike fighters, the P-3C Orion long-range maritime patrol aircraft, and all of the navy's surface combatants, will need to be replaced (or their tasks foregone). Addressing these issues will require the development of a sound appreciation of Australia's security environment, and of clear and coherent strategic guidance for defence force planning. The purpose of this volume is to assist and inform these processes