{"title":"ORF disease: a case report with images.","authors":"Lamis Elyamani, Yousef Almheirat, Kaoutar Belharti, Nassiba Zerrouki, Nada Zizi, Siham Dikhaye","doi":"10.52964/AMJA.0973","DOIUrl":"https://doi.org/10.52964/AMJA.0973","url":null,"abstract":"<p><p>This article presents the case of a 25-year-old Moroccan male who contracted Orf disease (Ecthyma contagiosum), a common zoonotic viral infection in sheep and goats. The disease, caused by a parapoxvirus, can be transmitted to humans through contact with infected animals. The patient developed painful lesions on his fingers after interacting with a sheep during the Feast of Sacrifice. Diagnosis was clinically established considering exposure history and lesion characteristics. Treatment involved local antiseptics and 2% fusidic acid cream. The lesions resolved spontaneously over a few weeks without functional impairment.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 1","pages":"50-51"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute MedicinePub Date : 2024-01-01DOI: 10.52964/AMJA.0983
Vicky Price, Michael Trimble
{"title":"Guest Editorial - Moral injury in acute medicine.","authors":"Vicky Price, Michael Trimble","doi":"10.52964/AMJA.0983","DOIUrl":"10.52964/AMJA.0983","url":null,"abstract":"<p><p>Recently I had to have a few minutes in my office to regroup after I'd seen a patient. I didn't quite know how to process my feelings. I was feeling ashamed and upset. My patient had been in our waiting room for over 18 hours. He was a bilateral amputee and a wheelchair user. His medical problem was not life threatening and easy to treat but was affecting his arm and so affected his ability to care for himself, hence the need for admission. He was usually normally independent, worked full time, headed up a local charity but now suddenly found himself incredibly vulnerable.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"98-99"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guest Editorial - Shifting Dynamics: ICU Admissions in Denmark during the First Wave of the COVID-19 Pandemic.","authors":"Christian P Subbe, John Welch, Ramani Moonesinghe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The advent of the SARS-CoV-2 pandemic brought unprecedented challenges to healthcare systems worldwide. As the virus spread across continents, hospitals faced a surge in patient admissions, particularly to intensive care units (ICUs). Understanding the impact of the pandemic on the sickest patients admitted to hospital is crucial for enhancing preparedness for future outbreaks. In this edition of the journal, authors from Denmark report on a register-based national observational study that sheds light on the changes in ICU admission rates and demographic profiles of patients during the initial phase of the pandemic.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 2","pages":"56-57"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Broad, T Knight, S Kiani, N Rajaiah, S Clare, D Lasserson
{"title":"POCUS use in Acute Hospital at Home - working through clinical presentations and addressing management questions.","authors":"A Broad, T Knight, S Kiani, N Rajaiah, S Clare, D Lasserson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Point of care ultrasound (POCUS) is increasing in use and popularity as the technology advances and understanding deepens. For many specialities such as Acute Internal Medicine and Emergency Medicine, POCUS is now mandated in the curriculum. The benefits of POCUS have been identified in multiple settings however currently there is little literature focusing on POCUS in the acute community setting as seen in Hospital at Home (HaH) and there is no formal framework for POCUS in HaH. As a result, the development and safety of this modality is at potential risk. Through adaptation of established protocols and accreditation pathways this could easily be addressed benefiting the patients care foremost, the clinician and the National Health Service as a whole.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"195-199"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of antipyretic medication on the relationship between heart rate, respiratory rate and temperature in acutely admitted medical patients: A retrospective study.","authors":"S Sværke, A V Krusenstjerna-Hafstrøm, M Brabrand","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Research has shown an association between body temperature, heart rate and respiratory rate. We speculated that antipyretics could influence this. We performed this study with the aim of clarifying the association. We included 1,612 acutely admitted medically ill patients and registered their use of antipyretics. We performed crude and adjusted linear regression analyses. In adjusted analysis, we found that heart rate increased with 7.3 (95% CI: 4.5, 10.1) beats/min/°C in patients who were not on antipyretics and 10.0 (95% CI: 6.2, 13.9) beats/min/°C in patients who were. Respiratory rate increased 0.4 (95% CI: -0.2, 0.9) and 1.5 (95% CI: 0.6, 2.3), respectively. Our data shows that use of antipyretics affect the association between temperature, heart rate and respiratory rate positively.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"176-180"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial Intelligence: its Future and Impact on Acute Medicine","authors":"Michiel Schinkel, Ketan Paranjape, Sheena Charente Bhagirath, Prabath WB Nanayakkara","doi":"10.52964/amja.0950","DOIUrl":"https://doi.org/10.52964/amja.0950","url":null,"abstract":"This commentary explores the potential impact of artificial intelligence (AI) in acute medicine, considering its possibilities and challenges. With its ability to simulate human intelligence, AI holds the promise for supporting timely decision-making and interventions in acute care. While AI has significantly contributed to improvements in various sectors, its implementation in healthcare remains limited. The development of AI tools tailored to acute medicine can improve clinical decision-making, and AI’s role in streamlining administrative tasks, exemplified by ChatGPT, may offer immediate benefits. However, challenges include uniform data collection, privacy, bias, and preserving the doctor-patient relationship. Collaboration among AI researchers, healthcare professionals, and policymakers is crucial to harness the potential of AI in acute medicine and create a future where advanced technologies synergistically enhance human expertise.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute MedicinePub Date : 2023-07-01DOI: 10.52964/amja.0953
Luís Marote Correia, Mariana Bilreiro
{"title":"A case of a diabetic woman with an uncontrollable arm","authors":"Luís Marote Correia, Mariana Bilreiro","doi":"10.52964/amja.0953","DOIUrl":"https://doi.org/10.52964/amja.0953","url":null,"abstract":"We present the case of an 83-year-old female patient with left-side hemichorea and hemiballism associated with poorly controlled type 2 diabetes mellitus. Hyperintensity in the right basal ganglia was evident in T1-weighted brain magnetic resonance. Clinical and radiological findings were consistent with diabetic striatopathy.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute MedicinePub Date : 2023-07-01DOI: 10.52964/amja.0946
Arnold Isabelle, Kuster Tobias, Busch Jeannette-Marie, Kellett John Gale, Brabrand Mikkel, Bingisser Roland, Nickel Christian
{"title":"Both acuity and long term prognosis are important Emergency Department metrics: comparison of mobility assessment with the Emergency Severity Index","authors":"Arnold Isabelle, Kuster Tobias, Busch Jeannette-Marie, Kellett John Gale, Brabrand Mikkel, Bingisser Roland, Nickel Christian","doi":"10.52964/amja.0946","DOIUrl":"https://doi.org/10.52964/amja.0946","url":null,"abstract":"Objective: To compare the SUHB mobility scale (i.e., stable(S), unstable gait(U), needing help to walk(H), or bedridden(B)) and the Emergency Severity Index (ESI) associations with admission and mortality outcomes. Design: Post-hoc analysis of a prospective observational study including all consenting presenting to the ED over a period of 3 weeks. Odd ratios and AUCs were calculated to assess predictive performance of SUHB and compared with ESI. Results: Out of 2422 patients, 65% presented with a stable gait, 45% with an ESI level 3. With increasing mobility impairment on the SUHB scale, the probability for admission and mortality increased. SUHB had a higher AUC than ESI for 1-year mortality. Conclusion: SUHB was a better predictor than ESI of long-term mortality. The scale, which is rapid, requires little additional training, and no extra costs, could be used as a useful supplement to the triage process.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute MedicinePub Date : 2023-07-01DOI: 10.52964/amja.0951
Sophie F Lane, Elizabeth Harvey-Jones, Olivia Ward, Roger Davies
{"title":"Renal replacement and extracorporeal therapies in critical care: current and future directions","authors":"Sophie F Lane, Elizabeth Harvey-Jones, Olivia Ward, Roger Davies","doi":"10.52964/amja.0951","DOIUrl":"https://doi.org/10.52964/amja.0951","url":null,"abstract":"There are a wide number of indications for extracorporeal therapies in the critical care environment. A common indication seen by the acute physician is continuous renal replacement therapy (CRRT) in a proportion of patients with acute kidney injury. It is therefore important that acute physicians have a sound understanding of the principles of CRRT in the acutely unwell patient. This review will outline the indications for its use, commonly used methods and anticoagulation considerations. It will discuss when to start and stop CRRT as well as describing potential treatment complications. This review will also discuss the role of therapeutic plasma exchange in critical care and novel extracorporeal therapies including blood purification in sepsis and carbon dioxide removal in acute respiratory distress syndrome and acute exacerbations of obstructive lung disease. Extracorporeal membrane oxygenation is outside of the scope of this article.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute MedicinePub Date : 2023-07-01DOI: 10.52964/amja.0944
Christian P Subbe
{"title":"Bad NEWS: standing still is risky for patients admitted to hospital (even with normal vital signs)","authors":"Christian P Subbe","doi":"10.52964/amja.0944","DOIUrl":"https://doi.org/10.52964/amja.0944","url":null,"abstract":"Acute Physicians care for acutely unwell patients. Recognising and prioritising those at greatest risk of death is therefore at the heart of our specialty. The risk of catastrophic deterioration in the Acute Medical Unit is usually quantified through the measurement of vital signs. These are being summarised into the National Early Warning Score or similar instruments. Those with higher Early Warning Scores are usually prioritised by clinicians in and out of hospital and being seen before those with lower grades of abnormalities and preferably assessed by a more senior clinician.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}