Retropharyngeal and parapharyngeal infections can be managed surgically or conservatively. A trial of medical treatment before considering computed tomography (CT) imaging may be appropriate.

This is a retrospective review of patients with retropharyngeal and parapharyngeal infections between October 2022 and April 2023. Descriptive and statistical analysis compared surgically and conservatively managed patients.

There were 33 patients (median age 58 months). CT imaging was acquired for 30 of 33 patients (90.9 per cent) and 25 had a CT scan within 24 hours of presentation. Fourteen patients (42.4 per cent) were managed surgically. The mean duration of antibiotics for surgically and conservatively managed patients was not significantly different (19.9 vs 21.4 days, p = 0.73). Larger lesions were observed on the CT scans of surgically treated patients (22.8 vs 15.6 mm, p = 0.01).

Management of paediatric retropharyngeal and parapharyngeal infections can be surgical or conservative. We propose a management algorithm that allows an initial trial of intravenous antibiotics before CT imaging for selected patients.

Little is known about when youth may be at greatest risk for attempting suicide, which is critically important information for the parents, caregivers, and professionals who care for youth at risk. This study used adolescent and parent reports, and a case-crossover, within-subject design to identify 24-hour warning signs (WS) for suicide attempts.

Adolescents (N = 1094, ages 13 to 18) with one or more suicide risk factors were enrolled and invited to complete bi-weekly, 8–10 item text message surveys for 18 months. Adolescents who reported a suicide attempt (survey item) were invited to participate in an interview regarding their thoughts, feelings/emotions, and behaviors/events during the 24-hours prior to their attempt (case period) and a prior 24-hour period (control period). Their parents participated in an interview regarding the adolescents’ behaviors/events during these same periods. Adolescent or adolescent and parent interviews were completed for 105 adolescents (81.9% female; 66.7% White, 19.0% Black, 14.3% other).

Both parent and adolescent reports of suicidal communications and withdrawal from social and other activities differentiated case and control periods. Adolescent reports also identified feelings (self-hate, emotional pain, rush of feelings, lower levels of rage toward others), cognitions (suicidal rumination, perceived burdensomeness, anger/hostility), and serious conflict with parents as WS in multi-variable models.

This study identified 24-hour WS in the domains of cognitions, feelings, and behaviors/events, providing an evidence base for the dissemination of information about signs of proximal risk for adolescent suicide attempts.

States have established public reporting of hospital-associated (HA) infections—including those of methicillin-resistant Staphylococcus aureus (MRSA)—but do not account for hospital case mix or postdischarge events

Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings.

A retrospective cohort study of 2009–2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals’ proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values.

Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0–102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40–0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment.

When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.

Infect Control Hosp Epidemiol 2014;35(10):1263–1270

A comparative analysis of emotional intelligence between psychiatrists and surgeons using the Bar-On Emotional Quotient Inventory (Bar-On EQ-i) validated assessment tool. Applied to psychiatrists and surgeons with postgraduate membership in Greater London.

A total of 148 individuals were recruited. The median scores for Total EQ scores were average, with no difference in Total EQ between psychiatrists and surgeons (P = 0.872). Psychiatrists scored significantly higher in the subscales of emotional self-awareness (P = 0.002), empathy (P = 0.005), social responsibility (P = 0.04) and impulse control (P = 0.011). Surgeons scored significantly higher in the subscales of self-regard (P = 0.005), stress tolerance (P < 0.0001) and optimism (P = 0.009).

There are significant differences between psychiatrists and surgeons in the component factors that make up the Total EQ score. They seemingly correspond with widely held perceptions.

The aim of this study was to examine visual problems among patients admitted to an inner city acute mental health unit. We measured visual acuity using a Snellen chart. Patients were also asked about perceived eye problems and access to services.

Of 55 in-patients on five acute general adult wards at an inner city mental health unit over a 3-day period, 31 agreed to participate in the study. Twenty (65%) had impaired visual acuity and 19 (61%) had not been to an optician for 5 or more years. Seventeen patients (55%) reported experiencing difficulty with their eyesight. The main problems reported were blurring of vision and periorbital pain. Of these 17 patients, 15 (88%) had impaired visual acuity on Snellen testing. Half of those who had previously been prescribed glasses or contact lenses reported that they had been lost.

Visual impairment appears to be another area of physical health which is underrecognised and undertreated in people with severe mental health problems. Although there are numerous issues that must be addressed by mental health staff, patients should be asked about eye problems and supported in accessing opticians.

A prospective descriptive study was set up to evaluate the feasibility, acceptability and activity of an innovative weekly primary care service for patients admitted for acute psychiatric care.

During 10 months, 36 clinics were held and 123 appointments were attended. Presenting complaints included a wide range of acute and chronic conditions, affecting all body systems. As well as treating specific complaints, the doctor providing this service undertook considerable health promotion work and gave advice about patient management to junior psychiatrists.

It appears that there is considerable need for primary care expertise within an acute psychiatric unit, and that a weekly clinic is a feasible model of care.