Impact of closure of mental health center: emergency department utilization and length of stay among patients with severe mental illness.

This paper demonstrates the impact of closure of a local mental health center on patients who suffer from severe mental illness. The authors analyze electronic health record data to show that these patients not only use emergency department services more than the general medical population, but also experience an increased length of stay in the emergency department.

Prednisone treatment for vestibular neuritis.

OBJECTIVE: To evaluate the value of corticosteroids in the treatment of vestibular neuritis (VN). DESIGN: Prospective controlled randomized. METHODS: Thirty VN patients, 15 in the study and 15 in the control group, were the subjects of the study. The study group was treated by 1 mg/kg prednisone for 5 days, followed by gradually reduced doses of prednisone for an additional 15 days, and vestibular sedatives for symptomatic relief during the first 5 days after presentation. The control group received a placebo and similar vestibular sedatives. The patients had a baseline evaluation and follow-up examinations after 1, 3, 6, and 12 months. The groups were compared for the presence of symptoms and signs, caloric lateralization on the electronystagmography (ENG), the presence of other pathologic findings in the ENG, and Dizziness Handicap Inventory scores. RESULTS: No differences were found between the groups in the occurrence of symptoms and signs, degree of caloric lateralization, presence of other ENG pathologic findings, and Dizziness Handicap Inventory scores at the end of the study. Complete resolution was observed in 64% of the study and in 80% of the control group. The study group showed earlier recovery of ENG lateralization at the 1- and 3-month follow-up evaluations and higher rates of complete resolution at the 3- and 6-month follow-up points. CONCLUSION: Prednisone therapy might enhance earlier recovery but does not improve the long-term prognosis of VN. The clinical and laboratory parameters in VN are not correlated, and both are required for complete patient evaluation.