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https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#1
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28723098/a-new-area-in-main-group-chemistry-zerovalent-monoatomic-silicon-compounds-and-their-analogues
#2
Shenglai Yao, Yun Xiong, Matthias Driess
Monoatomic zerovalent main-group element complexes emerged very recently and attracted increasing attention of both theoretical and experimental chemists. In particular, zerovalent silicon complexes and their congeners (metallylones) stabilized by neutral Lewis donors are of significant importance not only because of their intriguing electronic structure but also because they can serve as useful building blocks for novel chemical species. Featuring four valence electrons as two lone pairs at the central atoms, such complexes may form donor-acceptor adducts with Lewis acids...
July 19, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28716001/variant-ranker-a-web-tool-to-rank-genomic-data-according-to-functional-significance
#3
John Alexander, Dimitris Mantzaris, Marianthi Georgitsi, Petros Drineas, Peristera Paschou
BACKGROUND: The increasing volume and complexity of high-throughput genomic data make analysis and prioritization of variants difficult for researchers with limited bioinformatics skills. Variant Ranker allows researchers to rank identified variants and determine the most confident variants for experimental validation. RESULTS: We describe Variant Ranker, a user-friendly simple web-based tool for ranking, filtering and annotation of coding and non-coding variants...
July 17, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/28678057/hyaluronidase-assisted-resuscitation-in-kenya-for-severely-dehydrated-children
#4
Hijab Zubairi, Brett D Nelson, Priyanka Tulshian, Karla Fredricks, Zaid Altawil, Sarah Mireles, Fred Odongo, Thomas F Burke
BACKGROUND: Dehydration, mainly due to diarrheal illnesses, is a leading cause of childhood mortality worldwide. Intravenous (IV) therapy is the standard of care for patients who were unable to tolerate oral rehydration; however, placing IVs in fragile, dehydrated veins can be challenging. Studies in resource-rich settings comparing hyaluronidase-assisted subcutaneous rehydration with standard IV rehydration in children have demonstrated several benefits of subcutaneous rehydration, including time and success of line placement, ease of use, satisfaction, and cost-effectiveness...
July 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28654682/low-intensity-cognitive-behaviour-therapy-interventions-for-obsessive-compulsive-disorder-compared-to-waiting-list-for-therapist-led-cognitive-behaviour-therapy-3-arm-randomised-controlled-trial-of-clinical-effectiveness
#5
RANDOMIZED CONTROLLED TRIAL
Karina Lovell, Peter Bower, Judith Gellatly, Sarah Byford, Penny Bee, Dean McMillan, Catherine Arundel, Simon Gilbody, Lina Gega, Gillian Hardy, Shirley Reynolds, Michael Barkham, Patricia Mottram, Nicola Lidbetter, Rebecca Pedley, Jo Molle, Emily Peckham, Jasmin Knopp-Hoffer, Owen Price, Janice Connell, Margaret Heslin, Christopher Foley, Faye Plummer, Christopher Roberts
BACKGROUND: Obsessive-compulsive disorder (OCD) is prevalent and without adequate treatment usually follows a chronic course. "High-intensity" cognitive-behaviour therapy (CBT) from a specialist therapist is current "best practice." However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for "low-intensity" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support) can be provided remotely, which has the potential to increase access...
June 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28638278/lifespan-and-associated-factors-of-peripheral-intravenous-cannula-among-infants-admitted-in-public-hospitals-of-mekelle-city-tigray-ethiopia-2016
#6
Eskedar Birhane, Kalayou Kidanu, Mekuria Kassa, Dawit Gerezgiher, Lidia Tsegay, Brhanu Weldu, Genet Kidane, Hadgu Gerensea
BACKGROUND: Peripheral Intravenous cannula (IV) is the most common vascular access device used to administer medications with the exception of medication or fluid with high or low PH or hyperosmolarity which may cause severe damage to small veins. The insertion of a peripheral intravenous cannula in newborn infants can be difficult. Appropriate veins with sufficient capacity to insert a cannula become less available throughout the hospital stay. Once a peripheral intravenous cannula is inserted, it is desirable that its patency can be maintained as long as possible...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28461485/compositional-data-supports-decentralized-model-of-production-and-circulation-of-artifacts-in-the-pre-columbian-south-central-andes
#7
Marisa Lazzari, Lucas Pereyra Domingorena, Wesley D Stoner, María Cristina Scattolin, María Alejandra Korstanje, Michael D Glascock
The circulation and exchange of goods and resources at various scales have long been considered central to the understanding of complex societies, and the Andes have provided a fertile ground for investigating this process. However, long-standing archaeological emphasis on typological analysis, although helpful to hypothesize the direction of contacts, has left important aspects of ancient exchange open to speculation. To improve understanding of ancient exchange practices and their potential role in structuring alliances, we examine material exchanges in northwest Argentina (part of the south-central Andes) during 400 BC to AD 1000 (part of the regional Formative Period), with a multianalytical approach (petrography, instrumental neutron activation analysis, laser ablation inductively coupled plasma mass spectrometry) to artifacts previously studied separately...
May 16, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28454184/-register-of-difficult-surgical-situations
#8
Michael Korenkov, Henning Dralle, Ernst Klar, Stefan Saad, Norbert Senninger, Jens Standop, Albrecht Stier, Martin Strik, Alexis Ulrich, Rudolf Weiner
Every surgical problem that increases the likelihood of intraoperative and postoperative complications is considered to be a difficult surgical situation. Based on this definition, Korenkov et al. proposed to classify patients according to the following intraoperative difficulty levels (I to IV): (I) ideal situation (easy to operate, no problems), (II) fairly easy/manageable/simple (some minor difficulties may occur), (III) difficult/problematic (difficult to operate; some operative techniques are considerably more difficult than others), and (IV) very difficult (every operative step is difficult/challenging)...
April 28, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28425700/reaction-of-the-tricyanoborate-dianion-b-cn-3-2-with-hgcl2
#9
Eduard Bernhardt, Vera Bernhardt-Pitchougina, Carsten Jenne
The very reactive [B(CN)3](2-) dianion has a strongly nucleophilic boron atom and can be used for the synthesis of tricyanoborates, which otherwise are difficult to access. Herein the reaction of this anion with HgCl2 is reported. The main product is the anionic mercury complex [Hg(B(CN)3)2](2-). Heteronuclear NMR spectroscopic experiments shows that the reaction proceeds via the intermediate [ClHgB(CN)3](2-). Even though [Hg(B(CN)3)2](2-) is the main product, it is difficult to obtain it in pure form, because it slowly decomposes in the presence of water and air to [(NC)HgB(CN)3](-)...
April 20, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28342192/intravenous-versus-nonintravenous-benzodiazepines-for-the-cessation-of-seizures-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Abdussalam Alshehri, Ahmad Abulaban, Rakan Bokhari, Suleiman Kojan, Majid Alsalamah, Mazen Ferwana, Mohammad Hassan Murad
BACKGROUND: The acquisition of intravenous (IV) access in the actively convulsing patient is difficult. This often delays the administration of the IV benzodiazepine (BDZ) necessary for seizure cessation. Delays in seizure cessation are associated with increased pharmacoresistance, increased risk of neuronal injury, worse patient outcomes, and increased morbidity. OBJECTIVE: The objective was to assess whether the delay imposed by IV access acquisition is justified by improved outcomes...
March 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28272869/a-pyridine-alkoxide-chelate-ligand-that-promotes-both-unusually-high-oxidation-states-and-water-oxidation-catalysis
#11
Thoe K Michaelos, Dimitar Y Shopov, Shashi Bhushan Sinha, Liam S Sharninghausen, Katherine J Fisher, Hannah M C Lant, Robert H Crabtree, Gary W Brudvig
Water-oxidation catalysis is a critical bottleneck in the direct generation of solar fuels by artificial photosynthesis. Catalytic oxidation of difficult substrates such as water requires harsh conditions, so the ligand must be designed both to stabilize high oxidation states of the metal center and to strenuously resist ligand degradation. Typical ligand choices either lack sufficient electron donor power or fail to stand up to the oxidizing conditions. Our research on Ir-based water-oxidation catalysts (WOCs) has led us to identify a ligand, 2-(2'-pyridyl)-2-propanoate or "pyalk", that fulfills these requirements...
March 8, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#12
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28198293/locating-difficult-veins-for-venepuncture-and-cannulation
#13
Sally Jane Shaw
Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28140438/the-comparison-of-humeral-intraosseous-and-intravenous-administration-of-vasopressin-on-return-of-spontaneous-circulation-and-pharmacokinetics-in-a-hypovolemic-cardiac-arrest-swine-model
#14
COMPARATIVE STUDY
Mark H Wimmer, Kenneth Heffner, Michael Smithers, Richard Culley, Jennifer Coyner, Michael Loughren, Don Johnson
INTRODUCTION: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model...
2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28118813/tumblescore-run-and-tumble-analysis-for-low-frame-rate-motility-videos
#15
Alex Eli Pottash, Ryan McKay, Chelsea R Virgile, Hana Ueda, William E Bentley
Scientists often exploit the motility of peritrichously flagellated bacteria for various applications. A common alteration is modifying the frequency of mid-movement changes in direction, known as tumbles. Such differences in bacterial swimming patterns can prove difficult to quantify, especially for those without access to high-speed optical equipment. Traditionally, scientists have resorted to less accurate techniques, such as soft agar plate assays, or have been forced to invest in costly equipment. Here, we present TumbleScore, software designed to track and quantify bacterial movies with slow, as well as fast, frame-rates...
January 1, 2017: BioTechniques
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#16
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28018682/bent-metal-in-a-bone-a-rare-complication-of-an-emergent-procedure-or-a-deficiency-in-skill-set
#17
Mridula Krishnan, Katherine Lester, Amber Johnson, Kaye Bardeloza, Peter Edemekong, Ilya Berim
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27998615/analysis-of-intraosseous-blood-samples-using-an-epoc-point-of-care-analyzer-during-resuscitation
#18
Crystal Ives Tallman, Michael Darracq, Megann Young
BACKGROUND: In the early phases of resuscitation in a critically ill patient, especially those in cardiac arrest, intravenous (IV) access can be difficult to obtain. Intraosseous (IO) access is often used in these critical situations to allow medication administration. When no IV access is available, it is difficult to obtain blood for point of care analysis, yet this information can be crucial in directing the resuscitation. We hypothesized that IO samples may be used with a point of care device to obtain useful information when seconds really do matter...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27995500/adrenal-crises-perspectives-and-research-directions
#19
REVIEW
R Louise Rushworth, David J Torpy, Henrik Falhammar
Adrenal crises are life-threatening complications of adrenal insufficiency. These events have an estimated incidence of between 5 and 10  adrenal crises/100 patient years and are responsible for some of the increased morbidity and excess mortality experienced by patients with adrenal insufficiency. Treatment involves urgent administration of IV/IM hydrocortisone and IV fluids. Patient education regarding preventive measures, such as increasing the dose of replacement therapy ("stress dosing") when sick, using parenteral hydrocortisone as necessary and accessing medical assistance promptly, is still considered the best approach to averting the onset of an adrenal crisis at times of physiological stress, most commonly an infection...
February 2017: Endocrine
https://www.readbyqxmd.com/read/27886365/the-use-of-ultrasound-for-peripheral-iv-placement-by-vascular-access-team-nurses-at-a-tertiary-children-s-hospital
#20
COMPARATIVE STUDY
Marsha Elkhunovich, Joanna Barreras, Valerie Bock Pinero, Nurit Ziv, Aisha Vaiyani, Thomas Mailhot
PURPOSE: Children receiving treatment in the hospital frequently require intravenous (IV) access. Placement of short peripheral catheters can be painful and challenging especially in those children who have difficult access. Many children's hospitals have teams of specialized vascular access nurses experienced in peripheral catheter insertion, and at times use vein visualization devices, including ultrasound (US), to assist in peripheral IV placement. Our objectives were to describe the prevalence and success rate of US-guided peripheral IV placement by vascular access team nurses at a single tertiary children's hospital...
January 18, 2017: Journal of Vascular Access
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