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Emergency Management

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https://www.readbyqxmd.com/read/29351549/weeds-and-ground-dwelling-predators-response-to-two-different-weed-management-systems-in-glyphosate-tolerant-cotton-a-farm-scale-study
#1
Esteban García-Ruiz, Íñigo Loureiro, Gema P Farinós, Pablo Gómez, Elena Gutiérrez, Francisco Javier Sánchez, María Concepción Escorial, Félix Ortego, María Cristina Chueca, Pedro Castañera
The use of glyphosate, as a post-emergence broad-spectrum herbicide in genetically modified glyphosate-tolerant (GT) cotton, supposes a big change in weed management programs with respect to a conventional regime. Thus, alterations in arable flora and arthropod fauna must be considered when evaluating their potential impacts. A 3-year farm-scale study was conducted in a 2-ha GT cotton crop, in southern Spain, to compare the effects of conventional and glyphosate herbicide regimes on weed abundance and diversity and their consequences for ground-dwelling predators...
2018: PloS One
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#2
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351176/technological-complexity-and-emergence-of-the-entanglement
#3
Thomas R Clancy
As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on the application of management strategies in health systems. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This article is the 3rd in a series of articles that focus on why technological complexity is increasing and strategies nurse administrators can use to successfully implement change in the face of it...
February 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29350672/rebounds-after-discharge-from-the-emergency-department-for-community-acquired-pneumonia-focus-on-the-usefulness-of-severity-scoring-systems
#4
Rodolfo Ferrari, Pierluigi Viale, Paolo Muratori, Fabrizio Giostra, Daniela Agostinelli, Roberto Lazzari, Riccardo Voza, Mario Cavazza
BACKGROUND: Community-acquired pneumonia (CAP) is common cause of hospital admission and leading cause of morbidity and mortality. Severity scoring systems are used to predict risk profile, outcome and mortality, and to help decisions about management strategies. Aim of the work and Methods: To critically analyze pneumonia "rebound" cases, once discharged from the emergency department (ED) and afterwards admitted. We conducted an observational clinical study in the acute setting of a university teaching hospital, prospectively analyzing, in a 1 year period, demographic, medical, clinical and laboratory data, and the outcome...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350663/effectiveness-of-a-tailored-medical-support-to-overcome-the-barriers-to-education-treatment-and-good-metabolic-control-in-children-with-type-1-diabetes-from-ethnic-minorities
#5
Brunella Iovane, Antonina Marta Cangelosi, Ilaria Bonaccini, Carla Mastrorilli, Dora Di Mauro, Valentina Fainardi, Giovanni Chiari, Marilena Maltese, Carlo Caffarelli, Maurizio Vanelli
AIM: To analyze the effectiveness of a tailored medical support to help children from ethnic minorities to achieve the same good metabolic control of autochthonous peers with type-1 diabetes (T1D). METHODS: Children <10 years of age belonging to ethnic minority (EM) families (Group 1) were compared with autochthonous peers (Group 2) who received the diagnosis of T1D in 2014-2016. The Protocol for minorities included other than the standard protocol: booklets translated in ethnic minority languages; weekly visits at home or at school; family-guides; clinic visits supported by professional interpreters...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350546/-we-re-like-a-gang-we-stick-together-experiences-of-ventricular-assist-device-communities
#6
Holly C Standing, Catherine Exley, Guy A MacGowan, Tim Rapley
BACKGROUND: Ventricular assist devices (VADs) are a relatively new development in the management of advanced heart failure. In the UK, VAD recipients comprise a unique group of less than 200 patients. This is the first paper to explore the experience of VAD communities, the extent to which communities are developed around the device, and how these influence the experience of living with the VAD. METHODS: Qualitative interviews were conducted with 20 VAD recipients (implanted as a bridge to transplantation), 11 interviews also included the VAD recipients' partners...
January 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29350545/sensitive-multiplex-real-time-rt-qpcr-assay-for-the-detection-of-filoviruses
#7
Vladimir G Dedkov, N'Faly Magassouba, Marina V Safonova, Sergey A Bodnev, Oleg V Pyankov, Jacob Camara, Bakary Sylla, Alexander P Agafonov, Victor V Maleev, German A Shipulin
Filoviruses are important etiological agents of emergent diseases with high mortality rates. Traditionally, filovirus fever diseases have primarily been a burden of African countries; however, global interconnectedness has increased the probability of the worldwide spread of filoviruses. Therefore, national healthcare organizations need tools for managing filovirus risk, including diagnostic kits based on real-time reverse transcription PCR (RT-qPCR), as this is the most suitable method for diagnosing filovirus fever diseases...
January 19, 2018: Health Security
https://www.readbyqxmd.com/read/29350414/ross-river-virus-in-australian-blood-donors-possible-implications-for-blood-transfusion-safety
#8
Helen M Faddy, Thu V Tran, Veronica C Hoad, Clive R Seed, Elvina Viennet, Hiu-Tat Chan, Robert Harley, Elise Hewlett, Roy A Hall, Helle Bielefeldt-Ohmann, Robert L P Flower, Natalie A Prow
BACKGROUND: Emerging transfusion-transmissible pathogens, including arboviruses such as West Nile, Zika, dengue, and Ross River viruses, are potential threats to transfusion safety. The most prevalent arbovirus in humans in Australia is Ross River virus (RRV); however, prevalence varies substantially around the country. Modeling estimated a yearly risk of 8 to 11 potentially RRV-viremic fresh blood components nationwide. This study aimed to measure the occurrence of RRV viremia among donors who donated at Australian collection centers located in areas with significant RRV transmission during one peak season...
January 19, 2018: Transfusion
https://www.readbyqxmd.com/read/29350373/pediatric-dural-venous-sinus-thrombosis-following-closed-head-injury-an-easily-overlooked-diagnosis-with-devastating-consequences
#9
Joe M Das, Rashmi Sapkota, Binjura Shrestha
Dural venous sinus thrombosis (DVST) is an uncommon finding after traumatic brain injury. The diagnosis can often be initially missed, particularly if not associated with an overlying fracture. Pediatric DVST following closed head injury and without an overlying fracture is very rare, with only 20 cases reported in the literature to date. Here we present the case of a 19-month-old boy who presented with a history of trivial fall and an episode of fever. On presentation, the pediatric Glasgow Coma Scale (pGCS) score was E3V4M6, and initial brain computed tomography (CT) was normal...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29350340/poem-in-the-treatment-of-esophageal-disorders
#10
REVIEW
Nasim Parsa, Mouen A Khashab
OPINION STATEMENT: PURPOSE OF THE REVIEW: Peroral endoscopic myotomy (POEM) is a novel minimally invasive technique that has emerged as the preferred option for the treatment of achalasia and spastic esophageal disorders (SED) at many centers around the world. In this article, we review and summarize the recent literature on POEM in patients with achalasia and SED. The current article is largely focused on the new developments and findings, extended applications, and long-term outcomes of POEM in patients with achalasia and SED...
January 19, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29349881/speech-and-language-therapists-perspectives-of-therapeutic-alliance-construction-and-maintenance-in-aphasia-rehabilitation-post-stroke
#11
Michelle Lawton, Karen Sage, Gillian Haddock, Paul Conroy, Laura Serrant
BACKGROUND: Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change...
January 18, 2018: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29349856/self-responsibility-rationing-and-treatment-decision-making-managing-moral-narratives-alongside-fiscal-reality-in-the-obesity-surgery-clinic
#12
Amanda Owen-Smith, Joanna Coast, Jenny L Donovan
BACKGROUND: Addressing the prevalence of severe obesity and its concomitant morbidities is widely acknowledged as one of the most pressing global health priorities. Nevertheless, a paucity of effective interventions and universal pressure on health-care budgets means that access to obesity treatments is often limited. Although health-care rationing can be conceived as a socially constructed process, little is known about how decisions emerge within the context of face-to-face doctor-patient interactions...
January 19, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29349733/point-of-care-ultrasound-pocus-of-the-upper-airway
#13
REVIEW
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29349680/ultrasound-evaluation-of-the-airway-in-the-ed-a-feasibility-study
#14
Elizabeth A Hall, Ibrahim Showaihi, Frances S Shofer, Nova L Panebianco, Anthony J Dean
BACKGROUND: Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol...
January 18, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29349639/outcomes-in-syncope-research-a-systematic-review-and-critical-appraisal
#15
Monica Solbiati, Viviana Bozzano, Franca Barbic, Giovanni Casazza, Franca Dipaola, James V Quinn, Matthew J Reed, Robert S Sheldon, Win-Kuang Shen, Benjamin C Sun, Venkatesh Thiruganasambandamoorthy, Raffaello Furlan, Giorgio Costantino
Syncope is the common clinical manifestation of different diseases, and this makes it difficult to define what outcomes should be considered in prognostic studies. The aim of this study is to critically analyze the outcomes considered in syncope studies through systematic review and expert consensus. We performed a systematic review of the literature to identify prospective studies enrolling consecutive patients presenting to the Emergency Department with syncope, with data on the characteristics and incidence of short-term outcomes...
January 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#16
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29349508/impact-of-intervention-time-on-hospital-survival-in-patients-requiring-emergent-airway-management-a-preliminary-study
#17
Kuo-Chuan Hung, Hsiu-Jung Lin, Shao-Wei Hsieh, Cheuk-Kwan Sun
BACKGROUND: The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients. METHODS: Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a...
January 18, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29349487/lay-first-responder-training-in-eastern-uganda-leveraging-transportation-infrastructure-to-build-an-effective-prehospital-emergency-care-training-program
#18
Peter G Delaney, Richard Bamuleke, Yang Jae Lee
BACKGROUND: Though road traffic injuries (RTIs) are a major cause of mortality in East Africa, few countries have emergency medical services. The aim was to create a sustainable and efficient prehospital lay first responder program, creating a system with lay first responders spread through the 53 motorcycle taxi stages of Iganga Municipality. METHODS: One hundred and fifty-four motorcycle taxi riders were taught a first aid curriculum in partnership with a local Red Cross first aid trainer and provided with a first aid kit following WHO guidelines for basic first aid...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29349422/hybrid-management-of-a-ruptured-right-subclavian-artery-aneurysm-dissection
#19
David Drullinsky, Heather Gill, Jason P Bayne, Jean-Francois Morin, Daniel Obrand
Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%). Aneurysms of aberrant subclavian arteries are extremely rare. This results in little experience with their treatment. We describe a case of a patient who presented to the emergency department with a dissection of an aberrant right subclavian artery that later progressed to rupture. Besides hemodynamic instability, this caused an acute superior vena cava syndrome, making airway control difficult. In the operating room, we obtained proximal control through thoracic endovascular aortic repair; median sternotomy was performed for distal control and evacuation of massive hemomediastinum...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349377/emergency-thoracic-endovascular-aortic-repair-with-celiac-artery-coverage-in-hereditary-hemorrhagic-telangiectasia
#20
Yuji Kawano, Yuji Kanaoka, Nobuhiko Hiraiwa, Daisuke Nakatsuka, Minoru Tabata
Celiac artery (CA) coverage during thoracic endovascular aortic repair has been demonstrated to be a feasible and effective strategy for selected cases. However, there is a potential risk of ischemic complications due to CA coverage in patients with certain types of hereditary hemorrhagic telangiectasia (HHT). Herein, we report a case of thoracoabdominal aortic rupture in a patient with HHT that was successfully treated with emergency thoracic endovascular aortic repair covering the CA preceded by hepatic artery bypass...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
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