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"Emergency Department" OR "ED" OR "ER" OR "Emergency Medicine" OR "Emergency Nursing" OR "ED" OR "ER"

Xiao-Fen Wen, Min Chen, Yang Wu, Min-Na Chen, Aleksandra Glogowska, Thomas Klonisch, Guo-Jun Zhang
Breast cancer is the second leading cause of cancer death in women worldwide. Incurable metastatic breast disease presents a major clinical challenge and is the main cause of breast cancer-related death. The epithelial-mesenchymal transition (EMT) is a critical early promoter of metastasis. In the present study, we identified a novel role for the inhibitor of DNA binding 2 (Id2), a member of the basic helix-loop-helix protein family, during the EMT of breast cancer. Expression of Id2 was positively correlated with Notch3 in breast cancer cells...
August 14, 2018: Translational Oncology
Manuel Toledo, Elena Fonseca, Marta Olivé, Manuel Requena, Manuel Quintana, Laura Abraira-Del-Fresno, Xavier Salas-Puig, Estevo Santamarina
PURPOSE: A number of antiepileptic drugs (AEDs) are currently available for treating acute seizures. It is recommended to select the initial treatment option according to the type of epileptic syndrome and the patient's clinical characteristics, but little is known about the long-term retention rates of AEDs started in the emergency department. METHODS: We recruited patients admitted with seizures over a two-year period. All patients underwent early neurological assessment, EEG testing, and neuroimaging...
August 11, 2018: Seizure: the Journal of the British Epilepsy Association
Bora İrer, Aylin Çelikhisar, Hakan Çelikhisar, Ozan Bozkurt, Ömer Demir
OBJECTIVE: To determine the presence of lower urinary tract symptoms (LUTS), nocturia, sexual dysfunction (SD) and the status of quality of life (QOL) in men with obstructive sleep apnea syndrome (OSAS) and after continuous positive airway pressure (CPAP) treatment, the changes in the presence of these conditions and the improvements of QOL. MATERIEL AND METHODS: In this study, 126 patients with suspicious diagnosis of OSAS were enrolled prospectively. International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Male LUTS (ICIQ-MLUTS), Overactive Bladder Symptoms Score (OABS-V8), Nocturia Quality of Life (Nqol), voiding diary, International Index of Erectile Function (IIEF-15) questionnaire and Short form 36 (SF-36) to assess the presence of SD, LUTS, nocturia and the status of QOL were filled by patients before polysomnography...
August 14, 2018: Urology
David B Nelson, Danica J Lapid, Kyle G Mitchell, Arlene M Correa, Wayne L Hofstetter, Reza J Mehran, David C Rice, Boris Sepesi, Garrett L Walsh, Ara A Vaporciyan, Stephen G Swisher, Jack A Roth, Mara B Antonoff
BACKGROUND: Previous studies have highlighted important biologic and survival-related differences among men and women with non-small cell lung cancer (NSCLC). However, differences in perioperative or short term outcomes have not been as well characterized. In this study, we investigated differences in the perioperative period and postoperative emergency room visits among men and women after lobectomy for stage I NSCLC. METHODS: A retrospective review was performed of patients who underwent a lobectomy for clinical stage I NSCLC at a single institution from 2010 to 2015...
August 14, 2018: Annals of Thoracic Surgery
Tsun-Kai Chang, David A Lawrence, Min Lu, Jenille Tan, Jonathan M Harnoss, Scot A Marsters, Peter Liu, Wendy Sandoval, Scott E Martin, Avi Ashkenazi
The kinases PERK and IRE1 alleviate endoplasmic reticulum (ER) stress by orchestrating the unfolded protein response (UPR). If stress mitigation fails, PERK promotes cell death by activating pro-apoptotic genes, including death receptor 5 (DR5). Conversely, IRE1-which harbors both kinase and endoribonuclease (RNase) modules-blocks apoptosis through regulated IRE1-dependent decay (RIDD) of DR5 mRNA. Under irresolvable ER stress, PERK activity persists, whereas IRE1 paradoxically attenuates, by mechanisms that remain obscure...
August 16, 2018: Molecular Cell
Jong-Ho Cha, Wen-Hao Yang, Weiya Xia, Yongkun Wei, Li-Chuan Chan, Seung-Oe Lim, Chia-Wei Li, Taewan Kim, Shih-Shin Chang, Heng-Huan Lee, Jennifer L Hsu, Hung-Ling Wang, Chu-Wei Kuo, Wei-Chao Chang, Sirwan Hadad, Colin A Purdie, Aaron M McCoy, Shirong Cai, Yizheng Tu, Jennifer K Litton, Elizabeth A Mittendorf, Stacy L Moulder, William F Symmans, Alastair M Thompson, Helen Piwnica-Worms, Chung-Hsuan Chen, Kay-Hooi Khoo, Mien-Chie Hung
Metformin has been reported to possess antitumor activity and maintain high cytotoxic T lymphocyte (CTL) immune surveillance. However, the functions and detailed mechanisms of metformin's role in cancer immunity are not fully understood. Here, we show that metformin increases CTL activity by reducing the stability and membrane localization of programmed death ligand-1 (PD-L1). Furthermore, we discover that AMP-activated protein kinase (AMPK) activated by metformin directly phosphorylates S195 of PD-L1. S195 phosphorylation induces abnormal PD-L1 glycosylation, resulting in its ER accumulation and ER-associated protein degradation (ERAD)...
August 16, 2018: Molecular Cell
Brian J Christensen, Earl Peter Park, Steven Nelson, Brett J King
PURPOSE: Pain and swelling from a necrotic tooth is a common complaint in emergency departments. These patients impose substantial burdens on hospital budgets and provider time. The initial triage of odontogenic infections can be difficult without advanced knowledge and training in head and neck anatomy and odontogenic disease pathogenesis. The purpose of this study was to determine the frequency with which emergency medicine physicians correctly determine the need for computed tomography (CT) and specialist consultation in patients with odontogenic infections...
July 24, 2018: Journal of Oral and Maxillofacial Surgery
Brian D Sumner, Emily A Grimsley, Niall H Cochrane, Ryan R Keane, Alexis B Sandler, Paul C Mullan, Karen J O'Connell
BACKGROUND: The National Association of EMS Physicians emphasizes the importance of high quality communication between emergency medical services (EMS) providers and emergency department (ED) staff for providing safe, effective care. The Joint Commission has identified ineffective handoff communication as a contributing factor in 80% of serious medical errors. The quality of handoff communication from EMS to ED teams for critically ill pediatric patients needs further exploration. OBJECTIVE: This study assessed the quality of handoff communication between EMS and ED staff during pediatric medical resuscitations...
August 17, 2018: Prehospital Emergency Care
Isabel T Gross, Ryan F Coughlin, David C Cone, Sandy Bogucki, Marc Auerbach, Mark X Cicero
OBJECTIVE: The aim of this study was to assess the staff perception of a global positioning system (GPS) as a patient tracking tool at an emergency department (ED) receiving patients from a simulated mass casualty event. METHODS: During a regional airport disaster drill a plane crash with 46 pediatric patients was simulated. Personnel from airport fire, municipal fire, law enforcement, emergency medical services, and emergency medicine departments were present. Twenty of the 46 patient actors required transport for medical evaluation, and we affixed GPS devices to 12 of these actors...
August 17, 2018: Prehospital Emergency Care
Tyson Schierholtz, Dustin Carter, Alisha Kane, Olivia Kemp, Camille Gallant, Bilal Sheikh, William Johnston, Aleksandra Zecevic
INTRODUCTION: The aging population in Canada is steadily increasing and is placing greater demand on paramedic services, especially through the growing number of non-emergent lift assist (LA) calls. A LA occurs when a person calls paramedic services and requests assistance to get up or mobilize, usually after experiencing a fall. The patient refuses transport to the emergency department for further medical attention. LA calls are time consuming and are non-reimbursable. The increase in number of this call type, specifically amongst older adults, is placing strain on paramedic services...
August 17, 2018: Prehospital Emergency Care
Steven G Schauer, Jason F Naylor, Joseph K Maddry, Carmen Hinojosa-Laborde, Michael D April
BACKGROUND: Tactical Combat Casualty Care (TCCC) guidelines regarding prehospital analgesia agents have evolved. The guidelines stopped recommending intramuscular (IM) morphine in 1996, recommending only intravenous (IV) routes. In 2006, the guidelines recommended oral transmucosal fentanyl citrate (OTFC), and in 2012 it added ketamine via all routes. It remains unclear to what extent prehospital analgesia administered on the battlefield adheres to these guidelines. We seek to describe trends in analgesia administration patterns on the battlefield during 2007-2016...
August 17, 2018: Prehospital Emergency Care
Benjamin J W Kuek, Huihua Li, Susan Yap, Marie X R Ng, Yih Yng Ng, Alexander E White, Marcus E H Ong
OBJECTIVES: This study aims to describe frequent users of Emergency Medical Services (EMS) conveyed to a Singapore tertiary hospital, focusing on a comparison between younger users (age <65) and older users in diagnoses and admission rates. METHODS: All patients conveyed by EMS to a tertiary hospital 4 times or more over a 1-year period in 2015 had their EMS ambulance charts and Emergency Department (ED) electronic records retrospectively analyzed (n = 243), with admission the primary outcome...
August 17, 2018: Prehospital Emergency Care
Lauren C Riney, Cole Brokamp, Andrew F Beck, Wendy J Pomerantz, Hamilton P Schwartz, Todd A Florin
BACKGROUND: Pediatric emergency medical services (EMS) utilization is costly and resource intensive; significant variation exists across large-scale geographies. Less is known about variation at smaller geographic levels where factors including lack of transportation, low health literacy, and decreased access to medical homes may be more relevant. Our objective was to determine whether pediatric EMS utilization varied across Hamilton County, Ohio, census tracts and whether such utilization was associated with socioeconomic deprivation...
August 17, 2018: Prehospital Emergency Care
Hanifi Ipek, Tugrul Kirtiloglu, Emine Diraman, Gokhan Acikgoz
BACKGROUND: The aim of this study was to compare osmotic pressure (OP) 1 week after the gingival depigmentation in two diffeent methods: Er: YAG laser and Kirkland knife. METHODS: This study included 20 patients, 13 women, and 7 men who had esthetic complaints of gingival melanin hyperpigmentation. The left side of the maxilla and mandible were depigmented with Er:YAG laser using air and water spray and the right side was removed with a Kirkland knife. Gingival biopsies were obtained from attached gingiva of operation sides with approximate dimensions of 2 mm × 2 mm before and 1 week after the depigmentation...
August 17, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Andrew K Chang, Polly E Bijur, Ashar Ata, Caron Campbell, Scott Pearlman, Deborah White, Andrew Chertoff, Andrew Restivo, E John Gallagher
OBJECTIVES: Older adults are at risk for undertreatment of pain. We examined IV acetaminophen as an analgesic adjunct to IV opioids in the care of older emergency department (ED) patients with acute severe pain. METHODS: This was a randomized clinical trial conducted in two emergency departments in the Bronx, New York. Eligible adults aged 65 years and older with acute severe pain were randomized to 0.5 mg IV hydromorphone and 1 gram IV acetaminophen or 0.5 mg IV hydromorphone and 100 cc normal saline placebo...
August 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Rebekah C Gullberg, J Jordan Steel, Venugopal Pujari, Joel Rovnak, Dean C Crick, Rushika Perera
Positive strand RNA viruses, such as dengue virus type 2 (DENV2) expand and structurally alter ER membranes to optimize cellular communication pathways that promote viral replicative needs. These complex rearrangements require significant protein scaffolding as well as changes to the ER chemical composition to support these structures. We have previously shown that the lipid abundance and repertoire of host cells are significantly altered during infection with these viruses. Specifically, enzymes in the lipid biosynthesis pathway such as fatty acid synthase (FAS) are recruited to viral replication sites by interaction with viral proteins and displayed enhanced activities during infection...
August 17, 2018: PLoS Pathogens
Laurel O'Connor, Matthew Rebesco, Conor Robinson, Karen Gross, Andrew Castellana, Mark J O'Connor, Marc Restuccia
OBJECTIVE: The goal of this study is to describe complications and outcomes of prehospital ketamine use for agitation as compared to other methods of physical or chemical restraint such as haloperidol plus benzodiazepine or physical restraint only. METHODS: We conducted a single-center retrospective review of patient encounters in which restraint was administered in the prehospital setting. At the beginning of our study window, only physical restraint was available to paramedics managing agitated patients, but subsequently, haloperidol and benzodiazepines were introduced, followed by ketamine two years later...
August 17, 2018: Prehospital Emergency Care
Jane H Brice, Julianne M Cyr, Andrew T Hnat, Trent L Wei, Stephanie Principe, Sarah E Thead, Theodore R Delbridge, James E Winslow, Jonathan R Studnek, Antonio R Fernandez, Emily E Forrest
OBJECTIVE: To characterize key health indicators in Emergency Medical Services (EMS) personnel and identify areas for intervention in order to ensure a strong and capable emergency health workforce. METHODS: Participants were EMS personnel delivering patients to four regional tertiary care emergency departments within North Carolina (NC). After transferring patient care and agreeing to participate, height, weight, and blood pressure (BP) measurements were recorded and each participant completed a questionnaire regarding demographics, activity levels, alcohol consumption, smoking, and medical history...
August 17, 2018: Prehospital Emergency Care
J Hofbrucker, A V Volotka, S Fritzsche
Elliptical dichroism is known in atomic photoionization as the difference in the photoelectron angular distributions produced in nonlinear ionization of atoms by left- and right-handed elliptically polarized light. We theoretically demonstrate that the maximum dichroism |Δ_{ED}|=1 always appears in two-photon ionization of any atom if the photon energy is tuned in so that the electron emission is dominantly determined by two intermediate resonances. We propose the two-photon ionization of atomic helium in order to demonstrate this remarkable phenomenon...
August 3, 2018: Physical Review Letters
S P Burton, C A Hostetler, A L Cook, J W Hair, S T Seaman, S Scola, D B Harper, J A Smith, M A Fenn, R A Ferrare, P E Saide, E V Chemyakin, D Müller
The NASA Langley airborne second-generation High Spectral Resolution Lidar (HSRL-2) uses a density-tuned field-widened Michelson interferometer to implement the HSRL technique at 355 nm. The Michelson interferometer optically separates the received backscattered light between two channels, one of which is dominated by molecular backscattering, while the other contains most of the light backscattered by particles. This interferometer achieves high and stable contrast ratio, defined as the ratio of particulate backscatter signal received by the two channels...
July 20, 2018: Applied Optics
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