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https://www.readbyqxmd.com/read/29454168/genetic-and-environmental-influences-on-pubertal-hormones-in-human-hair-across-development
#1
Andrew D Grotzinger, Daniel A Briley, Laura E Engelhardt, Frank D Mann, Megan W Patterson, Jennifer L Tackett, Elliot M Tucker-Drob, K Paige Harden
Puberty is a complex biopsychosocial process that can affect an array of psychiatric and medical disorders emerging in adolescence. Although the pubertal process is driven by neuroendocrine changes, few quantitative genetic studies have directly measured puberty-relevant hormones. Hair samples can now be assayed for accumulation of hormones over several months. In contrast to more conventional salivary measures, hair measures are not confounded by diurnal variation or hormonal reactivity. In an ethnically and socioeconomically diverse sample of 1286 child and adolescent twins and multiples from 672 unique families, we estimated genetic and environmental influences on hair concentrations of testosterone, DHEA, and progesterone across the period of 8-18 years of age...
February 12, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29454046/the-psychometric-properties-of-the-mbps-scale-used-to-assess-procedural-pain
#2
Dianne J Crellin, Franz E Babl, Nick Santamaria, Denise Harrison
The Modified Behavioral Pain Scale (MBPS) was designed to assess procedural pain in infants and is considered valid for assessing immunisation pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 children aged six to 42 months undergoing one of four procedures in the emergency department. Positive correlation between MBPS and VASobs pain (r = 0...
February 14, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29453642/repeated-closed-reduction-attempts-of-distal-radius-fractures-in-the-emergency-department
#3
Haggai Schermann, Assaf Kadar, Oleg Dolkart, Franck Atlan, Yishai Rosenblatt, Tamir Pritsch
INTRODUCTION: Repeated attempts of closed reduction of distal radius fractures (DRF) are performed in the emergency department setting to optimize fracture alignment and avoid surgery. The additional manipulation of the fracture may, however, increase dorsal comminution and lead to loss of reduction in the cast. This retrospective cohort study has investigated the effect of second reduction attempt on fracture alignment and comminution. MATERIALS AND METHODS: Six-hundred-eighteen patients with DRF were treated in the medical center in 2007-2010...
February 16, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29453548/-big-data-from-clinical-routine
#4
REVIEW
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
February 16, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29453473/prehospital-events-in-st-elevation-myocardial-infarction-undergoing-primary-angioplasty
#5
Sachin Dhungel, Rabi Malla, Chandramani Adhikari, Arun Maskey, Rajeeb Rajbhandari, Ranjit Sharma, Deewakar Sharma, Man Bhadhur Kc, Ajay Adhikari, Binaya Rauniyar, Dipak Limbu, Milan Gautam
INTRODUCTION: Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty. METHODS: This was a cross sectional study in Shahid Gangalal National Heart Centre for three months...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453418/periodic-reanalysis-of-whole-genome-sequencing-data-enhances-the-diagnostic-advantage-over-standard-clinical-genetic-testing
#6
Gregory Costain, Rebekah Jobling, Susan Walker, Miriam S Reuter, Meaghan Snell, Sarah Bowdin, Ronald D Cohn, Lucie Dupuis, Stacy Hewson, Saadet Mercimek-Andrews, Cheryl Shuman, Neal Sondheimer, Rosanna Weksberg, Grace Yoon, M Stephen Meyn, Dimitri J Stavropoulos, Stephen W Scherer, Roberto Mendoza-Londono, Christian R Marshall
Whole-genome sequencing (WGS) as a first-tier diagnostic test could transform medical genetic assessments, but there are limited data regarding its clinical use. We previously showed that WGS could feasibly be deployed as a single molecular test capable of a higher diagnostic rate than current practices, in a prospectively recruited cohort of 100 children meeting criteria for chromosomal microarray analysis. In this study, we report on the added diagnostic yield with re-annotation and reanalysis of these WGS data ~2 years later...
February 16, 2018: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29453296/understanding-the-characteristics-of-recurrent-visits-to-the-emergency-department-by-paediatric-patients-a-retrospective-observational-study-conducted-at-three-tertiary-hospitals-in-korea
#7
Byung-Soo Kim, Jung-Youn Kim, Sung-Hyuk Choi, Young-Hoon Yoon
OBJECTIVES: The number of paediatric patients visiting the emergency department (ED) continues to rise. In South Korea, approximately 25% of the patients who visit the ED are paediatric patients. In the USA, about 20% of the paediatric population were found to have visited the ED in the past year. A recent study demonstrated that 4.5%-8% of patients account for 25% of all ED visits. Therefore, the aim of this study was to identify the characteristics of recurrent visits. METHODS: Design: retrospective observational study...
February 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29453155/evaluation-of-the-triage-performed-by-registered-nurses-in-the-hospital-cl%C3%A3-nico-universitario-%C3%A2-lozano-blesa%C3%A2-emergency-service-saragossa-spain
#8
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29452973/the-alpha-defensin-test-for-diagnosing-periprosthetic-joint-infection-in-the-setting-of-an-adverse-local-tissue-reaction-secondary-to-a-failed-metal-on-metal-bearing-or-corrosion-at-the-head-neck-junction
#9
Kamil T Okroj, Tyler E Calkins, Erdan Kayupov, Michael M Kheir, Joshua S Bingham, Christopher P Beauchamp, Javad Parvizi, Craig J Della Valle
BACKGROUND: In patients with adverse local tissue reaction (ALTR) secondary to a failed metal-on-metal (MoM) bearing or corrosion at the head-neck junction in a metal-on-polyethylene bearing, ruling in or out periprosthetic joint infection (PJI) can be challenging. Alpha-defensin has emerged as an accurate test for PJI. The purpose of this multicenter, retrospective study was to evaluate the accuracy of the alpha-defensin synovial fluid test in detecting PJI in patients with ALTR. METHODS: We reviewed medical records of 26 patients from 3 centers with ALTR that had an alpha-defensin test performed...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452962/the-role-of-resiliency-and-coping-strategies-in-occurrence-of-positive-changes-in-medical-rescue-workers
#10
Nina Ogińska-Bulik, Magdalena Zadworna-Cieślak
BACKGROUND: Working in the emergency services entails exposure to traumatic events; however, their effects can be both negative and positive. Among the factors determining posttraumatic growth (PTG) after an experienced trauma are the personal resources and coping strategies. The purpose of the research was to investigate the role of resiliency and coping strategies with stress in posttraumatic growth in a group of medical rescue workers. MATERIALS AND METHODS: Data of 80 male medical rescuers who have experienced traumatic event in their worksite were analyzed...
February 13, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29452920/patient-centered-medical-homes-did-not-improve-access-to-timely-follow-up-after-ed-visit
#11
Shih-Chuan Chou, Craig Rothenberg, Alicia Agnoli, Ilse Wiechers, Jason Lott, Jennifer Voorhees, Steven L Bernstein, Arjun K Venkatesh
BACKGROUND: Patients newly insured through coverage expansion under the Affordable Care Act (ACA) may have difficulty obtaining timely primary care follow-up appointments after emergency department (ED) discharge. We evaluated the association between availability of timely follow-up appointment with practice access improvements, including patient-centered medical home (PCMH) designations or extended-hours appointments. METHODS: We performed a secret-shopper audit of primary care practices in greater New Haven, Connecticut...
February 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452918/predictors-of-safe-discharge-for-pediatric-drowning-patients-in-the-emergency-department
#12
Courtney E Brennan, Travis K F Hong, Vincent J Wang
OBJECTIVES: The purpose of this study is to determine if stable, well-appearing, drowning patients who have normal age-adjusted vital signs and pulse oximetry upon arrival to the emergency department may be safely discharged without a prolonged observation period. METHODS: Medical records were retrospectively reviewed for drowning patients presenting to a single pediatric emergency department from 1995 to 2014. Data were collected on vital signs and pulse oximetry at presentation, chest x-ray results, disposition and complications for each encounter...
January 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452744/emerging-concepts-in-diagnosis-and-treatment-of-syncope-by-pacing
#13
REVIEW
Richard Sutton, Jean-Claude Deharo, Michele Brignole, Mohamed H Hamdan
Neuroendocrine syncope is a newly proposed term to embody both syncope of reflex and adenosine-related etiology. Recent publications on tilt testing have revealed the presence of a hypotensive tendency in some patients, even in the face of severe cardioinhibition. This new understanding may allow better selection of older reflex syncope patients, documented by ECG loop recorder, for successful pacing where tilt testing is ideally negative for a good result in terms of few syncope recurrences and prompts a less aggressive management policy when hypotensive medication is required...
February 13, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29452729/postoperative-pneumonia-among-patients-with-and-without-copd-in-spain-from-2001-to-2015
#14
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José María de Miguel-Yanes, Rodrigo Jiménez-García
BACKGROUND: To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD. METHODS: We included hospitalized patients aged ≥40 years whose medical diagnosis included pneumonia and ventilator-associated pneumonia in the secondary's diagnosis field and who were discharged from Spanish hospitals from 2001 to 2015. Irrespectively of the position at the procedures coding list, we retrieved data about the type of surgical procedures using the enhanced ICD-9-CM codes...
February 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29452722/traumatic-lingual-hematoma-resulting-in-bilateral-temporal-mandibular-joint-dislocations
#15
Dhara P Amin, Michael N Cooper, Kim I Newton
BACKGROUND: Lingual hematoma (LH) is a relatively uncommon entity seen after both medical and traumatic etiologies. Regardless of the cause, the feared complication is acute airway obstruction. CASE REPORT: Our case involves a 39-year-old man who presented to the Emergency Department via emergency medical services with an enlarging LH after an unwitnessed fall, suspected to be an alcohol withdrawal seizure. The bleeding was likely exacerbated by previously undiagnosed thrombocytopenia...
February 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452563/code-red-the-essential-yet-neglected-role-of-emergency-care-in-health-law-reform
#16
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452351/impact-of-treatment-delay-on-mortality-in-st-segment-elevation-myocardial-infarction-stemi-patients-presenting-with-and-without-haemodynamic-instability-results-from-the-german-prospective-multicentre-fitt-stemi-trial
#17
Karl Heinrich Scholz, Sebastian K G Maier, Lars S Maier, Björn Lengenfelder, Claudius Jacobshagen, Jens Jung, Claus Fleischmann, Gerald S Werner, Hans G Olbrich, Rainer Ott, Harald Mudra, Karlheinz Seidl, P Christian Schulze, Christian Weiss, Josef Haimerl, Tim Friede, Thomas Meyer
Aims: The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results: Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI)...
February 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29452289/polypharmacy-in-people-with-dementia-associations-with-adverse-health-outcomes
#18
Christoph Mueller, Mariam Molokhia, Gayan Perera, Nicola Veronese, Brendon Stubbs, Hitesh Shetty, David Codling, Jonathan Huntley, Robert Stewart
Polypharmacy has been linked to higher risks of hospitalisation and death in community samples. It is commonly present in people with dementia but these risks have rarely been studied in this population. We aimed investigate associations between polypharmacy and emergency department attendance, any and unplanned hospitalisation, and mortality in patients with dementia. Using a large mental health care database in South London, linked to hospitalisation and mortality data, we assembled a retrospective cohort of patients diagnosed with dementia...
February 13, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29452240/the-effect-of-non-anti-tnf-targeting-biologics-and-small-molecules-on-insulin-resistance-in-inflammatory-arthritis
#19
REVIEW
Francesco Ursini, Emilio Russo, Piero Ruscitti, Roberto Giacomelli, Giovambattista De Sarro
Inflammatory arthritides are chronic diseases characterised by an increase in cardiovascular risk, largely attributable to the synergy between high-grade systemic inflammation and an elevated prevalence of traditional cardiovascular risk factors. Amongst the latter, insulin resistance and type 2 diabetes (T2D) play a key position. Previous studies demonstrated a potential insulin-sensiting effect of anti-TNF biologic medications. For converse, less is known about the role of newer biologics or small molecules...
February 13, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29452047/lessons-learned-from-ebola-vaccine-r-d-during-a-public-health-emergency
#20
Marie-Paule Kieny
In spite of a complete lack of Research and Development (R&D) preparedness, the 2013-2016 West-Africa Ebola experience demonstrated that it is possible to compress R&D timelines to less than a single year, from a more usual decade or longer. This is mostly to be credited to an unprecedented collaborative effort building on the availability of a small number of candidate diagnostic tests, drugs and vaccines that could be moved rapidly into the clinical phase evaluation. The World Health Organization (WHO) led international consultations and activities - including the organization of a successful Ebola vaccine efficacy trial in Guinea - as a contribution to the unprecedented global efforts to control the Ebola epidemic...
February 16, 2018: Human Vaccines & Immunotherapeutics
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