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https://www.readbyqxmd.com/read/28541852/the-pennsylvania-trauma-outcomes-study-risk-adjusted-mortality-model-results-of-a-statewide-benchmarking-program
#1
Douglas J Wiebe, Daniel N Holena, M Kit Delgado, Nathan McWilliams, Juliet Altenburg, Brendan G Carr
Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups)...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28538625/a-metric-of-our-own-failure-to-rescue-after-trauma
#2
Daniel N Holena, Elinore J Kaufman, M Kit Delgado, Douglas J Wiebe, Brendan G Carr, Jason D Christie, Patrick M Reilly
BACKGROUND: Failure to rescue (FTR) is defined as death after an adverse event. The original metric was derived in elective surgical populations and reclassifies deaths not preceded by recorded adverse events as FTR cases under the assumption these deaths resulted from missed adverse events. This approach lacks face validity in trauma because patients often die without adverse events as a direct result of injury. Another common approach simply excludes deaths without recorded adverse events, but this approach reduces the reliability of the FTR metric...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28431492/anti-drug-antibodies-in-colombian-patients-with-rheumatoid-arthritis-treated-with-enbrel-vs-etanar-preliminary-report
#3
Benjamín Reyes-Beltrán, Gabriela Delgado
The present study was undertaken to detect antibodies against etanercept (ETN) in a group of Colombian patients with rheumatoid arthritis (RA) and being treated with Enbrel(®) vs. Etanar(®). From these patients with RA, clinical and laboratory data were collected and serum taken for anti-drug antibody (ADAb) analysis. Samples from 32 patients (16 who had been treated with Enbrel(®) and 16 with Etanar(®)) were analyzed. Positive sera for ADAb were found in six of the 32 subjects (18.7%); five (31.2%) in the Enbrel(®) group and one (6...
December 2017: Journal of Immunotoxicology
https://www.readbyqxmd.com/read/28423170/us-emergency-department-encounters-for-law-enforcement-associated-injury-2006-2012
#4
Elinore J Kaufman, David N Karp, M Kit Delgado
No abstract text is available yet for this article.
April 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28410919/factors-associated-with-hospital-admission-after-an-emergency-department-treat-and-release-visit-for-older-adults-with-injuries
#5
Emily C Earl-Royal, Elinore J Kaufman, Alexandra L Hanlon, Daniel N Holena, Kristin L Rising, M Kit Delgado
INTRODUCTION: Emergency Department (ED) visits for injury often precede hospital admissions in older adults, but risk factors for these admissions are poorly characterized. We sought to determine the incidence and risk factors for hospitalization shortly following discharge home from an ED visit for traumatic injury in older adults. We hypothesized higher risk for admission in those with increased age, discharged home after falls, with increased comorbidity burden, and who live in poor neighborhoods...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28373872/type-i-interferon-gene-response-is-increased-in-early-and-established-rheumatoid-arthritis-and-correlates-with-autoantibody-production
#6
Julio E Castañeda-Delgado, Yadira Bastián-Hernandez, Noe Macias-Segura, David Santiago-Algarra, Jose D Castillo-Ortiz, Ana L Alemán-Navarro, Pedro Martínez-Tejada, Leonor Enciso-Moreno, Yolanda Garcia-De Lira, Diana Olguín-Calderón, Leendert A Trouw, Cesar Ramos-Remus, Jose A Enciso-Moreno
BACKGROUND: Rheumatoid arthritis (RA) is an inflammatory debilitating disease that affects the joints in the early and productive phases of an individual's life. Several cytokines have been linked to the disease pathogenesis and are known to contribute to the inflammatory state characteristic of RA. The participation of type I interferon (IFN) in the pathogenesis of the disease has been already described as well as the identity of the genes that are regulated by this molecule, which are collectively known as the type I IFN signature...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28369814/development-and-validation-of-the-agency-for-healthcare-research-and-quality-measures-of-potentially-preventable-emergency-department-ed-visits-the-ed-prevention-quality%C3%A2-indicators-for-general-health-conditions
#7
Sheryl Davies, Ellen Schultz, Maria Raven, Nancy Ewen Wang, Carol L Stocks, Mucio Kit Delgado, Kathryn M McDonald
OBJECTIVE: To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. DATA SOURCES: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases. STUDY DESIGN: Empirical analyses and structured panel reviews. METHODS: Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process...
March 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28319158/a-morphological-method-for-ammonia-detection-in-liver
#8
Virginia Gutiérrez-de-Juan, Sergio López de Davalillo, David Fernández-Ramos, Lucía Barbier-Torres, Imanol Zubiete-Franco, Pablo Fernández-Tussy, Jorge Simon, Fernando Lopitz-Otsoa, Javier de Las Heras, Paula Iruzubieta, María Teresa Arias-Loste, Erica Villa, Javier Crespo, Raúl Andrade, M Isabel Lucena, Marta Varela-Rey, Shelly C Lu, José M Mato, Teresa Cardoso Delgado, María-Luz Martínez-Chantar
Hyperammonemia is a metabolic condition characterized by elevated levels of ammonia and a common event in acute liver injury/failure and chronic liver disease. Even though hepatic ammonia levels are potential predictive factors of patient outcome, easy and inexpensive methods aiming at the detection of liver ammonia accumulation in the clinical setting remain unavailable. Thus, herein we have developed a morphological method, based on the utilization of Nessler´s reagent, to accurately and precisely detect the accumulation of ammonia in biological tissue...
2017: PloS One
https://www.readbyqxmd.com/read/28316308/where-we-fail-location-and-timing-of-failure-to-rescue-in-trauma
#9
Jennifer J Chung, Emily C Earl-Royal, M Kit Delgado, Jose L Pascual, Patrick M Reilly, Douglas J Wiebe, Daniel N Holena
Failure to rescue (FTR) is an outcome metric that reflects a center's ability to prevent mortality after a major complication. Identifying the timing and location of FTR events could help target efforts to reduce FTR rates. We sought to characterize the timing and location of FTR occurrences at our center, hypothesizing that FTR rates would be highest early after injury and in settings of lower intensity of care. We used data, prospectively collected from 2009 to 2013, on patients ≥16 years old with minimum Abbreviated Injury Score ≥2 from a single institution...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/27720288/variation-in-the-intensity-of-care-for-patients-with-uncomplicated-renal-colic-presenting-to-u-s-emergency-departments
#10
Joshua W Elder, M Kit Delgado, Benjamin I Chung, Elizabeth A Pirrotta, N Ewen Wang
BACKGROUND: Renal colic results in > 1 million ED visits per year, yet there exists a gap in understanding how the majority of these visits, namely uncomplicated cases, are managed. OBJECTIVE: We assessed patient- and hospital-level variation for emergency department (ED) management of uncomplicated kidney stones. METHODS: We identified ED visits from non-elderly adults (aged 19-79 years) with a primary diagnosis indicating renal stone or colic from the 2011 Nationwide Emergency Department Sample...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27695663/adolescent-cellphone-use-while-driving-an-overview-of-the-literature-and-promising-future-directions-for-prevention
#11
M Kit Delgado, Kathryn J Wanner, Catherine McDonald
Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16-19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially...
June 16, 2016: Media and Communication
https://www.readbyqxmd.com/read/27667446/oxidized-ldl-statin-use-morbidity-and-mortality-in-patients-receiving-maintenance-hemodialysis
#12
Sandra Wagner, Mugurel Apetrii, Ziad A Massy, Marcus E Kleber, Graciela E Delgado, Hubert Scharnagel, Winfried März, Marie Metzger, Patrick Rossignol, Alan Jardine, Hallvard Holdaas, Bengt Fellström, Roland Schmieder, Bénédicte Stengel, Faiez Zannad
Statin treatment reduces the risk of cardiovascular mortality in the general population, but it has little or no benefit in hemodialyzed (HD) patients. This may reflect different underlying pathophysiology of cardiovascular disease (CVD) in patients treated with HD, maybe involving the oxidative stress. Our aim was to assess the association of oxidized low-density lipoprotein (oxLDL), determined by Mercodia oxLDL enzyme-linked immunosorbent assay (ELISA) kit, with major adverse cardiac events (MACE) and all-cause mortality in HD patients based on the AURORA trial (rosuvastatin vs placebo), and patients not on HD from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study...
January 2017: Free Radical Research
https://www.readbyqxmd.com/read/27604134/whole-exome-sequencing-analysis-reveals-trpv3-as-a-risk-factor-for-cardioembolic-stroke
#13
Caty Carrera, Jordi Jiménez-Conde, Sophia Derdak, Kelly Rabionet, Cristofol Vives-Bauzá, Carolina Soriano-Tárrega, Eva Giralt-Steinhauer, Marina Mola-Caminal, Rosa M Diaz-Navarro, Silvia Tur, Elena Muiño, Cristina Gallego-Fabrega, Sergi Beltran, Jaume Roquer, Agustin Ruiz, Oscar Sotolongo-Grau, Jurek Krupinski, Jin-Moo Lee, Carlos Cruchaga, Pilar Delgado, Rainer Malik, Brad B Worrall, Sudha Seshadri, Joan Montaner, Israel Fernández-Cadenas
Genetic studies suggest that hundreds of genes associated with stroke remain unidentified. Exome sequencing proves useful for finding new genes associated with stroke. We aimed to find new genetic risk factors for cardioembolic stroke by analysing exome sequence data using new strategies. For discovery, we analysed 42 cardioembolic stroke cases and controls with extreme phenotypes (cohort 1), and for replication, 32 cardioembolic stroke cases and controls (cohort 2) using the SeqCapExome capture kit. We then analysed the replicated genes in two new cohorts that comprised 834 cardioembolic strokes and controls (cohort 3) and 64,373 cardioembolic strokes and controls (cohort 4)...
November 30, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27587425/perceptions-of-family-participation-in-intensive-care-unit-rounds-and-telemedicine-a-qualitative-assessment
#14
Elisabeth A Stelson, Brendan G Carr, Kate E Golden, Niels Martin, Therese S Richmond, M Kit Delgado, Daniel N Holena
BACKGROUND: Family-centered rounds involve purposeful interactions between patients' families and care providers to refocus the delivery of care on patients' needs. OBJECTIVES: To examine perspectives of patients' family members and health care providers on family participation in rounds in the surgical intensive care unit (ICU) and the potential use of telemedicine to facilitate this process. METHODS: Patients' family members and surgical ICU care providers were recruited for semistructured interviews exploring stakeholders' perspectives on family participation in ICU rounds and the potential role of telemedicine...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27524804/hla-genotyping-in-the-clinical-laboratory-comparison-of-next-generation-sequencing-methods
#15
T Profaizer, E Lázár-Molnár, D W Close, J C Delgado, A Kumánovics
Implementation of human leukocyte antigen (HLA) genotyping by next-generation sequencing (NGS) in the clinical lab brings new challenges to the laboratories performing this testing. With the advent of commercially available HLA-NGS typing kits, labs must make numerous decisions concerning capital equipment and address labor considerations. Therefore, careful and unbiased evaluation of available methods is imperative. In this report, we compared our in-house developed HLA NGS typing with two commercially available kits from Illumina and Omixon using 10 International Histocompatibility Working Group (IHWG) and 36 clinical samples...
July 2016: HLA
https://www.readbyqxmd.com/read/27510605/evaluation-of-phosphatidylserine-dependent-antiprothrombin-antibody-testing-for-the-diagnosis-of-antiphospholipid-syndrome-results-of-an-international-multicentre-study
#16
MULTICENTER STUDY
O Amengual, R Forastiero, M Sugiura-Ogasawara, K Otomo, K Oku, C Favas, J Delgado Alves, P Žigon, A Ambrožič, M Tomšič, I Ruiz-Arruza, G Ruiz-Irastorza, M L Bertolaccini, G L Norman, Z Shums, J Arai, A Murashima, A E Tebo, M Gerosa, P L Meroni, I Rodriguez-Pintó, R Cervera, J Swadzba, J Musial, T Atsumi
Objective A task force of scientists at the International Congress on Antiphospholipid Antibodies recognized that phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) might contribute to a better identification of antiphospholipid syndrome (APS). Accordingly, initial and replication retrospective, cross-sectional multicentre studies were conducted to ascertain the value of aPS/PT for APS diagnosis. Methods In the initial study (eight centres, seven countries), clinical/laboratory data were retrospectively collected...
March 2017: Lupus
https://www.readbyqxmd.com/read/27460511/recurrent-violent-injury-magnitude-risk-factors-and-opportunities-for-intervention-from-a-statewide-analysis
#17
Elinore Kaufman, Kristin Rising, Douglas J Wiebe, David J Ebler, Marie L Crandall, M Kit Delgado
INTRODUCTION: Although preventing recurrent violent injury is an important component of a public health approach to interpersonal violence and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established. METHODS: We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following up patients injured in 2010 for recurrence through 2012...
September 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27386120/late-prostatic-metastasis-of-an-uveal-melanoma-in-a-miniature-schnauzer-dog
#18
Esmeralda Delgado, João X Silva, Hugo Pissarra, Maria C Peleteiro, Richard R Dubielzig
This manuscript describes a previously unreported clinical case of canine uveal melanoma in a miniature Schnauzer dog with an unusual location of metastasis (prostate) and delayed occurrence (3 years after primary tumor diagnosis and enucleation). Immunohistochemical labeling of both tumors with Melan A, Ki-67, and c-kit added some valuable information.
July 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27178369/cost-effectiveness-of-field-trauma-triage-among-injured-adults-served-by-emergency-medical-services
#19
Craig D Newgard, Zhuo Yang, Daniel Nishijima, K John McConnell, Stacy A Trent, James F Holmes, Mohamud Daya, N Clay Mann, Renee Y Hsia, Tom D Rea, N Ewen Wang, Kristan Staudenmayer, M Kit Delgado
BACKGROUND: The American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥95% sensitivity and ≥65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared with triage strategies consistent with the national targets. STUDY DESIGN: This was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services agencies to 105 trauma and nontrauma hospitals in 6 regions of the western United States from 2006 through 2008...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26927882/national-differences-in-regional-emergency-department-boarding-times-are-us-emergency-departments-prepared-for-a-public-health-emergency
#20
Jennifer S Love, David Karp, M Kit Delgado, Gregg Margolis, Douglas J Wiebe, Brendan G Carr
OBJECTIVES: Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. METHODS: A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database...
August 2016: Disaster Medicine and Public Health Preparedness
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