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https://www.readbyqxmd.com/read/29321117/emergency-department-resuscitation-of-pediatric-trauma-patients-in-iraq-and-afghanistan
#1
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29320915/healthcare-utilization-and-costs-associated-with-treatment-for-opioid-dependence
#2
Ankit Shah, Margaret Duncan, Nipun Atreja, Kei Sing Tai, Mugdha Gore
OBJECTIVE: Opioid use disorder (OUD) can be managed with medication assisted therapy (MAT) (methadone [MET], buprenorphine [BUP], or extended-release naltrexone [XR-NTX]) or counseling alone (non-pharmacological therapy [NPT]). The objective of this study was to evaluate healthcare resource utilization and costs associated with XR-NTX compared with alternative treatments for opioid dependence. METHODS: Adults with a diagnosis of opioid dependence who initiated treatment with XR-NTX, BUP, MET, or NPT between January 1, 2011 and December 31, 2014 were identified in the Truven Health MarketScan Commercial administrative claims database...
January 10, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#3
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
January 9, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29311178/using-state-administrative-data-to-identify-social-complexity-risk-factors-for-children
#4
Kimberly C Arthur, Barbara A Lucenko, Irina V Sharkova, Jingping Xing, Rita Mangione-Smith
PURPOSE: Screening for social determinants of health is challenging but critically important for optimizing child health outcomes. We aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use. METHODS: We conducted a retrospective cohort study among children younger than 18 years with Washington State Medicaid insurance coverage (N = 505,367)...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29311114/frequent-use-of-emergency-departments-for-mental-and-substance-use-disorders
#5
Karen Urbanoski, Joyce Cheng, Jürgen Rehm, Paul Kurdyak
OBJECTIVES: We described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD. METHODS: This retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346)...
January 8, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29310686/comparison-of-two-different-coagulation-algorithms-on-the-use-of-allogenic-blood-products-and-coagulation-factors-in-severely-injured-trauma-patients-a-retrospective-multicentre-observational-study
#6
Alexander Kaserer, Mattias Casutt, Kai Sprengel, Burkhardt Seifert, Donat R Spahn, Philipp Stein
BACKGROUND: At the University Hospital Zurich (USZ) and the Cantonal Hospital of Lucerne (LUKS) an individualized goal-directed coagulation and transfusion algorithm was introduced and implemented before 2012 (Coagulation algorithm of the USZ: USZ-Alg; of the LUKS: LUKS-Alg). Main differences between both algorithms are: 1) A target haematocrit-range of 0.21-0.24 (USZ-Alg) vs. a lower haematocrit limit only (LUKS-Alg). 2) Blind coagulation-package in selected cases (LUKS-Alg only). 3) Factor XIII substitution is considered earlier according to the USZ-Alg...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29301703/in-ovol-leucine-administration-stimulates-lipid-metabolisms-in-heat-exposed-male-but-not-female-chicks-to-afford-thermotolerance
#7
Guofeng Han, Hui Yang, Takashi Bungo, Hiromi Ikeda, Yunhao Wang, Linh T N Nguyen, Hatem M Eltahan, Mitsuhiro Furuse, Vishwajit S Chowdhury
Thermal manipulation declined embryonic brain and liver concentrations of leucine (Leu). L-Leu in ovo injection afforded thermotolerance in male broiler chicks. This study aimed to examine the role of in ovo injection of L-Leu in metabolic functions, and differences between male and female broiler chicks in thermotolerance. L-Leu injection was performed in ovo on embryonic day (ED) 7 to reveal its role in metabolic activity in embryos and in post-hatch male and female broiler chicks under heat stress. To examine the metabolic activity of embryos, oxygen (O2) consumption, carbon dioxide (CO2) production, heat production and plasma metabolites were analyzed...
January 2018: Journal of Thermal Biology
https://www.readbyqxmd.com/read/29298247/the-effect-of-early-knowledge-of-respiratory-syncytial-virus-positivity-on-medical-decision-making-and-throughput-time-within-the-pediatric-emergency-department
#8
Jessica Schnell, Lisa Schroeder, Kelly Sinclair, Lina Patel, Denise Dowd
OBJECTIVE: The aim of this study was to evaluate whether early knowledge of respiratory syncytial virus (RSV) positivity by rapid triage-based testing protocol improved emergency department (ED) throughput time and decreased ED ancillary testing and antibiotic administration. METHODS: A retrospective cohort study was performed of ED patients aged 2 to 12 months, presenting November 1 to March 31 for the years 2008-2013. Included patients presented with fever and upper respiratory tract symptoms...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29283705/asthmonia-a-clinical-definition-of-a-commonly-used-colloquial-term
#9
Caleb D Wasser, Anna Grushevsky, Stephanie T Johnson, Sharon R Smith
OBJECTIVE: To describe the clinical characteristics of pediatric asthmonia, a syndrome in which children have both an acute asthma exacerbation and a concomitant diagnosis of community acquired pneumonia. METHODS: A retrospective chart review was conducted on children admitted to Connecticut Children's Medical Center in the pediatric emergency department from January 1, 2012 to December 31, 2012. Children with asthma and pneumonia were identified using ICD-9 codes 493 (asthma) or 482 (pneumonia)...
December 28, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29274187/sex-differences-in-diagnoses-treatment-and-outcomes-for-emergency-department-patients-with-chest-pain-and-elevated-cardiac-troponin
#10
Karin H Humphries, May K Lee, Mona Izadnegahdar, Min Gao, Daniel T Holmes, Frank X Scheuermeyer, Martha Mackay, Andre Mattman, Eric Grafstein
OBJECTIVE: While sex differences in the treatment and outcomes of subjects with acute coronary syndromes are well documented, little is known about the impact of cardiac troponin (cTn) levels obtained in the emergency department (ED) on the observed sex differences. We sought to determine whether cTn levels by chest pain features modify sex differences in diagnosis, treatment and outcomes in patients presenting with chest pain suggestive of ischemia. METHODS: All adults presenting to two hospitals in Vancouver, Canada between May 2008 and Mar 2013 with ischemic chest pain and with cTn testing were included in the study...
December 23, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29273366/effects-of-semielemental-diet-containing-whey-peptides-on-peyer-s-patch-lymphocyte-number-immunoglobulin-a-levels-and-intestinal-morphology-in-mice
#11
Tomoyuki Moriya, Kazuhiko Fukatsu, Midori Noguchi, Makoto Nishikawa, Hiromi Miyazaki, Daizoh Saitoh, Hideki Ueno, Junji Yamamoto
BACKGROUND: Enteral nutrition (EN) is the gold standard of nutritional therapy for critically ill or severely injured patients, because EN promotes gut and hepatic immunity, thereby preventing infectious complications as compared with parenteral nutrition. However, there are many EN formulas with different protein and fat contents. Their effects on gut-associated lymphoid tissue remain unclear. Recently, semielemental diets (SEDs) containing whey peptides as a nitrogen source have been found to be beneficial in patients with malabsorption or pancreatitis...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29250223/california-study-of-ablation-caabl-early-utilization-after-index-hospitalization-for-non-valvular-atrial-fibrillation
#12
Uma Srivatsa, Beate Danielsen, Ezra Amsterdam, Yingbo Yang, Dali Fan, Nayereh Pezeshkian, Richard H White
Background: Catheter ablation (ABL) for non-valvular AF (NVAF) is recommended for symptomatic patients refractory to medical therapy and its success is related to the duration of the arrhythmia prior to intervention.Our aim was to assess the early utilization and the factors that prompted ABL in patients hospitalized for new onset NVAF. Methods: Using de-identified administrative discharge records for hospitalizations and emergency department (ED) visits, we determined the patients who had a first-time (since 1991) health record diagnosis of AF between2005 - 2011...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29249343/a-universal-deep-learning-approach-for-modeling-the-flow-of-patients-under-different-severities
#13
Shancheng Jiang, Kwai-Sang Chin, Kwok L Tsui
BACKGROUND AND OBJECTIVE: The Accident and Emergency Department (A&ED) is the frontline for providing emergency care in hospitals. Unfortunately, relative A&ED resources have failed to keep up with continuously increasing demand in recent years, which leads to overcrowding in A&ED. Knowing the fluctuation of patient arrival volume in advance is a significant premise to relieve this pressure. Based on this motivation, the objective of this study is to explore an integrated framework with high accuracy for predicting A&ED patient flow under different triage levels, by combining a novel feature selection process with deep neural networks...
February 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29247351/round-the-clock-performance-of-coronary-ct-angiography-for-suspected-acute-coronary-syndrome-results-from-the-beacon-trial
#14
Marisa M Lubbers, Admir Dedic, Akira Kurata, Marcel Dijkshoorn, Jeroen Schaap, Jeroen Lammers, Evert J Lamfers, Benno J Rensing, Richard L Braam, Hendrik M Nathoe, Johannes C Post, Pleunie P Rood, Carl J Schultz, Adriaan Moelker, Mohamed Ouhlous, Bas M van Dalen, Eric Boersma, Koen Nieman
OBJECTIVE: To assess the image quality of coronary CT angiography (CCTA) for suspected acute coronary syndrome (ACS) outside office hours. METHODS: Patients with symptoms suggestive of an ACS underwent CCTA at the emergency department 24 hours, 7 days a week. A total of 118 patients, of whom 89 (75 %) presented during office hours (weekdays between 07:00 and 17:00) and 29 (25 %) outside office hours (weekdays between 17:00 and 07:00, weekends and holidays) underwent CCTA...
December 15, 2017: European Radiology
https://www.readbyqxmd.com/read/29247042/intravenous-versus-oral-paracetamol-for-acute-pain-in-adults-in-the-emergency-department-setting-a-prospective-double-blind-double-dummy-randomised-controlled-trial
#15
Jeremy Furyk, Deahnne Levas, Benjamin Close, Kathryn Laspina, Meghan Fitzpatrick, Kelvin Robinson, Venkat N Vangaveti, Robin Ray
OBJECTIVE: To determine if intravenous paracetamol was superior to oral paracetamol as an adjunct to opioids in the management of moderate to severe pain in the ED setting. METHODS: A prospective, randomised, double-blind, double-dummy, controlled trial was conducted at a single academic tertiary care ED. Adult patients with moderate to severe pain were randomly assigned to receive either the intravenous paracetamol or oral paracetamol. The primary outcome was Visual Analogue Scale (VAS) pain reduction at 30 min...
December 15, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29245337/assessment-of-pulmonary-arterial-enhancement-on-ct-pulmonary-angiography-using-a-leg-vein-for-contrast-media-administration
#16
Cherry Kim, Choong Wook Lee, Gil-Sun Hong, Gihong Kim, Ki Yeol Lee, Sung-Soo Kim
The purpose of our study was to compare pulmonary artery (PA) enhancement according to venous routes of contrast media (CM) administration in patients who underwent CT pulmonary angiography (CTPA) in the emergency department (ED).This retrospective study reviewed the CTPAs of 24 patients who administered CM via leg veins (group A) and 72 patients via arm veins (group B) with age and gender matching at a ratio of 1:3. Clinical data, aorta attenuation (Aoatten), and PA attenuation (PAatten) were compared between group A and B...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243367/vaccinations-are-not-associated-with-inhibitor-development-in-boys-with-severe-haemophilia-a
#17
H Platokouki, K Fischer, S C Gouw, A Rafowicz, M Carcao, G Kenet, R Liesner, K Kurnik, G E Rivard, H M van den Berg
BACKGROUND: Inhibitor development in previously untreated patients (PUPs) with severe haemophilia A is a multifactorial event. It is unknown whether paediatric vaccinations given in close proximity to factor VIII (FVIII) are associated with inhibitor development. OBJECTIVE: To assess whether paediatric vaccinations in close proximity to FVIII within the first 75 exposure days (EDs) are associated with inhibitor development in PUPs with severe haemophilia A. METHODS: We included 375 PUPs with severe haemophilia A (<0...
December 15, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29239753/the-use-of-intranasal-analgesia-for-acute-pain-control-in-the-emergency-department-a-literature-review
#18
REVIEW
Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov
BACKGROUND: Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED. METHODS: The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29229301/earlier-initiation-of-community-based-palliative-care-is-associated-with-fewer-unplanned-hospitalisations-and-emergency-department-presentations-in-the-final-months-of-life-a-population-based-study-amongst-cancer-decedents
#19
Cameron M Wright, David Youens, Rachael E Moorin
CONTEXT: While community-based palliative care (CPC) is associated with decreased acute care use in the lead up to death, it is unclear how the timing of CPC initiation affects this association. OBJECTIVES: We aimed to explore the association between timing of CPC initiation and hospital use, over the final 1, 3, 6 and 12 months of life. METHODS: We conducted a retrospective, population-based study in Perth, Western Australia. Linked administrative data including cancer registry, mortality, hospital admissions, emergency department (ED) and CPC records were obtained for cancer decedents from 1 January 2001 to 31 December 2011...
December 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29215420/interdisciplinary-guidelines-for-care-of-women-presenting-to-the-emergency-department-with-pregnancy-loss
#20
Anita Catlin
In April 2016, the National Perinatal Association and Kaiser Permanente Northern California Nursing Research Community Benefits Grant sponsored an interdisciplinary summit to explore the needs of women who present with actual or potential pregnancy loss to the emergency department (ED). Thirty-two experts in the field of pregnancy loss, 17 of whom represented their professional organizations, participated. These experts, which included nurses, physicians, social workers, counselors, authors, and parents, worked together to create guidelines for care of women with a pregnancy loss in the ED...
January 2018: MCN. the American Journal of Maternal Child Nursing
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