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https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#1
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29040841/-caught-with-a-body-yet-protected-by-law-calling-911-for-opioid-overdose-in-the-context-of-the-good-samaritan-law
#2
Amanda D Latimore, Rachel S Bergstein
BACKGROUND: To address soaring opioid overdose fatality rates, 41U.S. states have passed Good Samaritan Laws (GSLs) extending legal immunity to overdose bystanders who call for emergency assistance. This study, conducted during the period that followed implementation of a GSL, aimed to characterize current factors determining the decision to call for emergency medical help (911) at the scene of an overdose with specific attention to exploring the role of the GSL as one such factor in decision-making...
October 14, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#3
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29040427/what-is-the-end-of-life-period-trajectories-and-characterization-based-on-primary-caregiver-reports
#4
Jiska Cohen-Mansfield, Rinat Cohen, Michal Skornick-Bouchbinder, Shai Brill
BACKGROUND: As the population lives longer, end of life (EOL) is emerging as a distinct life phase, about which there is still limited understanding. Characterizing this important period is vital for clarifying issues regarding trajectory and decline at EOL and for health service planning on an institutional, communal, and societal level. In this paper we aim to characterize the EOL period, examining the duration and number of EOL stages, as well as the functional, attitudinal and emotional trajectories...
October 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29040244/a-prospective-study-of-the-causes-of-bruises-in-premobile-infants
#5
Kenneth W Feldman, Tricia M Tayama, Leslie E Strickler, Lee A Johnson, Gauri Kolhatkar, Catherine A DeRidder, Dana C Matthews, Robert Sidbury, James A Taylor
OBJECTIVE: This study had 2 objectives. First, to determine the behavior of physicians evaluating premobile infants with bruises. Second, and most importantly, to learn whether infants with unexplained bruising who had been initially evaluated by primary care and emergency department (ED) physicians are as likely to have their bruises attributed to child abuse as those children evaluated by child abuse physicians. METHODS: Primary care, ED, and child abuse pediatricians (CAPs) in King County, Washington, San Mateo, Calif, Albuquerque, NM, La Crosse, Wis, and Torrance, Calif prospectively identified and studied infants younger than 6 months with less than 6 bruises, which were judged by the evaluating clinician to be explained or unexplained after their initial clinical examination...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29040242/epidemiology-and-predictors-of-orbital-fractures-in-children
#6
Andrew F Miller, Daniel M Elman, Paul L Aronson, Amir A Kimia, Mark I Neuman
OBJECTIVES: Data regarding clinical predictors of orbital fractures in children are limited. We sought to describe the epidemiology of pediatric orbital fractures and identify the signs and symptoms of orbital fractures in children. METHODS: We performed a retrospective cohort study of children younger than 22 years who underwent a facial or orbital computed tomography (CT) scan to evaluate for orbital fracture. We included patients presenting to an emergency department of a tertiary care children's hospital between January 2009 and May 2013...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29040241/barriers-to-implementation-of-recommendations-for-transport-of-children-in-ground-ambulances
#7
Rashida H Woods, Manish Shah, Cara Doughty, Anthony Gilchrest
OBJECTIVES: The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. METHODS: We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29037013/angioplasty-stenting-and-other-potential-treatments-of-atherosclerotic-stenosis-of-the-intracranial-arteries-past-present-and-future
#8
REVIEW
Ashley Wabnitz, Marc Chimowitz
Although there is an intuitive appeal to treat symptomatic stenotic intracranial arteries with endovascular therapies such as angioplasty and stenting, current data from randomized trials show intensive medical therapy is far superior for preventing stroke. This is in large part due to the high risk of peri-procedural stroke from angioplasty and stenting. If angioplasty and stenting is to emerge as a proven treatment for intracranial stenosis, endovascular techniques will need to become much safer, identification of patients with intracranial stenosis who are at particularly high risk of stroke despite intensive medical therapy will need to be targeted, and well-designed randomized trials will be necessary to show endovascular therapy is superior to medical therapy in these high-risk patients...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29036955/-comparision-of-risk-factors-and-pathogens-in-patients-with-early-and-late-onset-ventilator-associated-pneumonia-in-intensive-care-unit
#9
Y J Liang, Z L Li, L Wang, B Y Liu, R Y Ding, X C Ma
Objective: To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU). Methods: This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital, China Medical University from Jan 2012 to Jun 2016. Subjects were classified by ventilator status: early-onset VAP (< 5 d ventilation, E-VAP) or late-onset VAP (≥ 5 d ventilation, L-VAP)...
October 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29036855/diagnostic-criteria-for-persistent-postural-perceptual-dizziness-pppd-consensus-document-of-the-committee-for-the-classification-of-vestibular-disorders-of-the-b%C3%A3-r%C3%A3-ny-society
#10
Jeffrey P Staab, Annegret Eckhardt-Henn, Arata Horii, Rolf Jacob, Michael Strupp, Thomas Brandt, Adolfo Bronstein
This paper presents diagnostic criteria for persistent postural-perceptual dizziness (PPPD) to be included in the International Classification of Vestibular Disorders (ICVD). The term PPPD is new, but the disorder is not. Its diagnostic criteria were derived by expert consensus from an exhaustive review of 30 years of research on phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. PPPD manifests with one or more symptoms of dizziness, unsteadiness, or non-spinning vertigo that are present on most days for three months or more and are exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli...
October 7, 2017: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/29036711/impacts-of-electroconvulsive-therapy-on-1-year-outcomes-in-patients-with-schizophrenia-a-controlled-population-based-mirror-image-study
#11
Hai-Ti Lin, Shi-Kai Liu, Ming H Hsieh, Yi-Ling Chien, I-Ming Chen, Shih-Cheng Liao, Hui-Ju Tsai, Chi-Shin Wu
Objectives: Despite the decline in the use of electroconvulsive therapy (ECT) in patients with schizophrenia, ECT augmentation is still recommended for those with poor response to standard pharmacological intervention. However, the effectiveness of augmentation of antipsychotics with ECT on long-term clinical outcomes needs to be verified in an expanded sample. Methods: Patients who were hospitalized for schizophrenia and received ECT for the first time during that hospitalization were identified from the total population health insurance database in Taiwan between 2002 and 2011...
September 23, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29036640/toxicokinetics-of-the-synthetic-cathinone-%C3%AE-pyrrolidinohexanophenone
#12
Yuji Fujita, Toshinori Mita, Kiyotaka Usui, Yoshito Kamijo, Satoshi Kikuchi, Makoto Onodera, Yasuhisa Fujino, Yoshihiro Inoue
Synthetic cathinones inhibit monoamine transporters, such as serotonin, norepinephrine, and dopamine transporters, and act on the central nervous system via increasing synaptic concentrations of monoamines. These compounds, which are highly addictive and potentially poisonous, are new psychoactive substances. In this study, we investigated the toxicokinetics of the synthetic cathinone, α-pyrrolidinohexanophenone (α-PHP), and assessed the relationship between the toxicokinetics and the long-term clinical symptoms induced by α-PHP in a male patient...
September 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29036253/understanding-state-regulation-of-biosimilars-and-effect-on-prescribers
#13
Katerina Yale, Olabola Awosika, Monica Rengifo-Pardo, Alison Ehrlich
Biologics are a mainstay of treatment for many dermatologic conditions, however the high costs can be prohibitive for many patients. A growing market of biosimilar drugs is emerging with the hope of providing patients access to more affordable medications. While the FDA has created an abbreviated licensure pathway for these drugs, states are still in the process of creating regulations regarding their substitution for reference biologics. This article looks to raise awareness of the current federal regulations and the differences among state regulations regarding the use of biosimilars...
October 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29036173/pre-treatment-with-gnrha-or-ulipristal-acetate-prior-to-laparoscopic-and-laparotomic-myomectomy-a-systematic-review-and-meta-analysis
#14
Inge de Milliano, Moniek Twisk, Johannes C Ket, Judith A Huirne, Wouter J Hehenkamp
BACKGROUND: Myomectomy has potential risks of complications. To reduce these risks, medical pre-treatment can be applied to reduce fibroid size and thereby potentially decrease intra-operative blood loss, the need for blood transfusion and emergency hysterectomy. The aim of this systematic review and meta-analysis is to study the effectiveness of medical pre-treatment with Gonadotropin-releasing hormone agonists (GnRHa) or ulipristal acetate prior to laparoscopic or laparotomic myomectomy on intra-operative and post-operative outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/29035989/-it-doesn-t-make-sense-for-us-not-to-have-one-understanding-reasons-why-community-sports-organizations-chose-to-participate-in-a-funded-automated-external-defibrillator-program
#15
Lauren V Fortington, Sheree Bekker, Damian Morgan, Caroline F Finch
OBJECTIVE: Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training. DESIGN: Face-to-face interviews. SETTING: Community sports organizations in Victoria, Australia. PARTICIPANTS: Representatives from 14 organizations who participated in a government-funded AED program...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29035942/phase-ii-randomized-sham-controlled-study-of-renal-denervation-for-individuals-with-uncontrolled-hypertension-wave-iv
#16
Roland E Schmieder, Christian Ott, Stefan W Toennes, Peter Bramlage, Michael Gertner, Omar Dawood, Peter Baumgart, Benjamin O'Brien, Indranil Dasgupta, Georg Nickenig, John Ormiston, Manish Saxena, Andrew S P Sharp, Horst Sievert, Jindrich Spinar, Zdenek Starek, Joachim Weil, Ulrich Wenzel, Adam Witkowski, Melvin D Lobo
OBJECTIVES: The aim of this double-blind, randomized, sham-controlled study was to verify the blood pressure (BP)-lowering efficacy of externally delivered focused ultrasound for renal denervation (RDN). BACKGROUND: Nonrandomized, first proof-of-concept study and experimental evidence suggested that noninvasive techniques of RDN emerged as an alternative approach of RDN to invasive technologies. METHODS: WAVE IV, an international, randomized (1 : 1) sham-controlled, double-blind prospective clinical study, was prematurely stopped...
October 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29035757/pulmonary-hypertension-associated-with-bronchopulmonary-dysplasia-in-preterm-infants
#17
REVIEW
Christine B Bui, Merrin A Pang, Arvind Sehgal, Christiane Theda, Jason C Lao, Philip J Berger, Marcel F Nold, Claudia A Nold-Petry
Bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension (BPD-PH) are chronic inflammatory cardiopulmonary diseases with devastating short- and long-term consequences for infants born prematurely. The immature lungs of preterm infants are ill-prepared to achieve sufficient gas exchange, thus usually necessitating immediate commencement of respiratory support and oxygen supplementation. These therapies are life-saving, but they exacerbate the tissue damage that is inevitably inflicted on a preterm lung forced to perform gas exchange...
October 2, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29034944/power-of-protein-trna-functional-assembly-against-aberrant-aggregation
#18
Charles Bou-Nader, Ludovic Pecqueur, David Cornu, Murielle Lombard, Manuela Dezi, Magali Nicaise, Christophe Velours, Marc Fontecave, Djemel Hamdane
Understanding the mechanisms of protein oligomerization and aggregation is a major concern for biotechnology and medical purposes. However, significant challenges remain in determining the mechanism of formation of these superstructures and the environmental factors that can precisely modulate them. Notably the role that a functional ligand plays in the process of protein aggregation is largely unexplored. We herein address these issues with an original flavin-dependent RNA methyltransferase (TrmFO) used as a protein model since this protein employs a complex set of cofactors and ligands for catalysis...
October 16, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/29034865/patients-attending-emergency-departments
#19
Martin Scherer, Dagmar Lühmann, Agata Kazek, Heike Hansen, Ingmar Schäfer
BACKGROUND: The number of patients in emergency departments has risen steadily in recent years, with a particular increase in patients not requiring urgent treatment. The aim of this study is to characterize this group of patients with respect to their sociodemographic features, health status, and reasons for attending an emergency department. METHODS: PiNo Nord is a cross-sectional observational study representing two full working weeks in five different hospitals...
September 29, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29034649/implementation-a-medical-simulation-curriculum-in-emergency-medicine-residency-program
#20
Amirhossein Jahanshir, Maryam Bahreini, Mohsen Banaie, Mohammad Jallili, Shahram Hariri, Fatemeh Rasooli, Hamed Sotoodehnia, Javad Seyed Hosseini, Arash Safaie, Ehsan Karimi, Ali Labaf, Hadi Mir Fazaelian, Elnaz Vahidi
Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks...
August 2017: Acta Medica Iranica
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