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Emergency medicine, ER

Lauren L Siewertsz van Reesema, Vasilena Zheleva, Janet S Winston, Rick J Jansen, Carolyn F O'Connor, Andrew J Isbell, Minglei Bian, Rui Qin, Patricia T Bassett, Virginia J Hinson, Kimberly A Dorsch, Brad W Kirby, Robert E Van Sciver, Angela M Tang-Tan, Elizabeth A Harden, David Z Chang, Cynthia A Allen, Roger R Perry, Richard A Hoefer, Amy H Tang
BACKGROUND: Metastatic breast cancer exhibits diverse and rapidly evolving intra- and inter-tumor heterogeneity. Patients with similar clinical presentations often display distinct tumor responses to standard of care (SOC) therapies. Genome landscape studies indicate that EGFR/HER2/RAS "pathway" activation is highly prevalent in malignant breast cancers. The identification of therapy-responsive and prognostic biomarkers is paramount important to stratify patients and guide therapies in clinical oncology and personalized medicine...
September 2016: EBioMedicine
Ting Pan, Wenjing Song, Huichang Gao, Tianjie Li, Xiaodong Cao, Shizhen Zhong, Yingjun Wang
Precise control of stem cells, such as human bone marrow-derived mesenchymal stem cells (hMSCs), is critical for the development of effective cellular therapies for tissue engineering and regeneration medicine. Emerging evidence suggests that several miRNAs act as key regulators of diverse biological processes, including differentiation of various stem cells. In this study, we have described a delivery system for miR-29b using PEI-capped gold nanoparticles (AuNPs) to synergistically promote osteoblastic differentiation...
August 3, 2016: ACS Applied Materials & Interfaces
Thomas R Einarson, Susana Maia-Lopes, Pushpendra Goswami, Basil G Bereza, Kristel Van Impe
OBJECTIVE: Patients with chronic schizophrenia suffer a huge burden, as do their families/caregivers. Treating schizophrenia is costly for health systems. The European Medicines Agency has approved paliperidone palmitate (PP-LAI; Xeplion), an atypical antipsychotic depot; however, its pharmacoeconomic profile in Portugal is unknown. A cost-effectiveness analysis was conducted from the viewpoint of the Portuguese National Health Service. METHODS: PP-LAI was compared with long acting injectables risperidone (RIS-LAI) and haloperidol (HAL-LAI) and oral drugs (olanzapine; oral-OLZ) adapting a 1-year decision tree to Portugal, guided by local experts...
September 2016: Journal of Medical Economics
Braden Hexom, N Seth Trueger, Rachel Levene, Kimon L H Ioannides, David Cherkas
There is a paucity of research on the quality and quantity of clinical teaching in the emergency department (ED) setting. While many factors impact residents' perceptions of attending physicians' educational skill, the authors hypothesized that the amount of time residents spend with attending in direct teaching is a determinant of residents' perception of their shift's educational value. Researchers shadowed emergency medicine (EM) attendings during ED shifts, and recorded teaching time with each resident...
April 8, 2016: Internal and Emergency Medicine
Avi Z Rosenberg, Michael D Armani, Patricia A Fetsch, Liqiang Xi, Tina Thu Pham, Mark Raffeld, Yun Chen, Neil O'Flaherty, Rebecca Stussman, Adele R Blackler, Qiang Du, Jeffrey C Hanson, Mark J Roth, Armando C Filie, Michael H Roh, Michael R Emmert-Buck, Jason D Hipp, Michael A Tangrea
Precision medicine promises to enhance patient treatment through the use of emerging molecular technologies, including genomics, transcriptomics, and proteomics. However, current tools in surgical pathology lack the capability to efficiently isolate specific cell populations in complex tissues/tumors, which can confound molecular results. Expression microdissection (xMD) is an immuno-based cell/subcellular isolation tool that procures targets of interest from a cytological or histological specimen. In this study, we demonstrate the accuracy and precision of xMD by rapidly isolating immunostained targets, including cytokeratin AE1/AE3, p53, and estrogen receptor (ER) positive cells and nuclei from tissue sections...
2016: PloS One
Stephen Hargarten
No abstract text is available yet for this article.
July 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Amy Johnston, Louisa Abraham, Jaimi Greenslade, Ogilvie Thom, Eric Carlstrom, Marianne Wallis, Julia Crilly
Employees in EDs report increasing role overload because of critical staff shortages, budgetary cuts and increased patient numbers and acuity. Such overload could compromise staff satisfaction with their working environment. This integrative review identifies, synthesises and evaluates current research around staff perceptions of the working conditions in EDs. A systematic search of relevant databases, using MeSH descriptors ED/EDs, Emergency room/s, ER/s, or A&E coupled with (and) working environment, working condition/s, staff perception/s, as well as reference chaining was conducted...
February 2016: Emergency Medicine Australasia: EMA
John G Hanly, Kara Thompson, Chris Skedgel
OBJECTIVE: To determine total physician encounters, emergency room (ER) visits, and hospitalizations in an incident cohort of systemic lupus erythematosus (SLE) cases and matched control patients over 13 years. METHODS: A retrospective cohort study was performed utilizing administrative health care data from approximately 1 million people with access to universal health care. Using International Classification of Diseases, Ninth and Tenth Revisions diagnostic codes, 7 SLE case definitions were used...
August 2016: Arthritis Care & Research
Pierre-Géraud Claret, Thierry Boudemaghe, Xavier Bobbia, Andrew Stowell, Élodie Miard, Mustapha Sebbane, Paul Landais, Jean-Emmanuel De La Coussaye
Objective Emergency rooms play an important role by providing continuous access to healthcare 24 h a day, 7 days a week, but the lack of available hospital beds has become a major difficulty. Changing bed management policy could improve patient flow. The aim of the present study was to evaluate the consequences of a change in patient prioritisation on available beds.Methods The study consisted of a computerised bed management simulation based on day-by-day data collected from 1 to 31 January 2013 in a teaching hospital...
October 19, 2015: Australian Health Review: a Publication of the Australian Hospital Association
Zeliha Kocak Tufan, Fatma Civelek Eser, Emre Vudali, Ayse Batirel, Bircan Kayaaslan, Aliye Tanrici Bastug, Deniz Eray, Vedat Turhan, Fazilet Duygu, Duran Tok, Serife Altun, Cemal Bulut, Mehmet A Tasyaran
OBJECTIVES: Sepsis is a severe condition with possible high mortality outcomes. A multicentre-survey to detect the knowledge of the physicians who are involved in sepsis management in daily work was conducted. MATERIALS AND METHODS: The study was held in October 2013. A questionnaire consisting of questions about sepsis bundles was prepared. Eight centers from different regions of the country were invited to join the survey. The questionnaires were introduced to physicians from infectious diseases, internal diseases, emergency (ER) and anaesthesiology departments...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
J-M Castillo, C Agard, M Artifoni, J-M Brisseau, J Connault, C Durant, O Espitia, A Masseau, A Neel, F Perrin, M-A Pistorius, B Planchon, T Ponge, M Hamidou, P Pottier
PURPOSE: Clinical reasoning and treatment challenges within the scope of general practice led to the development of an internal medicine assistance line provided by Nantes University Hospital. The primary outcome of this study was to describe callers' profile, their requests and answers provided. METHODS: A prospective, cross-sectional, observational, descriptive study was undertaken. For each call were identified the calling physician, her/his specialty and work setting, the call's object and adequacy, the answer provided, the time needed to connect with the assistance line, the time devoted by the internal medicine physician to provide an answer to the request, and whether the assistance line prevented a visit to the emergency room...
May 2016: La Revue de Médecine Interne
A Wafaisade, T Paffrath, R Lefering, C Ludwig, M Fröhlich, M Mutschler, M Banerjee, B Bouillon, C Probst
BACKGROUND: Penetrating injuries are rare in European populations so their management represents a particular challenge. The aim was to assess early therapeutic aspects that are associated with favourable outcomes in patients with penetrating trauma. METHODS: Patients with penetrating injuries documented from 2009 to 2013 in the TraumaRegister DGU® were analysed. Patients with a primary admission and an Injury Severity Score (ISS) of at least 9 were included. The Revised Injury Severity Classification (RISC) II score was used for mortality prediction, and a standardized mortality ratio (SMR) calculated per hospital...
September 2015: British Journal of Surgery
H Trentzsch, S Imach, T Kohlmann, B Urban, L Lazarovici, S Prückner
BACKGROUND: Every year preventable adverse events endanger a considerable number of patients. Current guidelines of the Federal Joint Committee require clinical quality management to provide amongst others an independent clinical risk management and a critical incident reporting system (CIRS). Such guidelines increase the pressure to actively deal with errors, even in emergency medicine. Human error is considered to be the main cause of preventable adverse events in high-risk industries, such as aviation...
August 2015: Der Unfallchirurg
Oyvind Thomassen, Clifford Mann, Juma Salum Mbwana, Guttorm Brattebo
BACKGROUND: Mnazi Mmoja Hospital is a tertiary hospital in Zanzibar serving a population of 1.2 million. The emergency department was overcrowded and understaffed and the hospital management initiated a quality improvement project. The aim of this article is to describe the approach, methods and main results of this quality improvement process. METHODS: The Plan-Do-Study-Act (PDSA) method was used in a five-circle process. In addition, a consensus-based approach was performed to identify areas of improvement...
2015: International Journal of Emergency Medicine
Andrea L Schaffer, Sallie-Anne Pearson, Timothy A Dobbins, Chuang C Er, Robyn L Ward, Claire M Vajdic
BACKGROUND: Little is known about patterns of care after a cancer of unknown primary (CUP) diagnosis. METHODS: We performed a retrospective cohort study to describe and compare the treatment, health service use and survival of patients with CUP and metastatic cancer of known primary among 143,956 Australian Government Department of Veterans' Affairs clients, 2004-2007. We randomly matched clients with CUP (C809; n=252) with clients with a first diagnosis of metastatic solid cancer of known primary (n=980)...
August 2015: Cancer Epidemiology
Jin-yong Shin, Hak Chang
A 34-year-old-female patient visited our emergency room for symptoms of disturbance of urination and shortness of breath. She was diagnosed with rhabdomyolysis with acute kidney injury after laser-assisted liposuction and required hemodialysis. Although laser-assisted liposuction is a well-used procedure, it can cause local complications, such as burns and skin irregularities, as well as systemic complications, such as infection, fever, and emboli. However, laser-assisted, liposuction-induced rhabdomyolysis has not been reported...
August 2015: Aesthetic Plastic Surgery
M Leitinger, G Kalss, A Rohracher, G Pilz, H Novak, J Höfler, I Deak, G Kuchukhidze, J Dobesberger, A Wakonig, E Trinka
BACKGROUND: Status epilepticus (SE) is a frequent neurological emergency complicated by high mortality and often poor functional outcome in survivors. The aim of this study was to review available clinical scores to predict outcome. METHODS: Literature review. PubMed Search terms were "score", "outcome", and "status epilepticus" (April 9th 2015). Publications with abstracts available in English, no other language restrictions, or any restrictions concerning investigated patients were included...
August 2015: Epilepsy & Behavior: E&B
Theodore G MacKinney, Kamal Raj Soti, Poojan Shrestha, Buddha Basnyat
Camphor is usually used in the USA to repel insects, but it is widely used in other countries as an herb. We report the case of a 52-year-old previously healthy Nepali man who ingested approximately 10 g of pure camphor with therapeutic intention. He developed grand mal seizures, and was evaluated in an emergency room. He failed to recall the camphor ingestion initially, and was treated with phenytoin for new-onset idiopathic seizures. Examining physicians only later found out about his camphor ingestion. Finding the cause of new-onset seizures is often challenging for emergency room physicians, internists and neurologists...
2015: BMJ Case Reports
Dan-Ping Xu, Huan-Lin Wu, Tao-Hua Lan, Xia Wang, Xiao-Gang Sheng, Yu Lin, Song Li, Chao-Yang Zheng
OBJECTIVE: To evaluate the efficacy and safety of a combination therapy using Chinese medicine (CM) Shenzhu Guanxin Recipe (, SGR) and standard Western medicine treatment (SWMT) in patients with angina pectoris after percutaneous coronary intervention (PCI). METHODS: Double-blind randomized controlled trial was used in this experimental procedure. One hundred and eighty-seven patients with coronary heart disease receiving SWMT after PCI were randomly assigned to the treatment (SGR) and control (placebo) groups...
June 2015: Chinese Journal of Integrative Medicine
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