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JOURNAL ARTICLE
Martin Roessler, Claudia Schulte, Christoph Bobeth, Danny Wende, Christian Karagiannidis
BACKGROUND: The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of data on characteristics of hospital cases using EMS. OBJECTIVES: To analyze and compare the characteristics of cases hospitalized with and without the use of EMS. MATERIALS AND METHODS: The BARMER health insurance data on more than 2 million hospital cases admitted in 2022 were analyzed...
April 23, 2024: Medizinische Klinik, Intensivmedizin und Notfallmedizin
#2
Delcroix Luca, Tamburello Sara, Innocenti Marco, Campanacci Domenico Andrea
BACKGROUND: Post-oncologic surgical reconstruction of lower limbs in pediatrics remains a challenging topic. Microsurgical techniques allow reconstructions of large bony defects. The use of vascularized fibular flap with allograft has proven to be an ideal biologic construct. We aim to assess the success rate of this operation, including flap survival, bony union, weight-bearing ambulation, and complications in a long-term follow-up in our case series compared to the literature. PATIENTS AND METHODS: Our case-series includes 18 femoral resections (9 osteosarcomas, 8 Ewing sarcoma, and 1 desmoid tumor) and 15 tibial resections (10 osteosarcoma, 4 Ewing sarcoma, and 1 Malignant Fibrous Histiocytoma)...
May 2024: Microsurgery
#3
JOURNAL ARTICLE
Qi En Hong, Jonah Ee Hsiang Kua, Vincent K S Tay, Stephanie L S Chan, Christopher Wei Guang Ho, Jeremy Mingfa Sun
BACKGROUND: The goals of reconstruction have progressed from filling a defect to enhancing function and aesthetic appearance. We aimed to achieve better aesthetic and functional outcomes in terms of shoe fitting and mobility. This is accomplished via a classification of the subunits and aesthetic considerations of the lower limb. METHODS: Between April 2017 and December 2021, 66 cases of lower extremity free fasciocutaneous flap reconstruction cases were included in this retrospective study...
April 2024: Plastic and Reconstructive Surgery. Global Open
#4
JOURNAL ARTICLE
Xiaobing Li, Jing Bai, Xin Guo, Yaqian Mu, Zhengli Di, Gejuan Zhang, Bo Wang, Yun Zhang, Xinyao Liu, Yan Shi, Shinuan Lin, Linyu Wu, Ya Bai, Xuedong Liu
BACKGROUND: Multiple system atrophy (MSA) is a disease with diverse symptoms and the commonly used classifications, MSA-P and MSA-C, do not cover all the different symptoms seen in MSA patients. Additionally, these classifications do not provide information about how the disease progresses over time or the expected outcome for patients. OBJECTIVE: To explore clinical subtypes of MSA with a natural disease course through a data-driven approach to assist in the diagnosis and treatment of MSA...
April 12, 2024: Journal of Parkinson's Disease
#5
JOURNAL ARTICLE
Peter G Passias, Peter S Tretiakov, Oluwatobi O Onafowokan, Matthew Galetta, Nathan Lorentz, Jamshaid M Mir, Ankita Das, Pooja Dave, Renaud Lafage, Timothy Yee, Bassel Diebo, Shaleen Vira, Pawel P Jankowski, Aaron Hockley, Alan Daniels, Andrew J Schoenfeld, Praveen Mummaneni, Carl B Paulino, Virginie Lafage
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To investigate the impact of evolving Enhanced Recovery After Surgery (ERAS) protocols on outcomes after cervical deformity (CD) surgery. BACKGROUND: ERAS can help accelerate patient recovery and assist hospitals in maximizing the incentives of bundled payment models while maintaining high-quality patient care. However, there remains a paucity of literature assessing how developments have impacted outcomes after adult CD surgery...
April 9, 2024: Clinical Spine Surgery
#6
RANDOMIZED CONTROLLED TRIAL
Chunyan Li, Mingshu Tao, Dexian Chen, Qi Wei, Xingyu Xiong, Wenxin Zhao, Wen Tan, Jie Yang, Yuan Han, Hongxing Zhang, Song Zhang, He Liu, Jun-Li Cao
IMPORTANCE: Perioperative anxiety is prevalent among patients undergoing surgical treatment of cancer and often influences their prognosis. Transcranial direct current stimulation (tDCS) has shown potential in the treatment of various anxiety-related disorders, but data on the impact of tDCS on perioperative anxiety are limited. OBJECTIVE: To evaluate the effect of tDCS in reducing perioperative anxiety among patients undergoing laparoscopic colorectal cancer (CRC) resection...
April 1, 2024: JAMA Network Open
#7
JOURNAL ARTICLE
Paul J Braybrook, Hideo Tohira, Deon Brink, Judith Finn, Peter L Buzzacott
INTRODUCTION: Outdoor activities offer physical and mental health benefits. However, incidents can occur requiring ambulance transport to hospital. This study aimed to describe the epidemiology and severity of traumatic and medical incidents for mountain bikers and hikers transported by ambulance within Western Australia. METHODS: This was a retrospective cohort study of ambulance-transported mountain bikers and hikers within Western Australia from 2015 to 2020...
April 18, 2024: Wilderness & Environmental Medicine
#8
JOURNAL ARTICLE
Anna M Johnsen, Petra Wagman, Anders Broström, Eleonor I Fransson
Objectives . This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods . The cross-sectional study ( N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work...
April 18, 2024: International Journal of Occupational Safety and Ergonomics: JOSE
#9
REVIEW
Adaobi Margaret Okonji, Adeyinka G Ishola, Love Bukola Ayamolowo, Omowumi M Femi-Akinlosotu, Boladale Mapayi, Morenike Oluwatoyin Folayan
BACKGROUND: Sexual assault occurring within healthcare settings represents a significant breach of public trust. This scoping review aimed to highlight the profile of people raped, those who committed the rape within the health facilities, and the legal actions taken to resolved cases. METHODS: Media-reported data on incidents of rape in healthcare settings were collected. The search was conducted in May and June 2023, focusing on English-language publications with accessible full texts...
April 16, 2024: BMC Psychology
#10
JOURNAL ARTICLE
A Thomas, J Delic, P Hudson, M Batchelor, H Johannsen, L E Grzeskowiak
BACKGROUND: Anaphylaxis is a potentially life-threatening allergic reaction, with presentations to emergency departments (EDs) increasing across Australia. Understanding the features of those presenting with anaphylaxis and aspects related to its optimal clinical management across the admission, treatment and discharge settings is needed to minimise its impact. We aimed to evaluate the nature and management of presentations related to anaphylaxis across two Australian EDs. METHODS: Retrospective audit of paediatric and adult patients presenting to a community or tertiary level ED with anaphylaxis from 1 May 2018 to 30 April 2019...
April 17, 2024: BMC Emergency Medicine
#11
JOURNAL ARTICLE
M Luz Sánchez-Sánchez, Maria-Arantzazu Ruescas-Nicolau, Anna Arnal-Gómez, Marco Iosa, Sofía Pérez-Alenda, Sara Cortés-Amador
BACKGROUND: Incorporating instrument measurements into clinical assessments can improve the accuracy of results when assessing mobility related to activities of daily living. This can assist clinicians in making evidence-based decisions. In this context, kinematic measures are considered essential for the assessment of sensorimotor recovery after stroke. The aim of this study was to assess the validity of using an Android device to evaluate kinematic data during the performance of a standardized mobility test in people with chronic stroke and hemiparesis...
April 15, 2024: Journal of Neuroengineering and Rehabilitation
#12
JOURNAL ARTICLE
Travis S CreveCoeur, Rajiv R Iyer, Hannah E Goldstein, Mychael W Delgardo, Todd C Hankinson, Mark A Erickson, Sumeet Garg, David L Skaggs, Lindsay Andras, Benjamin C Kennedy, Patrick J Cahill, Lawrence G Lenke, Peter D Angevine, Benjamin D Roye, Michael G Vitale, Anil Mendiratta, Richard C E Anderson
BACKGROUND CONTEXT: Intraoperative neurophysiological monitoring (IONM) is used to reduce the risk of spinal cord injury during pediatric spinal deformity surgery. Significant reduction and/or loss of IONM signals without immediate recovery may lead the surgeon to acutely abort the case. The timing of when monitorable signals return remains largely unknown. PURPOSE: The goal of this study was to investigate the correlation between IONM signal loss, clinical examination, and subsequent normalization of IONM signals after aborted pediatric spinal deformity surgery to help determine when it is safe to return to the operating room...
April 11, 2024: Spine Journal: Official Journal of the North American Spine Society
#13
JOURNAL ARTICLE
Adam J Noble, Beth Morris, Pete Dixon, Amy Mathieson, Leone Ridsdale, Myfanwy Morgan, Jon Dickson, Steve Goodacre, Mike Jackson, Dyfrig Hughes, Anthony Marson, Emily Holmes
INTRODUCTION: Adults presenting to the ambulance service for diagnosed epilepsy are often transported to emergency departments (EDs) despite no clinical need. An alternative care pathway (CP) could allow paramedics to divert them from ED and instigate ambulatory care improvements. To identify the most promising CP configuration for subsequent testing, the COLLABORATE project surveyed people with epilepsy and family/friends who had recently used the English ambulance service to elicit preferences for 288 CP configurations for different seizures...
April 11, 2024: Seizure: the Journal of the British Epilepsy Association
#14
MULTICENTER STUDY
Laura Melero Guijarro, Francisco Martín-Rodríguez, Jesús Álvarez Manzanares, Carlos Del Pozo Vegas, Ancor Sanz García, Miguel Ángel Castro Villamor, Raúl López-Izquierdo
OBJECTIVES: To develop and validate a risk model for 1-year mortality based on variables available from early prehospital emergency attendance of patients with infection. MATERIAL AND METHODS: Prospective, observational, noninterventional multicenter study in adults with suspected infection transferred to 4 Spanish hospitals by advanced life-support ambulances from June 1, 2020, through June 30, 2022. We collected demographic, physiological, clinical, and analytical data...
April 2024: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
#15
JOURNAL ARTICLE
Ömer Taşkın, Nezihat Rana Dişel
OBJECTIVE: This study focuses on adults affected by the February 2023 Turkey earthquakes, aiming to uncover demographic and clinical traits. METHODS: A retrospective analysis of data from adult patients who sought emergency care between February 6 and February 21, 2023, following the earthquakes, was conducted. RESULTS: Among 3072 patients, 1544 (50.3%) of whom were women, trauma (31.1%) was the most prevalent cause of emergency department presentations...
April 11, 2024: Disaster Medicine and Public Health Preparedness
#16
JOURNAL ARTICLE
Ahmad A Abujaber, Ibrahem Albalkhi, Yahia Imam, Abdulqadir Nashwan, Naveed Akhtar, Ibraheem M Alkhawaldeh
OBJECTIVES: Predicting stroke mortality is crucial for personalized care. This study aims to design and evaluate a machine learning model to predict one-year mortality after a stroke. MATERIALS AND METHODS: Data from the National Multiethnic Stroke Registry was utilized. Eight machine learning (ML) models were trained and evaluated using various metrics. SHapley Additive exPlanations (SHAP) analysis was used to identify the influential predictors. RESULTS: The final analysis included 9840 patients diagnosed with stroke were included in the study...
April 15, 2024: Heliyon
#17
JOURNAL ARTICLE
Nezahat Muge Catikkas, Vildan Binay Safer, Suleyman Bas, Deniz Sevindik Gunay, Ayfer Durak, Irem Kirac Utku, Umut Safer
BACKGROUND AND AIMS: There are limited data on the comparison of body compositions between diabetic and non-diabetic patients. We aimed to compare the muscle mass and fat parameters measured by ultrasonography (USG) and dual-energy x-ray absorptiometry (DXA) between older palliative care patients with and without type 2 diabetes mellitus (DM). METHODS: We conducted a prospective, cross-sectional study. We recorded the demographics, comorbidities, blood pressures, microvascular complications, pressure injuries, ambulation and nutritional status, and laboratory parameters...
April 11, 2024: Journal of Clinical Ultrasound: JCU
#18
JOURNAL ARTICLE
Lara Maria Nau, Gunter Laux, Attila Altiner, Joachim Szecsenyi, Rüdiger Leutgeb
BACKGROUND: The increasing number of requests for help for acutely ill patients and their management is a major problem in the health systems of many countries, but especially in Germany. Rescue coordination centers and ambulances in Germany are increasingly overloaded. As a result, rides as a part of rescue operations have been increasing in length for years, yet a relevant proportion of these operations represent low-acuity calls (LACs). The basic objective of this pilot study is the quantitative analysis of the potential misuse of requests to the rescue control center...
April 10, 2024: JMIR Research Protocols
#19
JOURNAL ARTICLE
Oliver Schwartz, Katharina Vill, Michelle Pfaffenlehner, Max Behrens, Claudia Weiß, Jessika Johannsen, Johannes Friese, Andreas Hahn, Andreas Ziegler, Sabine Illsinger, Martin Smitka, Arpad von Moers, Heike Kölbel, Gudrun Schreiber, Nadja Kaiser, Ekkehard Wilichowski, Marina Flotats-Bastardas, Ralf A Husain, Matthias Baumann, Cornelia Köhler, Regina Trollmann, Annette Schwerin-Nagel, Astrid Eisenkölbl, Mareike Schimmel, Martin Fleger, Birgit Kauffmann, Gert Wiegand, Manuela Baumgartner, Christian Rauscher, Sebahattin Cirak, Dieter Gläser, Günther Bernert, Tim Hagenacker, Susanne Goldbach, Kristina Probst-Schendzielorz, Hanns Lochmüller, Wolfgang Müller-Felber, Ulrike Schara-Schmidt, Maggie C Walter, Janbernd Kirschner, Astrid Pechmann
IMPORTANCE: There is increasing evidence that early diagnosis and treatment are key for outcomes in infants with spinal muscular atrophy (SMA), and newborn screening programs have been implemented to detect the disease before onset of symptoms. However, data from controlled studies that reliably confirm the benefits of newborn screening are lacking. OBJECTIVE: To compare data obtained on patients with SMA diagnosed through newborn screening and those diagnosed after clinical symptom onset...
April 8, 2024: JAMA Pediatrics
#20
JOURNAL ARTICLE
Amir Dori, Marianna Scutifero, Luigia Passamano, Dario Zoppi, Lucia Ruggiero, Antonio Trabacca, Luisa Politano
Duchenne muscular dystrophy (DMD) is a devastating X-linked neuromuscular disorder caused by dystrophin gene deletions (75%), duplications (15-20%) and point mutations (5-10%), a small portion of which are nonsense mutations. Women carrying dystrophin gene mutations are commonly unaffected because the wild X allele may produce a sufficient amount of the dystrophin protein. However, approximately 8-10% of them may experience muscle symptoms and 50% of those over 40 years develop cardiomyopathy. The presence of symptoms defines the individual as an affected " symptomatic or manifesting carrier"...
2024: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
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