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Ambulance clinical data

Justin Ralph Abbatemarco, Mary Alissa Willis, Robert G Wilson, Sean J Nagel, Andre G Machado, Francois A Bethoux
OBJECTIVES: Stiff-person syndrome (SPS) is associated with axial rigidity superimposed on sustained muscle spasms. These symptoms commonly interfere with the performance of activities of daily living including ambulation. This retrospective case series evaluates the outcomes of screening tests and chronic infusion of intrathecal baclofen (ITB) in patients diagnosed with SPS treated in our spasticity clinic. MATERIALS AND METHODS: Patients were identified from an institutional review board-approved clinical registry of ITB therapy...
March 13, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Yuko Nakamura, Yoshiaki Saito, Norika Kubota, Wataru Matsumura, Chika Hosoda, Akiko Tamasaki-Kondo, Yoko Nishimura, Yoshihide Sunada, Masuyuki Fukada, Takako Ohno, Yoshihiro Maegaki, Masafumi Matsuo, Yasuko Tokita
AIM: To report on sleep hypercapnia in Becker muscular dystrophy (BMD) at earlier stages than ever recognized. SUBJECTS AND METHODS: This retrospective study examined nocturnal hypercapnia in six young Becker muscular dystrophy (BMD) patients with deletions of one or more exons of DMD gene. Clinical information, consecutive data on forced vital capacity (FVC%), forced expiratory volume in one second (FEV1%), peak expiratory flow (PEF%), peak cough flow (PCF), average PCO2 in all-night monitoring, and left ventricular ejection fraction (LVEF) were reviewed...
March 8, 2018: Brain & Development
Obieze Chiemeka Nwanna-Nzewunwa, Marquise Kouo Ngamby, Elinor Shetter, Georges Alain Etoundi Mballa, Isabelle Feldhaus, Martin Ekeke Monono, Adnan A Hyder, Rochelle Dicker, Kent A Stevens, Catherine Juillard
INTRODUCTION: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. METHODS: In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009...
March 10, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Yingying Hu, Jun Xu, Huadong Zhu, Guoxiu Zhang, Feng Sun, Yazhi Zhang, Xuezhong Yu
OBJECTIVE: To investigate the status of cardiopulmonary resuscitation (CPR) in patients with sudden cardiac arrest (CA) in the emergency department. METHODS: A multicenter prospective observational study was conducted. The patients with CA admitted to 13 hospitals from 6 provinces in four different regions, including North China, Southern China, East China, Southwest China, from July 1st, 2015 to July 31st, 2017 were enrolled. A modified Utstein template was applied to collect clinical data, including general data, CA related data and prognosis, and primary outcome indicator was the return of spontaneous circulation (ROSC) rate, and the secondary outcome indicator was 28-day survival rate...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Koichiro Sota, Yuki Uchiyama, Mitsuhiro Ochi, Shuji Matsumoto, Kenji Hachisuka, Kazuhisa Domen
BACKGROUND: Functional electrical stimulation (FES) for patients with stroke and foot drop is an alternative to ankle foot orthoses. Characteristics of FES responders and non-responders have not been clarified. OBJECTIVES: 1. To investigate the effects of treatment with FES on patients with stroke and foot drop. 2. To determine which factors may relate to responders and non-responders. DESIGN: Multicenter, non-randomized, prospective study...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
Massimo Breccia, Francesca Palandri, Luigiana Luciano, Giulia Benevolo, Massimiliano Bonifacio, Giovanni Caocci, Fausto Castagnetti, Giuseppe A Palumbo, Alessandra Iurlo, Francesco Landi
The incidence of cancer, including myeloproliferative neoplasms (MPNs), is projected to increase significantly due to the growing proportion of people aged > 65 years. These older individuals are a heterogeneous population in terms of fitness, comorbidity, and psychological reserve. Therefore, age per se does not always provide an accurate indication of condition in patients with cancer. Frailty has been proposed as an alternative measure of vulnerability that might better indicate which patients can tolerate standard cancer treatment and those who may benefit from treatment adjustment...
February 22, 2018: Annals of Hematology
Yong Suk Moon, Dong Rak Kwon, Yoon-Jin Lee
Introduction Immobilisation causes significant muscle loss. This study's goal was to investigate the regenerative effect of microcurrent electrical stimulation (MES) on gastrocnemius muscle (GCM) atrophy induced by immobilisation by cast (IC) in rabbits. Methods Fifteen rabbits were divided into 3 groups: IC (group 1), IC and free re-ambulation for 2 weeks after cast removal (CR) (group 2), and IC and MES for 2 weeks after CR (group 3). We evaluated clinical parameters (calf circumference, compound muscle action potential of tibial nerve, thickness of GCM by ultrasound), histomorphometric data (muscle composition and cross sectional area), and immunohistochemistry...
February 21, 2018: Muscle & Nerve
Ashley E Iodence, Anastasia M Olsen, Kirk C McGilvray, Colleen G Duncan, Felix M Duerr
OBJECTIVE To quantitatively measure the amount of pressure induced at the calcaneus and cranial tibial surface of dogs by use of 2 cast configurations. ANIMALS 13 client- or student-owned dogs. PROCEDURES Pressure sensors were placed over the calcaneus and cranial tibial surface. Dogs then were fitted with a fiberglass cast on a pelvic limb extending from the digits to the stifle joint (tall cast). Pressure induced over the calcaneus and proximal edge of the cast at the level of the cranial tibial surface was simultaneously recorded during ambulation...
March 2018: American Journal of Veterinary Research
Melissa K James, R Jonathan Robitsek, Syed M Saghir, Patricia A Gentile, Marylin Ramos, Frances Perez
BACKGROUND: Falls can result in injuries that require rehabilitation and long-term care after hospital discharge. Identifying factors that contribute to prediction of discharge disposition is crucial for efficient resource utilization and reducing cost. Several factors may influence discharge location after hospitalization for a fall. The aim of this study was to examine clinical and non-clinical factors that may predict discharge disposition after a fall. We hypothesized that age, injury type, insurance type, and functional status would affect discharge location...
February 14, 2018: Injury
Lee-Anne Chapple, Adam Deane
PURPOSE OF REVIEW: Gastrointestinal dysmotility occurs frequently in the critically ill. Although the causes underlying dysmotility are multifactorial, both pain and its treatment with exogenous opioids are likely causative factors. The purpose of this review is to describe the effects of pain and opioids on gastrointestinal motility; outline the rationale for and evidence supporting the administration of opioid antagonists to improve dysmotility; and describe the potential influence opioids drugs have on the intestinal microbiome and infectious complications...
February 15, 2018: Current Opinion in Critical Care
George Bozas, Natalie Jeffery, Deiva Ramanujam-Venkatachala, Ged Avery, Andrew Stephens, Hilary Moss, June Palmer, Mandi Elliott, Anthony Maraveyas
Background: An incidental/unsuspected diagnosis of pulmonary embolism (IPE) in cancer patients is a frequent occurrence. This single-institution analysis of uniformly managed patients investigates short and long-term outcomes and proposes a prognostic risk score, aiming to assist clinical decision-making. Methods: Data from a prospectively recorded cohort of 234 consecutive cancer patients with IPE were analysed. Multivariate logistic regression and the Cox regression survival methods were used to identify factors with independent association with early (30-day, 3-month, 6-month) mortality and survival...
2018: Thrombosis Journal
Hilary Z Hu, Nicolas Granger, S Balakrishna Pai, Ravi V Bellamkonda, Nick D Jeffery
Many hundreds of thousands of people around the world are living with the long-term consequences of spinal cord injury and they need effective new therapies. Laboratory research in experimental animals has identified a large number of potentially translatable interventions but transition to the clinic is not straightforward. Further evidence of efficacy in more clinically-relevant lesions is required to gain sufficient confidence to commence human clinical trials. Of the many therapeutic candidates currently available, intraspinally applied chondroitinase ABC has particularly well documented efficacy in experimental animals...
February 9, 2018: Brain: a Journal of Neurology
Courtney A Bishop, Valeria Ricotti, Christopher D J Sinclair, Matthew R B Evans, Jordan W Butler, Jasper M Morrow, Michael G Hanna, Paul M Matthews, Tarek A Yousry, Francesco Muntoni, John S Thornton, Rexford D Newbould, Robert L Janiczek
Subjects with Duchenne Muscular Dystrophy (DMD) suffer from progressive muscle damage leading to diaphragmatic weakness that ultimately requires ventilation. Emerging treatments have generated interest in better characterizing the natural history of respiratory impairment in DMD and responses to therapy. Dynamic (cine) Magnetic Resonance Imaging (MRI) may provide a more sensitive measure of diaphragm function in DMD than the commonly used spirometry. This study presents an analysis pipeline for measuring parameters of diaphragmatic motion from dynamic MRI and its application to investigate MRI measures of respiratory function in both healthy controls and non-ambulant DMD boys...
2018: Frontiers in Neurology
Daniele Magistro, Paolo Riccardo Brustio, Marco Ivaldi, Dale Winfield Esliger, Massimiliano Zecca, Alberto Rainoldi, Gennaro Boccia
BACKGROUND: Accurate measurement devices are required to objectively quantify physical activity. Wearable activity monitors, such as pedometers, may serve as affordable and feasible instruments for measuring physical activity levels in older adults during their normal activities of daily living. Currently few available accelerometer-based steps counting devices have been shown to be accurate at slow walking speeds, therefore there is still lacking appropriate devices tailored for slow speed ambulation, typical of older adults...
2018: PloS One
Eamonn Byrne, Gerard Bury
BACKGROUND: Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring...
February 8, 2018: Irish Journal of Medical Science
Rossella Parini, Paola De Lorenzo, Andrea Dardis, Alberto Burlina, Alessandra Cassio, Paolo Cavarzere, Daniela Concolino, Roberto Della Casa, Federica Deodato, Maria Alice Donati, Agata Fiumara, Serena Gasperini, Francesca Menni, Veronica Pagliardini, Michele Sacchini, Marco Spada, Roberta Taurisano, Maria Grazia Valsecchi, Maja Di Rocco, Bruno Bembi
BACKGROUND: Enzyme replacement therapy (ERT) has deeply modified the clinical history of Infantile Onset Pompe Disease (IOPD). However, its long-term effectiveness is still not completely defined. Available data shows a close relationship between clinical outcome and patients' cross-reactive immunological status (CRIM), being CRIM-negative status a negative prognostic factor. At the same time limited data are available on the long-term treatment in CRIM-positive infants. METHODS: A retrospective multicentre observational study was designed to analyse the long-term effectiveness of ERT in IOPD...
February 8, 2018: Orphanet Journal of Rare Diseases
Ashleigh Delorenzo, Toby St Clair, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Rapid sequence intubation (RSI) is an advanced airway procedure for critically ill or injured patients. Paramedic-performed RSI in the prehospital setting remains controversial, as unsuccessful or poorly conducted RSI is known to result in significant complications. In Victoria, intensive care flight paramedics (ICFPs) have a broad scope of practice including RSI in both the adult and pediatric population. We sought to describe the success rates and characteristics of patients undergoing RSI by ICFPs in Victoria, Australia...
February 6, 2018: Prehospital Emergency Care
LaTonya J Hickson, Bjorg Thorsteinsdottir, Priya Ramar, Megan S Reinalda, Cynthia S Crowson, Amy W Williams, Robert C Albright, Macaulay A Onuigbo, Andrew D Rule, Nilay D Shah
BACKGROUND/AIMS: Over one-third of hospital discharges among dialysis patients are followed by 30-day readmission. The first year after dialysis start is a high-risk time frame. We examined the rate, causes, timing, and predictors of 30-day readmissions among adult, incident dialysis patients. METHODS: Hospital readmissions were assessed from the 91st day to the 15th month after the initiation of dialysis using a Mayo Clinic registry linkage to United States Renal Data System claims during the period January 2001-December 2010...
January 9, 2018: Nephron
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND AND OBJECTIVE: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common presentation to emergency departments (ED) but data regarding its epidemiology and outcomes are scarce. We describe the epidemiology, clinical features, treatment and outcome of patients treated for AECOPD in ED. METHODS: This was a planned sub-study of patients with an ED diagnosis of AECOPD identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study...
February 2, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
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