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https://www.readbyqxmd.com/read/28072708/life-threatening-motor-vehicle-crashes-in-bright-sunlight
#1
Donald A Redelmeier, Sheharyar Raza
: Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28050391/comparison-of-efficacy-and-safety-of-intramuscular-piroxicam-and-tramadol-for-post-operative-pain-in-patients-undergoing-caesarean-delivery
#2
Tejashree Thippeswamy, Bhuvana Krishnaswamy, Girish M Bengalorkar, Narayanaswamy Mariyappa
INTRODUCTION: Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. AIM: To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. MATERIALS AND METHODS: Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28039683/injury-epidemiology-in-iran-a-systematic-review
#3
Saber Azami-Aghdash, Homayoun Sadeghi-Bazargani, Hosein Shabaninejad, Hassan Abolghasem Gorji
BACKGROUND: Injuries are the second greatest cause of mortality in Iran. Information about the epidemiological pattern of injuries is effective in decision-making. In this regard, the aim of the current study is to elaborate on the epidemiology of injuries in Iran through a systematic review. METHODS: Required data were collected searching the following key words and their Persian equivalents; trauma, injury, accident, epidemiology, prevalence, pattern, etiology, risk factors and Iran...
January 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28033266/combined-adductor-canal-block-with-periarticular-infiltration-versus-periarticular-infiltration-for-analgesia-after-total-knee-arthroplasty
#4
Jinhui Ma, Fuqiang Gao, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: Both adductor canal block (ACB) and periarticular infiltration (PI) have been shown to reduce pain after total knee arthroplasty (TKA) without the motor blockade. However, the efficacy and safety of combined ACB with PI (ACB + PI) as compared to PI alone for analgesia after TKA remains controversial. We therefore performed a meta-analysis to compare the effects of ACB + PI with PI alone on pain controll after TKA. METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify studies comparing ACB + PI with PI alone for TKA patients...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#5
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27979421/a-comparison-between-evacuation-from-the-scene-and-interhospital-transportation-using-a-helicopter-for-subarachnoid-hemorrhage
#6
Kouhei Ishikawa, Kazuhiko Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Hiromichi Ohsaka, Yasuaki Nakao, Takuji Yamamoto, Youichi Yanagawa
PURPOSE: We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system METHODS: We retrospectively investigated all of the patients with non-traumatic SAH who were transported by a Dr. Heli between January 2010 and March 2016...
December 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27965227/effects-of-ambulation-and-nondependent-transfers-on-vital-signs-in-patients-receiving-norepinephrine
#7
Rosario Arcaya Nievera, Ann Fick, Hilary K Harris
PURPOSE: To assess the safety of mobilizing patients receiving low-dose norepinephrine (0.05 μg/kg per min) by examining mean arterial pressure and heart rate before and after activity with parameters set by the physician. BACKGROUND: Norepinephrine is a peripheral vasoconstrictor administered for acute hypotension. During activity, blood flows to the periphery to supply muscles with oxygen, which may oppose the norepinephrine vasoconstriction. The safety of mobilizing patients receiving norepinephrine is unclear...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27938449/ems-systems-in-lower-middle-income-countries-a-literature-review
#8
Suryanto, Virginia Plummer, Malcolm Boyle
: Introduction Prehospital care is one of the many issues that require addressing by lower-middle income countries (LMICs) where approximately 90% of global injuries occur. This may arise from more traffic in LMICs, poor road conditions, lack of public awareness of the importance of road safety, and the lack of ability to provide first aid to the victims. However, prehospital care in LMICs remains underdeveloped. Problem There is insufficient evidence regarding the development of prehospital care among LMICs...
December 12, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27931184/postprocedural-radial-artery-occlusion-rate-using-a-sheathless-guiding-catheter-for-left-ventricular-endomyocardial-biopsy-performed-by-transradial-approach
#9
Behrouz Kherad, Clemens Köhncke, Frank Spillmann, Heiner Post, Michel Noutsias, Burkert Pieske, Florian Krackhardt, Carsten Tschöpe
BACKGROUND: For coronary interventions the arterial access via the radial artery is associated with fewer vascular access site complications, and has been shown to reduce major bleeding when compared to the femoral approach. But the endomyocardial biopsy (EMB) approach is usually done by a transfemoral or cervical access known to be associated with an increased risk of artery puncture and its potential complications (i.e., false aneurysm, artery-venous fistula) and needs post-procedural immobilization...
December 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27923422/first-responders-and-prehospital-care-for-road-traffic-injuries-in-malawi
#10
Linda Chokotho, Wakisa Mulwafu, Isaac Singini, Yasin Njalale, Limbika Maliwichi-Senganimalunje, Kathryn H Jacobsen
: Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. METHODS: In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes...
December 7, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27919173/carbon-monoxide-poisoning-during-camping-in-korea
#11
Youn-Jung Kim, Chang Hwan Sohn, Bum Jin Oh, Kyoung Soo Lim, Won Young Kim
OBJECTIVE: The aim of this study was to evaluate the epidemiology and characteristics of unintentional carbon monoxide (CO) poisoning during camping in Korea. METHODS: We performed a retrospective observational study on patients with unintentional camping-related CO poisoning who were admitted to the emergency department (ED) from 1 January 2010 to 31 December 2014. News reports about incidents of camping-related CO poisoning were collected using news search engines...
December 2016: Inhalation Toxicology
https://www.readbyqxmd.com/read/27917268/effects-of-the-genium-knee-system-on-functional-level-stair-ambulation-perceptive-and-economic-outcomes-in-transfemoral-amputees
#12
M Jason Highsmith, Jason T Kahle, Matthew M Wernke, Stephanie L Carey, Rebecca M Miro, Derek J Lura, Bryce S Sutton
Compared to non-microprocessor knees, the C-Leg microprocessor knee (MPK) is bioenergentically and economically more efficient and safer for transfemoral amputation (TFA) patients. The Genium MPK has demonstrated improvements in perceived function, knee kinematics, and physical functional performance compared to C-Leg. Clinical and health economic analyses have not been conducted with the Genium knee system. The purpose of this study was to determine if laboratory determined benefits of Genium are detectable using common clinical assessments and if there are economic benefits associated with its use...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/27893526/effect-of-oxygen-therapy-on-myocardial-salvage-in-st-elevation-myocardial-infarction-the-randomized-soccer-trial
#13
Ardavan Khoshnood, Marcus Carlsson, Mahin Akbarzadeh, Pallonji Bhiladvala, Anders Roijer, David Nordlund, Peter Höglund, David Zughaft, Lizbet Todorova, Arash Mokhtari, Håkan Arheden, David Erlinge, Ulf Ekelund
OBJECTIVE: Recent studies suggest that administration of O2 in patients with acute myocardial infarction may have negative effects. With the use of cardiac MRI (CMR), we evaluated the effects of supplemental O2 in patients with ST elevation myocardial infarction (STEMI) accepted for acute percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This study was a randomized-controlled trial conducted at two university hospitals in Sweden. Normoxic STEMI patients were randomized in the ambulance to either supplemental O2 (10 l/min) or room air until the conclusion of the PCI...
November 23, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27890031/a-national-assessment-of-the-health-and-safety-of-emergency-medical-services-professionals
#14
Melissa A Bentley, Roger Levine
OBJECTIVES: The objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed. METHODS: Data were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#15
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#16
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#17
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27826781/randomized-controlled-trial-comparing-clinical-outcomes-of-3d-and-2d-laparoscopic-surgery-for-gastric-cancer-an-interim-report
#18
Jun Lu, Chao-Hui Zheng, Hua-Long Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chang-Ming Huang
OBJECTIVE: In this study, we evaluated the short-term outcomes following three-dimensional (3D) or two-dimensional (2D) laparoscopic surgery for patients with gastric cancer. BACKGROUND: There is a lack of prospective evidence regarding the safety and efficacy of 3D versus 2D laparoscopic surgery for patients with gastric cancer. Therefore, we conducted a phase III single-center, prospective, randomized, controlled trial to compare 3D and 2D laparoscopic surgery for patients with gastric cancer...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27817198/heart-of-the-tropics-delivering-evidence-based-care-for-acute-coronary-syndromes-in-northern-australia
#19
Greg Starmer, Ryan Schrale
Acute coronary syndromes (ACS) are life-threatening medical emergencies that require urgent treatment, posing particular challenges for systems of health care in regional and remote parts of the world characterised by large distances and widely dispersed populations and healthcare facilities. Northern Australia is such an environment. The prevalence of cardiovascular risk factors, coronary artery disease and ACS (myocardial infarction and unstable angina) in northern Australia is amongst the highest in Australia...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27792443/optimising-patient-safety-when-using-elastomeric-pumps-to-administer-outpatient-parenteral-antibiotic-therapy
#20
Gemma Oliver
Outpatient parenteral antibiotic therapy (OPAT) is a growing area of practice that has numerous benefits for both patients and the healthcare system. In order for OPAT services to be successful, strategies need to be in place to maximise efficiency while providing safe, high-quality care. The use of elastomeric pumps to deliver intravenous (IV) antibiotics can have many benefits for OPAT services; they are cost-effective, easy to use and allow the patient to be fully ambulant. However, plans need to be put in place to make sure their use is safe and effective...
October 27, 2016: British Journal of Nursing: BJN
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