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https://www.readbyqxmd.com/read/29352675/impact-of-intestinal-mannitol-on-hyperammonemia-oxidative-stress-and-severity-of-hepatic-encephalopathy-in-the-ed
#1
Daniel H Montes-Cortés, José L Novelo-Del Valle, Ivonne M Olivares-Corichi, José V Rosas-Barrientos, Luis J Jara, María Pilar Cruz-Domínguez
Hyperammonemia results from hepatic inability to remove nitrogenous products generated by protein metabolism of intestinal microbiota, which leads to hepatic encephalopathy (HE) in chronic liver disease (CLD). In ammonium neurotoxicity, oxidative stress (OxS) plays a pathogenic role. Our objective was to evaluate if intestinal mannitol is as effective and safe as conventional treatment for diminishing hyperammonemia, OxS, and HE in patients with CLD. MATERIAL AND METHODS: We included 30 patients with HE classified by "Haven Criteria for Hepatic Encephalopathy"...
January 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29349422/hybrid-management-of-a-ruptured-right-subclavian-artery-aneurysm-dissection
#2
David Drullinsky, Heather Gill, Jason P Bayne, Jean-Francois Morin, Daniel Obrand
Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%). Aneurysms of aberrant subclavian arteries are extremely rare. This results in little experience with their treatment. We describe a case of a patient who presented to the emergency department with a dissection of an aberrant right subclavian artery that later progressed to rupture. Besides hemodynamic instability, this caused an acute superior vena cava syndrome, making airway control difficult. In the operating room, we obtained proximal control through thoracic endovascular aortic repair; median sternotomy was performed for distal control and evacuation of massive hemomediastinum...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29347791/beyond-the-faster-is-slower-effect
#3
I M Sticco, F E Cornes, G A Frank, C O Dorso
The "faster-is-slower" effect arises when crowded people push each other to escape through an exit during an emergency situation. As individuals push harder, a statistical slowing down in the evacuation time can be achieved. The slowing down is caused by the presence of small groups of pedestrians (say, a small human cluster) that temporarily block the way out when trying to leave the room. The pressure on the pedestrians belonging to this blocking cluster increases for increasing anxiety levels and/or a larger number of individuals trying to leave the room through the same door...
November 2017: Physical Review. E
https://www.readbyqxmd.com/read/29344902/occupational-exposure-to-electromagnetic-fields-in-magnetic-resonance-environment-basic-aspects-and-review-of-exposure-assessment-approaches
#4
Valentina Hartwig, Stefania Romeo, Olga Zeni
The purpose of this review is to make a contribution to build a comprehensive knowledge of the main aspects related to the occupational exposure to electromagnetic fields (EMFs) in magnetic resonance imaging (MRI) environments. Information has been obtained from original research papers published in international peer-reviewed journals in the English language and from documents published by governmental bodies and authorities. An overview of the occupational exposure scenarios to static magnetic fields, motion-induced, time-varying magnetic fields, and gradient and radiofrequency fields is provided, together with a summary of the relevant regulation for limiting exposure...
January 18, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29344747/healthcare-based-on-cloud-electrocardiogram-system-a-medical-center-experience-in-middle-taiwan
#5
Xiu-Shu Zhang, Fang-Yie Leu, Ching-Wen Yang, Lai-Shiun Lai
Electrocardiogram (ECG) as one of the best methods to measure irregular heartbeats is a dispensable method for doctor to diagnose Acute Myocardial Infarction (AMI) patients. Most medical centers in Taiwan implement the reduction of Door to Balloon (D2B) time, which is defined as the time interval starting when an Acute-Myocardial-Infarction patient arrives at the Emergency Department, and ending when a catheter guide wire crosses the culprit lesion as the acute-myocardial-infarction treatment on the patient in the cardiac catheterization room...
January 17, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29344707/effects-of-the-establishment-of-a-trauma-center-and-a-new-protocol-on-patients-with-hemodynamically-unstable-pelvic-fractures-at-a-single-institution-in-korea
#6
Min A Lee, Byungchul Yu, Jungnam Lee, Jae Jeong Park, Gil Jae Lee, Kang Kook Choi, Youngeun Park, Jihun Gwak, Ahram Han
PURPOSE: The aim of this study was to determine whether the outcomes of patients with hemodynamically unstable pelvic bone fractures changed after the introduction of a protocol including extraperitoneal pelvic packing (EPP) and the establishment of a trauma center. METHODS: We analyzed data of adult patients (≥ 18 years old) with hemodynamically unstable pelvic bone fractures who visited a single trauma center from February 2009 to October 2016. In July 2014, a new protocol for pelvic fractures was implemented, and a trauma center was established...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29344661/plasma-levels-of-microrna-21-126-and-423-5p-alter-during-clinical-improvement-and-are-associated-with-the-prognosis-of-acute-heart-failure
#7
Stéfanie Ingrid Dos Reis Schneider, Daiane Silvello, Nidiane Carla Martinelli, Arthur Garbin, Andréia Biolo, Nadine Clausell, Michael Andrades, Kátia Gonçalves Dos Santos, Luís Eduardo Rohde
MicroRNAs are associated with myocardial damage and heart failure (HF). The present study investigated whether the plasma levels of microRNA (miR)‑21, ‑126 and ‑423‑5p alter according to the (de)compensated state of patients with HF and are associated with all‑cause mortality. In 48 patients with HF admitted to the emergency room for an episode of acute decompensation, blood samples were collected to measure miR and B‑type natriuretic peptide levels within 24 h of hospital admission, at the time of hospital discharge, and a number of weeks post‑discharge (chronic stable compensated state)...
January 15, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29344472/status-epilepticus-as-an-unusual-manifestation-of-heat-stroke
#8
Won Gu Lee, So-Young Huh, Jin-Hyung Lee, Bong Goo Yoo, Meyung Kug Kim
Heat stroke (HS) is a medical emergency and life threatening condition, characterized by body temperature over 40°C. This can lead to dysfunction of multiple organs such as the heart, liver, kidneys, lungs, blood coagulation system, and central nervous system. Neurological complications include change in consciousness, cerebellar dysfunction, convulsions, aphasia, muscular weakness, and parkinsonism. Cerebellar syndrome is the most common neurological finding in HS. We report a case of HS presenting with status epilepticus, without any other neurological manifestations...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#9
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29343466/long-term-cardiovascular-prognosis-after-transient-ischemic-attack-associated-predictors
#10
Angel Ois, Ana Zabalza, Antia Moreira, Elisa Cuadrado-Godia, Jordi Jimenez-Conde, Eva Giralt-Steinhauer, Ana Rodríguez-Campello, Carolina Soriano-Tarraga, Jaume Roquer
OBJECTIVE: To determine long-term cardiovascular risk after TIA and to identify the factors associated with increased risk. METHODS: This was a prospective observational registry of TIA patients admitted to the emergency room of our tertiary stroke center from June 2006 to January 2016. New vascular events (NVEs) were recorded from 3 months after TIA onset until June 2017, including both stroke and nonstroke events (coronary and peripheral disease). We registered TIA etiology, age, sex, vascular risk factors, radiologic data, and clinical TIA features and analyzed these variables in relation to NVE long-term risk...
January 17, 2018: Neurology
https://www.readbyqxmd.com/read/29342985/community-based-health-and-exposure-study-around-urban-oil-developments-in-south-los-angeles
#11
Bhavna Shamasunder, Ashley Collier-Oxandale, Jessica Blickley, James Sadd, Marissa Chan, Sandy Navarro, Michael Hannigan, Nicole J Wong
Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites...
January 15, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29342494/how-does-the-patient-react-after-reading-the-informed-consent-form-of-a-gynecological-surgery-a-qualitative-study
#12
Andrea Cristina Amorim, Luis Guilherme Teixeira Dos Santos, Omero Benedicto Poli-Neto, Luiz Gustavo Oliveira Brito
OBJECTIVE:  To analyze the reaction of women after reading the Informed Consent Form (ICF) before undergoing elective gynecological/urogynecological surgeries. METHODS:  A qualitative study with 53 women was conducted between September 2014 and May 2015. The analysis of the content was conducted after a scripted interview was made in a reserved room and transcribed verbatim. We read the ICF once more in front of the patient, and then she was interviewed according to a script of questions about emotions and reactions that occurred about the procedure and her expectations about the intra- and postoperative period...
January 17, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29342270/whole-genome-analysis-reveals-the-evolution-and-transmission-of-an-mdr-dh-nap11-106-clostridium-difficile-clone-in-a-paediatric-hospital
#13
Larry K Kociolek, Egon A Ozer, Dale N Gerding, David W Hecht, Sameer J Patel, Alan R Hauser
Background: Clostridium difficile strain DH/NAP11/106, a relatively antibiotic-susceptible strain, is now the most common cause of C. difficile infection (CDI) among adults in the USA. Objectives: To identify mechanisms underlying the evolution and transmission of an MDR DH/NAP11/106 clone. Methods: WGS (Illumina MiSeq), restriction endonuclease analysis (REA) and antibiotic susceptibility testing were performed on 134 C. difficile isolates collected from paediatric patients with CDI over a 2 year period...
January 12, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29340938/pharmacologic-treatment-of-hypertensive-urgency-in-the-outpatient-setting-a-systematic-review
#14
Claudia L Campos, Charles T Herring, Asima N Ali, Deanna N Jones, James L Wofford, Augustus L Caine, Robert L Bloomfield, Janine Tillett, Karen S Oles
BACKGROUND: Hypertensive urgency (HU), defined as acute severe uncontrolled hypertension without end-organ damage, is a common condition. Despite its association with long-term morbidity and mortality, guidance regarding immediate management is sparse. Our objective was to summarize the evidence examining the effects of antihypertensive medications to treat. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Cochrane Database of Systematic Reviews, Web of Science, Google Scholar, and Embase through May 2016...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29340526/simulating-the-behavior-of-patients-who-leave-a-public-hospital-emergency-department-without-being-seen-by-a-physician-a-cellular-automaton-and-agent-based-framework
#15
Milad Yousefi, Moslem Yousefi, F S Fogliatto, R P M Ferreira, J H Kim
The objective of this study was to develop an agent based modeling (ABM) framework to simulate the behavior of patients who leave a public hospital emergency department (ED) without being seen (LWBS). In doing so, the study complements computer modeling and cellular automata (CA) techniques to simulate the behavior of patients in an ED. After verifying and validating the model by comparing it with data from a real case study, the significance of four preventive policies including increasing number of triage nurses, fast-track treatment, increasing the waiting room capacity and reducing treatment time were investigated by utilizing ordinary least squares regression...
January 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29340508/-space-time-and-power-in-hospital-health-care-contributions-based-on-the-ethnography-of-an-obstetric-center
#16
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29338987/update-on-the-epidemiology-of-scorpion-envenomation-in-the-south-of-tunisia
#17
Olfa Chakroun-Walha, Rim Karray, Mouna Jerbi, Abdennour Nasri, Fadhila Issaoui, Ben Rebeh Amine, Mabrouk Bahloul, Mounir Bouaziz, Hichem Ksibi, Noureddine Rekik
INTRODUCTION: Scorpion envenomation is still a frequent occurance in tropical and subtropical regions. In Tunisia, multiple studies on scorpion envenoming have contributed to an improved understanding of cardiac dysfunction and factors predictive of poor prognosis. These previous studies have contributed to the current standardized management of envenomed patients. However, the epidemiology of scorpion envenoming in Tunisia has not been updated for more than 10 years. The aim of this study was to report an update of the epidemiological features of scorpion envenomation in the southern region of Tunisia...
January 12, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29337091/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-ii-and-iii-data
#18
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: This study aimed to calculate the multiple-level likelihood ratios (LRs) and posttest probabilities for a positive, indeterminate, or negative test result for multidetector computed tomography pulmonary angiography (MDCTPA) ± computed tomography venography (CTV) and magnetic resonance pulmonary angiography (MRPA) ± magnetic resonance venography (MRV) for each clinical probability level (two-, three-, and four-level) for the nine most commonly used clinical prediction rules (CPRs) (Wells, Geneva, Miniati, and Charlotte)...
January 11, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#19
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336766/the-implications-of-transfer-to-an-acute-care-surgical-tertiary-service
#20
Rebecca Britt, Pamela Davis, Anjali Gresens, Leonard Weireter, T J Novosel, Jay Collins, L D Britt
Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER...
December 1, 2017: American Surgeon
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