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https://www.readbyqxmd.com/read/29787440/developments-in-biodosimetry-methods-for-triage-with-a-focus-on-x-band-electron-paramagnetic-resonance-in-vivo-fingernail-dosimetry
#1
Steven G Swarts, Jason W Sidabras, Oleg Grinberg, Dmitriy S Tipikin, Maciej M Kmiec, Sergey V Petryakov, Wilson Schreiber, Victoria A Wood, Benjamin B Williams, Ann Barry Flood, Harold M Swartz
Instrumentation and application methodologies for rapidly and accurately estimating individual ionizing radiation dose are needed for on-site triage in a radiological/nuclear event. One such methodology is an in vivo X-band, electron paramagnetic resonance, physically based dosimetry method to directly measure the radiation-induced signal in fingernails. The primary components under development are key instrument features, such as resonators with unique geometries that allow for large sampling volumes but limit radiation-induced signal measurements to the nail plate, and methodological approaches for addressing interfering signals in the nail and for calibrating dose from radiation-induced signal measurements...
July 2018: Health Physics
https://www.readbyqxmd.com/read/29769803/gender-dysphoria-assessment-and-action-for-youth-review-of-health-care-services-and-experiences-of-trans-youth-in-manitoba
#2
Jack Heard, Amanda Morris, Nicole Kirouac, Jennifer Ducharme, Simon Trepel, Brandy Wicklow
Objectives: To describe the paediatric transgender population accessing health care through the Manitoba Gender Dysphoria Assessment and Action for Youth (GDAAY) program, and report youth's experiences accessing health care in Manitoba. Methods: Demographic, medical, surgical and mental health information was extracted from the medical records of youth referred to the GDAAY program (n=174). A 77-item online survey was conducted with a subset of those youth (n=25) to identify common health care experiences and perceptions of trans youth in Manitoba...
May 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#3
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29750130/light-sheet-microscopy-for-slide-free-non-destructive-pathology-of-large-clinical-specimens
#4
Adam K Glaser, Nicholas P Reder, Ye Chen, Erin F McCarty, Chengbo Yin, Linpeng Wei, Yu Wang, Lawrence D True, Jonathan T C Liu
For the 1.7 million patients per year in the U.S. who receive a new cancer diagnosis, treatment decisions are largely made after a histopathology exam. Unfortunately, the gold standard of slide-based microscopic pathology suffers from high inter-observer variability and limited prognostic value due to sampling limitations and the inability to visualize tissue structures and molecular targets in their native 3D context. Here, we show that an open-top light-sheet microscope optimized for non-destructive slide-free pathology of clinical specimens enables the rapid imaging of intact tissues at high resolution over large 2D and 3D fields of view, with the same level of detail as traditional pathology...
July 2017: Nature Biomedical Engineering
https://www.readbyqxmd.com/read/29740815/screening-for-dysglycaemia-in-dental-primary-care-practice-settings-systematic-review-of-the-evidence
#5
REVIEW
Ingrid Glurich, Barbara Bartkowiak, Richard L Berg, Amit Acharya
INTRODUCTION: Increasing prevalence of diabetes and periodontal disease is prompting identification of additional clinical settings to identify patients at risk for dysglycaemia. A systematic review of studies that have examined feasibility of screening for at-risk patients in general dentistry settings at point-of-care (POC) was undertaken. MATERIALS AND METHODS: Systematic review of pragmatic clinical field trials piloting POC screening for dysglycaemia risk in dental settings was undertaken in studies whose primary objective was to explore rates of dysglycaemia among undiagnosed patient populations...
May 8, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29729813/a-two-center-validation-of-patient-does-not-follow-commands-and-three-other-simplified-measures-to-replace-the-glasgow-coma-scale-for-field-trauma-triage
#6
Emily Hopkins, Steven M Green, Michael Kiemeney, Jason S Haukoos
STUDY OBJECTIVE: Out-of-hospital personnel worldwide calculate the 13-point Glasgow Coma Scale (GCS) score as a routine part of field trauma triage. We wish to independently validate a simpler binary assessment to replace the GCS for this task. METHODS: We analyzed trauma center registries from Loma Linda University Health (2003 to 2015) and Denver Health Medical Center (2009 to 2015) to compare the binary assessment "patient does not follow commands" (ie, GCS motor score <6) with GCS score less than or equal to 13 for the prediction of 5 trauma outcomes: emergency intubation, clinically significant brain injury, need for neurosurgical intervention, Injury Severity Score greater than 15, and mortality...
May 2, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29685471/the-age-of-undertriage-current-trauma-triage-criteria-underestimate-the-role-of-age-and-comorbidities-in-early-mortality
#7
Elizabeth R Benjamin, Desmond Khor, Jayun Cho, Subarna Biswas, Kenji Inaba, Demetrios Demetriades
BACKGROUND: National guidelines recommend that prehospital and emergency department (ED) criteria identify patients who might benefit from trauma center triage and highest-level trauma team activation. However, some patients who are seemingly "stable" in the field and do not meet the standard criteria for trauma activation still die. OBJECTIVES: The purpose of this study was to identify these at-risk patients to potentially improve triage algorithms. METHODS: Patients enrolled in the National Trauma Data Bank (2007-2012) were included...
April 19, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29682003/differentiation-in-an-inclusive-trauma-system-allocation-of-lower-extremity-fractures
#8
F S Würdemann, D P J Smeeing, S Ferree, F Nawijn, E J M M Verleisdonk, L P H Leenen, R M Houwert, F Hietbrink
Background: Implementation of an inclusive trauma system leads to reduced mortality rates, specifically in polytrauma patients. Field triage is essential in this mortality reduction. Triage systems are developed to identify patients with life-threatening injuries, and trauma mechanisms are important for triaging. Although complex extremity fractures are mostly non-lethal, these injuries are frequently the result of a high-energy trauma mechanism. The aim of this study is to compare injury and patient characteristics, as well as resource demands, of lower extremity fractures between a level (L)1 and level (L)2 trauma centre in a mature inclusive trauma system...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29667789/updates-and-controversies-in-the-management-of-acute-optic-neuritis
#9
Ethan Meltzer, Sashank Prasad
Optic neuritis remains a common diagnosis with controversial management. Although typical optic neuritis is often associated with "good" recovery of visual acuity, patients are often left with persistent impairments of contrast sensitivity, color vision, and visual field. These permanent visual deficits correlate with structural injury to the anterior visual pathway and are closely linked to visual quality of life. High dose corticosteroids are commonly used for patients with acute optic neuritis...
April 18, 2018: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29648566/sers-based-lateral-flow-assay-for-quantitative-detection-of-c-reactive-protein-as-an-early-bio-indicator-of-a-radiation-induced-inflammatory-response-in-nonhuman-primates
#10
Zhen Rong, Rui Xiao, Shuang Xing, Guolin Xiong, Zuyin Yu, Limei Wang, Xiaofei Jia, Keli Wang, Yuwen Cong, Shengqi Wang
In accidental irradiation situations, rapid in-field evaluation of acute radiation syndrome is critical for effective triage and timely medical treatment of irradiated individuals. A surface-enhanced Raman scattering (SERS)-based lateral flow assay was developed for the quantitative detection of C-reactive protein (CRP) as an early bio-indicator of a radiation-induced inflammatory response in nonhuman primates. Raman reporter-embedded gold-core silver-shell nanoparticles with built-in hot spots were synthesized and conjugated with a CRP detection antibody to serve as SERS tags in the lateral flow assay...
April 12, 2018: Analyst
https://www.readbyqxmd.com/read/29557102/pre-hospital-management-of-decompression-illness-expert-review-of-key-principles-and-controversies
#11
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29540611/ambulance-clinical-triage-for-acute-stroke-treatment-paramedic-triage-algorithm-for-large-vessel-occlusion
#12
Henry Zhao, Lauren Pesavento, Skye Coote, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, Leonid Churilov, Nawaf Yassi, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND PURPOSE: Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability. METHODS: The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher <10 seconds, (2) severe language deficit (if right arm is weak) or gaze deviation/hemineglect assessed by simple shoulder tap test (if left arm is weak), and (3) eligibility and stroke mimic screen...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29502527/expert-consensus-on-the-evaluation-and-diagnosis-of-combat-injuries-of-the-chinese-people-s-liberation-army
#13
Zhao-Wen Zong, Lian-Yang Zhang, Hao Qin, Si-Xu Chen, Lin Zhang, Lei Yang, Xiao-Xue Li, Quan-Wei Bao, Dao-Cheng Liu, Si-Hao He, Yue Shen, Rong Zhang, Yu-Feng Zhao, Xiao-Zheng Zhong
The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army (PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia (MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level II facilities...
February 13, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29468262/a-consensus-based-criterion-standard-for-the-requirement-of-a-trauma-team
#14
Christian Waydhas, Markus Baake, Lars Becker, Boris Buck, Helena Düsing, Björn Heindl, Kai Oliver Jensen, Rolf Lefering, Carsten Mand, T Paffrath, Uwe Schweigkofler, Kai Sprengel, Heiko Trentzsch, Bernd Wohlrath, Dan Bieler
BACKGROUND: Trauma team activation (TTA) represents a considerable expenditure of trauma centre resources. It is mainly triggered by field triage criteria. The overall quality of the criteria may be evaluated based on the rate of over- and undertriage. However, there is no gold standard that defines which adult patients truly require a trauma team. The objective of this study was to develop consensus-based criteria defining the necessity for a trauma team. METHODS: A consensus group was formed by trauma specialists experienced in emergency and trauma care with a specific interest in field triage and having previously participated in guideline development...
February 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29429772/reliability-of-glasgow-coma-score-in-pediatric-trauma-patients
#15
Sandra R DiBrito, Marcelo Cerullo, Seth D Goldstein, Susan Ziegfeld, Dylan Stewart, Isam W Nasr
BACKGROUND: Discordant assessments of Glasgow Coma Score (GCS) following trauma can result in inappropriate triage. This study sought to determine the reliability of prehospital GCS compared to emergency department (ED) GCS. METHODS: We conducted a retrospective review of traumas from 01/2000 to 12/2015 at a Level-1 pediatric trauma center. We evaluated reliability between field and ED GCS using Pearson's correlation. We ascertained the difference between prehospital and ED GCS (delta-GCS)...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29425472/the-use-of-field-triage-in-disaster-and-mass-casualty-incidents-a-survey-of-current-practices-by-ems-personnel
#16
Kevin Ryan, Douglas George, James Liu, Patricia Mitchell, Kerrie Nelson, Ricky Kue
BACKGROUND: Mass casualty incident (MCI) triage and the use of triage tags to assign treatment priorities are not fully implemented despite emergency medical services (EMS) personnel training during drills and exercises. OBJECTIVES: To compare current field triage practices during both training and actual MCIs and identify any potential barriers to use. METHODS: During training sessions from November 2015 through March 2016, an anonymous survey was distributed to personnel in 3 distinct types of paid full-time EMS systems: Boston EMS (2-tiered, municipal third-service); Portland Fire Department (fire department-based ALS); and Stokes County EMS (county-based ALS) combined with Forsyth County EMS (county-based ALS)...
February 9, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29398493/impact-on-quality-when-pediatric-urgent-care-centers-are-staffed-with-radiology-technologists
#17
J Herman Kan, Robert C Orth, Terry A Yen, Erica K Schallert, Wei Zhang, Lane F Donnelly
PURPOSE: The proliferation of pediatric urgent care centers has increased the need for diagnostic imaging support, but the impact of employing radiology technologists at these centers is not known. The purpose of this study was to evaluate radiographic impact and quality at urgent care centers with and without radiology technologists. METHODS: A retrospective case-control study was conducted comparing 235 radiographic examinations (study) performed without and 83 examinations (control) performed with a radiology technologist at the authors' pediatric urgent care centers...
February 2, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29386721/combat-radiology-challenges-and-opportunities
#18
Vivek Sharma, C M Sreedhar, J Debnath
Radiology services in a combat situation are essentially centred on assisting the battle field physicians/surgeons to save/salvage life and limb. Timely and accurate detection of type and mapping of extent of injury can aid in making imaging based triage which can be of immense help to the treating physicians/trauma surgeons. With the availability of rapid assessment (clinical as well as imaging based) and quick transport facility, the focus has gradually been shifting from merely limb-saving to life-saving strategies...
October 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29373044/interactive-effect-between-on-scene-hypoxia-and-hypotension-on-hospital-mortality-and-disability-in-severe-trauma
#19
Min Woo Kim, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Yu Jin Kim, Ki Jeong Hong, Joo Jeong, Tae Han Kim, Jeong Ho Park, So Yeon Kong
BACKGROUND: It is unclear whether effect size of the hypoxia is different on in-hospital mortality and disability according to hypotension status in the field. METHODS: Adult severe trauma (ST) patients during 2012-13 who were treated by emergency medical services (EMS) and had abnormal revised trauma scores in the field or who had positive trauma triage criteria were analyzed. Exposure was hypoxia (<94%) measured by EMS. End points were hospital mortality and disability defined as a Glasgow Outcome Scale that decreased by 2 points or more...
January 26, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29307922/determining-best-practices-in-reconnoitering-sites-for-habitability-potential-on-mars-using-a-semi-autonomous-rover-a-geoheuristic-operational-strategies-test
#20
R A Yingst, J Berger, B A Cohen, B Hynek, M E Schmidt
We tested science operations strategies developed for use in remote mobile spacecraft missions, to determine whether reconnoitering a site of potential habitability prior to in-depth study (a walkabout-first strategy) can be a more efficient use of time and resources than the linear approach commonly used by planetary rover missions. Two field teams studied a sedimentary sequence in Utah to assess habitability potential. At each site one team commanded a human "rover" to execute observations and conducted data analysis and made follow-on decisions based solely on those observations...
March 2017: Acta Astronautica
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