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Field triage

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https://www.readbyqxmd.com/read/29139199/in-silico-ligand-based-modeling-of-hbace-1-inhibitors
#1
Govindan Subramanian, Gennady Poda
Alzheimer's disease (AD) is a chronic neurodegenerative disease affecting more than 30 million people worldwide. Development of small molecule inhibitors of human β-secretase 1 (hBACE-1) is being the focus of pharmaceutical industry for the past 15-20 years. Here, we successfully applied multiple ligand-based in silico modeling techniques to understand the inhibitory activities of a diverse set of small molecule hBACE-1 inhibitors reported in the scientific literature. Strikingly, the use of only a small subset of 230 (13%) molecules allowed us to develop quality models that performed reasonably well on the validation set of 1476 (87%) inhibitors...
November 15, 2017: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/29127439/trauma-patients-centralization-for-the-mechanism-of-trauma-old-questions-without-answers
#2
S Magnone, A Ghirardi, M Ceresoli, L Ansaloni
INTRODUCTION: Centralization of trauma patients has become the standard of care. Unfortunately, overtriage can overcome the capability of Trauma Centres. This study aims to analyse the association of different mechanisms of injury with severe or major trauma defined as Injury Severity Score (ISS) greater than 15 and an estimation of overtriage upon our Trauma Centre. METHODS: A retrospective review of our prospective database was undertaken from March 2014 to August 2016...
November 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29108469/the-incidence-of-traumatic-intracranial-hemorrhage-in-head-injured-older-adults-transported-by-ems-with-and-without-anticoagulant-or-antiplatelet-use
#3
Daniel Kiden Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Adam Blitz, Andrew R Elms, Roel D Farrales, James Montoya, Troy Bair, Calvin Howard, Megan Gilbert, Renee Trajano, Kaela Hatchel, Mark Faul, Jeneita M Bell, Victor Coronado, David R Vinson, Dustin W Ballard, Daniel J Tancredi, Hernando Garzon, Kevin E Mackey, Kiarash Shahlaie, James F Holmes
Field triage guidelines recommend transport of head-injured patients on anticoagulants or antiplatelets to a higher-level trauma center based on studies suggesting a high incidence of traumatic intracranial hemorrhage (tICH). We compared the incidence of tICH in older adults transported by EMS with and without anticoagulation or antiplatelet use and evaluated the accuracies of different sets of field triage criteria to identify tICH. This was a prospective, observational study at 5 EMS agencies and 11 hospitals...
November 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29094149/undertriage-remains-a-vexing-problem-for-even-the-most-highly-developed-trauma-systems-the-need-for-innovations-in-field-triage
#4
Craig D Newgard, Tarsicio Uribe-Leitz, Adil H Haider
No abstract text is available yet for this article.
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29094144/accuracy-of-prehospital-triage-in-selecting-severely-injured-trauma-patients
#5
Frank J Voskens, Eveline A J van Rein, Rogier van der Sluijs, Roderick M Houwert, Robert Anton Lichtveld, Egbert J Verleisdonk, Michiel Segers, Ger van Olden, Marcel Dijkgraaf, Luke P H Leenen, Mark van Heijl
Importance: A major component of trauma care is adequate prehospital triage. To optimize the prehospital triage system, it is essential to gain insight in the quality of prehospital triage of the entire trauma system. Objective: To prospectively evaluate the quality of the field triage system to identify severely injured adult trauma patients. Design, Setting, and Participants: Prehospital and hospital data of all adult trauma patients during 2012 to 2014 transported with the highest priority by emergency medical services professionals to 10 hospitals in Central Netherlands were prospectively collected...
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29069460/characterization-of-fluorescent-nuclear-track-detectors-as-criticality-dosimeters-ii
#6
J Harrison, B Moreno, O Van Hoey, L-C Mihailescu, F Vanhavere, M Million, V Fomenko, M Akselrod
Fluorescent nuclear track detectors (FNTDs) as criticality dosimeters for both neutrons and gamma are further characterized in terms of angular dependence and quick dose assessment. The power spectrum integral depth profiles obtained from stacks of fluorescent images acquired within FNTDs exposed to a broad spectrum neutron field at various angles are analyzed to determine a calibration curve for angular dependence. MCNPX simulations were shown to be in good agreement with experimental results. A prototype triage reader was also designed and tested for quick assessment of dose...
October 21, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28865685/association-between-compliance-with-triage-directions-from-an-organized-state-trauma-system-and-trauma-outcomes
#7
Benjamin Martinez, John T Owings, Christopher Hector, Paige Hargrove, Shoichiro Tanaka, Margaret Moore, Patrick Greiffenstein, Joseph Giaimo, Shahrzad Talebinejad, John P Hunt
BACKGROUND: The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. STUDY DESIGN: Trauma patients directed by LERN from the field in 2014 were included...
October 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28822212/comparison-of-start-and-salt-triage-methodologies-to-reference-standard-definitions-and-to-a-field-mass-casualty-simulation
#8
COMPARATIVE STUDY
Salvatore Silvestri, Adam Field, Neal Mangalat, Tory Weatherford, Christopher Hunter, Zoe McGowan, Zachary Stamile, Trevor Mattox, Tanner Barfield, Aarian Afshari, George Ralls, Linda Papa
OBJECTIVES: We compared Sort, Assess, Lifesaving Intervention, Treatment/Transport (SALT) and Simple Triage and Rapid Treatment (START) triage methodologies to a published reference standard, and evaluated the accuracy of the START method applied by emergency medical services (EMS) personnel in a field simulation. DESIGN: Simulated mass casualty incident (MCI). Paramedics trained in START triage assigned each victim to green (minimal), yellow (delayed), red (immediate), or black (dead) categories...
2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28816338/prediction-of-emergency-department-hospital-admission-based-on-natural-language-processing-and-neural-networks
#9
Xingyu Zhang, Joyce Kim, Rachel E Patzer, Stephen R Pitts, Aaron Patzer, Justin D Schrager
OBJECTIVE: To describe and compare logistic regression and neural network modeling strategies to predict hospital admission or transfer following initial presentation to Emergency Department (ED) triage with and without the addition of natural language processing elements. METHODS: Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a cross-sectional probability sample of United States EDs from 2012 and 2013 survey years, we developed several predictive models with the outcome being admission to the hospital or transfer vs...
October 26, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28810911/outcomes-from-patients-with-presumed-drug-resistant-tuberculosis-in-five-reference-centers-in-brazil
#10
MULTICENTER STUDY
D M P Ramalho, P F C Miranda, M K Andrade, T Brígido, M P Dalcolmo, E Mesquita, C F Dias, A N Gambirasio, J Ueleres Braga, A Detjen, P P J Phillips, I Langley, P I Fujiwara, S B Squire, M M Oliveira, A L Kritski
BACKGROUND: The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. METHODS: Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28798972/diagnostic-precision-of-triage-algorithms-for-mass-casualty-incidents-english-version
#11
A R Heller, N Salvador, M Frank, J Schiffner, R Kipke, C Kleber
BACKGROUND: Regarding survival and quality of life recent mass casualty incidents again emphasize the importance of early identification of the correct degree of injury/illness to enable prioritization of treatment amongst patients and their transportation to an appropriate hospital. The present study investigated existing triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as its process duration in a relevant emergency patient cohort. METHODS: In this study 500 consecutive air rescue missions were evaluated by means of standardized patient records...
August 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28780982/validation-of-the-criteria-for-early-critical-care-resource-use-in-assessing-the-effectiveness-of-field-triage
#12
Ki Ok Ahn, Sang Chul Kim, Ju Ok Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
BACKGROUND: This study aimed to validate the criteria for early critical care resource (CCR) use as an outcome predictor for seriously injured patients triaged in the field by comparing the effectiveness of the criteria for early CCR use with that of criteria defined by an Injury Severity Score (ISS) >15. METHODS: We analysed data from seriously injured trauma patients who were triaged using a field triage protocol by emergency medical service providers (EMS-ST patients)...
July 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28758798/reconfiguring-diagnostic-work-in-danish-general-practice-regulation-triage-and-the-secretaries-as-diagnostician
#13
Rikke Sand Andersen, Rikke Aarhus
Health care systems as well as bodies of medical knowledge are dynamic and change as the result of political and social transformations. In recent decades, health care systems have been subjected to a whole assemblage of regulatory practices. The local changes undertaken in Denmark that are being explored here are indicative of a long-term shift that has occurred in many welfare states intended to make public services in the Global North more efficient and transparent. Departing in prolonged field work in Danish general practice and the anthropological literature on audit culture, this paper suggests that the introduction of regulatory practices has enhanced the need for triage as a key organising principle...
July 31, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28758715/serial-sonographic-assessment-of-pulmonary-edema-in-patients-with-hypertensive-acute-heart-failure
#14
Jennifer L Martindale, Michael Secko, John F Kilpatrick, Ian S deSouza, Lorenzo Paladino, Andrew Aherne, Ninfa Mehta, Alyssa Conigiliaro, Richard Sinert
OBJECTIVES: Objective measures of clinical improvement in patients with acute heart failure (AHF) are lacking. The aim of this study was to determine whether repeated lung sonography could semiquantitatively capture changes in pulmonary edema (B-lines) in patients with hypertensive AHF early in the course of treatment. METHODS: We conducted a feasibility study in a cohort of adults with acute onset of dyspnea, severe hypertension in the field or at triage (systolic blood pressure ≥ 180 mm Hg), and a presumptive diagnosis of AHF...
July 31, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28710612/-diagnostic-quality-of-triage-algorithms-for-mass-casualty-incidents
#15
A R Heller, N Salvador, M Frank, J Schiffner, R Kipke, C Kleber
BACKGROUND: Regarding survival and quality of life, recent mass casualty incidents have once more emphasized the importance of early identification of the correct degree of injury or illness, to enable prioritizing treatment of patients and transportation to an appropriate hospital. The present study investigated international triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as the process duration in a relevant emergency patient cohort. METHODS: A total of 500 consecutive air rescue missions were evaluated by means of standardized patient records...
October 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28699306/strategies-for-building-a-successful-ultrasound-guided-fna-practice-in-department-of-pathology-experience-at-a-university-hospital
#16
Maoxin Wu, Kenneth R Shroyer
INTRODUCTION: Although pathology services focused on fine needle aspiration (FNA) biopsy of superficial palpable masses with on-site cytological evaluation are available in a wide range of clinical and academic settings, the addition of ultrasound (US) guidance into FNA practice by a cytopathologist group can be challenging. An US-FNA service provided by a cytopathologist in the department of Pathology is a relatively new practice in the field of medicine. This report summarizes our experience and strategies in achieving this objective and our successful preliminary results...
July 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28653834/residue-specific-peptide-modification-a-chemist-s-guide
#17
REVIEW
Justine N deGruyter, Lara R Malins, Phil S Baran
Advances in bioconjugation and native protein modification are appearing at a blistering pace, making it increasingly time consuming for practitioners to identify the best chemical method for modifying a specific amino acid residue in a complex setting. The purpose of this perspective is to provide an informative, graphically rich manual highlighting significant advances in the field over the past decade. This guide will help triage candidate methods for peptide alteration and will serve as a starting point for those seeking to solve long-standing challenges...
August 1, 2017: Biochemistry
https://www.readbyqxmd.com/read/28639854/rapid-on-site-evaluation-of-endobronchial-ultrasound-guided-transbronchial-needle-aspirations-for-the-diagnosis-of-lung-cancer-a-perspective-from-members-of-the-pulmonary-pathology-society
#18
Deepali Jain, Timothy Craig Allen, Dara L Aisner, Mary Beth Beasley, Philip T Cagle, Vera Luiza Capelozzi, Lida P Hariri, Sylvie Lantuejoul, Ross Miller, Mari Mino-Kenudson, Sara E Monaco, Andre Moreira, Kirtee Raparia, Natasha Rekhtman, Anja Christiane Roden, Sinchita Roy-Chowdhuri, Gilda da Cunha Santos, Erik Thunnissen, Giancarlo Troncone, Marina Vivero
CONTEXT: - Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool in the field of diagnostic respiratory cytology. Rapid on-site evaluation (ROSE) of EBUS-TBNA not only has the potential to improve diagnostic yield of the procedure but also to triage samples for predictive molecular testing to guide personalized treatments for lung cancer. OBJECTIVE: - To provide an overview of the current status of the literature regarding ROSE of EBUS-TBNA in the diagnosis of lung cancer...
June 22, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28638258/evacuation-of-hospitals-during-disaster-establishment-of-a-field-hospital-and-communication
#19
REVIEW
Erdal Tekin, Atif Bayramoglu, Mustafa Uzkeser, Zeynep Cakir
The buildings, working personnel, and patients and their relatives may directly or indirectly be affected by the disasters. Here we will discuss evacuation, establishing a field hospital, communication, the role of the media in disasters, and defending against sabotage. The affected individuals should be evacuated and transferred to secure zones safely and rapidly. How the decision for evacuation should be made and how the evacuation triage should be performed are important issues. Field hospitals should be established within the bounds of possibility for continuation of the treatments of evacuated people...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28637569/assessing-field-triage-decisions-and-the-international-classification-injury-severity-score-iciss-at-predicting-outcomes-of-trauma-patients
#20
COMPARATIVE STUDY
Casey J Allen, Daniel J Baldor, Carl I Schulman, Louis R Pizano, Alan S Livingstone, Nicholas Namias
Florida considers the International Classification Injury Severity Score (ICISS) from hospital discharges within a geographic region in the apportionment of trauma centers (TCs). Patients with an ICISS <0.85 are considered to require triage to a TC, yet many are triaged to an emergency department (ED). We assess outcomes of those with an ICISS <0.85 by the actual triage decision of emergency medical services (EMS). From October 2011 to October 2013, 39,021 consecutive admissions with injury ICD-9 codes were analyzed...
June 1, 2017: American Surgeon
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