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43 papers 0 to 25 followers
By Terren Trott
Tom Clynes
No abstract text is available yet for this article.
September 7, 2016: Nature
Cristin E Kearns, Laura A Schmidt, Stanton A Glantz
Early warning signals of the coronary heart disease (CHD) risk of sugar (sucrose) emerged in the 1950s. We examined Sugar Research Foundation (SRF) internal documents, historical reports, and statements relevant to early debates about the dietary causes of CHD and assembled findings chronologically into a narrative case study. The SRF sponsored its first CHD research project in 1965, a literature review published in the New England Journal of Medicine, which singled out fat and cholesterol as the dietary causes of CHD and downplayed evidence that sucrose consumption was also a risk factor...
September 12, 2016: JAMA Internal Medicine
Teri M Kozik, Sachin Shah, Mouchumi Bhattacharyya, Teresa T Franklin, Therese Farrell Connolly, Walter Chien, George S Charos, Michele M Pelter
BACKGROUND: Energy drink consumption has increased significantly over the past decade and is associated with greater than 20,000 emergency department visits per year. Most often these visits are due to cardiovascular complaints ranging from palpitations to cardiac arrest. OBJECTIVE: To determine if energy drinks alter; blood pressure, electrolytes, activated bleeding time (ACT), and/or cardiac responses measured with a 12-lead electrocardiographic (ECG) Holter. METHODS: Continuous ECG data was collected for five hours (30 minutes baseline and 4 hours post consumption [PC])...
July 2016: American Journal of Emergency Medicine
Melanie Heniff
More questions than answers arise from Dr. Alerhand's thought-provoking reflection. Aside from the question of what laws permit and what emergency medicine professional society standards support (1, 2), when is a particular physician qualified to testify as an expert witness? When is an expert witness physician truly an "expert?" Although expertise is difficult to quantify, 10 years of deliberate practice (defined as repeated practice in motivated individuals receiving feedback) has been cited as one objective measure of what it takes to achieve expertise in medicine as well as in other fields such as music...
April 30, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Howard Blumstein
No abstract text is available yet for this article.
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Daniel C Cullinane, Henry J Schiller, Martin D Zielinski, Jaroslaw W Bilaniuk, Bryan R Collier, John Como, Michelle Holevar, Enrique A Sabater, S Andrew Sems, W Matthew Vassy, Julie L Wynne
BACKGROUND: Hemorrhage from pelvic fracture is common in victims of blunt traumatic injury. In 2001, the Eastern Association for the Surgery of Trauma (EAST) published practice management guidelines for the management of hemorrhage in pelvic trauma. Since that time there have been new practice patterns and larger experiences with older techniques. The Practice Guidelines Committee of EAST decided to replace the 2001 guidelines with an updated guideline and systematic review reflecting current practice...
December 2011: Journal of Trauma
Malkeet Gupta, David L Schriger, Jonathan R Hiatt, Henry G Cryer, Areti Tillou, Jerome R Hoffman, Larry J Baraff
STUDY OBJECTIVE: Routine pan-computed tomography (CT, including of the head, neck, chest, abdomen/pelvis) has been advocated for evaluation of patients with blunt trauma based on the belief that early detection of clinically occult injuries will improve outcomes. We sought to determine whether selective imaging could decrease scan use without missing clinically important injuries. METHODS: This was a prospective observational study of 701 patients with blunt trauma at an academic trauma center...
November 2011: Annals of Emergency Medicine
Nicholas D Caputo, Chris Stahmer, George Lim, Kaushal Shah
BACKGROUND: Traumatic injury in the United States is the Number 1 cause of mortality for patients 1 year to 44 years of age. Studies suggest that early identification of major injury leads to better outcomes for patients. Imaging, such as computed tomography (CT), is routinely used to help determine the presence of major underlying injuries. We review the literature to determine whether whole-body CT (WBCT), a protocol including a noncontrast scan of the brain and neck and a contrast-enhanced scan of the chest, abdomen, and pelvis, detects more clinically significant injuries as opposed to selective scanning as determined by mortality rates...
October 2014: Journal of Trauma and Acute Care Surgery
Bala Natarajan, Prateek K Gupta, Samuel Cemaj, Megan Sorensen, Georgios I Hatzoudis, Robert Armour Forse
BACKGROUND: During the last decade, focused assessment with sonography for trauma increasingly has become the initial diagnostic modality of choice in trauma patients. It is still questionable, however, whether its use results in the underdiagnosis of intra-abdominal injury. It also remains doubtful whether a positive focused assessment with sonography for trauma affects clinical decision making in hemodynamically stable blunt trauma patients as evidenced through abdominal computerized tomography use...
October 2010: Surgery
Jeffrey W Carter, Mark H Falco, Michael S Chopko, William J Flynn, Charles E Wiles Iii, Weidun Alan Guo
INTRODUCTION: The Focused Assessment with Sonography in Trauma examination (FAST) is currently taught and recommended in the ATLS(®), often as an addendum to the primary survey for patients with blunt abdominal trauma. Although it is non-invasive and rapidly performed at bedside, the utility of FAST in blunt abdominal trauma has been questioned. We designed this study to examine our hypothesis that FAST is not an efficacious screening tool for identifying intra-abdominal injuries. METHODS: We performed a retrospective chart review of all patients with confirmatory diagnosis of blunt abdominal injuries with CT and/or laparotomy for a period of 1...
May 2015: Injury
Kenji Inaba, Konstantinos Chouliaras, Scott Zakaluzny, Stuart Swadron, Thomas Mailhot, Dina Seif, Pedro Teixeira, Emre Sivrikoz, Crystal Ives, Galinos Barmparas, Nikolaos Koronakis, Demetrios Demetriades
OBJECTIVE: The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT). BACKGROUND: RT is a high-risk, low-salvage procedure performed in arresting trauma patients with poorly defined indications. METHODS: Patients undergoing RT from 10/2010 to 05/2014 were prospectively enrolled. A FAST examination including parasternal/subxiphoid cardiac views was performed before or concurrent with RT...
September 2015: Annals of Surgery
Carmen Camacho Leis, Consuelo Canencia Hernández, Ma José Garcia-Ochoa Blanco, Paloma Covadonga Rey Paterna, Ramón de Elias Hernández, Ervigio Corral Torres
BACKGROUND: Several studies recommend not initiating advanced life support in traumatic cardiac arrest (TCA), mainly owing to the poor prognosis in several series that have been published. This study aimed to analyze the survival of the TCA in our series and to determine which factors are more frequently associated with recovery of spontaneous circulation (ROSC) and complete neurologic recovery (CNR). METHODS: This is a cohort study (2006-2009) of treatment benefits...
February 2013: Journal of Trauma and Acute Care Surgery
Brian R Plaisier
BACKGROUND: Accidental hypothermia resulting in cardiac arrest poses numerous therapeutic challenges. Cardiopulmonary bypass (CPB) should be used if feasible since it optimally provides both central rewarming and circulatory support. However, this modality may not be available or is contraindicated in certain cases. Thoracic lavage (TL) provides satisfactory heat transfer and may be performed by a variety of physicians. This paper presents the physiological rationale, technique, and role for TL in accidental hypothermia with cardiac arrest...
July 2005: Resuscitation
A Schober, F Sterz, C Handler, I Kürkciyan, A Laggner, M Röggla, M Schwameis, C Wallmueller, C Testori
BACKGROUND: Accidental hypothermic cardiac arrest is associated with unfortunate prognosis and large studies are rare. We therefore have performed an outcome analysis in patients that were admitted to Vienna University Hospital with the diagnosis of accidental hypothermic cardiac arrest. METHODS: This study employed a retrospective outcome analysis of prospectively collected data in a selected cohort of hypothermic cardiac arrest patients. We screened 3800 cardiac arrest patients, treated at our department between 1991 and 2010, for eligibility...
June 2014: Resuscitation
Jonas Hilmo, Torvind Naesheim, Mads Gilbert
Hypothermic cardiac arrest has high mortality and few known prognostic factors. We studied retrospectively 34 victims of accidental hypothermia with cardiac arrest admitted to The University Hospital of North Norway during 1985-2013 who were resuscitated and rewarmed by extracorporeal circulation. No patient survived prior to 1999, while nine out of 24 (37.5%) survived hypothermic cardiac arrest from 1999 to 2013. The lowest measured core temperature among survivors was 13.7°C; the longest time from cardiac arrest to return of spontaneous circulation was 6 h and 52 min...
September 2014: Resuscitation
S U Vassallo, K A Delaney, R S Hoffman, W Slater, L R Goldfrank
OBJECTIVE: To determine the effects of body temperature, ethanol use, electrolyte status, and acid-base status on the electrocardiograms (ECGs) of hypothermic patients. METHODS: Prospective, two-year, observational study of patients presenting to an urban ED with temperature < or =95 degrees F (< or =35 degrees C). All patients had at least one ECG obtained. Electrocardiograms were interpreted by a cardiologist blinded to the patient's temperature. J-point elevations known as Osborn waves were defined as present if they were at least 1 mm in height in two consecutive complexes...
November 1999: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Satoshi Higuchi, Toshiyuki Takahashi, Yusuke Kabeya, Tasuku Hasegawa, Susumu Nakagawa, Hideo Mitamura
BACKGROUND: The J wave is an ECG marker of ventricular fibrillation. However, the prevalence and clinical implications of J waves in hypothermic patients remain unclear. METHODS AND RESULTS: We evaluated the clinical characteristics and ECGs of patients who were admitted for accidental hypothermia (<35.0°C). J waves were defined as notches or slurs in the terminal part of the QRS complex with an amplitude ≥0.1mV. We analyzed the prevalence of J waves and the relationship between body temperature (BT) and J wave amplitude...
2014: Circulation Journal: Official Journal of the Japanese Circulation Society
Douglas J A Brown, Hermann Brugger, Jeff Boyd, Peter Paal
New England Journal of Medicine, Volume 367, Issue 20, Page 1930-1938, November 2012.
November 15, 2012: New England Journal of Medicine
Guillaume Debaty, Ibrahim Moustapha, Pierre Bouzat, Maxime Maignan, Marc Blancher, Amandine Rallo, Julien Brun, Olivier Chavanon, Vincent Danel, Françoise Carpentier, Jean-François Payen, Raphaël Briot
OBJECTIVE: To describe the factors associated with outcome after accidental deep hypothermia. METHODS: We conducted a retrospective cohort study on patients with accidental hypothermia (core temperature <28 °C) admitted to a Level I emergency room over a 10-year period. RESULTS: Forty-eight patients were included with a median temperature of 26 °C (range, 16.3-28 °C) on admission. The etiology of hypothermia was exposure to a cold environment (n = 27), avalanche (n = 13) or immersion in cold water (n = 8)...
August 2015: Resuscitation
Colin K Grissom, Chris H Harmston, John C McAlpine, Martin I Radwin, Brad Ellington, Ellie L Hirshberg, Andre Crouch
OBJECTIVE: To measure afterdrop and rewarming in subjects placed in a hypothermia wrap immediately after extrication from 60 minutes of snow burial. METHODS: We measured esophageal core body temperature (Tes) in 6 subjects buried in compacted snow (mean density 39%) for up to 60 minutes at an altitude of 2450 m while breathing with an AvaLung (Black Diamond Equipment, Salt Lake City, UT). Mean snow temperature was -3.5 ± 1.0 °C and mean air temperature was 0 ± 2 °C...
September 2010: Wilderness & Environmental Medicine
2016-01-06 21:54:01
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