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By Elif Celikel Emergency medicine specialist in turkey
Shawna D Bellew, Daniel Cabrera, Christine M Lohse, M Fernanda Bellolio
OBJECTIVES: Rapid response teams (RRT) respond to signs of deterioration in order to avoid morbidity and mortality. Early RRT activation (eRRT) in patients admitted from the emergency department (ED) is associated with significantly increased mortality. Predicting these events may represent an opportunity to identify patients who would benefit from further resuscitation, aid disposition decision making, or improve communication between ED and inpatient providers. We aimed to create a clinical prediction instrument to quantify the risk of eRRT...
September 9, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Javor K Kashlov, Ivan S Donev, Jordanka G Doneva, Veselin D Valkov, Arpine D Kirkorova, Peter I Ghenev, Nikolay V Conev, Temenuzhka R Radeva, Borislav D Ivanov, Zhaneta T Georgieva
The current study examined the serum levels of receptor-interacting protein kinase 3 (RIPK3) in 51 patients with New York Heart Association (NYHA) class III-IV heart failure, 53 patients with myocardial infarction with ST elevation (STEMI), and 19 healthy subjects serving as a control group. An enzyme-linked immunoadsorbent assay (ELISA) was used to measure the levels of RIPK3 expression in serum. The area under the receiver operating characteristic curve (AUC) was then used to evaluate the predictive performance of RIPK3 and troponin I in patients with STEMI...
September 5, 2016: Bioscience Trends
Bret A Nicks, Brian C Hiestand
No abstract text is available yet for this article.
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jeff D Williamson, Mark A Supiano, William B Applegate, Dan R Berlowitz, Ruth C Campbell, Glenn M Chertow, Larry J Fine, William E Haley, Amret T Hawfield, Joachim H Ix, Dalane W Kitzman, John B Kostis, Marie A Krousel-Wood, Lenore J Launer, Suzanne Oparil, Carlos J Rodriguez, Christianne L Roumie, Ronald I Shorr, Kaycee M Sink, Virginia G Wadley, Paul K Whelton, Jeffrey Whittle, Nancy F Woolard, Jackson T Wright, Nicholas M Pajewski
IMPORTANCE: The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. OBJECTIVE: To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT)...
June 28, 2016: JAMA: the Journal of the American Medical Association
Filippo Numeroso, Gianluigi Mossini, Michela Giovanelli, Giuseppe Lippi, Gianfranco Cervellin
OBJECTIVES: Despite guidelines, admission rates and expenditures for syncope remain high. This may be caused by an imprecise definition of cardiovascular disease considered at risk and an overestimation of the role of comorbidities and advanced age. In a cohort of patients with undetermined syncope, we prospectively compared the short-term prognosis of patients at intermediate risk (i.e., with stable heart diseases or comorbidities, of any age) versus those at high risk for cardiogenic syncope and identified factors associated with serious events...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Wesley H Self, Carlos G Grijalva, Derek J Williams, Alison Woodworth, Robert A Balk, Sherene Fakhran, Yuwei Zhu, D Mark Courtney, James Chappell, Evan J Anderson, Chao Qi, Grant W Waterer, Christopher Trabue, Anna M Bramley, Seema Jain, Kathryn M Edwards, Richard G Wunderink
BACKGROUND: Predicting the need for intensive care among adults with community-acquired pneumonia (CAP) remains challenging. METHODS: Using a multicenter prospective cohort study of adults hospitalized with CAP, we evaluated the association of serum procalcitonin (PCT) concentration at hospital presentation with the need for invasive respiratory or vasopressor support (IRVS), or both, within 72 h. Logistic regression was used to model this association, with results reported as the estimated risk of IRVS for a given PCT concentration...
October 2016: Chest
Segolene Mrozek, Matthieu Jabaudon, Samir Jaber, Catherine Paugam-Burtz, Jean-Yves Lefrant, Jean-Jacques Rouby, Karim Asehnoune, Bernard Allaouchiche, Olivier Baldesi, Marc Leone, Qin Lu, Jean-Etienne Bazin, Laurence Roszyk, Vincent Sapin, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: During acute respiratory distress syndrome (ARDS), computed tomography (CT) can reveal two distinct lung imaging patterns, focal or non-focal, with different responses to PEEP, recruitment maneuvers and prone position. Nevertheless, their association with plasma biomarkers and their distinct functional/pathobiological mechanisms are unknown. The objective of this study was to characterize focal and non-focal patterns of lung CT-based imaging with plasma markers of lung injury...
March 23, 2016: Chest
Sean B Smith, Jeffrey B Geske, Parul Kathuria, Michael Cuttica, Daniel R Schimmel, D Mark Courtney, Grant W Waterer, Richard G Wunderink
BACKGROUND: Pulmonary embolism (PE) remains a significant cause of hospital admission and health-care costs. Estimates of PE incidence came from the 1990s, and data are limited to describe trends in hospital admissions for PE over the past decade. METHODS: We analyzed Nationwide Inpatient Sample data from 1993 to 2012 to identify patients admitted with PE. We included admissions with International Classification of Diseases, 9th revision, codes listing PE as the principal diagnosis as well as admissions with PE listed secondary to principal diagnoses of respiratory failure or DVT...
July 2016: Chest
Wing-Yan Heidi Wan, Fay Hollins, Louise Haste, Lucy Woodman, Robert A Hirst, Sarah Bolton, Edith Gomez, Amanda Sutcliffe, Dhananjay Desai, Latifa Chachi, Vijay Mistry, Cédric Szyndralewiez, Andrew Wardlaw, Ruth Saunders, Christopher O'Callaghan, Peter W Andrew, Christopher E Brightling
BACKGROUND: Bronchial epithelial ciliary dysfunction is an important feature of asthma. We sought to determine the role in asthma of neutrophilic inflammation and nicotinamide adenine dinucleotide phosphate (NADPH) oxidases in ciliary dysfunction. METHODS: Bronchial epithelial ciliary function was assessed by using video microscopy in fresh ex vivo epithelial strips from patients with asthma stratified according to their sputum cell differentials and in culture specimens from healthy control subjects and patients with asthma...
June 2016: Chest
Hakan Sarlak, Salim Ozenc, Ibrahim Arzıman, Mustafa Tanrıseven
No abstract text is available yet for this article.
December 2015: American Journal of Emergency Medicine
J W Keep, A S Messmer, R Sladden, N Burrell, R Pinate, M Tunnicliff, E Glucksman
INTRODUCTION: Severe sepsis and septic shock (SS) are time-critical medical emergencies that affect millions of people in the world. Earlier administration of antibiotics has been shown to reduce mortality from SS; however, the initiation of early resuscitation requires recognition that a patient may have sepsis. Early warning scores (EWS) are broadly used to detect patient deterioration, but to date have not been evaluated to detect patients at risk for SS. The purpose of our study was to look at the relationship between the initial national EWS (NEWS) in the emergency department (ED) and the diagnosis of SS...
January 2016: Emergency Medicine Journal: EMJ
Sophie Perinel, François Vincent, Alexandre Lautrette, Jean Dellamonica, Christophe Mariat, Fabrice Zeni, Yves Cohen, Bernard Tardy, Bertrand Souweine, Michael Darmon
OBJECTIVE: To assess the prognostic impact of transient and persistent acute kidney injury in critically ill patients. DESIGN: Retrospective analysis of prospectively collected patient data SETTING: : Six hospital ICUs. PATIENTS: Critically-ill patients with ICU stay longer than three days. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Assessment of hospital survival with respect to acute kidney injury duration...
August 2015: Critical Care Medicine
Scott J Cameron, Sara K Ture, Deanne Mickelsen, Enakshi Chakrabarti, Kristina L Modjeski, Scott McNitt, Michael Seaberry, David J Field, Nhat-Tu Le, Jun-Ichi Abe, Craig N Morrell
BACKGROUND: Platelets have a pathophysiologic role in the ischemic microvascular environment of acute coronary syndromes. In comparison with platelet activation in normal healthy conditions, less attention is given to mechanisms of platelet activation in diseased states. Platelet function and mechanisms of activation in ischemic and reactive oxygen species-rich environments may not be the same as in normal healthy conditions. Extracellular regulated protein kinase 5 (ERK5) is a mitogen-activated protein kinase family member activated in hypoxic, reactive oxygen species-rich environments and in response to receptor-signaling mechanisms...
July 7, 2015: Circulation
Petteri Rinne, Ari Ahola-Olli, Salla Nuutinen, Emilia Koskinen, Katja Kaipio, Kim Eerola, Markus Juonala, Mika Kähönen, Terho Lehtimäki, Olli T Raitakari, Eriika Savontaus
OBJECTIVE: The melanocortin 1 receptor (MC1-R) is expressed by vascular endothelial cells and shown to enhance nitric oxide (NO) availability and vasodilator function on pharmacological stimulation. However, the physiological role of MC1-R in the endothelium and its contribution to vascular homeostasis remain unresolved. We investigated whether a lack of functional MC1-R signaling carries a phenotype with predisposition to vascular abnormalities. APPROACH AND RESULTS: Recessive yellow mice (MC1R(e/e)), deficient in MC1-R signaling, and their wild-type littermates were studied for morphology and functional characteristics of the aorta...
July 2015: Arteriosclerosis, Thrombosis, and Vascular Biology
Kevin S Shah, Nicholas A Marston, Christian Mueller, Sean-Xavier Neath, Robert H Christenson, James McCord, Richard M Nowak, Gary M Vilke, Lori B Daniels, Judd E Hollander, Fred S Apple, Chad M Cannon, John Nagurney, Donald Schreiber, Christopher deFilippi, Christopher J Hogan, Deborah B Diercks, Alexander Limkakeng, Inder S Anand, Alan H B Wu, Paul Clopton, Allan S Jaffe, W Frank Peacock, Alan S Maisel
OBJECTIVES: Chest pain is a common complaint to emergency departments (EDs) and clinical risk factors are used to predict which patients are at risk for worse outcomes and mortality. The goal was to assess the novel biomarker midregional proadrenomedullin (MR-proADM) in prediction of mortality and major adverse cardiac events (MACE). METHODS: This was a subanalysis of the CHOPIN study, a 16-center prospective trial that enrolled 2,071 patients presenting with chest pain within 6 hours of onset...
May 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Anna I Hårdemark Cedborg, Eva Sundman, Katarina Bodén, Hanne Witt Hedström, Richard Kuylenstierna, Olle Ekberg, Lars I Eriksson
BACKGROUND: Drugs used for sedation in anesthesia and intensive care may cause pharyngeal dysfunction and increased risk for aspiration. In this study, the authors investigate the impact of sedative doses of morphine and midazolam on pharyngeal function during swallowing and coordination of breathing and swallowing. METHODS: Pharyngeal function, coordination of breathing and swallowing, and level of sedation were assessed by manometry, videoradiography, measurements of respiratory airflow, and a visual analog scale in 32 healthy volunteers (age 19 to 35 yr)...
June 2015: Anesthesiology
Michael Gottlieb, John Bailitz
No abstract text is available yet for this article.
September 2015: Annals of Emergency Medicine
Aiham H Jbeli, Amornpol Anuwatworn, Marian S Petrasko
No abstract text is available yet for this article.
November 2015: American Journal of Emergency Medicine
Travis Deaton, Jonathan D Auten, Michael A Darracq
Patients with acute abdominal pain commonly present to emergency departments. The safe and effective relief of discomfort is a concern to patients and physicians. Intravenous opioids are the traditional method used to provide pain relief in this setting, but intravenous access is time consuming and not always achievable. Alternative methods of pain control may therefore be necessary for the acute management of painful conditions without adding to the overall physical or psychological discomfort. The purpose of this study was to evaluate the feasibility of nebulized fentanyl (NF) in the alleviation of acute and undifferentiated abdominal pain...
June 2015: American Journal of Emergency Medicine
Pablo Blanco, José Luis Do Pico, Maximiliano Matteoda
No abstract text is available yet for this article.
November 2015: American Journal of Emergency Medicine
2016-07-03 11:41:24
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