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Articles 31 - 60 of 401
Full-Text Articles in Medicine and Health Sciences
Terror Medicine As Part Of The Medical School Curriculum, L. A. Cole, K. Wagner, S. Scott, N. D. Connell, A. Cooper, C. A. Kennedy, B. Natal, S. Lamba
Terror Medicine As Part Of The Medical School Curriculum, L. A. Cole, K. Wagner, S. Scott, N. D. Connell, A. Cooper, C. A. Kennedy, B. Natal, S. Lamba
Journal Articles
Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, …
Sepsis: Current Dogma And New Perspectives, C. S. Deutschman, K. J. Tracey
Sepsis: Current Dogma And New Perspectives, C. S. Deutschman, K. J. Tracey
Journal Articles
Sepsis, a clinical syndrome occurring in patients following infection or injury, is a leading cause of morbidity andmortality worldwide. Current immunological mechanisms do not explain the basis of cellular dysfunction and organ failure, the ultimate cause of death. Here we review current dogma and argue that it is time to delineate novel immunometabolic and neurophysiological mechanisms underlying the altered cellular bioenergetics and failure of epithelial and endothelial barriers that produce organ dysfunction and death. These mechanisms might hold the key to future therapeutic strategies.
A Systematic Nomenclature For The Redox States Of High Mobility Group Box (Hmgb) Proteins, D. J. Antoine, H. E. Harris, U. Andersson, K. J. Tracey, M. E. Bianchi
A Systematic Nomenclature For The Redox States Of High Mobility Group Box (Hmgb) Proteins, D. J. Antoine, H. E. Harris, U. Andersson, K. J. Tracey, M. E. Bianchi
Journal Articles
High mobility group box 1 (HMGB1) is a central mediator in inflammation and immunity. Recently, it was shown that different redox states of the three cysteines of HMGB1 endow it with mutually exclusive activities, such as inducing chemotaxis or the transcription of cytokines and chemokines, via the interaction with different receptors. The different HMGB1 redox forms can be identified by mass spectrometry in body fluids of patients and may hold promise as biomarkers. We propose here a systematic nomenclature of the different redox forms of HMGB1 and related proteins, to replace the conflicting names used so far by different laboratories.
Targeting A Heterogeneous Tumor: The Promise Of The Interleukin-13 Receptor Alpha2, I. Bodhinayake, M. Ottenhausen, J. A. Boockvar
Targeting A Heterogeneous Tumor: The Promise Of The Interleukin-13 Receptor Alpha2, I. Bodhinayake, M. Ottenhausen, J. A. Boockvar
Journal Articles
No abstract provided.
Risk Factors Associated With Reticular Pseudodrusen Versus Large Soft Drusen, S. Boddu, M. D. Lee, M. Marsiglia, M. Marmor, K. B. Freund, R. T. Smith
Risk Factors Associated With Reticular Pseudodrusen Versus Large Soft Drusen, S. Boddu, M. D. Lee, M. Marsiglia, M. Marmor, K. B. Freund, R. T. Smith
Journal Articles
PURPOSE: To investigate genetic, environmental, and systemic risk factors in prospectively identified subjects with the age-related macular degeneration (AMD) phenotypes of (1) reticular pseudodrusen without large soft drusen and (2) large soft drusen without reticular pseudodrusen. DESIGN: Prospective case-case comparison. METHODS: In a clinical practice setting, patients with AMD were sequentially screened using clinical examination and scanning laser ophthalmoscopy imaging to prospectively identify subjects (n = 73) with the phenotypes of (1) reticular pseudodrusen without large soft drusen (n = 30) or (2) large soft drusen without reticular pseudodrusen (n = 43). Subjects were genotyped for 2 alleles associated with …
Glycated Hemoglobin Measurement And Prediction Of Cardiovascular Disease, E. Di Angelantonio, P. Gao, H. Khan, N. Wald, S. J. L. Bakker, P. H. Whincup, J. Kauhanen, J. T. Salonen, R. Dankner, J. Danesh, +66 Additional Authors
Glycated Hemoglobin Measurement And Prediction Of Cardiovascular Disease, E. Di Angelantonio, P. Gao, H. Khan, N. Wald, S. J. L. Bakker, P. H. Whincup, J. Kauhanen, J. T. Salonen, R. Dankner, J. Danesh, +66 Additional Authors
Journal Articles
IMPORTANCE The value of measuring levels of glycated hemoglobin (HbA(1c)) for the prediction of first cardiovascular events is uncertain. OBJECTIVE To determine whether adding information on HbA(1c) values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk. DESIGN, SETTING, AND PARTICIPANTS Analysis of individual-participant data available from 73 prospective studies involving 294 998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. MAIN OUTCOMES AND MEASURES Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories …
Early Initial Clinical Experience With Intravitreal Aflibercept For Wet Age-Related Macular Degeneration, P. J. Ferrone, F. Anwar, J. Naysan, K. Chaudhary, D. Fastenberg, K. Graham, V. Deramo
Early Initial Clinical Experience With Intravitreal Aflibercept For Wet Age-Related Macular Degeneration, P. J. Ferrone, F. Anwar, J. Naysan, K. Chaudhary, D. Fastenberg, K. Graham, V. Deramo
Journal Articles
Background Age-related macular degeneration (AMD) is a degenerative process that leads to severe vision loss. Wet AMD is defined by choroidal neovascularisation, leading to the accumulation of subretinal fluid (SRF), macular oedema (ME), and pigment epithelium detachments (PED). Purpose To evaluate the initial clinical experience of conversion from bevacizumab or ranibizumab to aflibercept in wet AMD patients. Methods Records of 250 consecutive wet AMD patients were retrospectively reviewed. Of 250 patients, 29 were naive (with no previous treatment), and 221 were previously treated with bevacizumab (1/3) or ranibizumab (2/3). On average, converted patients received 14 injections every 6 weeks on …
Spectral-Domain Optical Coherence Tomography Staging And Autofluorescence Imaging In Achromatopsia, J. P. Greenberg, J. Sherman, S. A. Zweifel, R. W. Chen, T. Duncker, S. Kohl, B. Baumann, B. Wissinger, L. A. Yannuzzi, S. H. Tsang
Spectral-Domain Optical Coherence Tomography Staging And Autofluorescence Imaging In Achromatopsia, J. P. Greenberg, J. Sherman, S. A. Zweifel, R. W. Chen, T. Duncker, S. Kohl, B. Baumann, B. Wissinger, L. A. Yannuzzi, S. H. Tsang
Journal Articles
IMPORTANCE Evidence is mounting that achromatopsia is a progressive retinal degeneration, and treatments for this condition are on the horizon. OBJECTIVES To categorize achromatopsia into clinically identifiable stages using spectral-domain optical coherence tomography and to describe fundus autofluorescence imaging in this condition. DESIGN, SETTING, AND PARTICIPANTS A prospective observational study was performed between 2010 and 2012 at the Edward S. Harkness Eye Institute, New York-Presbyterian Hospital. Participants included 17 patients (aged 10-62 years) with full-field electroretinography-confirmed achromatopsia. MAIN OUTCOMES AND MEASURES Spectral-domain optical coherence tomography features and staging system, fundus autofluorescence and near-infrared reflectance features and their correlation to optical …
Giant Cell Arteritis Presenting With Bilateral Orbital Inflammatory Disease And Enhancing Superficial Temporal Arteries, J. R. Mitchell, I. Krashin-Bichler, M. Rosenblum, E. L. Diamond, M. J. Dinkin
Giant Cell Arteritis Presenting With Bilateral Orbital Inflammatory Disease And Enhancing Superficial Temporal Arteries, J. R. Mitchell, I. Krashin-Bichler, M. Rosenblum, E. L. Diamond, M. J. Dinkin
Journal Articles
No abstract provided.
Gene Therapy In Patient-Specific Stem Cell Lines And A Preclinical Model Of Retinitis Pigmentosa With Membrane Frizzled-Related Protein Defects, Y. Li, W. H. Wu, C. W. Hsu, H. V. Nguyen, Y. T. Tsai, L. Chan, T. Nagasaki, I. H. Maumenee, L. A. Yannuzzi, S. H. Tsang, +3 Additional Authors
Gene Therapy In Patient-Specific Stem Cell Lines And A Preclinical Model Of Retinitis Pigmentosa With Membrane Frizzled-Related Protein Defects, Y. Li, W. H. Wu, C. W. Hsu, H. V. Nguyen, Y. T. Tsai, L. Chan, T. Nagasaki, I. H. Maumenee, L. A. Yannuzzi, S. H. Tsang, +3 Additional Authors
Journal Articles
Defects in Membrane Frizzled-related Protein (MFRP) cause autosomal recessive retinitis pigmentosa (RP). MFRP codes for a retinal pigment epithelium (RPE)-specific membrane receptor of unknown function. In patient-specific induced pluripotent stem (iPS)-derived RPE cells, precise levels of MFRP, and its dicistronic partner CTRP5, are critical to the regulation of actin organization. Overexpression of CTRP5 in naive human RPE cells phenocopied behavior of MFRP-deficient patient RPE (iPS-RPE) cells. AAV8 (Y733F) vector expressing human MFRP rescued the actin disorganization phenotype and restored apical microvilli in patient-specific iPS-RPE cell lines. As a result, AAV-treated MFRP mutant iPS-RPE recovered pigmentation and transepithelial resistance. The efficacy …
Late Recurrence Of Myopic Foveoschisis After Successful Repair With Primary Vitrectomy And Incomplete Membrane Peeling, G. Sepulveda, S. Chang, K. B. Freund, S. Park, Q. V. Hoang
Late Recurrence Of Myopic Foveoschisis After Successful Repair With Primary Vitrectomy And Incomplete Membrane Peeling, G. Sepulveda, S. Chang, K. B. Freund, S. Park, Q. V. Hoang
Journal Articles
PURPOSE: To report three cases of late recurrence of myopic foveoschisis (MF) after initial successful repair with pars plana vitrectomy and membrane peeling to assess the importance of internal limiting membrane peeling. METHODS: A retrospective noncomparative case series was performed of patients who underwent a primary pars plana vitrectomy by a single surgeon with successful resolution of MF, but eventually underwent repeat pars plana vitrectomy for recurrent MF. Best-corrected visual acuity, fundus photography, and optical coherence tomography were obtained at each examination. RESULTS: Three eyes of three patients underwent pars plana vitrectomy for recurrent MF. Myopic foveoschisis recurrence occurred 6, …
Photoreceptor Perturbation Around Subretinal Drusenoid Deposits As Revealed By Adaptive Optics Scanning Laser Ophthalmoscopy, Y. Zhang, X. Wang, E. B. Rivero, M. E. Clark, C. D. Witherspoon, R. F. Spaide, C. A. Girkin, C. Owsley, C. A. Curcio
Photoreceptor Perturbation Around Subretinal Drusenoid Deposits As Revealed By Adaptive Optics Scanning Laser Ophthalmoscopy, Y. Zhang, X. Wang, E. B. Rivero, M. E. Clark, C. D. Witherspoon, R. F. Spaide, C. A. Girkin, C. Owsley, C. A. Curcio
Journal Articles
PURPOSE: To describe the microscopic structure of photoreceptors impacted by subretinal drusenoid deposits, also called pseudodrusen, an extracellular lesion associated with age-related macular degeneration (AMD), using adaptive optics scanning laser ophthalmoscopy (AOSLO). DESIGN: Observational case series. METHODS: We recruited 53 patients with AMD and 10 age-similar subjects who had normal retinal health. All subjects underwent color fundus photography, infrared reflectance, red-free reflectance, autofluorescence, and spectral-domain optical coherence tomography (OCT). Subretinal drusenoid deposits were classified by a 3-stage OCT-based grading system. Lesions and surrounding photoreceptors were examined by AOSLO. RESULTS: Subretinal drusenoid deposits were found in 26 eyes of 13 patients …
Bioactive Lysophospholipids Generated By Hepatic Lipase Degradation Of Lipoproteins Lead To Complement Activation Via The Classical Pathway, W. Ma, D. C. Paik, G. R. Barile
Bioactive Lysophospholipids Generated By Hepatic Lipase Degradation Of Lipoproteins Lead To Complement Activation Via The Classical Pathway, W. Ma, D. C. Paik, G. R. Barile
Journal Articles
PURPOSE: We determined bioactivity of lysophospholipids generated by degradation of the low-density (LDL), very low-density (VLDL), and high-density (HDL) lipoproteins with hepatic lipase (HL), cholesterol esterase (CE), and lipoprotein-associated phospholipase A2 (Lp-PLA2). METHODS: The LDL, VLDL, and HDL were treated with HL, CE, and Lp-PLA2 after immobilization on plates, and complement activation studies were performed with diluted human serum. Complement component 3 (C3) fixation, a marker for complement activation, was determined with a monoclonal anti-human C3d antibody. Enzymatic properties of HL and CE were assayed with triglyceride and phosphatidylcholine substrates for triglyceride hydrolase and phospholipase A activities. The ARPE-19 cells …
Twelve Or 30 Months Of Dual Antiplatelet Therapy After Drug-Eluting Stents, L. Mauri, D. J. Kereiakes, R. W. Yeh, P. Driscoll-Shempp, K. N. Garratt, D. P. Lee, T. K. Pow, P. V. Lee, M. J. Rinaldi, J. M. Massaro, +12 Additional Authors
Twelve Or 30 Months Of Dual Antiplatelet Therapy After Drug-Eluting Stents, L. Mauri, D. J. Kereiakes, R. W. Yeh, P. Driscoll-Shempp, K. N. Garratt, D. P. Lee, T. K. Pow, P. V. Lee, M. J. Rinaldi, J. M. Massaro, +12 Additional Authors
Journal Articles
BACKGROUND Dual antiplatelet therapy is recommended after coronary stenting to prevent thrombotic complications, yet the benefits and risks of treatment beyond 1 year are uncertain. METHODS Patients were enrolled after they had undergone a coronary stent procedure in which a drug-eluting stent was placed. After 12 months of treatment with a thienopyridine drug (clopidogrel or prasugrel) and aspirin, patients were randomly assigned to continue receiving thienopyridine treatment or to receive placebo for another 18 months; all patients continued receiving aspirin. The coprimary efficacy end points were stent thrombosis and major adverse cardiovascular and cerebrovascular events (a composite of death, myocardial …
Multi-Detector Coronary Ct Imaging For The Identification Of Coronary Artery Stenoses In A "Real-World" Population, A. N. Makaryus, S. Henry, L. Loewinger, J. N. Makaryus, L. Boxt
Multi-Detector Coronary Ct Imaging For The Identification Of Coronary Artery Stenoses In A "Real-World" Population, A. N. Makaryus, S. Henry, L. Loewinger, J. N. Makaryus, L. Boxt
Journal Articles
BACKGROUND: Multi-detector computed tomography (CT) has emerged as a modality for the non-invasive assessment of coronary artery disease (CAD). Prior studies have selected patients for evaluation and have excluded many of the "real-world" patients commonly encountered in daily practice. We compared 64-detector-CT (64-CT) to conventional coronary angiography (CA) to investigate the accuracy of 64-CT in determining significant coronary stenoses in a "real-world" clinical population. METHODS: A total of 1,818 consecutive patients referred for 64-CT were evaluated. CT angiography was performed using the GE LightSpeed VCT (GE((R)) Healthcare). Forty-one patients in whom 64-CT results prompted CA investigation were further evaluated, and …
Implications Of Gender Difference In Coronary Calcification As Assessed By Ct Coronary Angiography, A. N. Makaryus, C. Sison, M. Kohansieh, J. N. Makaryus
Implications Of Gender Difference In Coronary Calcification As Assessed By Ct Coronary Angiography, A. N. Makaryus, C. Sison, M. Kohansieh, J. N. Makaryus
Journal Articles
BACKGROUND: Arterial calcium as measured by 64-slice computed tomography coronary angiography (64-CT) is a reliable predictor of cardiovascular disease risk. Lipid-rich plaques with lower degrees of calcification may pose greater risk for adverse coronary events than more stabilized calcified plaques as a result of the increased risk of plaque rupture, migration, and subsequent acute coronary syndrome. We sought to examine coronary artery calcium scores as measured via 64-CT to assess the extent of calcification and plaque distribution in women compared to men. METHODS: A total of 138 patients referred for 64-CT were evaluated. Computerized tomographic angiography was performed using the …
Inappropriate Implantable Cardioverter-Defibrillator Shocks Attributed To Alternating-Current Leak In A Swimming Pool, J. N. Makaryus, J. Angert-Gilman, M. Yacoub, A. Patel, B. Goldner
Inappropriate Implantable Cardioverter-Defibrillator Shocks Attributed To Alternating-Current Leak In A Swimming Pool, J. N. Makaryus, J. Angert-Gilman, M. Yacoub, A. Patel, B. Goldner
Journal Articles
Implantable cardioverter-defibrillators (ICDs) are the standard of care for preventing sudden cardiac death in patients who are predisposed to malignant ventricular arrhythmias. Causes of inappropriate ICD shock include equipment malfunction, improper arrhythmia evaluation, misinterpretation of myopotentials, and electromagnetic interference. As the number of implanted ICDs has increased, other contributors to inappropriate therapy have become known, such as minimal electrical current leaks that mimic ventricular fibrillation. We present the case of a 63-year-old man with a biventricular ICD who received 2 inappropriate shocks, probably attributable to alternating-current leaks in a swimming pool. In addition, we discuss ICD sensitivity and offer recommendations …
Takotsubo Cardiomyopathy As A Sequela Of Elective Direct-Current Cardioversion For Atrial Fibrillation, J. S. Siegfried, S. Bhusri, N. Guttenplan, N. L. Coplan
Takotsubo Cardiomyopathy As A Sequela Of Elective Direct-Current Cardioversion For Atrial Fibrillation, J. S. Siegfried, S. Bhusri, N. Guttenplan, N. L. Coplan
Journal Articles
In takotsubo cardiomyopathy, the clinical appearance is that of an acute myocardial infarction in the absence of obstructive coronary artery disease, with apical ballooning of the left ventricle. The condition is usually precipitated by a stressful physical or psychological experience. The mechanism is unknown but is thought to be related to catecholamine excess. We present the case of a 67-year-old woman who experienced cardiogenic shock caused by takotsubo cardiomyopathy, immediately after undergoing elective direct-current cardioversion for atrial fibrillation. After a course complicated by left ventricular failure, cardiogenic shock, and ventricular tachycardia, she made a complete clinical and echocardiographic recovery In …
Surgical Management Of Ascending Aortic Aneurysm And Its Complications, S. Sran, M. Sran, N. Ferguson, A. N. Makaryus
Surgical Management Of Ascending Aortic Aneurysm And Its Complications, S. Sran, M. Sran, N. Ferguson, A. N. Makaryus
Journal Articles
Ascending aortic aneurysms involving the proximal aortic arch, arising anywhere from the aortic valve to the innominate artery, represent various problems in which open surgery is generally required. Surgical options include excision of the aortic pathology or wrapping the aneurysm shell with an aortic Dacron graft. Intervention using the latter method can lead to extravasation of blood along the suture lines resulting in continuous bleeding within the periprosthetic space. The Cabrol technique was developed as a method for decompression of postoperative leaks by the formation of a conduit system from the periprosthetic space to the right atrium. The coronary ostia …
Athletic Pubalgia And Associated Rehabilitation, A. A. Ellsworth, M. P. Zoland, T. F. Tyler
Athletic Pubalgia And Associated Rehabilitation, A. A. Ellsworth, M. P. Zoland, T. F. Tyler
Journal Articles
BACKGROUND: Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term …
Assessing 2 D-Dimer Age-Adjustment Strategies To Optimize Computed Tomographic Use In Ed Evaluation Of Pulmonary Embolism, A. Gupta, A. S. Raja, I. K. Ip, R. Khorasani
Assessing 2 D-Dimer Age-Adjustment Strategies To Optimize Computed Tomographic Use In Ed Evaluation Of Pulmonary Embolism, A. Gupta, A. S. Raja, I. K. Ip, R. Khorasani
Journal Articles
STUDY OBJECTIVE: Validate the sensitivity and specificity of 2 age adjustment strategies for d-dimer values in identifying patients at risk for pulmonary embolism (PE) compared with traditional D-dimer cutoff value (500 ng/mL) to decrease inappropriate computed tomography pulmonary angiography (CTPA) use. METHODS: This institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included all adult emergency department patients evaluated for PE over a 32-month period (1/1/11-8/30/13). Only patients undergoing CTPA and D-dimer testing were included. We used a validated natural language processing algorithm to parse CTPA radiology reports and determine the presence of acute PE. Outcome measures were …
Incidence And Predictors Of Acute Psychological Distress And Dissociation After Motor Vehicle Collision: A Cross-Sectional Study, G. C. Lewis, T. F. Platts-Mills, I. Liberzon, E. Bair, R. Swor, N. Rathlev, D. Lee, R. Domeier, P. Hendry, S. A. Mclean, +2 Additional Authors
Incidence And Predictors Of Acute Psychological Distress And Dissociation After Motor Vehicle Collision: A Cross-Sectional Study, G. C. Lewis, T. F. Platts-Mills, I. Liberzon, E. Bair, R. Swor, N. Rathlev, D. Lee, R. Domeier, P. Hendry, S. A. Mclean, +2 Additional Authors
Journal Articles
Objective: We examined the incidence and predictors of peritraumatic distress and dissociation after one of the most common forms of civilian trauma exposure: motor vehicle collision (MVC). Method: In this study, patients presenting to the emergency department after MVCs who were without serious injury and discharged to home after evaluation (n = 935) completed an emergency department interview evaluating sociodemographic, collision-related, and psychological characteristics. Results: The incidence and predictors of distress (Peritraumatic Distress Inventory score 23) and dissociation (Michigan Critical Events Perception Scale score >3) were assessed. Distress was present in 355 of 935 patients (38%), and dissociation was present …
Sideline Coverage: When To Get Radiographs? A Review Of Clinical Decision Tools, S. J. Gould, D. A. Cardone, J. Munyak, P. J. Underwood, S. A. Gould
Sideline Coverage: When To Get Radiographs? A Review Of Clinical Decision Tools, S. J. Gould, D. A. Cardone, J. Munyak, P. J. Underwood, S. A. Gould
Journal Articles
CONTEXT: Sidelines coverage presents unique challenges in the evaluation of injured athletes. Health care providers may be confronted with the question of when to obtain radiographs following an injury. Given that most sidelines coverage occurs outside the elite level, radiographs are not readily available at the time of injury, and the decision of when to send a player for radiographs must be made based on physical examination. Clinical tools have been developed to aid in identifying injuries that are likely to result in radiographically important fractures or dislocations. EVIDENCE ACQUISITION: A search for the keywords x-ray and decision rule along …
Effect Of Clinical Decision Support On Documented Guideline Adherence For Head Ct In Emergency Department Patients With Mild Traumatic Brain Injury, A. Gupta, I. K. Ip, A. S. Raja, J. E. Andruchow, A. Sodickson, R. Khorasani
Effect Of Clinical Decision Support On Documented Guideline Adherence For Head Ct In Emergency Department Patients With Mild Traumatic Brain Injury, A. Gupta, I. K. Ip, A. S. Raja, J. E. Andruchow, A. Sodickson, R. Khorasani
Journal Articles
Imaging utilization in emergency departments (EDs) has increased significantly. More than half of the 1.2 million patients with mild traumatic brain injury (MTBI) presenting to US EDs receive head CT. While evidence-based guidelines can help emergency clinicians decide whether to obtain head CT in these patients, adoption of these guidelines has been highly variable. Promulgation of imaging efficiency guidelines by the National Quality Forum has intensified the need for performance reporting, but measuring adherence to these imaging guidelines currently requires labor-intensive and potentially inaccurate manual chart review. We implemented clinical decision support (CDS) based on published evidence to guide emergency …
Examining Clinical Decision Support Integrity: Is Clinician Self-Reported Data Entry Accurate?, A. Gupta, A. S. Raja, R. Khorasani
Examining Clinical Decision Support Integrity: Is Clinician Self-Reported Data Entry Accurate?, A. Gupta, A. S. Raja, R. Khorasani
Journal Articles
The aim of this study was to assess the accuracy of clinician-entered data in imaging clinical decision support (CDS). We used CDS-guided CT angiography (CTA) for pulmonary embolus (PE) in the emergency department as a case example because it required clinician entry of d-dimer results which could be unambiguously compared with actual laboratory values. Of 1296 patients with CTA orders for suspected PE during 2011, 1175 (90.7%) had accurate d-dimer values entered. In 55 orders (4.2%), incorrectly entered data shielded clinicians from intrusive computer alerts, resulting in potential CTA overuse. Remaining data entry errors did not affect user workflow. We …
The Hmgb1/Rage Inflammatory Pathway Promotes Pancreatic Tumor Growth By Regulating Mitochondrial Bioenergetics, R. Kang, D. Tang, N. E. Schapiro, T. Loux, K. M. Livesey, T. R. Billiar, H. Wang, B. Van Houten, M. T. Lotze, H. J. Zeh
The Hmgb1/Rage Inflammatory Pathway Promotes Pancreatic Tumor Growth By Regulating Mitochondrial Bioenergetics, R. Kang, D. Tang, N. E. Schapiro, T. Loux, K. M. Livesey, T. R. Billiar, H. Wang, B. Van Houten, M. T. Lotze, H. J. Zeh
Journal Articles
Tumor cells require increased adenosine triphosphate (ATP) to support anabolism and proliferation. The precise mechanisms regulating this process in tumor cells are unknown. Here, we show that the receptor for advanced glycation endproducts (RAGE) and one of its primary ligands, high-mobility group box 1 (HMGB1), are required for optimal mitochondrial function within tumors. We found that RAGE is present in the mitochondria of cultured tumor cells as well as primary tumors. RAGE and HMGB1 coordinately enhanced tumor cell mitochondrial complex I activity, ATP production, tumor cell proliferation and migration. Lack of RAGE or inhibition of HMGB1 release diminished ATP production …
Incidence And Predictors Of Neck And Widespread Pain After Motor Vehicle Collision Among Us Litigants And Nonlitigants, S. A. Mclean, J. C. Ulirsch, G. D. Slade, A. C. Soward, R. A. Swor, D. A. Peak, J. S. Jones, N. K. Rathlev, D. C. Lee, E. Bair, +3 Additional Authors
Incidence And Predictors Of Neck And Widespread Pain After Motor Vehicle Collision Among Us Litigants And Nonlitigants, S. A. Mclean, J. C. Ulirsch, G. D. Slade, A. C. Soward, R. A. Swor, D. A. Peak, J. S. Jones, N. K. Rathlev, D. C. Lee, E. Bair, +3 Additional Authors
Journal Articles
Debate continues regarding the influence of litigation on pain outcomes after motor vehicle collision (MVC). In this study we enrolled European Americans presenting to the emergency department (ED) in the hours after MVC (n = 948). Six weeks later, participants were interviewed regarding pain symptoms and asked about their participation in MVC-related litigation. The incidence and predictors of neck pain and widespread pain 6 weeks after MVC were compared among those engaged in litigation (litigants) and those not engaged in litigation (nonlitigants). Among the 859 of 948 (91%) participants completing 6-week follow-up, 711 of 849 (83%) were nonlitigants. Compared to …
A Consensus Parameter For The Evaluation And Management Of Angioedema In The Emergency Department, J. J. Moellman, J. A. Bernstein, C. Lindsell, A. Banerji, P. J. Busse, C. A., Jr. Camargo, S. P. Collins, R. L. Campbell, S. Schneider, R. Sinert, +10 Additional Authors
A Consensus Parameter For The Evaluation And Management Of Angioedema In The Emergency Department, J. J. Moellman, J. A. Bernstein, C. Lindsell, A. Banerji, P. J. Busse, C. A., Jr. Camargo, S. P. Collins, R. L. Campbell, S. Schneider, R. Sinert, +10 Additional Authors
Journal Articles
Despite its relatively common occurrence and life-threatening potential, the management of angioedema in the emergency department (ED) is lacking in terms of a structured approach. It is paramount to distinguish the different etiologies of angioedema from one another and more specifically differentiate histaminergic-mediated angioedema from bradykinin-mediated angioedema, especially in lieu of the more novel treatments that have recently become available for bradykinin-mediated angioedema. With this background in mind, this consensus parameter for the evaluation and management of angioedema attempts to provide a working framework for emergency physicians (EPs) in approaching the patient with angioedema in terms of diagnosis and management …
Case Report: Transient Small Bowel Intussusception Presenting As Right Lower Quadrant Pain In A 6-Year-Old Male, M. J. Nelson, T. Paterson, C. Raio
Case Report: Transient Small Bowel Intussusception Presenting As Right Lower Quadrant Pain In A 6-Year-Old Male, M. J. Nelson, T. Paterson, C. Raio
Journal Articles
In children presenting to the emergency room with right lower quadrant pain, ultrasound is the preferred initial modality. In our patient, a 6-year-old male with a sudden onset of severe right lower quadrant pain, the differential is broad, including appendicitis and intussusception. In order to narrow our differential and secure the diagnosis, our first modality was ultrasonography. With the increased use of point-of-care ultrasound in the emergency department, the diagnosis of appendicitis and ileo-colic intussusception has been made more frequently. In addition, other entities such as transient small bowel intussusception may be identified. As in our case, obstruction secondary to …
Hmgb1 In Health And Disease, R. Kang, R. C. Chen, Q. H. Zhang, W. Hou, S. Wu, X. G. Fan, Z. W. Yan, X. F. Sun, H. C. Wang, D. L. Tang, +8 Additional Authors
Hmgb1 In Health And Disease, R. Kang, R. C. Chen, Q. H. Zhang, W. Hou, S. Wu, X. G. Fan, Z. W. Yan, X. F. Sun, H. C. Wang, D. L. Tang, +8 Additional Authors
Journal Articles
Complex genetic and physiological variations as well as environmental factors that drive emergence of chromosomal instability, development of unscheduled cell death, skewed differentiation, and altered metabolism are central to the pathogenesis of human diseases and disorders. Understanding the molecular bases for these processes is important for the development of new diagnostic biomarkers, and for identifying new therapeutic targets. In 1973, a group of non-histone nuclear proteins with high electrophoretic mobility was discovered and termed high-mobility group (HMG) proteins. The HMG proteins include three superfamilies termed HMGB, HMGN, and HMGA. High-mobility group box 1 (HMGB1), the most abundant and well-studied HMG …