Medicine and Health Sciences Commons^™

Brief Review: Regional Anesthesia For Vaso-Occlusive Pain Crises, Oluwatomi Alade

Rowan-Virtua Research Day

Vaso-occlusive pain crisis occurs with obstruction of blood vessels from sickled red blood cells. This results in ischemic injury causing in pain. Acute vasoocclusive pain crisis is one of the most common reasons for patients with sickle cell disease to present to the hospital for medical attention. Acute treatment involves IV opioid therapy, non-opioid therapy, and IV hydration. There is a known lack of trust between a patient in acute pain and a provider in the emergency department (ED) and hospital secondary to stereotypes regarding pain seeking behavior. Here we discuss a case of vasoocclusive pain crisis refractory to opioid …

Current Best Practice In Pelvic And Hip Fracture Management In The Older Adult Population, Anthony P. Joseph

Journal of Geriatric Emergency Medicine

Fractures of the pelvis and hip are a relatively frequent occurrence in the older population. Pelvic fractures in older patients usually occur after a fall from standing height. CT scan is the investigation of choice. There are several classifications available which are useful in risk stratification and predicting surgical treatment. Haemorrhage is a major complication and can usually be treated by interventional radiology. An Orthopedic opinion should be sought promptly, and surgical stabilisation (if indicated) should be completed as early as possible to enable early mobilisation and the avoidance of complications such as deep vein thrombosis or pneumonia.

Hip fractures …

Older Person Fracture Presentation And Management Including Tips For Pain Management, Timothy D W Arnold

Journal of Geriatric Emergency Medicine

Fractures in older adults occur in patients who commonly carry chronic, complex multi-system disease. Nuanced management for these injuries is required in this patient group to reduce mortality, morbidity and improve outcomes.

Abc's Of Geriatric Trauma, Teresita Hogan

Journal of Geriatric Emergency Medicine

The ABC's approach to geriatric trauma alerts clinicians to specific important factors in emergency evaluation of an injured older adult.

Anticancer Effect Of Illicium Verum (Star Anise Fruit) Against Human Breast Cancer Mcf-7 Cell Line, Asra Khan Pahore, Shagufta Khan, Nasim Karim

Department of Biological & Biomedical Sciences

Objective: To investigate the anticancer effect of Illicium verum against human breast cancer MCF-7 cell line.
Methods: An experimental study was conducted in Multidisciplinary and Tissue Culture Laboratory, Aga Khan University in collaboration with Pharmacology Department of Bahria University Medical and Dental College, Karachi, Pakistan from January 2021 to June 2021. MCF-7 cells of Luminal-A breast cancer were seeded in 96-well plate and treated with I.verum methanol extract. After incubation, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) dye was used for cell viability and cell proliferation assays to determine the number of dead and viable cells, and the absorbance was measured using an enzyme-linked …

Managing Acute Pain In Hiv+/Aids Patients: Knowledge And Practice Trends Among Emergency Physicians Of Major Tertiary Care Centers Of A Developing Country, Aliya Ahmed, Gauhar Afshan, Robyna Irshad Khan, Badar Afzal Khan, Seemin Jamali, Nighat Farooq, Sarosh Saleem, Rubaba Naeem, Uzma R. Khan

Department of Anaesthesia

Objective: To assess knowledge and practice trends in managing acute pain in patients infected with human immunodeficiency virus (HIV+) or having acquired immunodeficiency syndrome (AIDS) among emergency physicians of four tertiary care hospitals. Acute pain management in such patients is complex because of multiple concomitant painful conditions related to their disease. After obtaining ethical approval and written informed consent, emergency physicians were requested to fill out a questionnaire.
Results: Out of 84 physicians who participated, 49 had managed HIV+/AIDS patients during the preceding year. Out of the 49, 30 (61.2%) physicians stated that they used a combination of analgesics for …

Bringing Upstairs Care Downstairs; Integration Of Rehabilitation Medicine, Care Management, And The Hospital Elder Life Program (Help) Into An Emergency Department., Robert Anderson, Molly Anderson, Rhonda Babine, Farid Feghali, Elizabeth Dunstan, Matthew Glazer, Susan Horton, Stephanie O'Brien, Elizabeth Pontius, David Smith, Megan Viens, Heather Williams

Journal of Maine Medical Center

Introduction: Services such as physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), social work (SW), care management, and elder life specialists have long been an established part of care for patients admitted to Maine Medical Center (MMC) but not for patients in the Emergency Department (ED). Methods and Results: Driven in part by changes in Medicare reimbursement models, care management established a presence in the Emergency Department (ED) in 2003 with a focus on care planning and cost avoidance. In recent years PT, OT, SLP, SW, and the Hospital Elder Life Program (HELP) have increased their ED involvement substantially. …

Geographical Variation And Predictors Of Physical Activity Level In Adults With Congenital Heart Disease., Lena Larsson, Bengt Johansson, Camilla Sandberg, Silke Apers, Adrienne Kovacs, Koen Luyckx, Corina Thomet, Werner Budts, Junko Enomoto, Maayke Sluman, Jou-Kou Wang, Jamie Jackson, Paul Khairy, Stephen Cook, Luis Alday, Katrine Eriksen, Mikael Dellborg, Malin Berghammer, Gwen Rempel, Samuel Menahem, Maryanne Caruana, Martha Tomlin, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Philip Moons

Psychology Faculty Works

Background: Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin. Methods: 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated …

Redefining Frequent Emergency Department Users, Amy Waldner, Maria Raven, Danielle Lazar, Jesse Pines

Center for Health Care Quality

Frequent ED users are perceived to be a costly population that often abuse or misuse ED services due to a combination of unmet social needs and medical conditions that, in theory, could be treated outside of the ED at a lower cost. The reality is that factors contributing to frequent ED use are more varied and complex than originally believed.

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 …

Effect Of Pain Location And Duration On Life Function In The Year After Motor Vehicle Collision, A. V. Bortsov, T. F. Platts-Mills, D. A. Peak, J. S. Jones, R. A. Swor, D. C. Lee, N. K. Rathlev, P. L. Hendry, R. B. Fillingim, S. A. Mclean, +1 Additional Author

Journal Articles

Persistent musculoskeletal pain is common after motor vehicle collision (MVC) and often results in substantial disability. The objective of this study was to identify distributions of post-MVC pain that most interfere with specific life functions and that have the greatest interference with aggregate life function. Study data were obtained from a prospective longitudinal multicenter emergency department-based cohort of 948 European Americans experiencing MVC. Overall pain (0-10 numeric rating scale [NRS]), pain in each of 20 body regions (0-10 NRS), and pain interference (Brief Pain Inventory, 0-10 NRS) were assessed 6 weeks, 6 months, and 1 year after MVC. After adjustment …

Special Maneuver For Removal Of An Impacted Bronchial Foreign Body At Thoracotomy, Saima H. Khan, Asad Mian, Qaisar M. Khan, Naeem-Uz-Zafar Khan

Department of Emergency Medicine

Tracheobronchial foreign body aspiration is a common, but often unobserved event in children. A delay in diagnosis can lead to difficulty in removal of the aspirated object. The present case report highlights a special intraoperative maneuver at thoracotomy that was adopted to remove an impacted foreign body that could not be removed at bronchoscopy.

Late Onset Oesophageal Perforation Due To Gunshot Injury Of Chest: Successful Non-Operative Management In A Young Child, Asad Mian, Saima H. Khan, Naeem-Uz-Zafar Khan

Department of Emergency Medicine

Penetrating firearm injuries of the chest have become commonplace in children living in violent urban areas. Esophageal perforation may present as a late manifestation of peadiatric thoracic trauma due to gunshot injury. Opinion varies as to the surgical or nonsurgical management of such a patient. The authors report a case of a 12-year-old girl who presented with a similar dilemma and her successful conservative management, that they opted for; is discussed.