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Articles 1 - 30 of 244
Full-Text Articles in Medical Specialties
Ratio Of Vascular Pedicle Width And Thoracic Diameter To Differentiate Cardiogenic And Non-Cardiogenic Pulmonary Edema, Rahmi Afifi, Achmad Fachri, Amir Sjarifuddin Madjid, Joedo Prihartono, Marcel Prasetyo, Andreas Christian
Ratio Of Vascular Pedicle Width And Thoracic Diameter To Differentiate Cardiogenic And Non-Cardiogenic Pulmonary Edema, Rahmi Afifi, Achmad Fachri, Amir Sjarifuddin Madjid, Joedo Prihartono, Marcel Prasetyo, Andreas Christian
Makara Journal of Health Research
Background: Excess intravascular volume evaluation is essential in the intensive care unit (ICU); however, clinical information to differentiate cardiogenic and non-cardiogenic pulmonary edema has been proven ineffective. Thus, this study aimed to distinguish cardiogenic from non-cardiogenic pulmonary edema using the ratio of vascular pedicle width (VPW) to thoracic diameter (VPTR).
Methods: This cross-sectional study was conducted based on secondary data from chest radiographs of 100 patients with clinical symptoms of pulmonary edema in the ICU from January 2013 to December 2015. Cardiogenic and non-cardiogenic pulmonary edema were distinguished using VPW and cardiothoracic ratio measurements (CTR). VPTR was measured …
Investigating The Effectiveness Of Prehospital Recognition And Administration Of Intravenous Antibiotics In Septic Patients, Laura Keane, Ian Peterson
Investigating The Effectiveness Of Prehospital Recognition And Administration Of Intravenous Antibiotics In Septic Patients, Laura Keane, Ian Peterson
Physician Assistant Capstones, 2020-current
Objective: To compare the 30-day mortality rate of suspected sepsis patients who received prehospital (Emergency Medical Services- EMS) antibiotic administration in an ambulance as compared to antibiotic administration in the hospital. Design: Systematic literature review. Methods: Research was conducted in PubMed and Google Scholar with the search terms: sepsis, antibiotics, prehospital, EMS, ambulance. The 3 articles selected were chosen after removing articles not from a randomized control trial, no antibiotic administration, and not a free article. Results: From our meta-analysis of the three studies, we concluded that providing antibiotics before arriving at the hospital for patients with suspected septic infections. …
Is A Lumbar Puncture Necessary? Identifying The Need For A Lp With A Negative Ct Scan When Diagnosing A Non-Traumatic Subarachnoid Hemorrhage, Carlee Raymond, Erin S. Lang
Is A Lumbar Puncture Necessary? Identifying The Need For A Lp With A Negative Ct Scan When Diagnosing A Non-Traumatic Subarachnoid Hemorrhage, Carlee Raymond, Erin S. Lang
Physician Assistant Capstones, 2020-current
Objective: To assess the current standard for the detection of non-traumatic subarachnoid hemorrhage (SAH), and evaluate the need for a lumbar puncture with a negative head CT. Is a negative head CT thorough enough to definitively rule out a SAH?
Design: Systematic literature review
Methods: Our research began on the PubMed database using the search terms Subarachnoid Hemorrhage and Lumbar Puncture. We filtered our data with filters including; data in the last ten years, primary research, and full text articles.
Results: Retrospective studies include; Bianchi et al. (2021), Chee et al. (2020) and Tulla et al.(2018). All three studies showed …
Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura
Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura
Physician Assistant Capstones, 2020-current
Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).
Design: Systematic literature review
Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …
Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho
Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho
Master's Projects and Capstones
The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …
The Geriatric Emergency Department At The University Of California San Francisco: Structures, Roles, And Lessons Learned, Todd James
Journal of Geriatric Emergency Medicine
No abstract provided.
Pre-Hospital Conditions Affecting The Hospitalization Risk In Older Adults At The Emergency Department, Karin Erwander, Kjell Ivarsson, Mona Landin-Olsson, Björn Agvall
Pre-Hospital Conditions Affecting The Hospitalization Risk In Older Adults At The Emergency Department, Karin Erwander, Kjell Ivarsson, Mona Landin-Olsson, Björn Agvall
Journal of Geriatric Emergency Medicine
BACKGROUND: The Emergency Department (ED) is a common route to hospitalization for critically ill and older adults. Older patients are admitted to hospital at a higher rate and have longer length of stay (LOS) when hospitalized. To be able to confront an increasing aging population, meet their medical needs and influence rising costs of health care, there is a need to focus on the older population. In Scandinavia, few studies are made that focus on the geriatric population at the ED. It is essential to early identify risk factors for hospitalization at the ED to improve the medical care for …
Unfavorable Social Determinants Of Health Are Associated With Higher Burden Of Financial Toxicity Among Patients With Atherosclerotic Cardiovascular Disease In The Us: Findings From The National Health Interview Survey, Javier Valero-Elizondo, Zulqarnain Javed, Rohan Khera, Mauricio E. Tano, Ramzi Dudum, Isaac Acquah, Adnan A. Hyder, Julia Andrieni, Garima Sharma, Salim S. Virani
Unfavorable Social Determinants Of Health Are Associated With Higher Burden Of Financial Toxicity Among Patients With Atherosclerotic Cardiovascular Disease In The Us: Findings From The National Health Interview Survey, Javier Valero-Elizondo, Zulqarnain Javed, Rohan Khera, Mauricio E. Tano, Ramzi Dudum, Isaac Acquah, Adnan A. Hyder, Julia Andrieni, Garima Sharma, Salim S. Virani
Office of the Provost
Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of financial toxicity, defined as excess financial strain from healthcare, in the US. Identifying factors that put patients at greatest risk can help inform more targeted and cost-effective interventions. Specific social determinants of health (SDOH) such as income are associated with a higher risk of experiencing financial toxicity from healthcare, however, the associations between more comprehensive measures of cumulative social disadvantage and financial toxicity from healthcare are poorly understood.
Methods: Using the National Health Interview Survey (2013-17), we assessed patients with self-reported ASCVD. We identified 34 discrete SDOH items, across 6 …
Anticancer Effect Of Illicium Verum (Star Anise Fruit) Against Human Breast Cancer Mcf-7 Cell Line, Asra Khan Pahore, Shagufta Khan, Nasim Karim
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 …
Feasibility Of Project Echo Telementoring To Build Capacity Among Non-Specialist Emergency Care Providers, Grace Wanjiku, Lindsay Dreizler, Gregory Bell, Benjamin Wachira
Feasibility Of Project Echo Telementoring To Build Capacity Among Non-Specialist Emergency Care Providers, Grace Wanjiku, Lindsay Dreizler, Gregory Bell, Benjamin Wachira
Emergency Medicine, East Africa
The COVID-19 pandemic has led to global disruptions in emergency medicine (EM) teaching and training and highlighted the need to strengthen virtual learning platforms. This disruption coincides with essential efforts to scale up training of the emergency healthcare workforce, particularly in low-resource settings where the specialty is not well developed. Thus, there is growing interest in strengthening virtual platforms that can be used to support emergency medicine educational initiatives globally. These platforms must be robust, context specific and sustainable in low-resource environments. This report describes the implementation of Project ECHO (Extension for Community Healthcare Outcomes), a telementoring platform originally designed …
Who Leads The Emergency Department Debrief?, Allison D. Lane, Ethan Bryce, Marcy R. Milbrandt, Lisa R. Stoneking
Who Leads The Emergency Department Debrief?, Allison D. Lane, Ethan Bryce, Marcy R. Milbrandt, Lisa R. Stoneking
Journal of Wellness
No abstract provided.
Covid-19 Vaccine Equity: Codesigning Public Health Interventions With Community Partners, Eva Varotsis, Lauren Schlegel, B. H. Slovis, Patricia C. Henwood, Sandra E Brooks, Robert S. Pugliese, Bon Ku, Morgan Hutchinson
Covid-19 Vaccine Equity: Codesigning Public Health Interventions With Community Partners, Eva Varotsis, Lauren Schlegel, B. H. Slovis, Patricia C. Henwood, Sandra E Brooks, Robert S. Pugliese, Bon Ku, Morgan Hutchinson
Department of Emergency Medicine Faculty Papers
No abstract provided.
Association Of Initial Sars-Cov-2 Test Positivity With Patient-Reported Well-Being 3 Months After A Symptomatic Illness., Lauren E Wisk, Michael A Gottlieb, Erica S Spatz, Huihui Yu, Ralph C Wang, B. H. Slovis, Sharon Saydah, Ian D Plumb, Kelli N O'Laughlin, Juan Carlos C Montoy, Samuel A Mcdonald, Zhenqiu Lin, Jin-Mann S Lin, Katherine Koo, Ahamed H Idris, Ryan M Huebinger, Mandy J Hill, Nicole L Gentile, Anna Marie Chang, Jill Anderson, Bala Hota, Arjun K Venkatesh, Robert A Weinstein, Joann G Elmore, Graham Nichol
Association Of Initial Sars-Cov-2 Test Positivity With Patient-Reported Well-Being 3 Months After A Symptomatic Illness., Lauren E Wisk, Michael A Gottlieb, Erica S Spatz, Huihui Yu, Ralph C Wang, B. H. Slovis, Sharon Saydah, Ian D Plumb, Kelli N O'Laughlin, Juan Carlos C Montoy, Samuel A Mcdonald, Zhenqiu Lin, Jin-Mann S Lin, Katherine Koo, Ahamed H Idris, Ryan M Huebinger, Mandy J Hill, Nicole L Gentile, Anna Marie Chang, Jill Anderson, Bala Hota, Arjun K Venkatesh, Robert A Weinstein, Joann G Elmore, Graham Nichol
Department of Emergency Medicine Faculty Papers
IMPORTANCE: Long-term sequelae after symptomatic SARS-CoV-2 infection may impact well-being, yet existing data primarily focus on discrete symptoms and/or health care use.
OBJECTIVE: To compare patient-reported outcomes of physical, mental, and social well-being among adults with symptomatic illness who received a positive vs negative test result for SARS-CoV-2 infection.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a planned interim analysis of an ongoing multicenter prospective longitudinal registry study (the Innovative Support for Patients With SARS-CoV-2 Infections Registry [INSPIRE]). Participants were enrolled from December 11, 2020, to September 10, 2021, and comprised adults (aged ≥18 years) with acute symptoms suggestive …
Association Of Initial Sars-Cov-2 Test Positivity With Patient-Reported Well-Being 3 Months After A Symptomatic Illness, Lauren E Wisk, Michael A Gottlieb, Erica S Spatz, Huihui Yu, Ralph C Wang, Benjamin H Slovis, Sharon Saydah, Ian D Plumb, Kelli N O'Laughlin, Juan Carlos C Montoy, Samuel A Mcdonald, Zhenqiu Lin, Jin-Mann S Lin, Katherine Koo, Ahamed H Idris, Ryan M Huebinger, Mandy J Hill, Nicole L Gentile, Anna Marie Chang, Jill Anderson, Bala Hota, Arjun K Venkatesh, Robert A Weinstein, Joann G Elmore, Graham Nichol, Inspire Group
Association Of Initial Sars-Cov-2 Test Positivity With Patient-Reported Well-Being 3 Months After A Symptomatic Illness, Lauren E Wisk, Michael A Gottlieb, Erica S Spatz, Huihui Yu, Ralph C Wang, Benjamin H Slovis, Sharon Saydah, Ian D Plumb, Kelli N O'Laughlin, Juan Carlos C Montoy, Samuel A Mcdonald, Zhenqiu Lin, Jin-Mann S Lin, Katherine Koo, Ahamed H Idris, Ryan M Huebinger, Mandy J Hill, Nicole L Gentile, Anna Marie Chang, Jill Anderson, Bala Hota, Arjun K Venkatesh, Robert A Weinstein, Joann G Elmore, Graham Nichol, Inspire Group
Journal Articles
IMPORTANCE: Long-term sequelae after symptomatic SARS-CoV-2 infection may impact well-being, yet existing data primarily focus on discrete symptoms and/or health care use.
OBJECTIVE: To compare patient-reported outcomes of physical, mental, and social well-being among adults with symptomatic illness who received a positive vs negative test result for SARS-CoV-2 infection.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a planned interim analysis of an ongoing multicenter prospective longitudinal registry study (the Innovative Support for Patients With SARS-CoV-2 Infections Registry [INSPIRE]). Participants were enrolled from December 11, 2020, to September 10, 2021, and comprised adults (aged ≥18 years) with acute symptoms suggestive …
Freedom As Prevention: Mechanisms Of Autonomy Support For Promoting Hiv Pre-Exposure Prophylaxis Use And Condom Use Among Black Msm In 3 Us Cities-Hptn 073, Laron E Nelson, Donte T Boyd, Geetha Beauchamp, Lynda Emel, Leo Wilton, Darren Whitfield, S Raquel Ramos, Wale Ajiboye, Mandy J Hill, Donaldson F Conserve, Portia Thomas, Lisa Hightow-Weidman, Steve Shoptaw, Manya Magnus, Kenneth H Mayer, Estelle Piwowar-Manning, Sheldon D Fields, Darrell P Wheeler, Hptn 073 Study Team
Freedom As Prevention: Mechanisms Of Autonomy Support For Promoting Hiv Pre-Exposure Prophylaxis Use And Condom Use Among Black Msm In 3 Us Cities-Hptn 073, Laron E Nelson, Donte T Boyd, Geetha Beauchamp, Lynda Emel, Leo Wilton, Darren Whitfield, S Raquel Ramos, Wale Ajiboye, Mandy J Hill, Donaldson F Conserve, Portia Thomas, Lisa Hightow-Weidman, Steve Shoptaw, Manya Magnus, Kenneth H Mayer, Estelle Piwowar-Manning, Sheldon D Fields, Darrell P Wheeler, Hptn 073 Study Team
Journal Articles
Healthcare providers who use controlling or coercive strategies may compel short-term enactment of HIV and sexually transmitted infection prevention behaviors but may inadvertently undermine their client's motivation to maintain those behaviors in the absence of external pressure. Autonomous motivation refers to the self-emanating and self-determined drive for engaging in health behaviors. It is associated with long-term maintenance of health behaviors. We used structural equation modeling to investigate whether autonomy support was associated with increased odds of therapeutic serum levels of pre-exposure prophylaxis, through a pathway that satisfies basic psychological needs for autonomous self-regulation and competence regarding pre-exposure prophylaxis use. We …
Fast Does Not Imply Flawed: Analyzing Emergency Physician Productivity And Medical Errors, Nathan R Hoot, Timothy J Barbosa, Hei Kit Chan, Jonathan G Rogg
Fast Does Not Imply Flawed: Analyzing Emergency Physician Productivity And Medical Errors, Nathan R Hoot, Timothy J Barbosa, Hei Kit Chan, Jonathan G Rogg
Journal Articles
OBJECTIVE: To determine whether emergency physician productivity is associated with the risk of medical errors.
METHODS: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal-Wallis testing to examine relationships …
Effectiveness Of Non-Invasive Respiratory Support Strategies In Patients With Covid-19: A Systematic Review And Meta Analysis, Vinesh Kumar, Umair Arshad Malik, Reshman Kumari, Berkha Berkha, Vijay Kumar, Manoj Kumar, Simran Simran, Suman Suman, Bushra Nasim
Effectiveness Of Non-Invasive Respiratory Support Strategies In Patients With Covid-19: A Systematic Review And Meta Analysis, Vinesh Kumar, Umair Arshad Malik, Reshman Kumari, Berkha Berkha, Vijay Kumar, Manoj Kumar, Simran Simran, Suman Suman, Bushra Nasim
Medical College Documents
Background: The effectiveness of non-invasive respiratory strategies, namely CPAP and HFNO, in reducing the risk of mortality and tracheal intubation in patients with severe COVID-19 is not well established.
Methods: A thorough literature search was conducted across 3 electronic databases (Medline, EMBASE and Cochrane Central) from inception through July 2022. Randomized controlled trials (RCTs) and observational studies assessing the impact of CPAP or HFNO on clinical outcomes in patients infected with COVID-19 were considered for inclusion. End-points included all-cause mortality and risk of tracheal intubation. Evaluations were reported as risk ratios (RRs) with 95% confidence intervals (CI) and analysis was …
Tip-Over Injuries Among Children: Data From An Urban Emergency Department Of Karachi, Pakistan, Rubaba Naeem, Asrar Ali, Ahmed Raheem Buksh, Ayesha Quddusi, Uzma Rahim Khan
Tip-Over Injuries Among Children: Data From An Urban Emergency Department Of Karachi, Pakistan, Rubaba Naeem, Asrar Ali, Ahmed Raheem Buksh, Ayesha Quddusi, Uzma Rahim Khan
Department of Emergency Medicine
Introduction: Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department.
Methods: We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information …
Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan
Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan
Department of Psychiatry
Introduction: Suicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.
Methods and …
Sociodemographic Determinants Of Oral Anticoagulant Prescription In Patients With Atrial Fibrillations: Findings From The Pinnacle Registry Using Machine Learning, Zahra Azizi, Andrew T. Ward, Donghyun J. Lee, Sanchit S. Gad, Kanchan Bhasin, Robert J. Beetel, Tiago Ferreira, Sushant Shankar, John S. Rumsfeld, Salim S. Virani
Sociodemographic Determinants Of Oral Anticoagulant Prescription In Patients With Atrial Fibrillations: Findings From The Pinnacle Registry Using Machine Learning, Zahra Azizi, Andrew T. Ward, Donghyun J. Lee, Sanchit S. Gad, Kanchan Bhasin, Robert J. Beetel, Tiago Ferreira, Sushant Shankar, John S. Rumsfeld, Salim S. Virani
Office of the Provost
Background: Current risk scores that are solely based on clinical factors have shown modest predictive ability for understanding of factors associated with gaps in real-world prescription of oral anticoagulation (OAC) in patients with atrial fibrillation (AF).
Objective: In this study, we sought to identify the role of social and geographic determinants, beyond clinical factors associated with variation in OAC prescriptions using a large national registry of ambulatory patients with AF.
Methods: Between January 2017 and June 2018, we identified patients with AF from the American College of Cardiology PINNACLE (Practice Innovation and Clinical Excellence) Registry. We examined associations between patient …
Validation Of Prediction Rules For Computed Tomography Use In Children With Blunt Abdominal Or Blunt Head Trauma: Protocol For A Prospective Multicenter Observational Cohort Study, Irma T Ugalde, Pradip P Chaudhari, Mohamed Badawy, Paul Ishimine, Kevan A Mccarten-Gibbs, Kenneth Yen, Nisa S Atigapramoj, Allyson Sage, Donovan Nielsen, P David Adelson, Jeffrey Upperman, Daniel Tancredi, Nathan Kuppermann, James F Holmes
Validation Of Prediction Rules For Computed Tomography Use In Children With Blunt Abdominal Or Blunt Head Trauma: Protocol For A Prospective Multicenter Observational Cohort Study, Irma T Ugalde, Pradip P Chaudhari, Mohamed Badawy, Paul Ishimine, Kevan A Mccarten-Gibbs, Kenneth Yen, Nisa S Atigapramoj, Allyson Sage, Donovan Nielsen, P David Adelson, Jeffrey Upperman, Daniel Tancredi, Nathan Kuppermann, James F Holmes
Journal Articles
BACKGROUND: Traumatic brain injuries (TBIs) and intra-abdominal injuries (IAIs) are 2 leading causes of traumatic death and disability in children. To avoid missed or delayed diagnoses leading to increased morbidity, computed tomography (CT) is used liberally. However, the overuse of CT leads to inefficient care and radiation-induced malignancies. Therefore, to maximize precision and minimize the overuse of CT, the Pediatric Emergency Care Applied Research Network (PECARN) previously derived clinical prediction rules for identifying children at high risk and very low risk for IAIs undergoing acute intervention and clinically important TBIs after blunt trauma in large cohorts of children who are …
Effect Of Pharmacist Intervention On Emergency Department Geriatric Patients With Polypharmacy, Rachael Sheehan, Ashley Stajkowski, Lee Hraby, Melanie Mommaerts, Tyler Nichols, Marisa Nichols, Alex Beuning, Victor Warne
Effect Of Pharmacist Intervention On Emergency Department Geriatric Patients With Polypharmacy, Rachael Sheehan, Ashley Stajkowski, Lee Hraby, Melanie Mommaerts, Tyler Nichols, Marisa Nichols, Alex Beuning, Victor Warne
Journal of Geriatric Emergency Medicine
Background: Polypharmacy is common within the geriatric population due to the commonality of multiple comorbidities and use of multiple providers. The emergency department (ED) is a prime location to capture these patients, especially when they present with chief complaints which may be medication related. Much of this population is prescribed potentially inappropriate medications which increases their risk for adverse drug reactions. Pharmacist review of patient home medication lists has been shown to decrease the number of potentially inappropriate medications, as well as medication-related problems, such as therapeutic duplications and drug interactions. These reductions can increase patient safety.
Objective: The goal …
Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann
Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann
Department of Emergency Medicine Faculty Papers
Purpose: To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.
Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.
Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8minutes, over a quarter of visits (27%) were over 2hours. Patients waited an …
Emergency Medicine Clinician Experiences Addressing Uncertainty In First-Trimester Bleeding., Garrison Nord, Amanda Doty, Andrew J Monick, Danielle M Mccarthy, Robin J Casten, Amer Z Aldeen, Philip S Nawrocki, Kristin L. Rising
Emergency Medicine Clinician Experiences Addressing Uncertainty In First-Trimester Bleeding., Garrison Nord, Amanda Doty, Andrew J Monick, Danielle M Mccarthy, Robin J Casten, Amer Z Aldeen, Philip S Nawrocki, Kristin L. Rising
Department of Emergency Medicine Faculty Papers
The purpose of this work is to understand Emergency Department (ED) clinicians' experiences in communicating uncertainty about first-trimester bleeding (FTB) and their need for training on this topic. This cross-sectional study surveyed a national sample of attending physicians and advanced practice providers (APPs). The survey included quantitative and qualitative questions about communicating with patients presenting with FTB. These questions assessed clinicians' frequency encountering challenges, comfort, training, prior experience, and interest in training on the topic. Of 402 respondents, 54% reported that they encountered challenges at least sometimes when discussing FTB with patients where the pregnancy outcome is uncertain. While the …
A Consensus List Of Ultrasound Competencies For Graduating Emergency Medicine Residents, David A Haidar, William J Peterson, Patrick G Minges, Jennifer Carnell, Jason T Nomura, John Bailitz, Jeremy S Boyd, Megan M Leo, E Liang Liu, Youyou Duanmu, Josie Acuña, Ross Kessler, Marco F Elegante, Mathew Nelson, Rachel B Liu, Resa E. Lewiss, Arun Nagdev, Rob D Huang
A Consensus List Of Ultrasound Competencies For Graduating Emergency Medicine Residents, David A Haidar, William J Peterson, Patrick G Minges, Jennifer Carnell, Jason T Nomura, John Bailitz, Jeremy S Boyd, Megan M Leo, E Liang Liu, Youyou Duanmu, Josie Acuña, Ross Kessler, Marco F Elegante, Mathew Nelson, Rachel B Liu, Resa E. Lewiss, Arun Nagdev, Rob D Huang
Department of Emergency Medicine Faculty Papers
Objectives: Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there is no consensus list of competencies for EUS training, and graduating residents have varying levels of skill and comfort. The objective of this study was to define a widely accepted comprehensive list of EUS competencies for graduating EM residents through a modified Delphi method.
Methods: We developed a list of EUS applications through a comprehensive literature search, the American College of Emergency Physicians list of core EUS benchmarks, and the Council of Emergency Medicine Residency-Academy of Emergency Ultrasound consensus document. We assembled a multi-institutional …
Assessment During Covid-19: Quality Assurance Of An Online Open Book Formative Examination For Undergraduate Medical Students, Javeria Rehman, Rahila Ali Mazhar, Azam Afzal, Sara Shakil, Amber Shahmim Sultan, Romana Idress, Syeda Sadia Fatima
Assessment During Covid-19: Quality Assurance Of An Online Open Book Formative Examination For Undergraduate Medical Students, Javeria Rehman, Rahila Ali Mazhar, Azam Afzal, Sara Shakil, Amber Shahmim Sultan, Romana Idress, Syeda Sadia Fatima
Department of Pathology and Laboratory Medicine
Background: The spread of COVID-19 pandemic in early 2020 compelled all the educational activities, including medical education to be shifted from face-to-face interaction to a virtual platform. This shift provided opportunities for exploring online assessment modalities. One such assessment method is an online open book exam which is a unique concept in medical education of Pakistan. Limited information is available in literature regarding open book exam for the basic science subjects. Hence, the objective of the study was to determine the quality of the open book exam administered as a pilot project to the first-year medical students.
Methods: It was …
Serum Ctrp9 And High-Molecular Weight Adiponectin Are Associated With Ischemic Stroke., Yan-Qing Zhang, Yan-Wei Zhang, Jian-Li Dai, Chen Li, Wen-Qing Wang, Hai-Feng Zhang, Wayne Bond Lau, Xiao-Ming Wang, Xiao-Gang Liu, Rong Li
Serum Ctrp9 And High-Molecular Weight Adiponectin Are Associated With Ischemic Stroke., Yan-Qing Zhang, Yan-Wei Zhang, Jian-Li Dai, Chen Li, Wen-Qing Wang, Hai-Feng Zhang, Wayne Bond Lau, Xiao-Ming Wang, Xiao-Gang Liu, Rong Li
Department of Emergency Medicine Faculty Papers
BACKGROUND: C1q/TNF-related protein 9 (CTRP9) and adiponectin (APN) have beneficial metabolic regulatory and vasoprotective effects. This study explored alteration of CTRP9 and APN multimers during onset of ischemic stroke and development, to provide novel clinical and experimental basis for recognition and prevention of ischemic stroke.
METHODS: There were 269 patients with ischemic stroke and 182 control subjects included in this study. Serum levels of CTRP9 and APN multimers in different disease stages were measured.
RESULTS: Serum CTRP9, total APN (tAPN), and high-molecular weight (HMW) APN decreased gradually in stage I (acute stage, within 72 h of onset) of ischemic stroke …
Simultaneous Onset Of Haematological Malignancy And Covid: An Epicovideha Survey, Chiara Cattaneo, Jon Salmanton-García, Francesco Marchesi, Shaimaa El-Ashwah, Federico Itri, Barbora Weinbergerová, Maria Gomes Da Silva, Michelina Dargenio, Julio Dávila-Valls, Natasha Ali
Simultaneous Onset Of Haematological Malignancy And Covid: An Epicovideha Survey, Chiara Cattaneo, Jon Salmanton-García, Francesco Marchesi, Shaimaa El-Ashwah, Federico Itri, Barbora Weinbergerová, Maria Gomes Da Silva, Michelina Dargenio, Julio Dávila-Valls, Natasha Ali
Department of Pathology and Laboratory Medicine
Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines.
Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022.
Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients …
Sars-Cov-2 Spike Conformation Determines Plasma Neutralizing Activity Elicited By A Wide Panel Of Human Vaccines, John E. Bowen, Young-Jun Park, Cameron Stewart, Jack T. Brown, William K. Sharkey, Alexandra C. Walls, Anshu Joshi, Kumail Ahmed, Asefa Shariq, Najeeha Talat Iqbal
Sars-Cov-2 Spike Conformation Determines Plasma Neutralizing Activity Elicited By A Wide Panel Of Human Vaccines, John E. Bowen, Young-Jun Park, Cameron Stewart, Jack T. Brown, William K. Sharkey, Alexandra C. Walls, Anshu Joshi, Kumail Ahmed, Asefa Shariq, Najeeha Talat Iqbal
Department of Paediatrics and Child Health
Numerous safe and effective coronavirus disease 2019 vaccines have been developed worldwide that use various delivery technologies and engineering strategies. We show here that vaccines containing prefusion-stabilizing S mutations elicit antibody responses in humans with enhanced recognition of S and the S1 subunit relative to postfusion S as compared with vaccines lacking these mutations or natural infection. Prefusion S and S1 antibody binding titers positively and equivalently correlated with neutralizing activity, and depletion of S1-directed antibodies completely abrogated plasma neutralizing activity. We show that neutralizing activity is almost entirely directed to the S1 subunit and that variant cross-neutralization is mediated …
Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi
Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi
Community Health Sciences
Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …