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Articles 931 - 960 of 2631
Full-Text Articles in Medical Specialties
An Artificial Neural Network For Nasogastric Tube Position Decision Support, Ignat Drozdov, Rachael Dixon, Benjamin Szubert, Jessica Dunn, Darren Green, Nicola Hall, Arman Shirandami, Sofia Rosas, Ryan Grech, Srikanth Puttagunta, Mark Hall, David J Lowe
An Artificial Neural Network For Nasogastric Tube Position Decision Support, Ignat Drozdov, Rachael Dixon, Benjamin Szubert, Jessica Dunn, Darren Green, Nicola Hall, Arman Shirandami, Sofia Rosas, Ryan Grech, Srikanth Puttagunta, Mark Hall, David J Lowe
Faculty, Staff and Student Publications
PURPOSE: To develop and validate a deep learning model for detection of nasogastric tube (NGT) malposition on chest radiographs and assess model impact as a clinical decision support tool for junior physicians to help determine whether feeding can be safely performed in patients (feed/do not feed).
MATERIALS AND METHODS: A neural network ensemble was pretrained on 1 132 142 retrospectively collected (June 2007-August 2019) frontal chest radiographs and further fine-tuned on 7081 chest radiographs labeled by three radiologists. Clinical relevance was assessed on an independent set of 335 images. Five junior emergency medicine physicians assessed chest radiographs and made feed/do …
Metallic Implant-Related Osteosarcoma, Frawa Mohsin, Mustafa Bin Ali Zubairi, Kulsoom Fatima, Muhammad Asad Diwan
Metallic Implant-Related Osteosarcoma, Frawa Mohsin, Mustafa Bin Ali Zubairi, Kulsoom Fatima, Muhammad Asad Diwan
Department of Radiology
Orthopedic metallic prostheses are commonly used in the current practice of orthopedic surgery. Although, biomaterials used in these implants are generally considered to be biologically inert, there have been consequences of foreign body reactions and potential carcinogenesis. Majority of implant-related malignancies are high grade, and develop in bone or soft tissue around the implant site. No clear association has been identified between the biomaterial implanted and the type of sarcoma. We report the case of a 36-year-old male who underwent intramedullary nailing of femur for mid-shaft fracture secondary to trauma and presented with osteogenic sarcoma of femur 14 months later.
A Case Of Malignant Atrophic Papulosis With Septic Complications, Mengjiao Tao, Kaiwen Zhuang, Yaowen Jiang, Wayne Bond Lau, Yarong He
A Case Of Malignant Atrophic Papulosis With Septic Complications, Mengjiao Tao, Kaiwen Zhuang, Yaowen Jiang, Wayne Bond Lau, Yarong He
Department of Emergency Medicine Faculty Papers
No abstract provided.
Emergency Department Throughput: The Impact Of Vertical Care, Marc Wirtz
Emergency Department Throughput: The Impact Of Vertical Care, Marc Wirtz
Providence Nursing Research Conference 2023 – Present
References
Garrett JS, Berry C, Wong H, Qin H, Kline JA. The effect of vertical split-flow patient management on emergency department throughput and efficiency. Am J Emerg Med. 2018 Sep;36(9):1581-1584. doi: 10.1016/j.ajem.2018.01.035. Epub 2018 Jan 11. PMID: 29352674.
Hsieh A, Arena A, Oraha A, Cotarelo A, McLean M, Hsieh A, Hsieh A, Chen I, Mok N, Milizia R. Implementation of Vertical Split Flow Model for Patient Throughput at a Community Hospital Emergency Department. J Emerg Med. 2023 Jan 12:S0736-4679(22)00570-4. doi: 10.1016/j.jemermed.2022.10.007. Epub ahead of print. PMID: 36641257.
Rationale And Design Of The Restore Trial: A Multicenter, Randomized, Double-Blinded, Parallel-Group, Placebo-Controlled Trial To Evaluate The Effect Of Shenfu Injection On Myocardial Injury In Stemi Patients After Primary Pci, Xiao Wang, Ruifeng Guo, Yingying Guo, Qian Guo, Yan Yan, Wei Gong, Wen Zheng, Hui Wang, Lei Xu, Hui Ai, Bin Que, Xiaoyan Yan, Xin-Liang Ma, Shaoping Nie
Rationale And Design Of The Restore Trial: A Multicenter, Randomized, Double-Blinded, Parallel-Group, Placebo-Controlled Trial To Evaluate The Effect Of Shenfu Injection On Myocardial Injury In Stemi Patients After Primary Pci, Xiao Wang, Ruifeng Guo, Yingying Guo, Qian Guo, Yan Yan, Wei Gong, Wen Zheng, Hui Wang, Lei Xu, Hui Ai, Bin Que, Xiaoyan Yan, Xin-Liang Ma, Shaoping Nie
Department of Emergency Medicine Faculty Papers
BACKGROUND: The mortality following ST-segment elevation myocardial infarction (STEMI) remains substantial in the reperfusion era. Shenfu injection, as a traditional Chinese herbal formula, can alleviate ischemia-reperfusion injury through multiple pharmacologic effects. However, no robust data are available regarding the role of Shenfu injection in reducing infarct size for patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).
METHODS/DESIGN: This RESTORE trial is a multicenter, randomized, double-blind, parallel-group, placebo-controlled trial (NCT04493840). A total of 326 eligible patients with first-time anterior STEMI undergoing PPCI within 12 h of symptom onset will be enrolled from 10 centers in mainland China. Patients are randomized …
Lipoprotein(A) In Atherosclerotic Cardiovascular Disease And Aortic Stenosis: A European Atherosclerosis Society Consensus Statement, Florian Kronenberg, Samia Mora, Erik S G Stroes, Brian Ference Ference Ference, Benoit J. Arsenault, Lars Berglund, Marc R. Dweck, Marlys Koschinsky, Gilles Lambert, Salim S. Virani
Lipoprotein(A) In Atherosclerotic Cardiovascular Disease And Aortic Stenosis: A European Atherosclerosis Society Consensus Statement, Florian Kronenberg, Samia Mora, Erik S G Stroes, Brian Ference Ference Ference, Benoit J. Arsenault, Lars Berglund, Marc R. Dweck, Marlys Koschinsky, Gilles Lambert, Salim S. Virani
Office of the Provost
This 2022 European Atherosclerosis Society lipoprotein(a) [Lp(a)] consensus statement updates evidence for the role of Lp(a) in atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis, provides clinical guidance for testing and treating elevated Lp(a) levels, and considers its inclusion in global risk estimation. Epidemiologic and genetic studies involving hundreds of thousands of individuals strongly support a causal and continuous association between Lp(a) concentration and cardiovascular outcomes in different ethnicities; elevated Lp(a) is a risk factor even at very low levels of low-density lipoprotein cholesterol. High Lp(a) is associated with both microcalcification and macrocalcification of the aortic valve. Current findings do …
Examination Of Geriatric Care Processes Implemented In Level 1 And Level 2 Geriatric Emergency Departments, Ilianna Santangelo, Surriya Ahmad, Shan Liu, Lauren Southerland, Christopher Carpenter, Ula Hwang, Adriane Lesser, Nicole Tidwell, Kevin Biese, Maura Kennedy
Examination Of Geriatric Care Processes Implemented In Level 1 And Level 2 Geriatric Emergency Departments, Ilianna Santangelo, Surriya Ahmad, Shan Liu, Lauren Southerland, Christopher Carpenter, Ula Hwang, Adriane Lesser, Nicole Tidwell, Kevin Biese, Maura Kennedy
Journal of Geriatric Emergency Medicine
Background: Older adults constitute a large and growing proportion of the population and have unique care needs in the emergency department (ED) setting. The geriatric ED accreditation program aims to improve emergency care provided to older adults by standardizing care provided across accredited geriatric EDs (GED) and through implementation of geriatric-specific care processes.
Objective: The purpose of this study was to evaluate select care processes at accredited level 1 and level 2 GEDs.
Methods: This was a cross-sectional analysis of a cohort of level 1 and level 2 GEDs that received accreditation between May 7, 2018 and …
Mortality And Major Adverse Cardiovascular Events In Hospitalized Patients With Atrial Fibrillation With Covid-19, Lucas Wang, Lawrence Hoang, Kristopher Aten, Mujahed Abualfoul, Victor Canela, Sri Prathivada, Michael Vu, Yi Zhao, Manavjot Sidhu
Mortality And Major Adverse Cardiovascular Events In Hospitalized Patients With Atrial Fibrillation With Covid-19, Lucas Wang, Lawrence Hoang, Kristopher Aten, Mujahed Abualfoul, Victor Canela, Sri Prathivada, Michael Vu, Yi Zhao, Manavjot Sidhu
Faculty, Staff and Student Publications
COVID-19 results in increased incidence of cardiac arrhythmias, including atrial fibrillation (AF). However, little is known about the combined effect of AF and COVID-19 on patient outcomes. This study aimed to determine if AF, specifically new-onset AF (NOAF), is associated with increased risk of mortality and major adverse cardiovascular events (MACEs) in hospitalized patients with COVID-19. This multicenter retrospective analysis identified 2,732 patients with COVID-19 admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess if AF was associated with death or MACE. Patients with AF …
Adapting International Clinical Trials During Covid-19 And Beyond, Kamala Thriemer, Kamala Thriemer, Mohammad Shafiul Alam, Bipin Adhikari, Rupam Tripura, Mohammad Sharif Hossain, Michael Christian, Najia Bano Ghanchi, Hellen Mnjala, Muhammad Asim
Adapting International Clinical Trials During Covid-19 And Beyond, Kamala Thriemer, Kamala Thriemer, Mohammad Shafiul Alam, Bipin Adhikari, Rupam Tripura, Mohammad Sharif Hossain, Michael Christian, Najia Bano Ghanchi, Hellen Mnjala, Muhammad Asim
Department of Pathology and Laboratory Medicine
Background: The COVID-19 pandemic and resulting restrictions, particularly travel restrictions, have had significant impact on the conduct of global clinical trials. Our clinical trials programme, which relied on in-person visits for training, monitoring and capacity building across nine low- and middle-income countries, had to adapt to those unprecedented operational challenges. We report the adaptation of our working model with a focus on the operational areas of training, monitoring and cross-site collaboration.
The new working model: Adaptations include changing training strategies from in-person site visits with three or four team members to a multi-pronged virtual approach, with generic online training for …
Risk Factors For Ebola Virus Persistence In Semen Of Survivors In Liberia, Jonathan Dyal, Aaron Kofman, Jomah Z Kollie, John Fankhauser, Romeo Orone, Moses J Soka, Uriah Glaybo, Armah Kiawu, Edna Freeman, Giovanni Giah, Henry D Tony, Mylene Faikai, Mary Jawara, Kuku Kamara, Samuel Kamara, Benjamin Flowers, Mohammed L Kromah, Rodel Desamu-Thorpe, James Graziano, Shelley Brown, Maria E Morales-Betoulle, Deborah L Cannon, Kaihong Su, Susanne L Linderman, Mateusz Plucinski, Eric Rogier, Richard S Bradbury, W Evan Secor, Katherine E Bowden, Christi Phillips, Mary N Carrington, Yeon-Hwa Park, Maureen P Martin, Maria Del Pilar Aguinaga, Robert Mushi, Dana L Haberling, Elizabeth D Ervin, John D Klena, Moses Massaquoi, Tolbert Nyenswah, Stuart T Nichol, David E Chiriboga, Desmond E Williams, Steven H Hinrichs, Rafi Ahmed, Benjamin T Vonhm, Pierre E Rollin, Lawrence J Purpura, Mary J Choi
Risk Factors For Ebola Virus Persistence In Semen Of Survivors In Liberia, Jonathan Dyal, Aaron Kofman, Jomah Z Kollie, John Fankhauser, Romeo Orone, Moses J Soka, Uriah Glaybo, Armah Kiawu, Edna Freeman, Giovanni Giah, Henry D Tony, Mylene Faikai, Mary Jawara, Kuku Kamara, Samuel Kamara, Benjamin Flowers, Mohammed L Kromah, Rodel Desamu-Thorpe, James Graziano, Shelley Brown, Maria E Morales-Betoulle, Deborah L Cannon, Kaihong Su, Susanne L Linderman, Mateusz Plucinski, Eric Rogier, Richard S Bradbury, W Evan Secor, Katherine E Bowden, Christi Phillips, Mary N Carrington, Yeon-Hwa Park, Maureen P Martin, Maria Del Pilar Aguinaga, Robert Mushi, Dana L Haberling, Elizabeth D Ervin, John D Klena, Moses Massaquoi, Tolbert Nyenswah, Stuart T Nichol, David E Chiriboga, Desmond E Williams, Steven H Hinrichs, Rafi Ahmed, Benjamin T Vonhm, Pierre E Rollin, Lawrence J Purpura, Mary J Choi
Faculty, Staff and Student Publications
BACKGROUND: Long-term persistence of Ebola virus (EBOV) in immunologically privileged sites has been implicated in recent outbreaks of Ebola virus disease (EVD) in Guinea and the Democratic Republic of Congo. This study was designed to understand how the acute course of EVD, convalescence, and host immune and genetic factors may play a role in prolonged viral persistence in semen.
METHODS: A cohort of 131 male EVD survivors in Liberia were enrolled in a case-case study. "Early clearers" were defined as those with 2 consecutive negative EBOV semen test results by real-time reverse-transcription polymerase chain reaction (rRT-PCR) ≥2 weeks apart within …
Presence Of Symptoms 6 Weeks After Covid-19 Among Vaccinated And Unvaccinated Us Healthcare Personnel: A Prospective Cohort Study, Nicholas M. Mohr, Ian D. Plumb, Kari K. Harland, Tamara Pilishvili, Katherine E. Fleming-Dutra, Anusha Krishnadasan, Karin F. Hoth, Sharon H. Saydah, Zachary Mankoff, John P. Haran, Melissa Briggs-Hagen, Eliezer Santos León, David A. Talan
Presence Of Symptoms 6 Weeks After Covid-19 Among Vaccinated And Unvaccinated Us Healthcare Personnel: A Prospective Cohort Study, Nicholas M. Mohr, Ian D. Plumb, Kari K. Harland, Tamara Pilishvili, Katherine E. Fleming-Dutra, Anusha Krishnadasan, Karin F. Hoth, Sharon H. Saydah, Zachary Mankoff, John P. Haran, Melissa Briggs-Hagen, Eliezer Santos León, David A. Talan
Department of Emergency Medicine Faculty Papers
OBJECTIVES: Although COVID-19 vaccines offer protection against infection and severe disease, there is limited information on the effect of vaccination on prolonged symptoms following COVID-19. Our objective was to determine differences in prevalence of prolonged symptoms 6 weeks after onset of COVID-19 among healthcare personnel (HCP) by vaccination status, and to assess differences in timing of return to work.
DESIGN: Cohort analysis of HCP with COVID-19 enrolled in a multicentre vaccine effectiveness study. HCP with COVID-19 between December 2020 and August 2021 were followed up 6 weeks after illness onset.
SETTING: Health systems in 12 US states.
PARTICIPANTS: HCP participating …
Spontaneous Large Volume Hemothorax Managed With A Small-Bore Chest Tube, Moiz Salahuddin, Samia Ayub
Spontaneous Large Volume Hemothorax Managed With A Small-Bore Chest Tube, Moiz Salahuddin, Samia Ayub
Department of Medicine
A 67-year-old male with metastatic lung cancer presented with acute shortness of breath and increasing oxygen requirements. He had a decreasing hemoglobin for which he required red blood cell transfusions. His chest x-ray showed near complete white-out of the left lung. Bedside ultrasound (Handheld Sonostar C4PL) showed a large pleural effusion with swirling echogenic material suggestive of plankton sign. The pleural effusion was aspirated and showed frank blood, after which a small-bore chest tube (SBCT) was inserted. A total of 3200ml of blood was drained with the SBCT. There was complete clearance of the pleural space, and no further blood …
Prediction Of Suicide Attempts And Suicide-Related Events Among Adolescents Seen In Emergency Departments, David A Brent, Lisa M Horowitz, Jacqueline Grupp-Phelan, Jeffrey A Bridge, Robert Gibbons, Lauren S Chernick, Margaret Rea, Mary F Cwik, Rohit P Shenoi, Joel A Fein, E Melinda Mahabee-Gittens, Shilpa J Patel, Rakesh D Mistry, Susan Duffy, Marlene D Melzer-Lange, Alexander Rogers, Daniel M Cohen, Allison Keller, Robert W Hickey, Kent Page, T Charles Casper, Cheryl A King, Pediatric Emergency Care Applied Research Network (Pecarn)
Prediction Of Suicide Attempts And Suicide-Related Events Among Adolescents Seen In Emergency Departments, David A Brent, Lisa M Horowitz, Jacqueline Grupp-Phelan, Jeffrey A Bridge, Robert Gibbons, Lauren S Chernick, Margaret Rea, Mary F Cwik, Rohit P Shenoi, Joel A Fein, E Melinda Mahabee-Gittens, Shilpa J Patel, Rakesh D Mistry, Susan Duffy, Marlene D Melzer-Lange, Alexander Rogers, Daniel M Cohen, Allison Keller, Robert W Hickey, Kent Page, T Charles Casper, Cheryl A King, Pediatric Emergency Care Applied Research Network (Pecarn)
Faculty, Staff and Students Publications
IMPORTANCE: Screening adolescents in emergency departments (EDs) for suicidal risk is a recommended strategy for suicide prevention. Comparing screening measures on predictive validity could guide ED clinicians in choosing a screening tool.
OBJECTIVE: To compare the Ask Suicide-Screening Questions (ASQ) instrument with the Computerized Adaptive Screen for Suicidal Youth (CASSY) instrument for the prediction of suicidal behavior among adolescents seen in EDs, across demographic and clinical strata.
DESIGN, SETTING, AND PARTICIPANTS: The Emergency Department Study for Teens at Risk for Suicide is a prospective, random-series, multicenter cohort study that recruited adolescents, oversampled for those with psychiatric symptoms, who presented to …
Caesarean Section For Placenta Previa: A Retrospective Cohort Study Of Anaesthesia Techniques, Samina Ismail, Saima Rashid
Caesarean Section For Placenta Previa: A Retrospective Cohort Study Of Anaesthesia Techniques, Samina Ismail, Saima Rashid
Department of Anaesthesia
Objective: Placenta previa is associated with maternal and neonatal morbidity and mortality. This study aims to add to the limited literature from the developing world on the association of different anaesthetic techniques with blood loss, the need for blood transfusion, and maternal/ neonatal outcomes among women undergoing caesarean section with placenta previa.
Methods: This retrospective study was conducted at Aga University Hospital, Karachi, Pakistan. The patient population included parturients undergoing caesarean section for placenta previa from January 1, 2006, through December 31, 2019.
Results: Out of 276 consecutive cases of placenta previa progressing to caesarean section during the study period, …
Clinical Characteristics, Microbiology And Outcomes Of A Cohort Of Patients Treated With Ceftolozane/Tazobactam In Acute Care Inpatient Facilities, Houston, Texas, Usa, Truc T Tran, Nicolo L Cabrera, Anne J Gonzales-Luna, Travis J Carlson, Faris Alnezary, William R Miller, Aki Sakurai, An Q Dinh, Kirsten Rydell, Rafael Rios, Lorena Diaz, Blake M Hanson, Jose M Munita, Claudia Pedroza, Samuel A Shelburne, Samuel L Aitken, Kevin W Garey, Ryan Dillon, Laura Puzniak, Cesar A Arias
Clinical Characteristics, Microbiology And Outcomes Of A Cohort Of Patients Treated With Ceftolozane/Tazobactam In Acute Care Inpatient Facilities, Houston, Texas, Usa, Truc T Tran, Nicolo L Cabrera, Anne J Gonzales-Luna, Travis J Carlson, Faris Alnezary, William R Miller, Aki Sakurai, An Q Dinh, Kirsten Rydell, Rafael Rios, Lorena Diaz, Blake M Hanson, Jose M Munita, Claudia Pedroza, Samuel A Shelburne, Samuel L Aitken, Kevin W Garey, Ryan Dillon, Laura Puzniak, Cesar A Arias
Faculty, Staff and Student Publications
BACKGROUND: Ceftolozane/tazobactam is a β-lactam/β-lactamase inhibitor combination with activity against a variety of Gram-negative bacteria, including MDR
METHODS: We conducted a multicentre retrospective study of patients receiving at least 48 h of ceftolozane/tazobactam therapy from January 2016 through to September 2019 at two hospital systems in Houston. Demographic, clinical and microbiological data were collected, including the infecting bacterial isolate, when available. The primary outcome was composite clinical success at hospital discharge. Secondary outcomes included in-hospital mortality and clinical disposition at 14 and 30 days post ceftolozane/tazobactam initiation. Multivariable logistic regression analysis was used to identify predictors of the primary outcome …
Identification Of Bradycardia Following Remdesivir Administration Through The Us Food And Drug Administration American College Of Medical Toxicology Covid-19 Toxic Pharmacovigilance Project, Jason M Devgun, Rongmei Zhang, Jeffrey Brent, Paul Wax, Keith Burkhart, Alison Meyn, Sharan Campleman, Stephanie Abston, Kim Aldy
Identification Of Bradycardia Following Remdesivir Administration Through The Us Food And Drug Administration American College Of Medical Toxicology Covid-19 Toxic Pharmacovigilance Project, Jason M Devgun, Rongmei Zhang, Jeffrey Brent, Paul Wax, Keith Burkhart, Alison Meyn, Sharan Campleman, Stephanie Abston, Kim Aldy
Faculty, Staff and Student Publications
IMPORTANCE: The rapid spread and mortality associated with COVID-19 emphasized a need for surveillance system development to identify adverse events (AEs) to emerging therapeutics. Bradycardia is a remdesivir infusion-associated AE listed in the US Food and Drug Administration-approved prescribing information.
OBJECTIVE: To evaluate the magnitude and duration of bradycardic events following remdesivir administration.
DESIGN, SETTING, AND PARTICIPANTS: A multicenter cohort study of patients with recorded heart rate less than 60 beats per minute within 24 hours after administration of a remdesivir dose was conducted between November 23, 2020, and October 31, 2021. Participants included patients hospitalized with COVID-19 at 15 …
Emergency Department Virtual Happy Hour: A Novel Approach To Peer Group Support During A Pandemic, Adeola A Kosoko, Shabana Walia, Ryan Huebinger
Emergency Department Virtual Happy Hour: A Novel Approach To Peer Group Support During A Pandemic, Adeola A Kosoko, Shabana Walia, Ryan Huebinger
Faculty, Staff and Student Publications
Introduction Communities responded to the coronavirus disease 2019 (COVID-19) pandemic with mandatory social-distancing regulations. Pandemic and disaster research shows that social isolation can often cause negative emotions and medical provider burnout. The primary objective of this study was to create and evaluate a novel wellness program, the Happy Hour Wellness Initiative (HHWI), based on peer support group concepts to foster resilience for emergency healthcare providers in response to a novel disaster. Methods The study was performed at a large emergency department with physicians, advanced practice providers, and staff invited to attend weekly "virtual happy hour" sessions. Participants individually opted into …
Design And Characterization Of An Aerosol Test Chamber For Emergency Response Patient Contamination Control Simulation And Research, Megan L. Steele, Emily M. Spatz, George P. Lemmer, Jacob M. Denney, Casey Cooper, Jeremy M. Slagley, Robert M. Eninger
Design And Characterization Of An Aerosol Test Chamber For Emergency Response Patient Contamination Control Simulation And Research, Megan L. Steele, Emily M. Spatz, George P. Lemmer, Jacob M. Denney, Casey Cooper, Jeremy M. Slagley, Robert M. Eninger
Faculty Publications
Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental …
Paxlovid-Induced Tacrolimus Toxicity In The Treatment Of Covid-19: A Case Report., Stephanie Michael, Rachel Heilbronner, Christopher M Lloyd, Howard W Levitin
Paxlovid-Induced Tacrolimus Toxicity In The Treatment Of Covid-19: A Case Report., Stephanie Michael, Rachel Heilbronner, Christopher M Lloyd, Howard W Levitin
Pharmacy Articles
PaxlovidTM (nirmaltrelvir/ritonavir) received emergency use authorization from the Food and Drug Administration (FDA) in December 2021 to treat coronavirus disease 2019 (COVID-19). Given the actions of Paxlovid on cytochrome P450-3A4 (CYP3A4) enzymes, it is imperative to check for potential drug-drug interactions before prescribing. We describe a case in which the common emergency department presentation of generalized weakness was found to be caused by interactions between Paxlovid and a patient's home medications resulting in tacrolimus toxicity.
Geriatric Emergency Medicine Fellowship Journal Club: Syncope Risk Stratification & Geriatric-Specific Clinical Decision Rules, Kyle R. Burton Md Mpp, Phillip Magidson
Geriatric Emergency Medicine Fellowship Journal Club: Syncope Risk Stratification & Geriatric-Specific Clinical Decision Rules, Kyle R. Burton Md Mpp, Phillip Magidson
Journal of Geriatric Emergency Medicine
No abstract provided.
Frequency Of Von Willebrand Disease And Its Types: Data From A Tertiary Care Hospital Of Karachi, Pakistan, Jyoti Mohan Lal, Anila Rashid, Natasha Ali
Frequency Of Von Willebrand Disease And Its Types: Data From A Tertiary Care Hospital Of Karachi, Pakistan, Jyoti Mohan Lal, Anila Rashid, Natasha Ali
Department of Pathology and Laboratory Medicine
Introduction: von Willebrand disease is the most common inherited bleeding disorder. It is classified into 3 main types, type I and III are quantitative defects whereas type II is qualitative defect which is further sub-classified in to II-A, II-B, II-M, II-N. The aim of the present study is to see frequency and types of von Willebrand disease in a tertiary care hospital of Karachi, Pakistan.
Materials and methods: This retrospective cross-sectional study was conducted in the section of Hematology and Transfusion Medicine, Department of Pathology and Laboratory Medicine, the Aga Khan University hospital, Karachi, from May 2020 to April 2021 …
Recurrent Cyanotic Spells In An Octogenarian, Chin Tong Kwok, Chun Kit Wong
Recurrent Cyanotic Spells In An Octogenarian, Chin Tong Kwok, Chun Kit Wong
Journal of the Hong Kong College of Cardiology
We report rare case of an octogenarian who, after years of diagnostic delay, was found to have a patent foramen ovale, and due to an ascending aortic aneurysm that anatomically facilitated right-to-left shunt, presenting with life-threatening cyanotic attacks. The characteristic orthodeoxia-platypnea syndrome and high alveolar arterial gradient hint to the diagnosis. She was eventually treated successfully with urgent percutaneous PFO closure. Routine ordering of a transthoracic echocardiogram, without agitated saline injection under provocation maneuvers, may not be sufficient to rule out shunts.
Updated Documentation Requirements, Michael Gratson
Updated Documentation Requirements, Michael Gratson
Website/Multimedia Contributions
No abstract provided.
A Survey With Interventional Components Delivered On Tablet Devices Versus Usual Care To Increase Pre-Exposure Prophylaxis Uptake Among Cisgender Black Women: A Pilot Randomized Controlled Trial, Mandy J Hill, Angela M Heads, Robert Suchting, Angela L Stotts
A Survey With Interventional Components Delivered On Tablet Devices Versus Usual Care To Increase Pre-Exposure Prophylaxis Uptake Among Cisgender Black Women: A Pilot Randomized Controlled Trial, Mandy J Hill, Angela M Heads, Robert Suchting, Angela L Stotts
Faculty, Staff and Student Publications
BACKGROUND: Cisgender (cis) Black women in the USA are more likely to become HIV positive during their lifetime than other women. We developed and implemented a behavioral intervention, Increasing PrEP (iPrEP), the first pilot randomized controlled trial (RCT) aimed at motivating cis Black women to be willing to use PrEP for HIV prevention and attend an initial PrEP clinic visit following an emergency department visit.
METHODS: Eligible participants were Black cisgender women ages 18-55 years who acknowledged recent condomless sex and substance use. Participants were randomized to iPrEP or usual care (UC). iPrEP is a survey-based intervention designed to raise …
Is It Time To Re-Think Fast? A Systematic Review And Meta-Analysis Of Contrast-Enhanced Ultrasound (Ceus) And Conventional Ultrasound For Initial Assessment Of Abdominal Trauma, Bayu Sutarjono, Matthew Kessel, Dorian Alexander, Ekjot Grewal
Is It Time To Re-Think Fast? A Systematic Review And Meta-Analysis Of Contrast-Enhanced Ultrasound (Ceus) And Conventional Ultrasound For Initial Assessment Of Abdominal Trauma, Bayu Sutarjono, Matthew Kessel, Dorian Alexander, Ekjot Grewal
Faculty, Staff and Student Publications
BACKGROUND: The Focused Assessment with Sonography for Trauma (FAST) examination using conventional ultrasound has limited utility for detecting solid organ injury. Therefore, this systematic review and meta-analysis compares the performance of contrast-enhanced ultrasound (CEUS) to conventional ultrasound when used as the initial assessment for abdominal trauma prior to computed tomography (CT) imaging.
METHODS: A systematic literature search of major databases was conducted of human studies investigating the diagnostic accuracy of conventional ultrasound and CEUS occurring prior to CT imaging for abdominal trauma. The study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The quality of studies …
A Qualitative Description Of Barriers To Visual Rehabilitation Experienced By Stroke Survivors With Visual Impairment In Alberta, Canada, Kiran Pohar Manhas, Katelyn Brehon, Jennis Jiang, Karim F. Damji, Fiona Costello
A Qualitative Description Of Barriers To Visual Rehabilitation Experienced By Stroke Survivors With Visual Impairment In Alberta, Canada, Kiran Pohar Manhas, Katelyn Brehon, Jennis Jiang, Karim F. Damji, Fiona Costello
Department of Ophthalmology & Visual Sciences
Background: Post-stroke visual impairment (VI) is a common but under-recognized care challenge. Common manifestations of post-stroke VI include: diplopia, homonymous hemianopia, oscillopsia secondary to nystagmus, and visual inattention or neglect. In acute care settings, post-stroke VI recognition and treatment are often sub-optimal as emphasis is placed on survival. Stroke survivors with VI often face inconsistencies when accessing care out of hospital because variable availability and subsidization of visual rehabilitation. We sought to identify gaps in care experienced by stroke survivors with VI from stroke survivors' and care providers' perspectives.
Methods: We conducted a qualitative description study across 12 care sites …
Multisite Evaluation Of Prediction Models For Emergency Department Crowding Before And During The Covid-19 Pandemic, Ari J Smith, Brian W Patterson, Michael S Pulia, John Mayer, Rebecca J Schwei, Radha Nagarajan, Frank Liao, Manish N Shah, Justin J Boutilier
Multisite Evaluation Of Prediction Models For Emergency Department Crowding Before And During The Covid-19 Pandemic, Ari J Smith, Brian W Patterson, Michael S Pulia, John Mayer, Rebecca J Schwei, Radha Nagarajan, Frank Liao, Manish N Shah, Justin J Boutilier
Faculty, Staff and Student Publications
OBJECTIVE: To develop a machine learning framework to forecast emergency department (ED) crowding and to evaluate model performance under spatial and temporal data drift.
MATERIALS AND METHODS: We obtained 4 datasets, identified by the location: 1-large academic hospital and 2-rural hospital, and time period: pre-coronavirus disease (COVID) (January 1, 2019-February 1, 2020) and COVID-era (May 15, 2020-February 1, 2021). Our primary target was a binary outcome that is equal to 1 if the number of patients with acute respiratory illness that were ED boarding for more than 4 h was above a prescribed historical percentile. We trained a random forest …
Biorisk Management, Laboratory Acquired Infections And Clinical Containment, Kashif Ali, Furqan Kabir, Esmeralda Meyer
Biorisk Management, Laboratory Acquired Infections And Clinical Containment, Kashif Ali, Furqan Kabir, Esmeralda Meyer
Department of Paediatrics and Child Health
No abstract provided.
Sorting Through Life: Evaluating Patient-Important Measures Of Success In A Medication For Opioid Use Disorder (Moud) Treatment Program, Megan K Reed, Kelsey R Smith, Francesca Ciocco, Richard W. Hass, Avery Lin Cox, Erin L Kelly, Lara Weinstein
Sorting Through Life: Evaluating Patient-Important Measures Of Success In A Medication For Opioid Use Disorder (Moud) Treatment Program, Megan K Reed, Kelsey R Smith, Francesca Ciocco, Richard W. Hass, Avery Lin Cox, Erin L Kelly, Lara Weinstein
Department of Emergency Medicine Faculty Papers
Background: Medication for opioid use disorder (MOUD) is the gold standard treatment for opioid use disorder. Traditionally, "success" in MOUD treatment is measured in terms of program retention, adherence to MOUD, and abstinence from opioid and other drug use. While clinically meaningful, these metrics may overlook other aspects of the lives of people with opioid use disorder (OUD) and surprisingly do not reflect the diagnostic criteria for OUD.
Methods: Authors identified items for a pilesorting task to identify participant-driven measures of MOUD treatment success through semi-structured interviews. Interviews were transcribed verbatim and coded in Nvivo using directed and conventional content …
Relationship Of Abdominal Circumference And Trunk Length With Spinal Anesthesia Block Height In Geriatric Patients Undergoing Transurethral Resection Of Prostate, Muhammad Yahya, Aliya Ahmed, Iayla Fatima, Muhammad Nasir
Relationship Of Abdominal Circumference And Trunk Length With Spinal Anesthesia Block Height In Geriatric Patients Undergoing Transurethral Resection Of Prostate, Muhammad Yahya, Aliya Ahmed, Iayla Fatima, Muhammad Nasir
Department of Anaesthesia
Introduction: Spinal anesthesia is commonly used for various surgical procedures. Prediction of spinal anesthesia block height is always a challenging task for anesthetists. Higher than desired levels of spinal anesthesia blocks are associated with serious side effects, while inadequate block height does not provide satisfactory surgical anesthesia. In this study, we observed the relationship between the ratio of trunk length (TL) and square of the abdominal circumference (AC2) and spinal anesthesia sensory block height in geriatric patients undergoing transurethral resection of the prostate (TURP).
Material & Methods: This is a cross-sectional study conducted at the Aga Khan University …