Emergency Medicine Commons^™

Novel Mechanisms Of Herbal Therapies For Inhibiting Hmgb1 Secretion Or Action, A. H. Wu, L. He, W. Long, Q. Zhou, S. Zhu, P. Wang, S. Fan, H. Wang

Journal Articles

High mobility group box 1 (HMGB1) is an evolutionarily conserved protein and is constitutively expressed in virtually all types of cells. In response to microbial infections, HMGB1 is secreted from activated immune cells to orchestrate rigorous inflammatory responses. Here we review the distinct mechanisms by which several herbal components inhibit HMGB1 action or secretion, such as by modulating inflammasome activation, autophagic degradation, or endocytic uptake. In light of the reciprocal interactions between these cellular processes, it is possible to develop more effective combinational herbal therapies for the clinical management of inflammatory diseases.

High Mobility Group Box Protein 1 (Hmgb1): The Prototypical Endogenous Danger Molecule, Huan Yang, H. Wang, Sangeeta S. Chavan, Ulf Andersson

Journal Articles

No abstract provided.

Milk Fat Globule Epidermal Growth Factor-Factor 8-Derived Peptide Attenuates Organ Injury And Improves Survival In Sepsis, W. L. Yang, A. Sharma, F. Zhang, S. Matsuo, Z. Wang, H. Wang, P. Wang

Journal Articles

INTRODUCTION: Sepsis involves overwhelming inflammatory responses with subsequent immune-suppression that can lead to multiple organ dysfunction and ultimately death. Milk fat globule epidermal growth factor-factor 8 (MFG-E8) is a secretory protein found to have multiple biological activities against autoimmune and inflammatory diseases. MFG-E8 contains an Arg-Gly-Asp (RGD) motif involved in cell-cell and cell-matrix interactions. In sepsis, excessive neutrophils migration through endothelial cells and matrix to sites of inflammation results in organ damage. We hypothesized that MFG-E8-derived short peptides (MSP) flanking its RGD motif could provide protection against organ injury in sepsis. METHODS: The differentiated human neutrophil-like HL-60 cells (dHL60) were …

Hmgb1: A Novel Protein That Induced Platelets Active And Aggregation Via Toll-Like Receptor-4, Nf-Kappab And Cgmp Dependent Mechanisms, X. Yang, H. Wang, M. Zhang, J. Liu, B. Lv, F. Chen

Journal Articles

BACKGROUND: Thrombotic diseases are a group of prevalent and life-threatening diseases. Selective inhibition of pathological thrombosis holds the key to treat variety of thrombotic diseases. The pathological thrombosis can be induced by either tissue necrosis and deregulated inflammation. HMGB1, as an important proinflammatory cytokine and a late mediator, also involves on thrombosis disease. However, the underlying mechanisms are not fully understood. METHODS: Immunofluorescence, ELISA assay, Platelet Aggregation, Thromboelastogram (TEG) analyzes. Flow cytometric analysis and Western blot analysis were used to investigated the role of HMGB1 in platelet aggregation and obtained following observations. RESULTS: By doing so, we obtained the following …

Mitochondrial Dysfunction In Peripheral Blood Mononuclear Cells In Pediatric Septic Shock, S. L. Weiss, M. A. Selak, F. Tuluc, J. Perales Villarroel, V. M. Nadkarni, C. S. Deutschman, L. B. Becker

Journal Articles

OBJECTIVES: Mitochondrial dysfunction in peripheral blood mononuclear cells has been linked to immune dysregulation and organ failure in adult sepsis, but pediatric data are limited. We hypothesized that pediatric septic shock patients exhibit mitochondrial dysfunction within peripheral blood mononuclear cells which in turn correlates with global organ injury. DESIGN: Prospective observational study. SETTING: Academic PICU. PATIENTS: Thirteen pediatric patients with septic shock and greater than or equal to two organ failures and 11 PICU controls without sepsis or organ failure. INTERVENTIONS: Ex vivo measurements of mitochondrial oxygen consumption and membrane potential (DeltaPsim) were performed in intact peripheral blood mononuclear cells …

Prescription For Antidepressant In Reducing Future Alcohol-Related Readmission In Patients Suffering From Depression And Alcohol Use Disorder: A Retrospective Medical Record Review, P. Chan, K. Yomen, J. Turcios, M. Richman

Journal Articles

BACKGROUND: Patients suffering from major depressive disorder are more likely to suffer from alcohol use disorder. The data is inconclusive for the effectiveness of antidepressant treatment of patients suffering from both illnesses in regards to improving sobriety and reducing alcohol-related healthcare expenses such as hospitalizations. The objective of this study is to determine if a new prescription of an antidepressant upon inpatient discharge is associated with a reduction in the number of future acute alcohol-related hospital readmissions to the same institution in patients suffering from major depressive disorder and alcohol-use disorder. METHODS: A retrospective, medical record review study was conducted …

Mu-Opioid Receptor Gene A118 G Variants And Persistent Pain Symptoms Among Men And Women Experiencing Motor Vehicle Collision, S. D. Linnstaedt, J. M. Hu, A. V. Bortsov, A. C. Soward, R. Swor, J. Jones, D. Lee, R. Domeier, P. Hendry, S. A. Mclean, +2 Additional Authors

Journal Articles

The mu-opioid receptor 1 (OPRM1) binds endogenous opioids. Increasing evidence suggests that endogenous OPRM1 agonists released at the time of trauma may contribute to the development of posttraumatic musculoskeletal pain (MSP). In this prospective observational study, we evaluated the hypothesis that individuals with an AG or GG genotype at the OPRM1 A118 G allele, which results in a reduced response to opioids, would have less severe MSP 6 weeks after motor vehicle collision (MVC). Based on previous evidence, we hypothesized that this effect would be sex-dependent and most pronounced among women with substantial peritraumatic distress. European American men and women …

Genetic Polymorphisms In The Dopamine Receptor 2 Predict Acute Pain Severity After Motor Vehicle Collision, Y. J. Qadri, A. V. Bortsov, D. C. Orrey, R. A. Swor, D. A. Peak, J. S. Jones, N. K. Rathlev, D. C. Lee, P. L. Hendry, S. A. Mclean, +1 Additional Author

Journal Articles

Objectives:Dopaminergic signaling is implicated in nociceptive pathways. These effects are mediated largely through dopamine receptors and modulated in part by dopamine transporters. This study tested the hypothesis that genetic variants in the genes encoding dopamine receptor 2 (DRD2) and the dopamine active transporter (SLC6A3) influence acute pain severity after motor vehicle collision.Materials and Methods:European Americans presenting to the emergency department after motor vehicle collision were recruited. Overall pain intensity in emergency department was assessed using a 0 to 10 numeric rating scale. DNA was extracted from blood samples and genotyping of single-nucleotide polymorphisms (SNPs) in the DRD2 and SLC6A3 gene …

Er Referral Models: Specialty Clinic — Seattle King County, Swedish Medical Center, American Dental Association

Action for Dental Health

No abstract provided.

Pre-Hospital Tranexamic Acid Use For Trauma, Troy Thompson

Physician Assistant Scholarly Project Posters

• Nearly 40% of deaths after trauma can be attributed to blood loss. It is well known that early surgical interventions, combined with other treatment modalities found in the hospital setting, lead to the decreased morbidity and mortality of trauma patients. However, in an outpatient setting, treatments for hemorrhage control are extremely limited.

• The purpose of this literature review was to explore tranexamic acid (TXA) use as an option for hemorrhage control and to determine its effect on morbidity and mortality in both prehospital and outpatient settings. TXA is an FDA approved antifibrinolytic that has proven efficacy for hemorrhage …

Er Referral Models Summary, American Dental Association

Action for Dental Health

No abstract provided.

Effectiveness Of Helmets In Preventing Severe Injuries In A Setting With Poorly Enforced Quality Standards, Junaid Ahmad Bhatti, Junaid A. Razzak, Rashid Jooma

Department of Emergency Medicine

Helmets save lives, yet many countries do not have laws about their quality assessment or how they should be worn. We assessed the effectiveness of helmet use in preventing injuries in such a setting. The data were extracted from a large road traffic injury surveillance study in Karachi, Pakistan. We assessed the association of wearing helmets with several injury outcomes including deaths, injury severity (via New Injury Severity Score, NISS ≥ 9) and moderate or severe injury (via Abbreviated Injury Score, AIS ≥ 2) to head, face, or other regions of the body. The data about helmet use was available …

Unforgiving Heat Wave Deaths In The Largest Metropolitan City Of Pakistan: Lessons Learned, Muhammad Akbar Baig, Shahan Waheed, Asad Mian, Erfaan Hussain

Department of Emergency Medicine

Heat stroke is a deadly condition that needs astute care and timely management. Recently, the city of Karachi in Pakistan has been the victim of an intense heat wave, which has resulted in an insurmountable loss of life. We observed various deficiencies in dealing with this national threat that provides us with a valuable lesson regarding the measures that can be undertaken to avoid such a disaster from occurring again.

Community-Based Perceptions Of Emergency Care In Kenya, Morgan C. Broccoli, Emilie J.B Calvello, Alexander P. Skog, Benjamin W. Wachira, Lee A. Wallis

Emergency Medicine, East Africa

Access to quality emergency services is an essential component of the human right to health, but barriers to emergency care are found throughout Africa and the wider world. Data to support the development of emergency care are essential to improve access to care and further infrastructure development. We undertook this study to understand the community's emergency care needs and the barriers they face when trying to access care and to engage community members with developing high impact solutions to expand access to essential emergency services.

To accomplish this, we used a qualitative research methodology to conduct 59 focus groups with …

Subdural Hematoma As A Consequence Of Epidural Anesthesia., Tracy M Bishop Do, Kareem S. Elsayed Ms, Kathleen E. Kane Md

Department of Emergency Medicine

Regional spinal and epidural anesthesia are used commonly in operative procedures. While the most frequent complication, postdural puncture headache (PDPH), is a clinically diagnosed positional headache that is usually self-limited, subdural hemorrhage (SDH) is a potentially fatal complication that cannot be missed. We report a case of an otherwise healthy female who presented with persistent positional headache and was ultimately found to have a large subdural hematoma with midline shift requiring surgical evacuation.

Descriptive Study Of Prescriptions For Opioids From A Suburban Academic Emergency Department Before New York's I-Stop Act., Lyncean Ung, Ronald Dvorkin, Steven Sattler, David P. Yens

The School of Health Sciences Publications and Research

Introduction: Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration.

Methods: We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July …

Uchunguzi (Journal Watch/Montre De Journal) September 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Er Referral Models: Dental Intercept “Pay It Forward” Model — Calhoun County, Michigan, American Dental Association, Samanta Pearl

Action for Dental Health

No abstract provided.

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Quantification Of Opportunities For Early-Stage Paramedicine Students To Practice Clinical Skills During Clinical Placements Compared With An Equal Dose Of Simulation-Based Workshops, Brennen W. Mills, Owen B. Carter, Cobie Rudd, Jodie Mills, Nathan Ross, Joanne D. Ruck

Research outputs 2014 to 2021

Introduction A reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.

Methods N=37 first-year paramedicine students completed activity diaries during 3 days of CP …