Emergency Medicine Commons^™

The Alternative Crosstalk Between Rage And Nitrative Thioredoxin Inactivation During Diabetic Myocardial Ischemia-Reperfusion Injury., Yi Liu, Yan Qu, Rutao Wang, Yanzhuo Ma, Chenhai Xia, Chao Gao, Jingyi Liu, Kun Lian, Aibing Xu, Xiaoyan Lu, Lu Sun, Lu Yang, Wayne B. Lau, Erhe Gao, Walter Koch, Haichang Wang, Ling Tao

Department of Emergency Medicine Faculty Papers

The receptor for advanced glycation end products (RAGE) and thioredoxin (Trx) play opposing roles in diabetic myocardial ischemia-reperfusion (MI/R) injury. We recently demonstrated nitrative modification of Trx leads to its inactivation and loss of cardioprotection. The present study is to determine the relationship between augmented RAGE expression and diminished Trx activity pertaining to exacerbated MI/R injury in the diabetic heart. The diabetic state was induced in mice by multiple intraperitoneal low-dose streptozotocin injections. RAGE small-interfering RNA (siRNA) or soluble RAGE (sRAGE, a RAGE decoy) was via intramyocardial and intraperitoneal injection before MI/R, respectively. Mice were subjected to 30 min of …

The Use Of Mobile Phone Cameras In Guiding Treatment Decisions For Laceration Care, Neal Sikka, Michael Pirri, Katrina Norbury Carlin, Ryan Strauss, Faisal Rahimi, Jesse M. Pines

Emergency Medicine Faculty Publications

Objectives: Mobile phone technology may be useful in helping to guide medical decisions for lacerations. We examined whether emergency department (ED) provider opinions on which lacerations require repair differed using mobile phone–generated images compared with in-person evaluations.

Subjects and Methods: Patients presenting to an urban ED for initial and follow-up laceration care were prospectively enrolled. Patients took four mobile phone pictures of their laceration and provided a medical history. Cases were reviewed by ED providers who assessed image quality and made a recommendation about whether the laceration needed repair. The same provider then assessed the patient in-person. Concordant decision-making between …

The Effect Of Vessel Depth, Diameter, And Location On Ultrasound-Guided Peripheral Intravenous Catheter Longevity., J Matthew Fields, Anthony J Dean, Raleigh W Todman, Arthur K Au, Kenton L Anderson, Bon S Ku, Jesse M Pines, Nova L Panebianco

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity.

METHODS: A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed.

RESULTS: After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% …

Prolonged Intermediate Syndrome Pue To Prganophosphate Poisoning, Nadeem Ullah Khan, Muhammad Junaid Patel, M. N.M. Hifath, Saima Kamal, Syed Ather Hussain

Department of Emergency Medicine

Organophosphate poisoning can present as acute cholinergic syndrome, Intermediate syndrome and delayed neuropathy. Intermediate syndrome secondary to organophosphate poisoning is a serious health problem leading to increased morbidity and mortality. The incidence of problem varies and range from 8%-84% of organophosphate poisoning cases. The factors account for this difference is nature of organophosphate compound, severity of poisoning and inadequate Oxime therapy. The recognition of this syndrome is important as organophosphate poisoning is common in our country. We presented this case of organophosphate poisoning leading to prolonged intermediate syndrome. The muscle weakness associated with this syndrome generally resolves in 5-18 days …

Diagnostic Potential Of The Nmda Receptor Peptide Assay For Acute Ischemic Stroke, Svetlana A. Dambinova, Kerstin Bettermann, Theodore Glynn, Matthew Tews, David Olsen, Joseph D. Weissman, Richard K. Sowell

Faculty Articles

Background

The acute assessment of patients with suspected ischemic stroke remains challenging. The use of brain biomarker assays may improve the early diagnosis of ischemic stroke. The main goal of the study was to evaluate whether the NR2 peptide, a product of the proteolytic degradation of N-methyl-D-aspartate (NMDA) receptors, can differentiate acute ischemic stroke (IS) from stroke mimics and persons with vascular risk factors/healthy controls. A possible correlation between biomarker values and lesion sizes was investigated as the secondary objective.

Methods and Findings

A total of 192 patients with suspected stroke who presented within 72 h of symptom onset …

Unintentional, Paediatric Domestic Injury In A Semi Rural Area Of Karachi., Emaduddin Siddiqui, Kiran Ejaz, Uzma Siddiqui

Department of Emergency Medicine

OBJECTIVE:

To identify the characteristics of unintentional domestic injury in children living in a semi-rural area of Karachi.

METHODS:

This retrospective descriptive study was carried out at a private hospital located at the northern outskirts of Karachi, Pakistan, from January 2005 to January 2007. We enrolled 271 out-patient children of either gender with a positive injury history. A questionnaire inquiring socio-demographic characteristics, timing of injury, monthly variation, injury pattern and factors was filled out. Descriptive analysis and Chi-square test were applied to find out the statistically significant differences.

RESULTS:

Among the 271 patients, the male-to-female ratio was 1.2:1. Fall from …

C1q/Tumor Necrosis Factor-Related Protein-3, A Newly Identified Adipokine, Is A Novel Antiapoptotic, Proangiogenic, And Cardioprotective Molecule In The Ischemic Mouse Heart., Wei Yi, Yang Sun, Yuexing Yuan, Wayne Bond Lau, Qijun Zheng, Xiaoliang Wang, Yajing Wang, Xiying Shang, Erhe Gao, Walter J Koch, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

BACKGROUND: Obesity and diabetes mellitus adversely affect postischemic heart remodeling via incompletely understood mechanisms. C1q/tumor necrosis factor-related protein-3 (CTRP3) is a newly identified adipokine exerting beneficial metabolic regulation, similar to adiponectin. The aim of the present study was to determine whether CTRP3 may regulate postischemic cardiac remodeling and cardiac dysfunction, and, if so, to elucidate the underlying mechanisms.

METHODS AND RESULTS: Male adult mice were subjected to myocardial infarction (MI) via left anterior descending coronary artery occlusion. Both the effect of MI on endogenous CTRP3 expression/production and the effect of exogenous CTRP3 (adenovirus or recombinant CTRP3) replenishment on MI injury …

Overcrowded Emergency Departments: A Problem Looking For Solution., Amber Mehmood, Badar Afzal Khan, Munawar Khursheed

Department of Emergency Medicine

No abstract provided.

Cardiopulmonary Resuscitation: Is The Emergency Department Visit An Opportunity To Recommend Education? (Poster), Marna R. Greenberg Do, Mph, Facep, Gavin C. Barr Jr. Md, Jon D. Willardson Do, Nicholas M. Dowling Do, Jennifer L. Sears Do, Valerie Rupp Rn, Bsn, Kimberly Hamilton Ba, Kevin Weaver Do

Department of Emergency Medicine

No abstract provided.

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

A Successful Model Of Road Traffic Injury Surveillance In A Developing Country: Process And Lessons Learnt, Junaid Abdul Razzak, Muhammad Shahzad Shamim, Amber Mehmood, Syed Ameer Hussain, Mir Shabbar Ali, Rashid Jooma

Department of Emergency Medicine

Background: Road Traffic Injuries (RTIs) are one of the leading causes of death and disability worldwide with 90% of global mortality concentrated in the low and middle income countries. RTI surveillance is recommended to define the burden, identify high risk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This paper shares the experience of setting up an urban RTI surveillance program in the emergency departments of five major hospitals in Karachi, Pakistan.
Method: We describe the process of establishing a surveillance …

Beta2-Adrenoceptor Agonists For Dysmenorrhoea, Zbys Fedorowicz, Mona Nasser, Vanitha A. Jagannath, Jessica H. Beaman, Kiran Ejaz, Esther J. Van Zuuren

Department of Emergency Medicine

Background:Dysmenorrhoea is a common gynaecological complaint that can affect as many as 50% of premenopausal women, 10% of whom suffer severely enough to be rendered incapacitated for one to three days during each menstrual cycle. Primary dysmenorrhoea is where women suffer from menstrual pain but lack any pathology in their pelvic anatomy. Beta2-adrenoceptor agonists have been used in the treatment of women with primary dysmenorrhoea but their effects are unclear.
Objectives:To determine the effectiveness and safety of beta2-adrenoceptor agonists in the treatment of primary dysmenorrhoea. Search methods: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register, …

Teaching With Cultural Competence Requires Gender Sensitivity, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Accuracy Of Diagnosis And Relationship With Quality Of Emergency Medicine Training Program, Muhammad Shahid, Kamran Hameed, Romaina Iqbal, Osama Afzal, Rooham Nakeer, Junaid Razzak

Department of Emergency Medicine

An indicator for emergency room performance is the ability to establish the correct diagnosis within the emergency room over the years. The authors chose to examine the non-congruence of Emergency Room diagnoses to that established after hospital stay for three selected years. A total of 8488 records were reviewed and all disparate diagnosis were recorded and categorized. Retrospective chart reviews were done from July 2008 to February 2009 at the Aga Khan University Hospital, Karachi. A substantial reduction in the percentage of disparate diagnoses was seen over the years from 41% in the initial year to 14% in the last …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Medical Knowledge Professional Growth Plan, Gavin C. Barr Jr. Md, Kevin R. Weaver Do, Michael B. Weigner Md, Bryan G. Kane Md, Dawn M. Yenser, Donna M. Chormanski-Bigelow

Department of Emergency Medicine

No abstract provided.

Sdot Faculty And Resident Training Study, Kevin Weaver Do, Kathleen E. Kane Md, Gavin Barr Jr. Md, Allison Raines Do, Nicole L. Bendock Do, Brian M. Berry Do, Gregory Smeriglio Jr, Do, Bruce C. Stouch Phd, Dawn M. Yenser, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Profiling The Ethnic Characteristics Of Domestic Injuries In Children Younger Than Age 5 Years., Tolulope A. Oyetunji, Adrienne A. Stevenson, Aderonke O. Oyetunji, Sharon K. Onguti, Sarah A. Ames, Adil H. Haider, Benedict C. Nwomeh

Manuscripts, Articles, Book Chapters and Other Papers

The home remains a very common location for deadly injuries among children younger than 5 years. The aim of this study is to describe the demographic and injury characteristics of domestic injuries in children younger than 5 years. The National Trauma Data Bank's National Sample Program data set was queried for children younger than 5 years with the injury site classified as home. Bivariate analysis was performed to determine unadjusted differences by ethnicity. Appropriate weight was applied to the sample to determine accurate national estimates. A total of 7,364 children, representing 32,033 children, were analyzed. Overall mortality was 1.6 per …

Essential Role Of Caveolin-3 In Adiponectin Signalsome Formation And Adiponectin Cardioprotection., Yajing Wang, Xiaoliang Wang, Jean-François Jasmin, Wayne Bond Lau, Rong Li, Yuexin Yuan, Wei Yi, Kurt Chuprun, Michael P. Lisanti, Walter J Koch, Erhe Gao, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Adiponectin (APN) system malfunction is causatively related to increased cardiovascular morbidity/mortality in diabetic patients. The aim of the current study was to investigate molecular mechanisms responsible for APN transmembrane signaling and cardioprotection.

METHODS AND RESULTS: Compared with wild-type mice, caveolin-3 knockout (Cav-3KO) mice exhibited modestly increased myocardial ischemia/reperfusion injury (increased infarct size, apoptosis, and poorer cardiac function recovery; P

CONCLUSIONS: Taken together, these results demonstrated for the first time that Cav-3 plays an essential role in APN transmembrane signaling and APN anti-ischemic/cardioprotective actions.

Uchunguzi (Journal Watch/Montre De Journal) March 2012, Benjamin Wachira

Emergency 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.