keyword
https://read.qxmd.com/read/38041670/pragmatic-computerised-perfusion-diagnostics-for-non-convulsive-status-epilepticus-a-prospective-observational-study
#21
JOURNAL ARTICLE
Elena Merli, Michele Romoli, Simone Galluzzo, Lorenzo Bevacqua, Emanuele Saverio Cece, Gabriele Ricci, Stefania Testoni, Anna Zaniboni, Maria Maddalena Viola, Luigi Simonetti, Francesca Bisulli, Sara Contardi, Paolo Tinuper, Andrea Zini
BACKGROUND: Non-convulsive status epilepticus (NCSE) is a time-dependent neurological disorder often misdiagnosed in the emergency setting. Electroencephalography (EEG) is often not available on a 24/7 basis, and Salzburg criteria may at times miss the diagnosis. Here, we tested the accuracy of hyperperfusion on CT perfusion imaging (CTP) in the identification of NCSE against Salzburg criteria, to define its potential role in a pragmatic diagnostic workflow. METHODS: We enrolled consecutive patients with suspected acute seizure or seizure disorder undergoing brain imaging with CTP and EEG from January 2021 to March 2023...
November 24, 2023: Journal of Neurology, Neurosurgery, and Psychiatry
https://read.qxmd.com/read/38035051/safety-and-feasibility-of-a-fast-track-pathway-for-neurosurgical-craniotomy-patients-bypassing-the-intensive-care-unit
#22
JOURNAL ARTICLE
Carlos Perez-Vega, Devang K Sanghavi, Pablo Moreno Franco, Ryan M Chadha, Alberto E Ardon, Elird Bojaxhi, Klaus D Torp, Lisa A Marshall, Tiffany M Halstead, Valentino E Ford, Lynda M Christel, Sanjeet S Grewal, Kaisorn L Chaichana, Alfredo Quinones-Hinojosa, Levi W Howard, W Christopher Fox, William D Freeman
OBJECTIVE: To describe the safety and feasibility of a fast-track pathway for neurosurgical craniotomy patients receiving care in a neurosciences progressive care unit (NPCU). PATIENTS AND METHODS: Traditionally, most craniotomy patients are admitted to the neurosciences intensive care unit (NSICU) for postoperative follow-up. Decreased availability of NSICU beds during the coronavirus disease-2019 delta surge led our team to establish a de-novo NPCU to preserve capacity for patients requiring high level of care and would bypass routine NSICU admissions...
December 2023: Mayo Clinic Proceedings. Innovations, Quality & Outcomes
https://read.qxmd.com/read/38012289/fast-track-to-stroke-unit-for-patients-not-eligible-for-acute-intervention-a-case-control-register-study-on-1066-patients
#23
JOURNAL ARTICLE
Ingela Wennman, Helle Wijk, Katarina Jood, Eric Carlström, Bengt Fridlund, Linda Alsholm, Johan Herlitz, Per-Olof Hansson
Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case-control register study was to evaluate outcomes for such "low priority" stroke patients who were transported via Fast Track directly to the stroke unit, according to pre-specified criteria by emergency medical service (EMS). The outcomes of Fast Track patients, transported directly to stroke unit (cases) were compared with the outcomes of patients who fulfilled these critera for Fast Track, but instead were transported to the ED (controls)...
November 27, 2023: Scientific Reports
https://read.qxmd.com/read/37986333/remimazolam-based-anesthesia-with-flumazenil-allows-faster-emergence-than-propofol-based-anesthesia-in-older-patients-undergoing-spinal-surgery-a-randomized-controlled-trial
#24
JOURNAL ARTICLE
Yukari Toyota, Takashi Kondo, Kyoko Oshita, Toshiaki Haraki, Soshi Narasaki, Kenshiro Kido, Satoshi Kamiya, Ryuji Nakamura, Noboru Saeki, Yousuke T Horikawa, Yasuo M Tsutsumi
BACKGROUND: Remimazolam is a novel, ultrashort-acting benzodiazepine that can be antagonized by flumazenil. This study aimed to determine whether remimazolam-based anesthesia with flumazenil provides a more rapid emergence than propofol-based anesthesia in older patients undergoing spinal surgery. METHODS: This was a prospective, single-blind, randomized controlled trial. Forty-four patients > 75 years old who had undergone spinal surgery were enrolled in this study...
November 17, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/37938084/emergency-ambulatory-surgery-can-it-work
#25
REVIEW
Mark Skues
Ambulatory surgery has been shown to be a management regimen associated with high quality of care and patient satisfaction. Recent research has suggested that some facets of emergency care could similarly be improved by earlier senior face-to-face consultation, a reduced time awaiting a surgical procedure and a 'fast track' recovery process. This review aims to provide information regarding the pathway of emergency ambulatory surgery and the typical changes required to optimise the process, whereby patients receive non-elective care in the most efficient way...
September 2023: Best Practice & Research. Clinical Anaesthesiology
https://read.qxmd.com/read/37937878/a-fast-track-respiratory-protocol-for-high-cervical-spine-injury-a-case-report
#26
JOURNAL ARTICLE
Caixue Pan, Yao Chen, Yongfang Zhou
BACKGROUND: Cervical spinal cord injury can greatly affect pulmonary function, resulting in complications, including respiratory failure with prolonged mechanical ventilation, ultimately leading to increased mortality and high health care costs. Weaning from mechanical ventilation is particularly challenging in patients with complete high spinal cord injury. CASE PRESENTATION: We present the case of a 42-year-old man who suffered a complete cervical 5-6 spinal cord injury following a rollover motor vehicle crash and subsequently developed postoperative pneumonia and severe hypoxemic respiratory failure...
November 2023: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://read.qxmd.com/read/37937570/triple-burden-the-incorrigible-threat-of-tuberculosis-hiv-and-covid-19
#27
JOURNAL ARTICLE
Parakriti Gupta, Diljot Sandhu, Varsha Gupta, Lipika Singhal
The Coronavirus-19 (COVID-19) hasn't seen the dawn since its emergence, however waxing and waning has resulted in the emergence of deadly variants. The effects of the pandemic have not been limited to its virulence, but have rather conferred multiple collateral effects, especially in developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19, these infections in hidden pockets served as a reservoir for the emergence of the deadly Omicron...
November 6, 2023: Infectious Disorders Drug Targets
https://read.qxmd.com/read/37888799/artificial-intelligence-for-surface-enhanced-raman-spectroscopy
#28
REVIEW
Xinyuan Bi, Li Lin, Zhou Chen, Jian Ye
Surface-enhanced Raman spectroscopy (SERS), well acknowledged as a fingerprinting and sensitive analytical technique, has exerted high applicational value in a broad range of fields including biomedicine, environmental protection, food safety among the others. In the endless pursuit of ever-sensitive, robust, and comprehensive sensing and imaging, advancements keep emerging in the whole pipeline of SERS, from the design of SERS substrates and reporter molecules, synthetic route planning, instrument refinement, to data preprocessing and analysis methods...
October 27, 2023: Small Methods
https://read.qxmd.com/read/37812919/comparison-of-a-multiplex-real-time-pcr-technique-with-oxford-nanopore-technologies-next-generation-sequencing-for-identification-of-sars-cov-2-variants-of-concern
#29
JOURNAL ARTICLE
Zahra Ahmadi, Ali Maleki, Sana Eybpoosh, Zahra Fereydouni, Mahsa Tavakoli, Setareh Kashanian, Laya Asadi, Amir Hesam Nemati, Mostafa Salehi-Vaziri
INTRODUCTION: The rapid emergence of SARS-CoV-2 variants and their potential to endangering the global health, has increased the demand for a fast-tracking method in comparison to the Next-Generation-Sequencing (NGS) as a gold standard assay, particularly in developing countries. This study was designed to evaluate the performance of a commercial multiplex Real-Time PCR technique (GA SARS-CoV-2 OneStep RT-PCR Kit, Iran) for identification of SARS-CoV-2 variants of concern compared to Oxford Nanopore Next-Generation-Sequencing assay...
October 9, 2023: Intervirology
https://read.qxmd.com/read/37806334/routine-extubation-in-the-operating-room-after-isolated-coronary-artery-bypass
#30
JOURNAL ARTICLE
Les James, Deane E Smith, Aubrey C Galloway, Darien Paone, Michael Allison, Shashwat Shrivastava, Mikhail Vaynblat, Daniel G Swistel, Didier F Loulmet, Eugene A Grossi, Mathew R Williams, Elias Zias
BACKGROUND: The benefits of fast-track extubation in the intensive care unit (ICU) after cardiac surgery are well established. Although extubation in the operating room (OR) is safe in carefully selected patients, widespread use of this strategy in cardiac surgery remains unproven. This study was designed to evaluate perioperative outcomes with OR vs ICU extubation in patients undergoing nonemergency, isolated coronary artery bypass grafting (CABG). METHODS: The Society of Thoracic Surgeons (STS) data for all single-center patients who underwent nonemergency isolated CABG over a 6-year interval were analyzed...
January 2024: Annals of Thoracic Surgery
https://read.qxmd.com/read/37801938/models-of-care-with-advanced-practice-nurses-in-the-emergency-department-a-scoping-review
#31
REVIEW
Samantha Horvath, Sanja Visekruna, Kelley Kilpatrick, Melissa McCallum, Nancy Carter
INTRODUCTION: Emergency departments play a critical role in healthcare systems internationally. Visits for emergency care continue to increase, related to poor access to primary care, the COVID-19 pandemic, and health human resource issues. International literature shows similar stressors in the emergency department. Extended wait times to see health providers lead to poor outcomes, and innovative models of care are needed to address emergency department overcrowding and to meet the needs of patients...
September 18, 2023: International Journal of Nursing Studies
https://read.qxmd.com/read/37788025/covid-lateral-damage-impact-of-the-post-covid-19-era-on-procedural-training-in-emergency-medicine-residency
#32
JOURNAL ARTICLE
Daniel Frank, Thomas Perera, Moshe Weizberg
Introduction: Hospitalizations during the coronavirus 2019 (COVID-19) pandemic peaked in New York in March-April 2020. In the months following, emergency department (ED) volumes declined. Our objective in this study was to examine the effect of this decline on the procedural experience of emergency medicine (EM) residents compared to the pre-pandemic period. Methods: We conducted this multicenter, retrospective cohort study of patients seen and key procedures performed by EM residents at hospitals spanning three Accreditation Committee for Graduate Medical Education-approved EM residencies in New York City and Nassau County, NY...
September 2023: Western Journal of Emergency Medicine
https://read.qxmd.com/read/37712243/advancements-in-nipah-virus-treatment-analysis-of-current-progress-in-vaccines-antivirals-and-therapeutics
#33
REVIEW
Gayatree Mishra, Vishal Prajapat, Debasis Nayak
Nipah virus (NiV) causes severe encephalitis in humans. Three NiV strains NiV-Malaysia (NiVM ), NiV Bangladesh (NiVB ), and NiV India (NiVI reported in 2019) have been circulating in South-Asian nations. Sporadic outbreak observed in South-East Asian countries but human to human transmission raises the concern about its pandemic potential. The presence of the viral genome in reservoir bats has further confirmed that NiV has spread to the African and Australian continents. NiV research activities have gained momentum to achieve specific preparedness goals to meet any future emergency-as a result, several potential vaccine candidates have been developed and tested in a variety of animal models...
September 15, 2023: Immunology
https://read.qxmd.com/read/37535398/tixagevimab-cilgavimab-for-preventing-covid-19-during-the-omicron-surge-retrospective-analysis-of-national-veterans-health-administration-electronic-data
#34
JOURNAL ARTICLE
Yinong Young-Xu, Lauren Epstein, Vincent C Marconi, Victoria Davey, Caroline Korves, Gabrielle Zwain, Jeremy Smith, Fran Cunningham, Robert A Bonomo, Adit A Ginde
Little is known regarding the effectiveness of tixagevimab/cilgavimab in preventing SARS-CoV-2 infection in vaccinated immunocompromised patients, particularly after the emergence of the Omicron variant. In this retrospective cohort study with exact matching and propensity score adjustment within the U.S. Department of Veterans Affairs (VA) healthcare system, we selected immunocompromised veterans age ≥18 years as of 1 January 2022, receiving VA healthcare. We compared a cohort of 1,878 patients treated with at least one dose of intramuscular tixagevimab/cilgavimab to 7,014 matched controls selected from patients who met study criteria but were not treated...
August 3, 2023: MBio
https://read.qxmd.com/read/37486077/crispr-cas-transcriptomics-and-rna-interference-in-virus-disease-management
#35
JOURNAL ARTICLE
Kasi Viswanath Kotapati, Aflaq Hamid, Elijah Miinda Ateka, Hanu Pappu
Plant viruses infect a wide range of commercially important crop plants and cause significant crop production losses worldwide. Numerous alterations in plant physiology related to the reprogramming of gene expression may result from viral infections. While conventional IPM-based strategies have been effective in reducing the impact of several viral diseases, continued emergence of new viruses and strains, expanding host ranges, and emergence of resistance breaking strains necessitate a sustained effort toward the development and application of new approaches for virus management that would complement existing tactics...
July 24, 2023: Phytopathology
https://read.qxmd.com/read/37479279/pathways-to-cancer-diagnosis-current-state-and-recommendations
#36
JOURNAL ARTICLE
Amina Waheed
BACKGROUND: Diagnosing cancer early is crucial in improving patient outcomes. Primary care networks are encouraged to audit routes to cancer diagnosis, as suggested by the Network Contract Directed Enhanced Service Early Cancer Diagnosis Guidance. AIM: We aim to measure how many patients were diagnosed with cancer in the period of April 2021 to March 2022 at an Essex GP practice, and for each of those patients, to ascertain the route of their diagnosis. We also conducted learning event analyses for patients whose diagnoses were not detected through 2-week wait (2WW) or screening...
July 2023: British Journal of General Practice
https://read.qxmd.com/read/37477822/outcome-assessment-of-intraoperative-radiotherapy-for-brain-metastases-results-of-a-prospective-observational-study-with-comparative-matched-pair-analysis
#37
JOURNAL ARTICLE
Julian P Layer, Motaz Hamed, Anna-Laura Potthoff, Cas S Dejonckheere, Katharina Layer, Gustavo R Sarria, Davide Scafa, David Koch, Mümtaz Köksal, Fabian Kugel, Molina Grimmer, Jasmin A Holz, Thomas Zeyen, Lea L Friker, Valeri Borger, F Carsten Schmeel, Johannes Weller, Michael Hölzel, Niklas Schäfer, Stephan Garbe, Helmut Forstbauer, Frank A Giordano, Ulrich Herrlinger, Hartmut Vatter, Matthias Schneider, L Christopher Schmeel
PURPOSE: Intraoperative radiation therapy (IORT) is an emerging alternative to adjuvant stereotactic external beam radiation therapy (EBRT) following resection of brain metastases (BM). Advantages of IORT include an instant prevention of tumor regrowth, optimized dose-sparing of adjacent healthy brain tissue and immediate completion of BM treatment, allowing an earlier admission to subsequent systemic treatments. However, prospective outcome data are limited. We sought to assess long-term outcome of IORT in comparison to EBRT...
July 21, 2023: Journal of Neuro-oncology
https://read.qxmd.com/read/37448487/automated-analysis-of-unstructured-clinical-assessments-improves-emergency-department-triage-performance-a-retrospective-deep-learning-analysis
#38
JOURNAL ARTICLE
Dana R Sax, E Margaret Warton, Oleg Sofrygin, Dustin G Mark, Dustin W Ballard, Mamata V Kene, David R Vinson, Mary E Reed
OBJECTIVES: Efficient and accurate emergency department (ED) triage is critical to prioritize the sickest patients and manage department flow. We explored the use of electronic health record data and advanced predictive analytics to improve triage performance. METHODS: Using a data set of over 5 million ED encounters of patients 18 years and older across 21 EDs from 2016 to 2020, we derived triage models using deep learning to predict 2 outcomes: hospitalization (primary outcome) and fast-track eligibility (exploratory outcome), defined as ED discharge with <2 resource types used (eg, laboratory or imaging studies) and no critical events (eg, resuscitative medications use or intensive care unit [ICU] admission)...
August 2023: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/37415999/fatigue-it-is-not-always-in-the-head
#39
Jehan Zeb, Sana Zafar, Zehra Irshad
Fatigue is a common presenting complaint in patients seen in clinics and same-day emergency care. Although it has a simple presentation, it can be challenging to diagnose and manage, particularly when an underlying medical condition presents atypically as fatigue. Here we present an interesting case of giant cell arteritis (GCA) with only fatigue as the presenting complaint. GCA is the inflammation of medium and large vessels in the body, including the aortic arch and its branches. It typically manifests above the age of 50 with headaches, jaw claudication, temporal tenderness, arthralgia, night sweats, and unintentional weight loss...
June 2023: Curēus
https://read.qxmd.com/read/37386326/models-of-care-in-emergency-neurology-from-the-neuro-fast-track-to-the-emergency-neurologist-a-position-paper-of-the-italian-association-for-emergency-neurology-aneu
#40
JOURNAL ARTICLE
Giuseppe Micieli, Pietro Cortelli, Massimo Del Sette, Rocco Quatrale, Anna Cavallini, Maria Luisa Zedde, Carla Zanferrari, Arturo de Falco, Maria Guarino, Giovanni Cossu, Shalom Haggiag, Francesca Romana Pezzella, Alessandro Porreca, Francesca Pistoia, Vincenzo Andreone, Bruno Giometto, Claudio Gasperini, Elisa Giorli, Andrea Salmaggi, Simona Lattanzi, Carmelo Roberto Labate, Giuseppe Rinaldi, Maurizio Melis, Emanuele Caggia, Gino Volpi, Paolo Passadore, Francesco Corea, Giovanni Maria Franco
I n the context of an adequate health care organization, the figure of the neurologist as an emergency operator (in the emergency room-ER-and/or in a dedicated outpatient clinic) is crucial for an effective functional connection with the territory (and therefore with general practitioners), a reduction in inappropriate ER accesses, specific diagnostic and therapeutic approaches to neurological emergencies in the ER and a reduction in nonspecific or even unnecessary instrumental investigations. In this position paper of the Italian Association of Emergency Neurology (ANEU: Associazione Neurologia dell'Emergenza Urgenza), these issues are addressed, and two important organizational solutions are proposed: 1) The Neuro Fast Track, as an outpatient organization approach strongly linked to general practitioners and non-neurological specialists and dedicated to cases with deferrable urgency (to be assessed within 72 h) 2) The identification of an emergency neurologist, who is engaged in ER assessments as a consultant and involved in the management of the semi-intensive care unit of the emergency neurology and the stroke unit according to an appropriate rotation, as well as in consultations for patients with neurological emergencies in inpatient wards The possibility of computerizing the screening of patients with deferrable urgency in the Neuro Fast Track is described...
June 29, 2023: Neurological Sciences
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