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https://read.qxmd.com/read/30901391/prehospital-interventions-performed-in-afghanistan-between-november-2009-and-march-2014
#1
Julio Lairet, Vikhyat S Bebarta, Joseph K Maddry, Lauren Reeves, Alejandra Mora, Lorne Blackbourne, Todd Rasmussen
OBJECTIVE: Care provided to a casualty in the prehospital combat setting can influence subsequent medical interactions and impact patient outcomes; therefore, we aimed to describe the incidence of specific prehospital interventions (lifesaving interventions (LSIs)) performed during the resuscitation and transport of combat casualties. METHODS: We performed a prospective observational, IRB approved study between November 2009 and March 2014. Casualties were enrolled as they were cared for at nine U...
March 1, 2019: Military Medicine
https://read.qxmd.com/read/30901343/performance-and-usability-of-cepheid-genexpert-hiv-1-qualitative-and-quantitative-assay-in-kenya
#2
Priska Bwana, Joshua Ageng'o, Matilu Mwau
BACKGROUND: In Kenya, access to early infant diagnosis and viral load monitoring services for HIV patients on ART is significantly hampered by sample transportation challenges and long turnaround times. Near patient care testing technologies have the potential to obviate such constraints. The Cepheid GeneXpert was launched in 2010 as a TB assay and in 2014 as a potential point of care HIV viral load assay. Whereas it is widely is used for TB in Kenya, its utility for HIV testing has not been evaluated...
2019: PloS One
https://read.qxmd.com/read/30899797/physician-based-on-scene-airway-management-in-severely-injured-patients-and-in-hospital-consequences-is-the-misplaced-intubation-an-underestimated-danger-in-trauma-management
#3
Orkun Özkurtul, Manuel F Struck, Johannes Fakler, Michael Bernhard, Silja Seinen, Hermann Wrigge, Christoph Josten
Background: Endotracheal intubation (ETI) is the gold standard for the out-of-hospital emergency airway management in severely injured patients. Due to time-critical circumstances, poor patient presentation and hostile environments, it may be prone for mechanical complications and failure. Methods: In a retrospective study (January 2011 to December 2013), all patients who underwent out-of-hospital ETI before admittance to a level 1 trauma center were analyzed consecutively...
2019: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/30899794/world-trauma-education-hemorrhage-control-training-for-healthcare-providers-in-india
#4
Lindsay Andrea Smith, Sarah Caughey, Susan Liu, Cassandra Villegas, Mohan Kilaru, Aakanksha Gupta, Robert J Winchell, Mayur Narayan
Background: Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India. Methods: A cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant...
2019: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/30898661/neuropharmacokinetics-a-bridging-tool-between-cns-drug-development-and-therapeutic-outcome
#5
REVIEW
Swati Chaturvedi, Mamunur Rashid, Mohd Yaseen Malik, Arun Agarwal, Sandeep K Singh, Jiaur R Gayen, Muhammad Wahajuddin
WHO classified neurological disorders to be among 6.3% of the global disease burden. Among the most central aspects of CNS drug development is the ability of novel molecules to cross the blood-brain barrier (BBB) to reach the target site over a desired time period for therapeutic action. Based on various aspects, brain pharmacokinetics is considered to be one of the foremost perspectives for the higher attrition rate of CNS biologics. Although drug traits are important, the BBB and blood-cerebrospinal fluid barrier together with transporters become the mechanistic approach behind CNS drug delivery...
March 18, 2019: Drug Discovery Today
https://read.qxmd.com/read/30898290/analysis-of-transport-to-an-american-college-of-surgeons-level-i-trauma-center
#6
Daniel Hakakian, Karen Kong, Dorian Atanas Bogdanovski, Andrew Benvenuto, Louis Thomas DiFazio, Renay Durling-Grover, Rolando Hector Rolandelli, Zoltan H Nemeth
INTRODUCTION: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. SETTING: Morristown Medical Center (MMC), Morristown, NJ METHODS: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed...
March 2019: Air Medical Journal
https://read.qxmd.com/read/30896190/repetitive-mild-concussion-in-subjects-with-a-vulnerable-cholinergic-system-lasting-cholinergic-attentional-impairments-in-cht-mice
#7
Ajeesh Koshy Cherian, Natalie C Tronson, Vinay Parikh, Aaron Kucinski, Randy D Blakely, Martin Sarter
Previous research emphasized the impact of traumatic brain injury on cholinergic systems and associated cognitive functions. Here we addressed the converse question: Because of the available evidence indicating cognitive and neuronal vulnerabilities in humans expressing low-capacity cholinergic systems or with declining cholinergic systems, do injuries cause more severe cognitive decline in such subjects, and what cholinergic mechanisms contribute to such vulnerability? Using mice heterozygous for the choline transporter (CHT+/- mice) as a model for a limited cholinergic capacity, we investigated the cognitive and neuronal consequences of repeated, mild concussion injuries (rmCc)...
March 21, 2019: Behavioral Neuroscience
https://read.qxmd.com/read/30895697/a-trial-to-evaluate-the-effect-of-the-sodium-glucose-co-transporter-2-inhibitor-dapagliflozin-on-morbidity-and-mortality-in-patients-with-heart-failure-and-reduced-left-ventricular-ejection-fraction-dapa-hf
#8
John J V McMurray, David L DeMets, Silvio E Inzucchi, Lars Køber, Mikhail N Kosiborod, Anna M Langkilde, Felipe A Martinez, Olof Bengtsson, Piotr Ponikowski, Marc S Sabatine, Mikaela Sjöstrand, Scott D Solomon
BACKGROUND: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been shown to reduce the risk of incident heart failure hospitalization in individuals with type 2 diabetes who have, or are at high risk of, cardiovascular disease. Most patients in these trials did not have heart failure at baseline and the effect of SGLT2 inhibitors on outcomes in individuals with established heart failure (with or without diabetes) is unknown. DESIGN AND METHODS: The Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF) is an international, multicentre, parallel group, randomized, double-blind, study in patients with chronic heart failure, evaluating the effect of dapagliflozin 10 mg, compared with placebo, given once daily, in addition to standard care, on the primary composite outcome of a worsening heart failure event (hospitalization or equivalent event, i...
March 21, 2019: European Journal of Heart Failure
https://read.qxmd.com/read/30894912/the-evaluation-of-the-radiological-and-functional-outcome-of-distraction-osteogenesis-in-patients-with-infected-gap-nonunions-of-tibia-treated-by-bone-transport
#9
Ayush Kumar Singh, Mangal Parihar, Syed Bokhari
AIM: The aims of this investigation were: 1) to study the Functional outcome of performing distraction osteogenesis in cases of infected non-union of tibia treated with Ilizarov and Limb Reconstruction System, and 2) to study the Radiological outcome of performing distraction osteogenesis in cases of infected non-union of tibia treated with Ilizarov and Limb Reconstruction System. METHODS: The study was done with 27 patients of infected gap nonunions of the tibia at Sir JJ Hospitals, Mumbai from 2013-2016...
February 28, 2019: Open Access Macedonian Journal of Medical Sciences
https://read.qxmd.com/read/30894214/epidemiology-of-emergency-ambulance-service-calls-related-to-mental-health-problems-and-self-harm-a-national-record-linkage-study
#10
Edward A S Duncan, Catherine Best, Nadine Dougall, Silje Skar, Josie Evans, Alasdair R Corfield, David Fitzpatrick, Isabella Goldie, Margaret Maxwell, Helen Snooks, Cameron Stark, Chris White, Wojtek Wojcik
BACKGROUND: People experiencing a mental health crisis receive variable and poorer quality care than those experiencing a physical health crisis. Little is known about the epidemiology, subsequent care pathways of mental health and self-harm emergencies attended by ambulance services, and subsequent all-cause mortality, including deaths by suicide. This is the first national epidemiological analysis of the processes and outcomes of people attended by an ambulance due to a mental health or self-harm emergency...
March 20, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30894103/pharmacokinetics-placental-and-breastmilk-transfer-of-antiretroviral-drugs-in-pregnant-and-lactating-women-living-with-hiv
#11
E M Hodel, C Marzolini, C Waitt, N Rakhmanina
BACKGROUND: Remarkable progress has been achieved in the identification of HIV infection in pregnant women and prevention of vertical HIV transmission through maternal antiretroviral treatment (ART) and neonatal antiretroviral drug (ARV) prophylaxis in the last two decades. Millions of women globally are receiving combination ART throughout pregnancy and breastfeeding, periods associated with significant biological and physiological changes affecting the pharmacokinetics (PK) and pharmacodynamics (PD) of ARVs...
March 20, 2019: Current Pharmaceutical Design
https://read.qxmd.com/read/30893715/-analysis-of-screening-strategy-of-group-b-streptococcus-in-the-third-trimester-and-its-influence-on-pregnancy-outcome
#12
L J Wu, F L Wang, J H Zou, J Yang, Y E Huang, F Ming, X R Chen, R R Chen, Y F Zhu
Objective: To investigate the screening strategy of group B streptococcus (GBS) in the reproductive tract of women in the third trimester and analyze its impact on pregnancy outcome. Methods: A total of 85 461 pregnant women in 35-37 weeks of gestation from Bao'an Maternity and Child Health Hospital, Jinan University from January 2011 to June 2018 were enrolled. They were divided into 3 periods according to different GBS screening strategies, the unscreened period included 31 384 cases (36.72%), 33 267 cases (38...
March 25, 2019: Zhonghua Fu Chan Ke za Zhi
https://read.qxmd.com/read/30893573/evaluation-of-trauma-triage-criteria-performance-in-a-regional-trauma-system
#13
Nichole Bosson, Amy H Kaji, Marianne Gausche-Hill, Dennis Kim, Brant Putnam, Shira Schlesinger, George Singer, Roger J Lewis
OBJECTIVE: We evaluated the performance of individual trauma triage criteria using data from a regional trauma registry. METHODS: Los Angeles County (LAC) paramedics use triage criteria adapted from the 2011 Center for Disease Control (CDC) guidelines to triage injured patients to Trauma Centers (TCs). TCs report outcomes to a LAC EMS registry. We abstracted data for patients 15 years or older from 2013 to 2015 and identified all trauma triage criteria that were met for each encounter...
March 20, 2019: Prehospital Emergency Care
https://read.qxmd.com/read/30893040/how-can-clinicians-catalyze-investments-to-improve-community-health
#14
Robin Hacke, Alyia Gaskins
Where people live and work influences how long and how well they live. Clinicians can help keep patients healthy by encouraging health care organizations to support community investments that improve conditions that contribute to health risks, outcomes, and costs. These conditions-the social determinants of health-include housing, transportation, jobs, and educational opportunities. Hospitals and health systems have assets-financial capital, land, and expertise, for example-that can be used to help support community health...
March 1, 2019: AMA Journal of Ethics
https://read.qxmd.com/read/30891740/automatic-generation-of-locally-refined-composite-grids-for-efficient-solute-transport-modeling
#15
M Adil Sbai, N Amraoui
Widely used numerical models of solute transport processes in subsurface aquifers are limited to non-locally refined rectangular, or logically rectangular, structured grids. This presents an unsuitable option to efficient numerical simulations maintaining an acceptable level of accuracy. Optimal selection of locally refined cells for efficient solute transport models is challenging to the current generation of numerical models. We present a novel and relatively simple to implement algorithm addressing these shortcomings...
March 20, 2019: Ground Water
https://read.qxmd.com/read/30890141/genetic-variation-in-the-atp-binding-cassette-transporter-abcc10-is-associated-with-neutropenia-for-docetaxel-in-japanese-lung-cancer-patients-cohort
#16
Kazuki Sone, Tetsuya Oguri, Takehiro Uemura, Akira Takeuchi, Satoshi Fukuda, Osamu Takakuwa, Ken Maeno, Kensuke Fukumitsu, Yoshihiro Kanemitsu, Hirotsugu Ohkubo, Masaya Takemura, Yutaka Ito, Akio Niimi
BACKGROUND: Docetaxel is a widely used cytotoxic agent for treatments of various cancers. The ATP binding cassette (ABC) transporter / multidrug resistance protein (MRP) ABCC10/MRP7, involved in transporting taxanes, has been associated with resistance to these agents. Since genetic variation in drug transporters may affect clinical outcomes, we examined whether polymorphism of ABCC10 could affect clinical responses to docetaxel. METHODS: Using 18 NSCLC cell lines and CRISPR-based genome-edited HeLa cells, we analyzed whether genetic variants of ABCC10 (rs2125739, rs9349256) affected cytotoxicity to docetaxel...
March 19, 2019: BMC Cancer
https://read.qxmd.com/read/30889592/impact-of-education-on-hypothermia-delivery-during-neonatal-transport
#17
Maria Saito-Benz, Sarah Cody, Fiona Dineen, Jelena Mladenovic, Mary J Berry
BACKGROUND: Moderate therapeutic hypothermia (TH) initiated within 6 h of life reduces adverse neurodevelopmental outcomes in infants after perinatal hypoxic ischaemic insult. For infants born in non-tertiary centres, TH may be initiated manually en route to a neonatal intensive care unit (NICU). However, both over- and undercooling is reported with this strategy, precluding some infants from the benefits of TH. OBJECTIVES: To evaluate the impact of a region-wide educational programme on the safety and efficacy of manual cooling administered by the Wellington Neonatal Transport Service (NeTS)...
March 19, 2019: Neonatology
https://read.qxmd.com/read/30888615/the-impact-of-carbon-emission-and-forest-activities-on-health-outcomes-empirical-evidence-from-china
#18
Muhammad Umar Farooq, Umer Shahzad, Suleman Sarwar, Li ZaiJun
The higher economic growth of China intensifies the consumption of fossil fuel, such as coal and oil, for electricity generation, transportation etc., which is responsible for environmental degradation through the emissions of carbon, sulfur, and nitrogen etc. The objectives of this study are to investigate the impact of greenhouse gas emission on health issues and provide the effective solution to overcome health-related issues, caused by carbon, sulfur, and nitrogen emission. For this purpose, we propose that higher afforestation activities can help to mitigate the carbon emission and can help to reduce the health diseases...
March 19, 2019: Environmental Science and Pollution Research International
https://read.qxmd.com/read/30888325/a-mobile-app-to-promote-adapted-exercise-and-social-networking-for-people-with-physical-disabilities-usability-study
#19
Byron Lai, Jereme Wilroy, Hui-Ju Young, Jennifer Howell, James H Rimmer, Tapan Mehta, Mohanraj Thirumalai
BACKGROUND: People with physical disabilities (PWD) experience several unique challenges that prevent them from participating in onsite exercise programs. Although mobile apps can provide a ubiquitous channel for delivering convenient exercise services within the community, no exercise apps have been designed for people with disabilities who experience certain functional limitations. OBJECTIVE: The aim of this study was to examine the usability of a mobile exercise app in PWD...
March 19, 2019: JMIR Formative Research
https://read.qxmd.com/read/30887235/the-creation-of-an-interatrial-right-to-left-shunt-in-patients-with-severe-irreversible-pulmonary-hypertension-rationale-devices-outcomes
#20
REVIEW
Anja Lehner, Ingram Schulze-Neick, Marcus Fischer, Silvia Fernandez-Rodriguez, Sarah Ulrich, Nikolaus A Haas, André Jakob
PURPOSE OF THE REVIEW: Targeted pharmacotherapies did improve survival rates, exercise capacity, and quality of life (QoL) of PAH patients. However, these pharmacological interventions are expensive and not always accessible. In addition, not all patients do respond similarly to these medications and many will continue to deteriorate. This review aims to discuss the beneficial role of an artificial right-to-left shunt and highlights current interventional devices and outcomes. RECENT FINDINGS: Since patients with preexisting atrial shunts or patients with Eisenmenger's disease show better survival rates, improved exercise capacity, and QoL, PAH patients clinically do benefit from an atrial septostomy by reducing signs of right heart failure, improving left heart filling, cardiac output, and systemic oxygen transport despite hypoxia...
March 18, 2019: Current Cardiology Reports
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