Upper Arm Versus Forearm Placement of Long Peripheral Catheters for Blood Sampling: A Randomized Controlled Trial.

Background: The impact of site selection on blood sampling and catheter functionality for long peripheral catheters (LPCs) is unclear.

Purpose: To compare outcomes of LPCs placed in the upper arm vs the forearm.

Methods: A single-site, randomized trial was conducted among adult patients requiring an LPC for difficult venous access or prolonged therapy.

Meta-analysis to evaluate the comparative effectiveness of enzalutamide and abiraterone acetate for first-line treatment of metastatic castration-resistant prostate cancer in real-world settings.

Introduction: Androgen-receptor pathway inhibitors such as abiraterone and enzalutamide have demonstrated clinical benefit in patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to conduct a meta-analysis of published real-world evidence studies comparing outcomes among patients treated with enzalutamide or abiraterone in the first-line setting.

Methods: We conducted a systematic literature review to identify eligible studies.

Anticipating impending peripheral intravenous catheter failure: A diagnostic accuracy observational study combining ultrasound and artificial intelligence to improve clinical care.

Objective: Peripheral intravenous catheter (PIVC) failure occurs in approximately 50% of insertions. Unexpected PIVC failure leads to treatment delays, longer hospitalizations, and increased risk of patient harm. In current practice there is no method to predict if PIVC failure will occur until it is too late and a grossly obvious complication has occurred.

A modified Delphi consensus regarding the clinical utility of triplet therapy in patients with metastatic hormone-sensitive prostate cancer patients in the UK.

Objectives: This study aimed to determine the clinical utility of the androgen deprivation therapy (ADT)+docetaxel (DOCE)+androgen receptor-targeted agent (ARTA) triplet therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the UK.

Design: A modified Delphi method. A steering group of eight UK healthcare professionals experienced in prostate cancer care discussed treatment challenges, developing 39 consensus statements across four topics.

Enzalutamide versus abiraterone acetate in the development of new-onset or worsening type 2 diabetes mellitus in patients with metastatic castration-resistant prostate cancer: EVADE study.

Purpose: To determine new-onset or worsening T2DM risk in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving abiraterone acetate (AA) vs. enzalutamide (ENZA) in England.

Methods: Records of patients on AA and/or ENZA (2015-2021) were analysed retrospectively from UK- or England-wide databases and data sets.

Cost effectiveness of a vascular access education and training program for hospitalized emergency department patients.

Objective: Education and training in vascular access is a critical component to delivering quality vascular access care. Given that organizations must invest resources to implement and sustain high-quality vascular access programming, we aimed to demonstrate the cost effectiveness of a program (Operation STICK (OSTICK)) in the emergency department (ED).

Methods: This was an observational cohort study conducted at a tertiary care academic center with 120,000 ED visits.

Optimizing Infusate Flow Patterns for Minimizing Vein Wall Trauma: An Exploratory Study with a Modified off-Axis Catheter Tip Opening.

Objective: Modifying the PIVC tip to direct infusates toward areas of highest hemodilution may reduce vein wall damage. This study compared flow patterns between a traditional PIVC with a central opening and one with an off-axis aperture.

Methods: This was an exploratory observational analysis conducted at a tertiary care emergency department (ED) comparing flow patterns of two intravenous catheters: PIVC 1 (2.

Operation STICK Improves Vascular Access Outcomes in a Specialty Team: A Quasi-Experimental Study.

Background: Education and training may improve outcomes within an experienced vascular access team.

Purpose: The purpose of this study was to measure the impact of a standardized peripheral intravenous catheter insertion educational program (Operation STICK) on vascular access outcomes.

Methods: A quasi-experimental study design was used.

The impact of health disparities on peripheral vascular access outcomes in hospitalized patients: an observational study.

Background: Placement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes.

Methods: This study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States.

Axitinib after Treatment Failure with Sunitinib or Cytokines in Advanced Renal Cell Carcinoma-Systematic Literature Review of Clinical and Real-World Evidence.

Background: We conducted a systematic literature review (SLR) to identify clinical evidence on treatments in advanced renal cell carcinoma (aRCC) after the failure of prior therapy with cytokines, tyrosine kinase inhibitors, or immune checkpoint inhibitors. Herein, we summarise the evidence for axitinib in aRCC after the failure of prior therapy with cytokines or sunitinib.

Methods: This SLR was registered with PROSPERO (CRD42023492931) and followed the 2020 PRISMA statement and the Cochrane guidelines.

Role of external radiation in benign tumors: A clinical outcome and safety audit of 7 years from a tertiary care center in India.

Purpose: Radiotherapy (RT) is a well-established modality for treating malignancies, but its role in treatment of benign lesions has not been well explored. Herein, we present a retrospective analysis of a 7-year data regarding the benefit and the safety profile of RT for treating benign tumors in our institute.

Materials And Methods: Data of 23 patients who received RT for benign tumors from January 2015 to April 2022 were retrieved, and a retrospective analysis was conducted.

Emergency Department Doppler Assessment of a Central Retinal Artery Occlusion: Case Report.

Introduction: Vision loss is a symptom found frequently in patients presenting to the emergency department (ED). Central retinal artery occlusion (CRAO) is an uncommon yet time-sensitive and critical cause of painless vision loss in which delayed diagnosis can lead to significant morbidity. Emergency medicine literature documents the ability to diagnose a CRAO using ultrasound by identifying the hyperechoic thrombus-coined the retrobulbar spot sign.

Updated Bivalent COVID-19 Vaccines Reduce Risk of Hospitalization and Severe Outcomes in Adults: An Observational Cohort Study.

Background: This study evaluates the real-world effectiveness of updated bivalent coronavirus disease 2019 (COVID-19) vaccines in adults, as the virus evolves and the need for new vaccinations increases.

Methods: In this observational, retrospective, multi-center, cohort analysis, we examined emergency care encounters with COVID-19 in metro Detroit, Michigan, from January 1, 2022, to March 9, 2023. Patients were categorized by vaccination status: unvaccinated, fully vaccinated, fully vaccinated and boosted (FV&B), or fully vaccinated and bivalent boosted (FV&BB).

The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre-post intervention study.

Background: Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections.

Objective: The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes.

Methods: This pre-post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States.

Pilot Evaluation of Perioperative High Dose Rate Brachytherapy in Head Neck Cancers.

Perioperative high dose rate brachytherapy involves insertion of brachytherapy catheter over the tumor bed during surgical removal of disease followed by radiation in the postoperative period. It has applications in radiotherapy dose escalation or reirradiation and for extending the surgical margins. We report here initial results of treatment in five cases of locally advanced head and neck cancers.

Adenoid Cystic Cancer of the Lacrimal Gland: Management Aspects and Treatment Outcomes.

Unlabelled: Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. The biological behavior of these tumors is characterized by a slow growth with frequent nerve invasion but rare invasion of the neck nodes. Local extension intracranially with bone erosions is seen in locally advanced tumors.

Antihypertensive prescription is associated with improved 30-day outcomes for discharged hypertensive emergency department patients.

Background: Hypertension (HTN) is common in discharged emergency department (ED) patients, yet the short-term outcomes of treating HTN at ED discharge are unclear. This study aimed to investigate whether emergency physician (EP) prescription of oral antihypertensive therapy at ED discharge for hypertensive patients is associated with a decreased 30-day risk of the severe adverse events (AEs), death, and revisits to the ED.

Methods: We conducted an observational cohort study assessing the 30-day outcomes of discharged ED patients with HTN, comparing outcomes based on whether antihypertensive therapy was prescribed.

Pediatric hemolysis in emergency departments: Prevalence, risk factors, and clinical implications.

Objective: This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce.

Methods: We conducted a multi-site observational cohort analysis of pediatric ED encounters in Metro Detroit, Michigan, United States. The study included participants below 18 years of age who had undergone peripheral intravenous catheter (PIVC) placement and laboratory testing.

Association between ABO blood type and coronavirus disease 2019 severe outcomes across dominant variant strains.

Objectives: Existing evidence suggests a link between ABO blood type and severe outcomes in coronavirus disease 2019 (COVID-19). We aimed to assess the relationship between blood type and severe outcomes across variant strains throughout the pandemic.

Methods: This was a multicenter retrospective observational cohort analysis from a large health system in southeastern Michigan using electronic medical records to evaluate emergency encounters, hospitalization, and severe outcomes in COVID-19 based on ABO blood type.

Operation STICK: A vascular access specialty program for the generalist emergency medicine clinician.

Objective: Comprehensive education and training programs are urgently needed to improve vascular access outcomes in the emergency department (ED). This study aimed to demonstrate the success of a formalized vascular access program in developing competent ED clinicians in traditional and ultrasound-guided insertion methods.

Methods: This was a retrospective observational study exploring the success of trainees in obtaining competency in peripheral vascular access at an academic suburban ED with 120,000 annual visits.

Evaluating the impact of external forces on peripheral intravenous catheter movement using ultrasound: A randomized pilot study.

Background: A major contributor to peripheral intravenous catheter (PIVC) failure may be related to PIVC movement within the vein which is associated with vein wall damage. The magnitude of PIVC movement against the vein wall has not previously been quantified. This study aimed to examine PIVC movement within the vein when minor forces were applied to the PIVC.