It has been proposed that telehealth may help to combat the epidemic of diabetes and other chronic diseases in the US. As a result of rapid technological advancement over the past decade, there has been an explosion in virtual diabetes management program offerings rooted in smartphone technology, connected devices for blood glucose monitoring, and remote coaching or support. Such offerings take many forms with unique features.
View Article and Find Full Text PDFIn June 2019, the Leona M. and Harry B. Helmsley Charitable Trust and JDRF International (JDRF) co-sponsored the Healthcare Professional Resource Workshop in San Francisco, California.
View Article and Find Full Text PDFBackground: The paucity of literature regarding the role of time and intraocular pressure (IOP) when treating ocular compartment syndrome (OCS) has resulted in limited guidance for emergency physicians (EP).
Objectives: Our goals were to investigate the ideal time frame for lateral canthotomy, to understand the relationship between IOP and visual outcome, and to determine the impact of EP performance on visual acuity (VA).
Methods: The study population included patients presenting over an 18-year period with traumatic retrobulbar hemorrhage (RBH) treated with lateral canthotomy.
Diabetes Technol Ther
January 2020
Recent years have brought about an explosion in the number of companies offering connected diabetes care products, defined as digital diabetes management systems based around (1) smartphone apps, (2) devices with built-in connectivity, and (3) remote human and automated coaching and support. These nascent models aim to provide more continuous and on-demand care, aligning with the 24/7 demands of chronic disease. It has been enabled by multiple factors, including the rising use of connected devices and apps to help people manage their chronic conditions, growing appreciation for the importance of outcomes beyond A1c, and the lofty and growing cost of health care.
View Article and Find Full Text PDFObjectives: To characterize emergency department sedation practices in mechanically ventilated patients, and test the hypothesis that deep sedation in the emergency department is associated with worse outcomes.
Design: Multicenter, prospective cohort study.
Setting: The emergency department and ICUs of 15 medical centers.
Background: Loading doses of vancomycin assist in the rapid achievement of target trough concentrations. Patients with renal dysfunction have been excluded from studies evaluating loading doses.
Objective: The purpose of this study was to investigate nephrotoxicity related to initial vancomycin dose in patients with severe renal dysfunction.
Eating and sleeping represent two mutually exclusive behaviors that satisfy distinct homeostatic needs. Because an animal cannot eat and sleep at the same time, brain systems that regulate energy homeostasis are likely to influence sleep/wake behavior. Indeed, previous studies indicate that animals adjust sleep cycles around periods of food need and availability.
View Article and Find Full Text PDFAfter assessing patient perspectives on the success of current diabetes therapies and the factors that have the greatest impact on daily life, we show that time-in-range is a crucial outcome for people with diabetes and that current therapies are falling short on this metric. We also show that patients feel significant stress and worry, and they believe they are falling short in diet, exercise, and weight maintenance. In addition, they believe diet and exercise and in-range blood glucose are the biggest drivers of improved diabetes management and mindset.
View Article and Find Full Text PDFObjective: Vancomycin loading doses are recommended; however, the risk of nephrotoxicity with these doses is unknown. The primary objective of this study was to compare nephrotoxicity in emergency department (ED) sepsis patients who received vancomycin at high doses (>20 mg/kg) versus lower doses (≤20 mg/kg).
Methods: A retrospective cohort study was performed in three academic EDs.
Background: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment.
Methods: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED.
Background: Optimizing vancomycin dosing may help eradicate bacteria while avoiding resistance. The guidelines recommend loading doses; however, there are no data to demonstrate that this may result in a more rapid achievement of therapeutic troughs.
Objective: To evaluate the percentage of troughs reaching therapeutic levels at 12, 24, and 36 hours following an initial vancomycin dose of 30 mg/kg compared with 15 mg/kg.
Background: Ultrasound-guidance for internal jugular central venous cannulation (CVC) has become the recommended best practice and has been shown to improve placement success and reduce complications. There is a dearth of studies that evaluate emergency point-of-care ultrasound guidance of femoral CVC.
Objective: Our aim was to determine if point-of-care ultrasound guidance for femoral CVC decreases adverse events and increases the likelihood of successful placement when compared with the landmark technique.
Background: To prevent the development of bacterial resistance, current guidelines recommend vancomycin dosages of 15-20 mg/kg based on actual body weight.
Objective: Our aim was to determine if two community teaching Emergency Departments followed the new recommendations for a weight-based dosing regimen for vancomycin.
Methods: A retrospective cohort study was conducted on the prescribing habits of vancomycin in the Emergency Department.