Background: The prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test.
View Article and Find Full Text PDFObjective: The Neiman Imaging Comorbidity Index (NICI) was developed and validated in a claims dataset encompassing >10 million privately insured beneficiaries, in which it outperformed the commonly used Charlson Comorbidity Index (CCI) in predicting advanced imaging use. This external validation assessed the broader generalizability of NICI for predicting receipt of advanced imaging in nationally representative populations, including patients insured by Medicare, Medicaid, and private payers.
Methods: All 2018 to 2019 patient-level claims from the CMS Medicare 5% Research Identifiable File, CMS Medicaid 100% Research Identifiable File, and private insurance (commercial and Medicare Advantage) claims from Inovalon Insights, LLC, were included.
Purpose: To determine if relative Medicaid-to-Medicare reimbursement rates are associated with patient imaging utilization.
Methods: This cross-sectional study estimated the association of diagnostic imaging utilization with the state-level Medicaid-to-Medicare reimbursement ratio (MMRR) of professional payments. State-specific reimbursement ratios were computed for each imaging modality.
Integrin signaling plays important roles in development and disease. An adhesion signaling network called the integrin adhesome has been principally defined using bioinformatics and cell-based proteomics. To date, the adhesome has not been studied using integrated proteomic and genetic approaches.
View Article and Find Full Text PDFBackground: The guidelines for Advanced Life Support issued by the European Resuscitation Council recommend considering drug delivery through intraosseous access if intravenous access to the vascular bed is not feasible or unsuccessful. Emergency prehospital intraosseous cannulation may theoretically lead to an increased risk of long-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome. Such complications have previously been reported in case reports or small sample case series.
View Article and Find Full Text PDFBackground: Arterial blood gas (ABG) values are important in the assessment of critically ill patients. However, arterial puncture may be challenging to perform in these patients. The venous-to-arterial conversion method (v-TAC) is used to convert venous blood gas values to calculated values meant to resemble arterial values.
View Article and Find Full Text PDFPurpose: Diagnostic imaging interpretations by nonphysician practitioners (NPPs) are increasing. With hospital-based imaging overwhelmingly interpreted by radiologists, we studied office-based interpretations by NPPs by their physician employer specialty.
Methods: Linking Medicare claims and provider datasets, we identified imaging interpretation claims submitted by nurse practitioners and physician assistants (together NPPs) in office settings, mapping NPPs to physician employer specialties, and assessed NPP characteristics and practice patterns.
Hyperpolarized 1-13C-pyruvate magnetic resonance spectroscopy (MRS) and MRS imaging (MRSI) offer noninvasive and real-time direct assessment of the altered metabolism of cancer cells known as the Warburg effect-a key hallmark of cancer. When combined with simultaneously acquired 18F-FDG PET in a PET/MR scanner, coined hyperPET by us, this dual-modality may unveil cancer-type specific glucose metabolic phenotypes with potential implications for patient prognostication, treatment-response assessment, and prediction. We here present the first human data of simultaneously acquired hyperpolarized MRS/MRSI and PET performed in a PET/MR scanner-and the first human hyperpolarized MRS/MRSI data from a patient with lymphoma.
View Article and Find Full Text PDFWith the increasing prevalence of Crohn's disease (CD), treatment options for patients who fail conventional and advanced therapy are highly needed. Therefore, we explored the safety and efficacy of extracorporeal photopheresis (ECP) using 5-aminolevulinic acid (ALA) and blue light (405 nm). Patients with active CD who failed or were intolerant to biological therapy were eligible.
View Article and Find Full Text PDFThis is a letter to the editor on the "Correspondence on "An algorithm for pharmacological treatment of mania during hospitalisation" Dan Med J 2024;71(5):A08230525.
View Article and Find Full Text PDFFront Immunol
September 2024
Scand J Trauma Resusc Emerg Med
September 2024
Background: During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic.
View Article and Find Full Text PDFA pivotal animal model for development of anticancer molecules is mice with subcutaneous tumors, grown by injection of xenografted tumor cells, where micro-Computed Tomography (µCT) of the mice is used to analyze the efficacy of the anticancer molecule. Manual delineation of the tumor region is necessary for the analysis, which is time-consuming and inconsistent, highlighting the need for automatic segmentation (AS) tools. This study introduces a preclinical µCT database, comprising 452 whole-body scans from 223 individual mice with subcutaneous tumors, spanning ten diverse µCT datasets conducted between 2014 and 2020 on a preclinical PET/CT scanner, making it the hitherto largest dataset of its kind.
View Article and Find Full Text PDFBackground Ultrasound-guided peripheral intravenous (USGPIV) placement is more successful, comfortable, and longer lasting than traditional landmark-based IVs. While many hospitals have protocols for becoming credentialed in this skill, there is little information available about the USGPIV success rate during and after training. Objectives This pilot study aimed to quantify USGPIV attempts by emergency nurses undergoing USGPIV training and to determine if 10 successful USGPIVs predicted success in the next USGPIV.
View Article and Find Full Text PDFCancer curing immune responses against heterogeneous solid cancers require that a coordinated immune activation is initiated in the antigen avid but immunosuppressive tumor microenvironment (TME). The plastic TME, and the poor systemic tolerability of immune activating drugs are, however, fundamental barriers to generating curative anticancer immune responses. Here, we introduce the CarboCell technology to overcome these barriers by forming an intratumoral sustained drug release depot that provides high payloads of immune stimulatory drugs selectively within the TME.
View Article and Find Full Text PDFBackground: Atopic diseases, obesity and neuropsychiatric disorders are lifestyle-related and environmental-related chronic inflammatory disorders, and the incidences have increased in the last years.
Objective: To outline the design of the 18-year follow-up of the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) birth cohort, where risk factors of atopic diseases, obesity and neuropsychiatric disorders are identified through extensive characterisation of the environment, along with deep clinical phenotyping and biosampling for omics profiling.
Methods: COPSAC is a Danish prospective clinical birth cohort study of 411 children born to mothers with asthma who were enrolled at 1 month of age and closely followed at the COPSAC clinical research unit through childhood for the development of atopic diseases.
Introduction: For high-risk women, breast magnetic resonance (MR) is the preferred supplemental imaging option, but spatial access differences may exacerbate disparities in breast care.
Methods: This was a cross-sectional study examining distance between ZIP codes and the nearest breast imaging facility (MR, mammography, ultrasound) using 2023 data from the Food and Drug Administration and the American College of Radiology. Linear regression was used to assess distance differences controlling for Area Deprivation Index (ADI), urbanicity, and population size.
Objective: To describe the change in admission rate and demographic profile of patients admitted to ICUs throughout Denmark before and during first wave of the SARS-CoV-2 pandemic.
Methods: A register-based national observational study of all patients admitted to ICU from December 2019 until April 2020, comparing ICU admission before and after lockdown.
Results: The number of admissions declined, especially in the age groups below 18 and above 70.
Introduction: Ambulance requests by general practitioners for primary care patients (GP-requested) are often omitted in studies on increased demand within emergency care but may comprise a substantial patient group. We aimed to assess acute severity, intensive care unit (ICU) admission, and diagnostic pattern, including comorbidity, and mortality among GP-requested ambulance patients, compared to emergency call ambulance patients. Our hypothesis was that emergency call patients had more severe health issues than GP-requested ambulance patients.
View Article and Find Full Text PDFPatients with small aortic annuli (SAAs) are predominantly women. We sought to compare gender-based and propensity-matched outcomes of index transcatheter aortic valve replacement (TAVR) in patients with SAAs. In this retrospective institutional analysis (2012 to 2023), primary stratification was by gender.
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