Fetal Growth Following Electronic Cigarette Use in Pregnancy.

Electronic cigarette (e-cig) use in pregnancy is common, but potential effects on fetal development are largely unknown. This study's goal was to examine the association between e-cig exposure and fetal growth. Data were extracted from medical charts in this single-site retrospective study.

Impact of in utero tobacco exposure on fetal growth: Amount of exposure and second trimester fetal growth measurements.

Background: Research reveals small and inconsistent findings linking prenatal tobacco exposure and early fetal growth, but failure to consider confounding and amount of exposure many explain inconsistencies.

Goal: To examine whether fetal growth effects following exposure to tobacco are evident in the second trimester, specific to certain growth parameters, and dose dependent.

Methods: Participants were pregnant women (64 smokers, 100 controls) with no other drug use.

Birth outcomes following in utero co-exposure to tobacco and marijuana.

Background: With recent changes in tobacco and marijuana use patterns, it becomes crucial to understand how the prenatal co-use of these substances impacts birth outcomes. The goal of this study was to examine the risk of adverse birth outcomes among infants born to women who used tobacco and marijuana concurrently throughout pregnancy compared to infants of women who used tobacco alone.

Methods: This study involved a retrospective chart review of pregnant women identified via self-report or biochemical testing who used tobacco products alone (N = 71) or tobacco and marijuana simultaneously (N = 127) at any point throughout pregnancy.

The impact of in utero cannabis exposure on fetal growth.

Background: The goal of this study was to examine if in utero cannabis exposure predicted reduced birth size and if these effects were evident in specific growth parameters as early as the second trimester.

Methods: Eligible women had an initial prenatal visit between January 1, 2010, and March 31, 2020, completed an anatomy ultrasound between 18-24 weeks' gestation, and had no self-reported alcohol, tobacco, or other biochemically verified drug use. The two primary study groups were cannabis users (n = 109) identified through self-report and urine toxicology screens, and a randomly selected control group of non-substance users (n = 171).

The impact of timing of in utero marijuana exposure on fetal growth.

Objective: To examine whether timing of marijuana exposure independently and negatively impacts fetal growth, and if these effects are global or specific to certain growth parameters.

Study Design: The two study groups were marijuana users ( = 109) and a randomly selected control group of biochemically verified non-users ( = 171). Study data were obtained manual abstraction of electronic medical records.

Improvised Management of Polycythemia Vera Using Whole Blood Transfusion Kits.

Polycythemia vera (PV) is a frequent myeloproliferative disease resulting in excessive red blood cells, white blood cells, and platelets rarely identified in military populations. Increased blood viscosity and platelets can lead to fatal myocardial infarction and stroke. Historically, regimented phlebotomy managed this condition, but modern medicinal advances now are utilized.

An Analysis of Prehospital Trauma Registry: After-Action Reviews on Airway Interventions in Afghanistan.

Background: Failed airway management is the second leading cause of preventable death on the battlefield. The prehospital trauma registry (PHTR) after action-review (AAR) allows for unique perspectives and an enhanced analysis of interventions performed. We analyzed AAR comments related to airway interventions performed in deployed settings to examine and identify trends in challenges related to airway management in combat.

An Analysis of Prehospital Trauma Registry After-Action Reviews in Afghanistan.

Background: After-action reviews (AARs) in the Prehospital Trauma Registry (PHTR) enable performance improvements and provide commanders feedback on care delivered at Role 1. No published data exist exploring overall trends of end-user performance-improvement feedback.

Methods: We performed an expert panel review of AARs within the PHTR in Afghanistan from January 2013 to September 2014.

Sharp Object in the Belly: A Case of Pediatric Intentional Razor Blade Ingestion in the Emergency Department.

Ingested foreign object (FOB) is a common complaint in the emergency department (ED), especially in pediatric patients. While many FOB ingestions are benign, sharp objects, including razor blades, are of particular concern given the acute risk of perforation throughout the gastrointestinal tracts. The majority of razor blade ingestions involve prisoners and psychiatric patients, which can complicate the diagnosis and treatment.

Conducting fresh whole blood transfusion training.

Fresh whole blood is the optimal resuscitation fluid for casualties in hemorrhagic shock according to the Committee on Tactical Combat Casualty Care and has demonstrated to improve outcomes in severely wounded patients. Like all medical interventions, fresh whole blood transfusions are not without risks, but similarly can be mitigated through increased training to develop provider knowledge and proficiency. To date, no literature has been published regarding the proper technique to conduct fresh whole blood transfusion training.

National Stop the Bleed Day: The impact of a social media campaign on the Stop the Bleed program.

Background: National Stop the Bleed Day (NSTBD) was created to increase public awareness of the official Stop-the-Bleed initiative and the Bleeding Control Basic course. The goal was to develop and employ an effective national social media strategy that would encourage and support efforts already in place to train the public in basic bleeding control techniques.

Methods: March 31, 2018, was designated as NSTBD.

Improved Cardiopulmonary Resuscitation Performance With CODE ACES: A Resuscitation Quality Bundle.

Background Over 6000 children have an in-hospital cardiac arrest in the United States annually. Most will not survive to discharge, with significant variability in survival across hospitals suggesting improvement in resuscitation performance can save lives. Methods and Results A prospective observational study of quality of chest compressions ( CC ) during pediatric in-hospital cardiac arrest associated with development and implementation of a resuscitation quality bundle.

Smallpox Autoinoculation Via Tattoo in a Soldier.

Since the National Smallpox Vaccination Program began in 2002, over 2.4 million military servicemembers have been inoculated. Use of bifurcated needles to introduce live vaccinia virus by repeated skin trauma is largely the same process that was first developed over 200 years ago, and is similar to that of tattoo administration.

Design and Deployment of a Pediatric Cardiac Arrest Surveillance System.

Objective: We aimed to increase detection of pediatric cardiopulmonary resuscitation (CPR) events and collection of physiologic and performance data for use in quality improvement (QI) efforts.

Materials And Methods: We developed a workflow-driven surveillance system that leveraged organizational information technology systems to trigger CPR detection and analysis processes. We characterized detection by notification source, type, location, and year, and compared it to previous methods of detection.

Solute segregation and deviation from bulk thermodynamics at nanoscale crystalline defects.

It has long been known that solute segregation at crystalline defects can have profound effects on material properties. Nevertheless, quantifying the extent of solute segregation at nanoscale defects has proven challenging due to experimental limitations. A combined experimental and first-principles approach has been used to study solute segregation at extended intermetallic phases ranging from 4 to 35 atomic layers in thickness.

Perspectives of Somali Bantu refugee women living with circumcision in the United States: a focus group approach.

Background: The purpose of this study was to explore healthcare perspectives of Somali Bantu refugees in relation to their status as women who have been circumcised and recently resettled in the United States. These women and their families were already uprooted from Somalia to Kenya for over 10 years, increasing their vulnerability and marginal status beyond that of women who have been circumcised.

Methods And Participants: A purposive, inclusive sample of 23 resettled Somali women in southwestern Pennsylvania of the United States participated in focus group sessions for data collection.

Participatory action research to understand and reduce health disparities.

Participatory action research (PAR) is an excellent way to systematically learn about the conditions under which people experience health disparities, what it is like from the perspective of those experiencing such disparities and, even more importantly, how to ameliorate this major public health problem and create a more equitable and effective health care system. This article describes the method of PAR, supports the appropriateness of PAR to learn about and reduce health disparities, and then presents some specific examples of research projects that have employed or are planning to employ PAR. These examples are from the work of several authors of this article, who are members of an interdisciplinary working group that serves as a forum for discussion of issues related to qualitative research methods and facilitates the development of qualitative studies.

The changing face of bronchopulmonary dysplasia: Part 2. Discharging an infant home on oxygen.

Transitioning an infant with bronchopulmonary dysplasia (BPD) home on oxygen is a complex process. It requires an interdisciplinary team, with clear but flexible discharge criteria, and a coordinated process to manage the complexity. In "The Changing Face of Bronchopulmonary Dysplasia: Part I" (Advances in Neonatal Care, December 2002, pp 327-338), the evolving nature of BPD was presented, along with new diagnostic criteria, a description of the risk factors and clinical profile of this condition, and a discussion of preventative strategies as well as the medical and neurodevelopmental outcomes.