Lidocaine patch for treatment of acute localized pain in the emergency department: a systematic review and meta-analysis.

Lidocaine patches are commonly prescribed for acute localized pain. Most of the existing evidence is, however, derived from postoperative or chronic pain. The objective of this study is to assess the efficacy and safety of lidocaine patch compared to placebo patch or nonsteroidal anti-inflammatory drugs (NSAIDs) for acute localized pain.

Interventions to improve emergency department throughput and care delivery indicators: A systematic review and meta-analysis.

Background: Emergency department (ED) crowding has repercussions on acute care, contributing to prolonged wait times, length of stay, and left without being seen (LWBS). These indicators are regarded as systemic shortcomings, reflecting a failure to provide equitable and accessible acute care. The objective was to evaluate the effectiveness of interventions aimed at improving ED care delivery indicators.

Endovascular aspiration of native tricuspid valve vegetation using INARI catheter in a patient with methicillin-sensitive endocarditis.

A middle-aged man presented to the hospital with chief complaint of worsening chest pain and shortness of breath. He was found to have methicillin-sensitive (MSSA) bacteremia, acute hypoxic respiratory failure secondary to MSSA pneumonia and septic emboli. The patient underwent a transesophageal echocardiogram which revealed a large, mobile tricuspid valve vegetation secondary to endocarditis.

Critical stenosis of axillary artery treated with percutaneous angioplasty and stenting: a case report and review of the literature.

Focal axillary artery stenosis or occlusion is a rare occurrence that is most commonly encountered after severe trauma involving the shoulder joint or proximal humerus. Other etiologies that can lead to axillary artery injury or pathology include different vasculitides, radiation arteritis, crutch-injury, and peripheral arterial disease. In this case report, a 70-year-old woman was referred for asymmetrically decreased right brachial artery systolic pressure and right-hand paresthesia with overhead abduction.

Severity of Hospitalizations From SARS-CoV-2 vs Influenza and Respiratory Syncytial Virus Infection in Children Aged 5 to 11 Years in 11 US States.

This cross-sectional study investigates the severity of hospitalizations from SARS-CoV-2 infection compared with that of influenza and respiratory syncytial virus in children aged 5 to 11 years in 11 US states.

The Effect of a Nursing Hold Team on Patient Satisfaction for Admitted Patients Discharged Directly From the Emergency Department.

Objectives: Emergency departments (ED) across the United States face challenges related to patient volume, available capacity, and patient throughput. Patient satisfaction is adversely affected by crowding and lengthy boarding times. This study aimed to determine whether the implementation of a dedicated nursing hold team (NHT) would improve patient satisfaction scores for admitted patients discharged directly from the ED.

Resource utilization of adult patients referred to the emergency department from an urgent care center.

Background: The rise of urgent care centers (UCC) continues to serve as an alternative to emergency departments (ED) for patients with a perceived lower acuity complaint. Patients that are deemed to be higher acuity are often evaluated at an UCC and then redirected to EDs. However, limited data exist on resource utilization by patients who are transferred from UCCs to EDs.

Altering Sphingolipid Metabolism Attenuates Cell Death and Inflammatory Response After Myocardial Infarction.

Background: Sphingolipids have recently emerged as a biomarker of recurrence and mortality after myocardial infarction (MI). The increased ceramide levels in mammalian heart tissues during acute MI, as demonstrated by several groups, is associated with higher cell death rates in the left ventricle and deteriorated cardiac function. Ceramidase, the only enzyme known to hydrolyze proapoptotic ceramide, generates sphingosine, which is then phosphorylated by sphingosine kinase to produce the prosurvival molecule sphingosine-1-phosphate.

Force-stabilizing synergies can be retained by coordinating sensory-blocked and sensory-intact digits.

The present study examined the effects of selective digital deafferentation on the multi-finger synergies as a function of total force requirement and the number of digits involved in isometric pressing. 12 healthy adults participated in maximal and sub-maximal isometric pressing tasks with or without digital anesthesia to selective digits from the right hand. Our results indicate that selective anesthesia paradigm induces changes in both anesthetized (local) and non-anesthetized (non-local) digits' performance, including: (1) decreased maximal force abilities in both local and non-local digits; (2) reduced force share during multi-finger tasks from non-local but not local digits; (3) decreased force error-making; and (4) marginally increased motor synergies.

Optimizing Modified mRNA Synthesis Protocol for Heart Gene Therapy.

Synthetic modified RNA (modRNA) is a novel vector for gene transfer to the heart and other organs. modRNA can mediate strong, transient protein expression with minimal induction of the innate immune response and risk for genome integration. modRNA is already being used in several human clinical trials, and its use in basic and translational science is growing.

The effect of practice settings on individual Doctor Press Ganey scores: A retrospective cohort review.

Objective: The Press Ganey (PG) survey is a patient experience survey mailed to patients upon discharge from the emergency department (ED). It is a nationally recognized survey that is commonly used to measure patient's perception of the healthcare delivered. Emergency medicine physicians at Staten Island University Hospital staff two distinct sites: a tertiary-care setting (SIUH-N) and a community setting (SIUH-S).

Characteristics of prior emergency departments visits associated with subsequent opioid overdose.

Objectives: In this study, we aim to identify and discuss the clinical and demographic characteristics of previous emergency department (ED) patient visits, at one of the only two medical centers in Staten Island, the epicenter of the opioid epidemic within Staten Island, who subsequently present to the ED with an opioid overdose.

Design: This was a retrospective, observational study of all patients presenting to the emergency ED between July 1, 2010 and December 31, 2015.

Setting: The study was conducted at Staten Island University Hospital.

Does Initial Temperature in the Emergency Department Predict Outcomes in Patients Admitted for Sepsis?

Background: Sepsis is a leading cause of morbidity and mortality in hospitalized patients. Prompt recognition and early treatment has been shown to improve mortality. Both low and high temperature are among the four elements of systemic inflammatory response required for the diagnosis of sepsis.

A Novel Approach to Addressing an Unintended Consequence of Direct to Room: The Delay of Initial Vital Signs.

Introduction: The concept of "direct to room" (DTR) and "immediate bedding" has been described in the literature as a mechanism to improve front-end, emergency department (ED) processing. The process allows for an expedited clinician-patient encounter. An unintended consequence of DTR was a time delay in obtaining the initial set of vital signs upon patient arrival.

Effects of eliminating routine use of oral contrast for computed tomography of the abdomen and pelvis: A pilot study.

Introduction: Computed tomography (CT) of the abdomen and pelvis using only intravenous contrast has been shown to have a high degree of accuracy in evaluating abdominal pain. The aim of this study was to determine the effect on time to completion of study, time to radiologist read, and length of stay in the emergency department (ED) of implementing a protocol that stopped the routine use of oral contrast for CT of the abdomen and pelvis.

Methods: This was a single-center, retrospective cohort study.

Optimizing Cardiac Delivery of Modified mRNA.

Modified mRNA (modRNA) is a new technology in the field of somatic gene transfer that has been used for the delivery of genes into different tissues, including the heart. Our group and others have shown that modRNAs injected into the heart are robustly translated into the encoded protein and can potentially improve outcome in heart injury models. However, the optimal compositions of the modRNA and the reagents necessary to achieve optimal expression in the heart have not been characterized yet.

Detection of Primary Malignancy and Metastases with FDG PET/CT in Patients with Cholangiocarcinomas: Lesion-based Comparison with Contrast Enhanced CT.

The current National Comprehensive Cancer Network (NCCN) Guidelines consider the role of 2-deoxy-2-(18)F-fluoro-d-glucose positron emission tomography/computer tomography (FDG PET/CT) in the evaluation of cholangiocarcinoma (CCA) as "uncertain," and have recommended contrast enhanced computed tomography (CECT) but not FDG PET/CT as a routine imaging test for CCA workup. We set out to compare the diagnostic performance of FDG PET/CT and CECT in patients with CCA. The retrospective study included patients with CCA who underwent FDG PET/CT and CECT within 2-month interval between 2011 and 2013 in our hospital.

Predictors of Clinically Significant Radiographic Shoulder Pathology in the Emergency Department.

Background: Although there are no clinical decision rules for radiograph use among persons with shoulder pain, they are ordered for most patients. Previously published reviews have demonstrated that radiography is overutilized in evaluating emergency department (ED) patients with shoulder pain, and clinical factors might define patients in whom plain film radiography need not be performed.

Objectives: The objectives of this study were to identify predictors of clinically significant shoulder pain and develop a clinical decision radiograph-ordering rule for adult ED patients with shoulder pain.

Tumor lysis syndrome and primary hepatic malignancy: case presentation and review of the literature.

Tumor lysis syndrome (TLS) represents a constellation of laboratory and clinical derangements that can occur following treatment of malignancies with high cellular turnover. Most commonly noted in hematologic malignancies, TLS has been reported to occur following liver-directed therapy in the form of both ablative therapies and transarterial therapies. Classification schemes exist, as do established diagnostic criteria, to aid in the definitive diagnosis of TLS.