Background: Patients with cancer frequently visit the emergency department (ED) and are at high risk for hospitalization due to severe illness from cancer progression or treatment side effects. With an aging population and rising cancer incidence rates worldwide, it is crucial to understand how EDs and other acute care venues manage oncologic emergencies. Insights from other nations and health systems may inform resources necessary for optimal ED management and novel care delivery pathways.
View Article and Find Full Text PDFPhysical activity is essential in enhancing the quality of life for individuals with multiple sclerosis (MS). However, there is limited evidence regarding the unique barriers individuals newly diagnosed with MS face. The purpose of this qualitative study is to understand the perspectives of persons newly diagnosed with MS about physical activity.
View Article and Find Full Text PDFPurpose: This study investigates the accuracy of fully-automated maximum aortic diameter measurements in abdominal aortic aneurysm (AAA) patients using artificial intelligence software (PRAEVAorta 2, Nurea, Bordeaux, France).
Materials And Methods: This is a multicenter, retrospective validation study using prospectively collected data from the Zenith alpha for aneurysm Repair Registry (ZEPHYR). Automated measurements of PRAEVAorta 2 are compared with measurements of an internationally recognized core laboratory (Syntactx, New York, New York State).
Mixed reality (MxR) enables the projection of virtual three-dimensional objects into the user's field of view via a head-mounted display (HMD). This phantom model study investigated three different workflows for navigated common femoral arterial (CFA) access and compared it to a conventional sonography-guided technique as a control. A total of 160 punctures were performed by 10 operators (5 experts and 5 non-experts).
View Article and Find Full Text PDFBackground: Acute respiratory distress syndrome (ARDS) is often seen in patients resuscitated from out-of-hospital cardiac arrest (OHCA). We aim to test whether inflammatory or endothelial injury markers are associated with the development of ARDS in patients hospitalized after OHCA.
Methods: We conducted a prospective, cohort, pilot study at an urban academic medical center in 2019 that included a convenience sample of adults with non-traumatic OHCA.
Objectives: To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis.
Design: Prospective cohort study.
Setting: Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington.
Physical activity and sedentary behavior may differentially impact health-related quality of life in adults with cerebral palsy. The present investigation assessed the independent relationships between aspects of physical activity and sedentary behavior related to health related quality of life in adults with cerebral palsy. Through a cross-sectional online survey of 118 adults with cerebral palsy, participants self-reported the extent of their functional impairments using the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System; while mental and physical health-related quality of life were assessed using the RAND-36.
View Article and Find Full Text PDFThis study aims to compare the experiences of women and men of different age groups with regard to their first autism spectrum disorder (ASD) diagnosis, symptoms, treatment, and gender roles to inform our understanding in clinical practice of differences as well as similarities. Semi-structured interviews were conducted amongst 22 women ( = 12) and men ( = 10) in three adult age groups regarding their diagnostic process, symptoms, treatment, and gender roles. Participants also filled out questionnaires on gender traits, social support, coping, and quality of life.
View Article and Find Full Text PDFWe developed a Dutch questionnaire called the Autistic Women's Experience (AWE) and compared its psychometric properties to the Autism Spectrum Quotient (AQ). Whilst attenuated gender differences on the AQ have been widely replicated, this instrument may not fully capture the unique experience of autistic women. The AWE was co-developed with autistic women to include items that reflect autistic women's experience.
View Article and Find Full Text PDFJ Prim Care Community Health
November 2023
Objectives: To identify the proportion of young people experiencing homelessness who are immunized against vaccine-preventable diseases, and to evaluate the impact of a nurse-led immunization program to improve vaccination coverage in this population.
Methods: A retrospective audit of electronic medical records included 400 participants aged 15 to 24 years who had an encounter with the Young People's Health Service, a nurse-led clinic co-located with a specialist youth homelessness service in Melbourne, Australia, between February 2019 and May 2021.
Results: Integrating an immunization nurse within a youth specialist homelessness service increased the percentage of young people who were up-to-date with routine vaccinations from 6.
Unlabelled: Sepsis causes 270,000 deaths and costs $38 billion annually in the United States. Most cases of sepsis present in the emergency department (ED), where rapid diagnosis remains challenging. The IntelliSep Index (ISI) is a novel diagnostic test that analyzes characteristics of WBC structure and provides a reliable early signal for sepsis.
View Article and Find Full Text PDFObjectives: Volatile organic compounds (VOCs) in the breathing air were found to be altered in schizophrenia patients compared to healthy participants. The aim of this study was to confirm these findings and to examine for the first time whether these VOCs are stable or change in concentration during the early treatment course. Moreover, it was investigated whether there is a correlation of the VOCs with the existing psychopathology of schizophrenia patients, i.
View Article and Find Full Text PDFBackground: Signatures from the metabolome and microbiome have already been introduced as candidates for diagnostic and treatment support. The aim of this study was to investigate the utility of volatile organic compounds (VOCs) from the breath for detection of schizophrenia and depression.
Methods: Patients with a diagnosis of major depressive disorder (MDD) or schizophrenia, as well as healthy controls, were recruited to participate.
To investigate the usability of Mixed-Reality (MR) during patient education in patients scheduled for abdominal aortic aneurysm (AAA) repair. Consecutive patients scheduled for elective AAA repair were block-randomized in either the Mixed-Reality group (MR group) or the conventional group (control group). Patients of both groups were educated about open and endovascular repair of their respective AAA.
View Article and Find Full Text PDFMult Scler Relat Disord
December 2022
Background: Although proprioception and cognitive dysfunction are commonly associated with balance impairment and fall risk in persons with multiple sclerosis (MS), the relationship between cognitive functioning and a quantitative measure of proprioception has not been examined in MS.
Objective: The primary goals of this study were to determine differences in vibratory sensation, a proxy measure of proprioception between persons with MS and healthy controls, examine relationships between cognition and vibration sensation, and determine the contribution of cognitive function and demographics to vibratory sensation between persons with MS and healthy controls.
Methods: One hundred and twenty-two individuals with MS, aged 20-60, with Expanded Disability Status Scale (EDSS) scores ≤5.
Background: "Mixed reality" (MR) allows the projection of virtual objects into the user's field of view through a head-mounted display (HMD). In the interventional and surgical treatment of vascular diseases MR applications could be of future benefit. The following scoping review aims to provide orientation on the current application of the aforementioned technologies in the field of vascular surgery and to define research goals for the future.
View Article and Find Full Text PDFBackground: Convalescent plasma has been one of the most common treatments for COVID-19, but most clinical trial data to date have not supported its efficacy.
Research Question: Is rigorously selected COVID-19 convalescent plasma with neutralizing anti-SARS-CoV-2 antibodies an efficacious treatment for adults hospitalized with COVID-19?
Study Design And Methods: This was a multicenter, blinded, placebo-controlled randomized clinical trial among adults hospitalized with SARS-CoV-2 infection and acute respiratory symptoms for < 14 days. Enrolled patients were randomly assigned to receive one unit of COVID-19 convalescent plasma (n = 487) or placebo (n = 473).
Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals.
View Article and Find Full Text PDFIntroduction: Disparities in care of older adults in cancer treatment trials and emergency department (ED) use exist. This report provides a baseline description of older adults ≥65 years old who present to the ED with active cancer.
Materials And Methods: Planned secondary analysis of the Comprehensive Oncologic Emergencies Research Network observational ED cohort study sponsored by the National Cancer Institute.
Older adults with cancer use the emergency department (ED) for acute concerns. Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data.
View Article and Find Full Text PDFPurpose: Emergency department (ED) visits by patients with cancer frequently end in hospitalization. As concerns about ED and hospital crowding increase, observation unit care may be an important strategy to deliver safe and efficient treatment for eligible patients. In this investigation, we compared the prevalence and clinical characteristics of cancer patients who received observation unit care with those who were admitted to the hospital from the ED.
View Article and Find Full Text PDFImportance: A comprehensive understanding of the benefits of COVID-19 vaccination requires consideration of disease attenuation, determined as whether people who develop COVID-19 despite vaccination have lower disease severity than unvaccinated people.
Objective: To evaluate the association between vaccination with mRNA COVID-19 vaccines-mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech)-and COVID-19 hospitalization, and, among patients hospitalized with COVID-19, the association with progression to critical disease.
Design, Setting, And Participants: A US 21-site case-control analysis of 4513 adults hospitalized between March 11 and August 15, 2021, with 28-day outcome data on death and mechanical ventilation available for patients enrolled through July 14, 2021.
Purpose: Our goal was to identify discrete clinical characteristics associated with safe discharge from an emergency department/urgent care for patients with a history of cancer and concurrent COVID-19 infection during the SARS-CoV-2 pandemic and prior to widespread vaccination.
Patients And Methods: We retrospectively analyzed 255 adult patients with a history of cancer who presented to Memorial Sloan Kettering Cancer Center (MSKCC) urgent care center (UCC) from March 1, 2020 to May 31, 2020 with concurrent COVID-19 infection. We evaluated associations between patient characteristics and 30-day mortality from initial emergency department (ED) or urgent care center (UCC) visit and the absence of a severe event within 30 days.