An Emergency Department Quality Improvement Project for Intravenous Levetiracetam Administration.

Levetiracetam is a readily available, safe anticonvulsive medication. It is frequently administered as IV piggyback with a pump, carrier fluid, and tubing. The Established Status Epilepticus Treatment Trial demonstrated levetiracetam being similarly effective to previously used treatments in doses up to 4500 mg administered over 10 minutes.

Evaluation of First-Dose, Intravenous Push Penicillins and Carbapenems in the Emergency Department.

Background: Early appropriate antibiotic administration is associated with improved outcomes in infectious illnesses. During drug shortages in 2017, the American Society of Health-System Pharmacists recommended intravenous push (IVP) administration of medications when possible to conserve small-volume parenteral solutions. Data supporting IVP penicillins and carbapenems was limited.

Gene characterization and expression of the γδ T cell co-receptor WC1 in sheep.

Sheep are known to express the hybrid co-receptor/pattern recognition receptor WC1 on their γδ T cells but details of the ovine WC1 multigenic array and gene expression were unknown. Annotation of the sheep genome assembly (Oar_rambouillet_v1.0) yielded 15 complete and 42 partial WC1 genes predicted to code for six different protein structures.

Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department.

Cannabinoid hyperemesis syndrome (CHS) is a disorder of cyclic and recurrent nausea, vomiting, and abdominal pain associated with high-frequency and extended-duration marijuana use. Standard antiemetic therapy is often ineffective; however, capsaicin, an agonist of transient receptor potential vanilloid 1 (TRPV1), has shown promise in treating CHS. This retrospective cohort analysis evaluated the safety and efficacy of topical capsaicin for patients presenting with CHS.

Healing experience for family caregivers after an intensive care unit death.

Objectives: Family caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.

Methods: Semi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU.

Intravenous Push Cephalosporin Antibiotics in the Emergency Department: A Practice Improvement Project.

Delays in administration of appropriate antibiotics to patients with septic shock are associated with increased mortality. To improve the care of patients with sepsis within our 73-bed emergency department (ED), a "first-dose" intravenous push (IVP) cephalosporin antibiotic protocol was initiated. This project was aimed at improving the time from provider order of antibiotic to administration, which follows the Sepsis Core Measure of timely antibiotic administration.

Improved Administration of Antibiotics in the Emergency Department: A Practice Improvement Project.

Problem: Although consensus exists among experts that early intravenous antibiotic therapy has an impact on patient mortality, the medical literature includes little information about ensuring that the patient receives the complete dose. At our emergency department, it had become standard clinical practice to administer antibiotics with primary pump tubing and an infusion pump. Clinical pharmacy staff identified this practice as a cause for concern, because at least 20 mL (up to 40%) of the dose volume remains in the tubing.

Why is the sex gap in feelings of depression wider in high gender equity countries? The effect of children on the psychological well-being of men and women.

This study uses data from 23 countries in the World Values Survey and the National Survey of Families and Households and finds that the sex gap in feelings of depression is wider in high gender equity societies even though overall levels of feelings of depression are lower. Using hierarchical logistic modeling, we find that the sex difference in feelings of depression is wider in high gender equity societies because children increase depression for women in high gender equity societies, while they reduce depression for women without paid employment in low gender equity societies. There is little difference in the effect of children on feelings of depression for men across societies.

Religion and the quality of life in the last year of life.

Objectives: Religious involvement in old age appears to remain quite stable until the very end of life, reflecting patterns established earlier in life. Are there differences in quality of life (QOL) for those who are religiously involved in that last year compared with those who are not?

Methods: We studied 499 elderly persons participating in ongoing annual interviews who died in the 12 months following an interview. We examined public and subjective religious involvement and indicators of health-related and psychosocial QOL, including health status and functional ability, family and friendship networks, depression, and well-being.

Preoperative and intraoperative risk factors associated with 30-day morbidity following urological surgery: the National Surgical Quality Improvement Program.

Purpose: The National Surgical Quality Improvement Program was established in 1994 to measure and enhance of the quality of surgical care. Since its inception, 30-day postoperative morbidity after major surgery in the Veterans Administration has decreased by 45%. We performed a pilot study to assess risk factors associated with 30-day morbidity using National Surgical Quality Improvement Program indicators in a private setting.

Sexual behavior, sexually transmitted diseases and prostatitis: the risk of prostate cancer in black men.

Purpose: Black men are diagnosed with prostate cancer more often than white men, present with more advanced disease and have worse stage specific survival. Given the high risk of incidence and mortality in this population, determining potentially modifiable factors is important. Recent studies have suggested a link between chronic inflammation and development of prostate cancer.

Low insulin-like growth factor-II levels predict weight gain in normal weight subjects with type 2 diabetes.

Purpose: Insulin-like growth factor (IGF)-I and IGF-II are important in the regulation of metabolism and growth. We previously reported in normoglycemic individuals of normal weight that low circulating IGF-II predicts future weight gain. We subsequently investigated whether such relationships persisted in circumstances of type 2 diabetes.

In sickness but not in health: self-ratings, identity, and mortality.

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy.

Longitudinal changes in lower urinary tract symptoms among a cohort of black American men: the Flint Men's Health Study.

Objectives: To examine the progression of lower urinary tract symptoms in a longitudinal population-based cohort of black men. Population-based studies of prostatism and longitudinal data regarding changes in lower urinary tract symptom severity have largely focused on white men, with little attention directed toward black men.

Methods: In 1996, a probability sample of 369 black men, aged 40 to 79 years, residing in Genesee County, Michigan, and without a prior history of prostate cancer/surgery participated in a prostate cancer screening protocol that included completing the American Urological Association Symptom Index (AUASI).