A retrospective review of out of hospital cardiac arrest at Gillette Stadium: 10 years of experience at a large sports venue.

Introduction: Rates of out-of-hospital cardiac arrest (OHCA) at major sporting events are as high as 0.7 per 100,000 attendees. However, factors contributing to OHCA at mass gatherings have not been well-described.

Should gabapentinoids be prescribed long-term for anxiety and other mental health conditions?

Prescription rates for gabapentinoids are rising in England. Pregabalin is currently recommended by NICE for the treatment of anxiety. Gabapentinoids have some overlap with the action of benzodiazepines, and have similar issues with tolerance, dependence, addiction and withdrawal.

Incidence and treatment costs of severe bacterial infections among people who inject heroin: A cohort study in South London, England.

Background: People who inject drugs often get bacterial infections. Few longitudinal studies have reported the incidence and treatment costs of these infections.

Methods: For a cohort of 2335 people who inject heroin entering treatment for drug dependence between 2006 and 2017 in London, England, we reported the rates of hospitalisation or death with primary causes of cutaneous abscess, cellulitis, phlebitis, septicaemia, osteomyelitis, septic arthritis, endocarditis, or necrotising fasciitis.

Telephone delivered incentives for encouraging adherence to supervised methadone consumption (TIES): Study protocol for a feasibility study for an RCT of clinical and cost effectiveness.

Unlabelled: The majority of people receiving treatment for their heroin addiction, are prescribed methadone; for which there is an extensive evidence base. When treatment starts, people take their daily dose of methadone under supervision at a community pharmacy. Supervision guarantees methadone is taken as directed by the individual for whom it has been prescribed, helps to ensure individuals take their correct dose every day, and safeguards against diversion and overdose.

Droplet Combinations: A Scalable Microfluidic Platform for Biochemical Assays.

Droplet-based microfluidics holds enormous potential for transforming high-throughput drug screening. Miniaturization through droplets in combination with automation contributes to reduce reagent use and analysis time as well as minimizing or eliminating labor-intensive steps leading to associated reductions in cost. In this paper, we demonstrate the potential of automated and cost-effective microfluidic droplet-generating technology in the context of an enzymatic activity assay for screening collagenase inhibitors.

Medicines associated with dependence or withdrawal: a mixed-methods public health review and national database study in England.

Background: Antidepressants, opioids for non-cancer pain, gabapentinoids (gabapentin and pregabalin), benzodiazepines, and Z-drugs (zopiclone, zaleplon, and zolpidem) are commonly prescribed medicine classes associated with a risk of dependence or withdrawal. We aimed to review the evidence for these harms and estimate the prevalence of dispensed prescriptions, their geographical distribution, and duration of continuous receipt using all patient-linked prescription data in England.

Methods: This was a mixed-methods public health review, comprising a rapid evidence assessment of articles (Jan 1, 2008, to Oct 3, 2018; with searches of MEDLINE, Embase, and PsycINFO, and the Cochrane and King's Fund libraries), an open call-for-evidence on patient experience and service evaluations, and a retrospective, patient-linked analysis of the National Health Service (NHS) Business Services Authority prescription database (April 1, 2015, to March 30, 2018) for all adults aged 18 years and over.

Use of Prescribed Psychotropic Medications in an Opioid Substitution Therapy Cohort.

Comorbid mental illness is extremely common in individuals receiving opioid substitution therapy. The use of common psychiatric medications is complex in this cohort with increased risks of drug-drug interaction, overdose, and diversion or abuse of prescribed medication. We have therefore investigated rates of co-prescribing and psychiatric comorbidity in a cohort of individuals receiving therapeutic methadone or buprenorphine.

Efficacy and cost-effectiveness of an adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial.

Background: Opioid use disorder is a chronic, debilitating, and costly disorder that has increased in prevalence in many countries, with an associated sharp rise in mortality. Maintenance opioid agonist therapy is the first-line treatment, but many patients do not stop using illicit or non-prescribed drugs concomitantly. We aimed to test the efficacy and cost-effectiveness of a personalised psychosocial intervention implemented with a toolkit of behaviour-change techniques as an adjunct to opioid agonist therapy.

Extended-release naltrexone versus standard oral naltrexone versus placebo for opioid use disorder: the NEAT three-arm RCT.

Background: People recovering from heroin addiction need better treatments than are currently offered. The chronic relapsing nature of drug dependence means that helping a patient to achieve abstinence is often difficult. Naltrexone blocks the effects of ingested heroin; however, evidence is conflicting regarding the best delivery method.

The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015.

Objective: Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness.

Methods: A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015.

A Systematic Review of Treatments of Relapsed/Refractory Mantle Cell Lymphoma.

A systematic review was conducted to evaluate the clinical effectiveness and safety of treatments for patients with relapsed/refractory mantle cell lymphoma (MCL) unsuitable for intensive treatment. The criteria for inclusion of the trials were established before the review. A search of Medline, Embase, and the Cochrane library databases was conducted to identify phase II or III randomized controlled trials (RCTs), reported from January 1, 1994 to May 29, 2016.

Improving Novice Radiology Trainees' Perception Using Fine Art.

Purpose: To determine if fine art perception training improved performance in novice radiology trainees.

Methods: On the first day of their residency, 15 radiology residents underwent a basic radiology perception test in which they were shown 15 different radiographs that each had a significant abnormality. This was followed by a focused session of interpretation training at a local art gallery where art experts taught the trainees how to thoroughly analyze a painting.

A highly sensitive and specific combined clinical and sonographic score to diagnose appendicitis.

Background: Computed tomography (CT) scanning reduces the negative appendectomy rate however it exposes the patient to ionizing radiation. Ultrasound (US) does not carry this risk but may be nondiagnostic. We hypothesized that a clinical-US scoring system would improve diagnostic accuracy.

Effectiveness of adjunctive, personalised psychosocial intervention for non-response to opioid agonist treatment: Study protocol for a pragmatic randomised controlled trial.

Introduction: Opioid use disorder (OUD) is a debilitating and relapsing psychiatric disorder; opioid agonist therapy (OAT) is the front-line, evidence-supported treatment. A substantial number of patients relapse or continue to use heroin or other illicit drugs during OAT. There is considerable heterogeneity in the OAT-resistant sub-population, with many behavioural moderators of treatment response.

The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

Background: The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds.

Objectives: This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses.

Design And Methods: The study used an observational design.

Proctoring of New Emergency Radiologists to Promote Clinical Excellence and Ensure Quality of Care.

Purpose: The authors' institution provides 24/7 attending radiologist final interpretations for all emergency, urgent, and inpatient studies. As a supplement to the existing emergency radiology faculty, the institution relies on two groups of radiologists to provide final imaging interpretations after hours: radiology fellows (RFs) and newly hired subspecialty radiologists (NRs). For both groups, subspecialty services provide overreads the following day to improve the skills of the staff members and ensure clinical excellence.

Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection.

Study Objective: Ascending aortic dissection (AAD) is an uncommon, time-sensitive, and deadly diagnosis with a nonspecific presentation. Ascending aortic dissection is associated with aortic dilation, which can be determined by emergency physician focused cardiac ultrasound (EP FOCUS). We seek to determine if patients who receive EP FOCUS have reduced time to diagnosis for AAD.

Reshaping the emergency radiology call experience after the merger of two programs: the Yale experience.

In the summer of 2013, 16 radiology residents from the Hospital of Saint Raphael (HSR) joined the 38 residents of Yale-New Haven Hospital (YNHH) to become a single 54-resident program. This posed a significant challenge given the number of residents and very different call structures of the two institutions. After evaluating the emergency radiology volume at both hospitals, it was determined that implementing YNHH's traditional call system at HSR would increase call by approximately 25 %.

Completion CT of Chest, Abdomen, and Pelvis after Acute Head and Cervical Spine Trauma: Incidence of Acute Traumatic Findings in the Setting of Low-Velocity Trauma.

Purpose: To determine the frequency of acute traumatic findings in computed tomographic (CT) chest abdomen pelvis (CAP) examinations in patients with acute traumatic head and/or cervical spine injury and no evidence suggesting bodily injury.

Materials And Methods: After institutional review board approval with a waiver of informed consent was obtained, a HIPAA-compliant retrospective study was performed. A review of the electronic medical records and dictated reports identified patients who met the following criteria: CT-documented acute head and/or cervical spine trauma, CT CAP performed at least 20 minutes after initial brain and/or cervical spine CT, and no evidence of bodily injury at physical examination or on initial plain radiographs.

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis.

There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease (IBD). However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented.

Aperius interspinous device for degenerative lumbar spinal stenosis: a review.

With an aging population, degenerative lumbar spinal stenosis (DLSS) leading to neurogenic intermittent claudication (NIC) is a growing problem. For patients suffering from this condition, interspinous process distraction devices (IPDs) offer an effective and cheap alternative to conservative or decompressive surgery. Aperius is one such device that has been gaining popularity for its percutaneous insertion under local anesthetic, short operative time, and low risk of complications.