Improving Healthcare Professionals' Access to Addiction Medicine Education Through VHA Addiction Scholars Program.

Introduction: The seemingly inexorable rise of opioid-related overdose deaths despite the reduced number of COVID-19 pandemic deaths demands novel responses and partnerships in our public health system's response. Addiction medicine is practiced in a broad range of siloed clinical environments that need to be included in addiction medicine training beyond the traditional fellowship programs. Our objective in this project was to implement a knowledge-based, live virtual training program that would provide clinicians and other healthcare professionals with an overview of addiction, substance use disorders (SUD), and clinical diagnosis and management of opioid use disorder (OUD).

A Review of Natural Language Processing in Medical Education.

Natural language processing (NLP) aims to program machines to interpret human language as humans do. It could quantify aspects of medical education that were previously amenable only to qualitative methods. The application of NLP to medical education has been accelerating over the past several years.

Emergency care and health systems: consensus-based recommendations and future research priorities.

The theme of the 14th annual Academic Emergency Medicine consensus conference was "Global Health and Emergency Care: A Research Agenda." The goal of the conference was to create a robust and measurable research agenda for evaluating emergency health care delivery systems. The concept of health systems includes the organizations, institutions, and resources whose primary purpose is to promote, restore, and/or maintain health.

Hyperlactatemia affects the association of hyperglycemia with mortality in nondiabetic adults with sepsis.

Background: Admission hyperglycemia has been reported as a mortality risk factor for septic nondiabetic patients; however, hyperglycemia's known association with hyperlactatemia was not addressed in these analyses.

Objectives: The objective was to determine whether the association of hyperglycemia with mortality remains significant when adjusted for concurrent hyperlactatemia.

Methods: This was a post hoc, nested analysis of a retrospective cohort study performed at a single center.

Impact of metformin use on the prognostic value of lactate in sepsis.

Objective: The objective of this study is to determine if metformin use affects the prevalence and prognostic value of hyperlactatemia to predict mortality in septic adult emergency department (ED) patients.

Methods: This is a single-center retrospective cohort study. Emergency department providers identified study subjects; data were collected from the medical record.

Inter-rater reliability of sonographic measurements of the inferior vena cava.

Background: Bedside ultrasound is emerging as a useful tool in the assessment of intravascular volume status by examining measurements of the inferior vena cava (IVC). Many previous studies do not fully describe their scanning protocol.

Objectives: The objective of this study was to evaluate which of three commonly reported IVC scanning methods demonstrates the best inter-rater reliability.

Real-time lung ultrasound for the diagnosis of alveolar consolidation and interstitial syndrome in the emergency department.

During the last few years, a growing number of studies have shown the accuracy of lung ultrasound in the diagnosis of pulmonary diseases. The latest developments in lung ultrasound are not because of technological advance, but are based on new applications and discovering the meanings of sonographic artifacts. Real-time sonography of the lung in the emergency department saves time and cost, providing immediate information to the clinician, relying on very easy-to-acquire data.

The utility of bedside ultrasound in the detection of a ruptured globe in a porcine model.

Background: Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye.

Objective: This study evaluated the ability of emergency physicians to detect a ruptured globe in an ex-vivo porcine model.

Validation of self-reported chronic obstructive pulmonary disease among patients in the ED.

Background: To determine whether the self-reported diagnosis of adults who present to the emergency department (ED) with an acute exacerbation of either asthma or chronic obstructive pulmonary disease (COPD) is validated by medical record review.

Methods: This is cross-sectional study of 78 consecutive adults, 55 years and older, presenting to 3 EDs with symptoms suggestive of an exacerbation of asthma or COPD. We used current spirometric guidelines for a "spirometrically validated" diagnosis of COPD (eg, postbronchodilator forced expiratory volume in 1 second/forced ventilatory capacity <70%).

Spirometric correlates of dyspnea improvement among emergency department patients with chronic obstructive pulmonary disease exacerbation.

Objective: To examine whether change in slow vital capacity (SVC) correlates to dyspnea improvement during emergency department (ED) treatment of chronic obstructive pulmonary disease (COPD) exacerbation.

Methods: We performed a prospective cohort study and enrolled consecutive patients during a 3-week period. ED patients > or = 55 years old with COPD exacerbation were asked to perform bedside spirometry shortly after ED arrival and again at discharge.

Does parental report of insurance status agree with hospital administrative data for children presenting to the ED?

We screened nearly 10,000 consecutive parents presenting to EDs throughout the United States and examined whether parent/guardian self-report of insurance status agrees with hospital administrative data. We also examined the relationship of patient characteristics with any observed discordance.

Research opportunities in the management of acute exacerbations of chronic obstructive pulmonary disease.

Acute exacerbations of chronic obstructive pulmonary disease are a common problem in the emergency department. Despite considerable research involving the management of this disease over the past decade, much remains unclear from an emergency medicine perspective. Increased research would better guide the management of these complex patients from the perspectives of the patient, the caregiver, and society.

A multicenter study of complementary and alternative medicine usage among ED patients.

Objectives: To estimate the prevalence of complementary and alternative medicine (CAM) usage among emergency department (ED) patients.

Methods: This study was a cross-sectional study in four Boston-area EDs. For two 24-hour periods, the authors interviewed consecutive patients age 18 and older about whether they had ever used or had recently (within the past year) used CAM "remedies" (e.

Predicted peak expiratory flow: differences across formulae in the literature.

The study objectives were to examine the differences between Peak Expiratory Flow (PEF) formulae in the literature and to assess the potential impact of those differences on the interpretation of clinical guidelines for asthma management. We calculated 100% PEF values for hypothetical patients at the 50(th) percentile for height and weight and classified the percent predicted PEF into severity groups according to national asthma guidelines. Choosing different formulae could give an 18 year old man a 100% predicted PEF as low as 501 L/min and as high as 730 L/min (delta = 229 L/min); and a 35 year old woman a classification of severe (46%) using one, but moderate (57%) using another.

Parental perception of waiting time and its influence on parental satisfaction in an urban pediatric emergency department: are parents accurate in determining waiting time?

Objective: The objective of this study was to determine whether parental perception of waiting time in an urban pediatric emergency department (ED) is accurate and whether the actual waiting times or their perception of waiting times impact on parental satisfaction.

Methods: A prospective convenience sample study in which the on-duty emergency physicians randomly administered a questionnaire at the time of the ED visit was used. During a 3-week period from December 15, 1999, through January 7, 2000, 500 parents or legal guardians of children who visited our ED were questioned about their perceived waiting time, and the responses were compared with the actual waiting time.