A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study.

Objective: Our objective was to determine whether organized or disorganized cardiac activity is associated with increased survival in patients who present in pulseless electrical activity (PEA) treated with either 1) standard advanced cardiac life support (ACLS) medications or 2) other interventions.

Methods: This was a secondary analysis of a prospective, multi-center observational study utilizing ultrasound in out-of-hospital or inemergency department PEA arrest. Bedside ultrasound was performed as ACLS protocol started and during pulse checks.

Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest.

Background: Point-of-care ultrasound has been suggested to improve outcomes from advanced cardiac life support (ACLS), but no large studies have explored how it should be incorporated into ACLS. Our aim was to determine whether cardiac activity on ultrasound during ACLS is associated with improved survival.

Methods: We conducted a non-randomized, prospective, protocol-driven observational study at 20 hospitals across United States and Canada.

The diagnostic accuracy of bedside ocular ultrasonography for the diagnosis of retinal detachment: a systematic review and meta-analysis.

The diagnostic accuracy of emergency department (ED) ocular ultrasonography may be sufficient for diagnosing retinal detachment. We systematically reviewed the literature to determine the diagnostic accuracy of ED ocular ultrasonography for the diagnosis of retinal detachment. This review conformed to the recommendations from the Meta-analysis of Observational Studies in Epidemiology statement.

Clinical impression and ascites appearance do not rule out bacterial peritonitis.

Background: Previous research has demonstrated that physician clinical suspicion, determined without assessing fluid appearance, is not adequate to rule out spontaneous bacterial peritonitis (SBP) without fluid testing.

Study Objective: To determine the sensitivity of physician clinical suspicion, including a bedside assessment of fluid appearance, in the detection of SBP in Emergency Department (ED) patients undergoing paracentesis.

Methods: We conducted a prospective, observational study of ED patients with ascites undergoing paracentesis at three academic facilities.

Physician clinical impression does not rule out spontaneous bacterial peritonitis in patients undergoing emergency department paracentesis.

Study Objective: We determine whether clinical characteristics and physician assessment are useful in the exclusion of spontaneous bacterial peritonitis in emergency department (ED) patients with ascites requiring paracentesis.

Methods: We conducted a prospective, observational study of ED patients with ascites undergoing paracentesis. Predefined clinical characteristics including historical features and ED vital signs were recorded.

Conflict of interest in the physician interface with the biomedical industry.

The physician interface with the pharmaceutical industry stands at the forefront of a debate about the effect this relationship has on the behavior of both researchers and clinicians. The authors explore the basis for this conflict of interest and show how it affects physician judgment and behavior. These effects lead to negative consequences for patients and threaten the professional status that society accords physicians.

The utility of ultrasound to determine ventricular capture in external cardiac pacing.

Determining electrical capture when using an external cardiac pacemaker is often difficult and confusing, especially when the resulting clinical signs of an effective blood pressure and pulse are inadequate or nondetectable. The objective of this study was to determine the efficacy of using 2-dimensional ultrasound (US) in determining the presence of ventricular capture of an external cardiac pacemaker in a swine model. Five anesthetized swine underwent external cardiac pacing (ECP) at variable levels of energy output while concurrent US images and electrocardiograph monitoring were recorded on videotape.

Neuropathological changes in scrapie and Alzheimer's disease are associated with increased expression of apolipoprotein E and cathepsin D in astrocytes.

With the rationale that the neuropathological similarities between scrapie and Alzheimer's disease reflect convergent pathological mechanisms involving altered gene expression, we set out to identify molecular events involved in both processes, using scrapie as a model to study the time course of these changes. We differentially screened a cDNA library constructed from scrapie-infected mice to identify mRNAs that increase or decrease during disease and discovered in this way two mRNAs that are increased in scrapie and Alzheimer's disease. These mRNAs were subsequently shown by sequence analysis to encode apolipoprotein E and cathepsin D (EC 3.

Nucleotide sequence analysis of a provirus derived from an individual with tropical spastic paraparesis.

Human T-cell lymphotropic virus type 1 (HTLV-1), the cause of inapparent infections and T-cell leukemias and lymphomas, has also been implicated in two chronic neurological diseases, tropical spastic paraparesis (TSP) and HTLV-1 associated myelopathy (HAM). We initiated a search for a neurotropic variant of HTLV-1 that might be responsible for these chronic progressive myelopathies by cloning and sequencing a provirus from a T-cell line from an individual with TSP. The LTRs and genes of the TSP provirus differ from HTLV-1 by 20-30 nucleotides in each region, but none of the substitutions ostensibly affect functional sites with the exception of the env gene.

Speculations on the role of transmissible agents in the pathogenesis of Alzheimer's disease.

Unconventional agents and conventional viruses provide model systems to investigate the pathogenesis of Alzheimer's disease (AD). The essay which follows examines the hypothetical role of herpes simplex in AD and presents some generally applicable experimental approaches to detecting genes in brain tissues. The concluding section, on parallels between AD and diseases of the brain caused by unconventional viruses, defines strategies for isolating genes related to pathology.

Intracellular location of rabbit poxvirus nucleic acid within infected cells as determined by in situ hybridization.

The intracellular location of rabbit poxvirus DNA within cells during the course of infection has been determined by the hybridization in situ of labeled viral DNA probes to uninfected and infected cells under various conditions. Extensive control experiments were performed to demonstrate that DNA could be detected selectively and accurately within the cell. Our results suggest that rabbit poxvirus DNA is located only within the cytoplasm during the reproductive cycle, and we found no evidence that viral DNA enters the cell nucleus.