Incidence of cervical spine injury in victims of dismounted blast: a systematic review.

Introduction: Dismounted blast has the potential to cause life-threatening injuries to multiple simultaneous casualties, including injury to the cervical spine (c-spine). Spinal immobilisation can be costly in terms of time and personnel required to apply and sustain it. C-spine 'clearing' tools frequently do not apply to the blast-injured casualty, so clinical judgement must be used to determine those requiring c-spine immobilisation.

Changes in opioid prescribing and prescription drug monitoring program utilization following electronic health record integration-Massachusetts, 2018.

Objective: In this study, we explored key prescription drug monitoring program-related outcomes among clinicians from a broad cohort of Massachusetts healthcare facilities following prescription drug monitoring program (PDMP) and electronic health record (EHR) data integration.

Methods: Outcomes included seven-day rolling averages of opioids prescribed, morphine milligram equivalents (MMEs) prescribed, and PDMP queries. We employed a longitudinal study design to analyze PDMP data over a 15-month study period which allowed for six and a half months of pre- and post-integration observations surrounding a two-month integration period.

Understanding the burden of injury in children from conflict: an analysis of radiological imaging from a Role 3 hospital in Afghanistan in 2011.

Introduction: There is a need for quality medical care for children injured in conflict, but a description of injuries and injury burden from blast and ballistic mechanisms is lacking. The radiology records of children imaged during the war in Afghanistan represent a valuable source of information about the patterns of paediatric conflict injuries.

Methods: The UK military radiological database was searched for all paediatric presentations to Camp Bastion during 2011.

The sensitivity of chest X-ray (CXR) for the detection of significant thoracic injury in children exposed to blast.

Introduction: Thoracic trauma is an important cause of morbidity and mortality in children exposed to blast and early recognition of these injuries is vital. While numerous studies have investigated the sensitivity of chest X-ray (CXR) for the detection of chest injury in blunt trauma, none have evaluated its performance in paediatric blast injury.

Methods: CXR and Computed Tomography (CT) thorax findings were compared for 105 children who were injured by blast and presented to the UK Role 3 Hospital, Camp Bastion, Helmand Province, during the recent conflict in Afghanistan from 2011 to 2013.

A Risk-Prediction Model for Placenta Accreta Spectrum Severity From Standardized Ultrasound Markers.

We aimed to generate a model to predict the risk of a woman having normal, abnormally adherent (AAP) or abnormally invasive placentation (AIP) based on the presence of recently codified ultrasound (US) markers and disease definitions of placenta accreta spectrum (PAS). We recruited women with anterior low-lying placenta or placenta previa and a history of previous caesarean delivery to a prospective cohort study. US markers of abnormal placentation were recorded on a standardized pro forma.

Achieving Reductions in Opioid Dispensing: A Qualitative Comparative Analysis of State-Level Efforts to Improve Prescribing.

Objective: To determine whether any combinations of state-level public health activities were necessary or sufficient to reduce prescription opioid dispensing.

Design: We examined 2016-2019 annual progress reports, 2014-2019 national opioid dispensing data (IQVIA), and interview data from states to categorize activities. We used crisp-set Qualitative Comparative Analysis to determine which program activities, individually or in combination, were necessary or sufficient for a better than average decrease in morphine milligram equivalent (MME) per capita.

Focused Assessment with Sonography in Trauma (FAST) performance in paediatric conflict injury.

Aim: To evaluate the efficacy of Focused Assessment with Sonography in Trauma (FAST) in a paediatric population with a substantial proportion of penetrating abdominal injuries.

Materials And Methods: FAST and computed tomography (CT) abdomen findings were compared for 98 children who presented to Camp Bastion during the war in Afghanistan in 2011. FAST performance was compared to the reference standard of free fluid detected on CT.

Implementation and outcomes of a pharmacist-led oral chemotherapy clinic at VA Maine Healthcare System.

Background: Patients undergoing intravenous chemotherapy tend to receive more structured follow-up and closer monitoring than those taking oral chemotherapy. The management of oral chemotherapy at our facility was historically segmented and weighed heavily on veteran self-advocacy. It was hypothesized that routine check-ins with a clinical pharmacy specialist with a scope of practice would allow for a more proactive, supportive approach to care.

The prognostic value of chest X-ray in patients with COVID-19 on admission and when starting CPAP.

Objective: The objective was to explore if chest X-ray severity, assessed using a validated scoring system, predicts patient outcome on admission and when starting continuous positive pressure ventilation (CPAP) for COVID-19.

Design: The study was a retrospective case-controlled study.

Participants: There were 163 patients with COVID-19 deemed candidates for CPAP on admission, including 58 who subsequently required CPAP.

An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015.

Introduction: Concurrent prescribing of opioids and benzodiazepines is discouraged by evidence-based clinical guidelines because of the known risks of taking these medications in combination.

Methods: This study analyzed concurrent opioid and benzodiazepine prescribing in 9 states using the 2015 Prescription Behavior Surveillance System, a multistate database of de-identified prescription drug monitoring program data. Concurrent prescribing rates were examined among individuals with both an opioid and a benzodiazepine prescription.

Are women antenatally diagnosed with abnormally invasive placenta receiving optimal management in England? An observational study of planned place of delivery.

Introduction: The aim of this study was to investigate the planned place of delivery for women antenatally diagnosed with abnormally invasive placenta (AIP) in England and identify how many units regard themselves to be "specialist centers" for the management of AIP.

Material And Methods: Observational study of obstetric-led units in England. An anonymous survey was sent to the delivery suite lead clinician in all 154 consultant-led units throughout England.

Factors contributing to frequent attendance to the emergency department of a remote Northern Territory hospital.

Objectives: To determine the clinical and environmental variables associated with frequent presentations by adult patients to a remote Australian hospital emergency department (ED) for reasons other than chronic health conditions.

Design: Unmatched case-control study of all adult patients attending Katherine Hospital ED between 1 January and 31 December 2012.

Participants: Cases were defined as frequent attenders (FAs) without a chronic health condition who presented to the ED six or more times during the 12-month period.

How cold is cold dark matter? Small-scales constraints from the flux power spectrum of the high-redshift lyman-alpha forest.

We present constraints on the mass of warm dark matter (WDM) particles derived from the Lyman-alpha flux power spectrum of 55 high-resolution HIRES spectra at 2.0 View Article and Find Full Text PDF

Molecular basis for sunitinib efficacy and future clinical development.

Sunitinib malate (SU11248/Sutent; Pfizer) is a multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities. Definitive efficacy has been demonstrated in advanced renal cell carcinoma and in gastrointestinal stromal tumours that are refractory or intolerant to imatinib (Gleevec; Novartis), which has provided the basis for the recent regulatory approvals for these indications. This article summarizes the discovery and development of sunitinib, and discusses key issues for the multitargeted approach in cancer treatment, such as markers of response and development of resistance, and their significance for the future development of sunitinib and other multikinase inhibitors.

Evaluation of two assessment tools in predicting driving ability of senior drivers.

Objective: To evaluate Motor Free Visual Perceptual Test (MVPT) and Clock Drawing Task (clock test) as quick assessment tools in predicting driving capability of senior drivers for an on-road driving test.

Design: Senior drivers (> or = 55 yrs) referred for evaluation and recommendation for license renewal were given the MVPT, clock test, and an on-road driving test. Receiving operating characteristic (ROC) analysis and stepwise multivariate logistic regression (SMLR) were used to develop a probability model to differentiate between capable and incapable senior drivers.

EXIT procedure: a case report.

The EXIT (Ex-Utero Intrapartum Treatment) procedure is an extremely valuable tool in providing time to secure the airway in infants with large fetal neck masses and abnormalities of the upper airway which impede resuscitation. The fetus is partially delivered while maintaining utero-placental-fetal circulation. We report the use of this technique in a case of huge cystic hygromas of the neck and chest due to a nuchal bleb-lethal dysplasia.

Evidence for a Black Hole and Accretion Disk in the LINER NGC 4203.

We present spectroscopic observations from the Hubble Space Telescope that reveal for the first time the presence of a broad pedestal of Balmer line emission in the LINER galaxy NGC 4203. The emission-line profile is suggestive of a relativistic accretion disk and is reminiscent of double-peaked transient Balmer emission observed in a handful of other LINERs. The very broad line emission thus constitutes clear qualitative evidence for a black hole, and spatially resolved narrow-line emission in NGC 4203 can be used to constrain its mass, MBH View Article and Find Full Text PDF