Publications by authors named "Talan D"
Background: Randomised controlled trials (RCTs) have found antibiotics to be a feasible and safe alternative to appendicectomy in adults with imaging-confirmed acute appendicitis. However, patient inclusion criteria and outcome definitions vary greatly between RCTs. We aimed to compare antibiotics with appendicectomy for the treatment of acute appendicitis using individual patient data and uniform outcome definitions.
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- The study aimed to determine if additional doses of the COVID-19 vaccine correlate with fewer COVID-19-like symptoms six weeks after infection among health care workers.
- A total of 2478 participants were enrolled, with 57% confirmed cases of COVID-19; symptoms like fatigue and sleep difficulties were common, especially in those infected.
- Results indicated that those who received extra vaccine doses after their primary series experienced significantly lower odds of symptoms at six weeks post-infection compared to those who did not get boosted.
In 2022, a global mpox outbreak occurred, primarily affecting gay and bisexual men who have sex with men (GBMSM). To screen for mpox's reemergence and investigate potentially unsuspected cases among non-GBMSM, prospective surveillance of patients aged ≥3 months with an mpox-compatible rash (vesicular, pustular, ulcerated, or crusted) was conducted at 13 U.S.
View Article and Find Full Text PDFBackground: A pathway for the treatment of acute bacterial skin and skin structure infections (ABSSSI) with a single intravenous (IV) dose of dalbavancin was previously shown to reduce hospital admissions and shorten inpatient length of stay (LOS).
Objectives: To describe pathway implementation at the emergency department (ED) and evaluate cost-effectiveness of a single-dose dalbavancin administered to ED patients who would otherwise be hospitalized to receive usual care with multidose IV antibiotics.
Methods: The dalbavancin pathway was previously implemented at 11 U.
Article Synopsis
- The study assessed the impact of COVID-19 on healthcare personnel's mental health and explored available support programs in academic emergency departments across the U.S.
- A cross-sectional survey was conducted with 1,541 ED staff, revealing that while support programs were widely available (>95%), their actual usage varied, with clinical work support programs being utilized more than individual support programs.
- A significant portion of respondents (57%) reported heightened stress and anxiety due to the pandemic, and 12% were at an increased risk of PTSD, indicating a need for better engagement with the available support resources.
Article Synopsis
- Access to timely COVID-19 testing is essential for reducing transmission and aiding early treatment decisions, yet the impact of demographic factors on testing delays remains unclear.
- The study focused on health care personnel (HCP) who exhibited COVID-19 symptoms and were evaluated for demographic influences on delayed testing from December 2020 to April 2022.
- The analysis involved 5,551 HCP and examined how demographics like sex, age, and comorbidities correlated with testing delays, revealing insights into the relative risks of delayed testing among different groups.
Article Synopsis
- The study aimed to evaluate the impact of the COVID-19 pandemic on emergency department (ED) staffing and the potential risks posed by COVID-19 positive health care personnel during 2020, before vaccines were available.
- Conducted through Project COVERED, the research involved surveys and testing of 1,673 ED personnel over several months, focusing on symptoms, exposures, and work attendance related to COVID-19.
- Results showed that while 5.3% of personnel missed work due to COVID-19 concerns, many continued working even after testing positive, with 98.7% of infected personnel working at least one shift before their diagnosis.
Background: Urinary tract infections (UTIs) are commonly treated in the emergency department (ED), and unfortunately, resistance to first-line agents is increasing.
Objectives: To characterize treatment of pyelonephritis in a nationally representative sample of ED patients and to identify patient- and treatment-specific factors associated with receiving initial inactive antibiotics.
Methods: We conducted a multicentre, observational cohort study utilizing the Emergency Medicine PHARMacotherapy Research NETwork (EMPHARM-NET), comprising 15 geographically diverse US EDs.
Article Synopsis
- COVID-19 vaccinations are effective at reducing complications, but many people, especially health care personnel (HCP), are hesitant to get the bivalent booster.
- A study of 1,656 HCP showed that concerns about contracting the virus, spreading it to family, and infecting colleagues significantly influenced their decision to get boosted.
- Those who did receive the booster were more likely to report relying on scientific literature and employer recommendations in their decision-making process.
Article Synopsis
- * A case-control study involving 3,647 healthcare personnel showed that bivalent vaccine effectiveness (VE) was about 34.1%, with the highest effectiveness (54.8%) observed shortly after administration, declining as time passed.
- * The study highlights that while bivalent doses initially provide substantial protection against COVID-19, their effectiveness significantly wanes after two months, suggesting the need for ongoing monitoring and potential updates to vaccination strategies.
Article Synopsis
- Protection against COVID-19 is crucial for healthcare workers, especially as vaccine effectiveness has decreased with the rise of the Omicron variant.
- A study evaluated the effectiveness of a monovalent mRNA booster dose from October 2021 to June 2022, finding that its effectiveness dropped significantly from 86% during Delta prevalence to 65% during Omicron prevalence.
- The results indicated that while a booster dose provides strong protection initially, its effectiveness wanes over time, dropping to 32% at least 120 days after vaccination, highlighting the importance of staying current with COVID-19 vaccinations.
Importance: Spanish-speaking participants are underrepresented in clinical trials, limiting study generalizability and contributing to ongoing health inequity. The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial intentionally included Spanish-speaking participants.
Objective: To describe trial participation and compare clinical and patient-reported outcomes among Spanish-speaking and English-speaking participants with acute appendicitis randomized to antibiotics.
Article Synopsis
- COVID-19 vaccines provide protection against infection and severe disease, but their effect on prolonged symptoms post-infection among healthcare personnel is not well understood.
- A study analyzed 681 healthcare workers who had COVID-19 to compare symptoms and return-to-work times between those who were vaccinated and those who weren't.
- Results showed that vaccinated healthcare workers experienced fewer COVID-like symptoms (60.6% vs 79.1%) and returned to work 2 days earlier than unvaccinated workers.
Article Synopsis
- - The study aimed to evaluate endotracheal intubation methods in emergency departments during the early COVID-19 pandemic by analyzing data from 20 US hospitals between May and December 2020.
- - Out of 3,435 intubations performed, 565 patients (18%) were known or suspected to have COVID-19; these patients were more likely to be intubated using video laryngoscopy and passive nasal oxygenation.
- - Although the success rate for the initial intubation attempt was similar between COVID-19 and non-COVID-19 patients, those with known or suspected COVID-19 experienced more adverse events, particularly hypoxia.
Importance: A patient's belief in the likely success of a treatment may influence outcomes, but this has been understudied in surgical trials.
Objective: To examine the association between patients' baseline beliefs about the likelihood of treatment success with outcomes of antibiotics for appendicitis in the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial.
Design, Setting, And Participants: This was a secondary analysis of the CODA randomized clinical trial.
Importance: Acute appendicitis is a common cause of abdominal pain and the most common reason for emergency surgery in several countries. Increased cases during summer months have been reported.
Objective: To investigate the incidence of acute appendicitis by considering local temperature patterns in geographic regions with different climate over several years.
Article Synopsis
- Emergency department health care personnel face a risk of SARS-CoV-2 infection, and this study aimed to assess the infection risk associated with providing patient care, evaluate PPE usage, and identify modifiable risk factors.
- A study was conducted involving 1,673 ED staff across 20 centers over 20 weeks in 2020, monitoring COVID-19 infection rates and related exposure factors, revealing that 4.5% of participants contracted the virus, with nurses showing a marginally higher risk.
- Results indicated PPE adherence was high, but lapses occurred frequently; significant infection risk factors included household and community exposure rather than direct patient care activities like intubation.
Objective: To compare secondary patient reported outcomes of perceptions of treatment success and function for patients treated for appendicitis with appendectomy vs. antibiotics at 30 days.
Summary Background Data: The Comparison of Outcomes of antibiotic Drugs and Appendectomy trial found antibiotics noninferior to appendectomy based on 30-day health status.
Article Synopsis
- The CODA trial found that outpatient management of acute appendicitis using antibiotics is a safe and effective alternative to immediate surgery, with about 50% of participants discharged within 24 hours.
- The cohort study analyzed data from 776 adults with imaging-confirmed appendicitis who received antibiotics and assessed the safety and outcomes of outpatient versus inpatient care.
- Results indicated that most treated participants managed their appendicitis without needing surgery, and outpatient management could reduce hospital visits, increase convenience, and lower healthcare costs.
Background: Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim of our study was to determine the prevalence of FQR from a geographically diverse sample of United States emergency departments (EDs).
Methods: We conducted a multi-center, observational cohort study using a network of 15 geographically diverse US EDs.