Optimal Timing of Cholecystectomy for Acute Cholecystitis: A Retrospective Cohort Study.

Background Laparoscopic cholecystectomy performed less than 72 hours from hospital admission for acute cholecystitis has shown to decrease hospital cost without an increase in length of stay (LOS). Very few studies have examined clinical and cost outcomes of performing cholecystectomy less than 24 hours from hospital admission. The aim of this study was to examine the cost and LOS of laparoscopic cholecystectomy performed on an early (less than 24 hours from admission) and late (more than 24 hours from hospital admission) basis.

American Helicopter Emergency Medical Service Pilots Report to Work Despite High Rates of Sleepiness.

Objective: Previous studies on helicopter emergency medical service (HEMS) pilots found a positive correlation among fatigue, nodding off in flight, and accidents. We sought to quantify the amount of sleepiness in HEMS pilots using the Epworth Sleepiness Scale (ESS).

Methods: An anonymous survey was sent via the National EMS Pilots Association emergency medical services listserv including demographics, the ESS, and subjective effects of fatigue on flying.

Cardiovascular Risk Factors in Younger Black Women: Results from the 10,000 Women Community Screening Project.

Background: Cardiovascular Disease (CVD) risk factors are prevalent in black women, but when these risk factors arise is not clear. We aimed to determine when obesity, hypertension, and hyperlipidemia appear in black women within a community screening program.

Methods: 945 black women who enrolled in the 10,000 Women community screening project in the metro Atlanta area were included (2015-2018).

A Western Massachusetts hospital system's response to the COVID-19 pandemic.

Objective: The objective of this paper was to outline a novel model created for the management of the critical care surge due to coronavirus disease 2019 (COVID-19) in a Western Massachusetts hospital.

Setting: This model was created and implemented at a Western Massachusetts Level 1 Trauma and tertiary referral center.

Conclusions: This article outlines a model devised by an interdisciplinary team for rapid expansion of critical care services by increasing allocated space, staffing, and supplies via modifications of existing systems of care to accommodate a predicted large critical care patient surge due to the COVID-19 pandemic.

Correction to: Mifepristone: An Uncommon Cause of Drug-Induced Liver Injury.

[This corrects the article DOI: 10.14740/gr1188.].

Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes: A Post Hoc Analysis of the PAMPer and COMBAT Clinical Trials.

Importance: Both military and civilian clinical practice guidelines include early plasma transfusion to achieve a plasma to red cell ratio approaching 1:1 to 1:2. However, it was not known how early plasma should be given for optimal benefit. Two recent randomized clinical trials were published, with apparently contradictory results.

Mifepristone: An Uncommon Cause of Drug-Induced Liver Injury.

Mifepristone is frequently used in large doses for management of Cushing's syndrome. This is a case of a 35-year-old woman with Cushing's syndrome, who presented with abdominal pain and jaundice. A month prior to admission, she had been started on a daily dose of 1,200 mg mifepristone.

Implementation of a prehospital air medical thawed plasma program: Is it even feasible?

Background: The Prehospital Air Medical Plasma (PAMPer) trial demonstrated a 30-day survival benefit among hypotensive trauma patients treated with prehospital plasma during air medical transport. We characterized resources, costs and feasibility of air medical prehospital plasma program implementation.

Methods: We performed a secondary analysis using data derived from the recent PAMPer trial.

Prehospital Blood Product and Crystalloid Resuscitation in the Severely Injured Patient: A Secondary Analysis of the Prehospital Air Medical Plasma Trial.

Objective: The aim of this study was to determine whether prehospital blood products reduce 30-day mortality in patients at risk for hemorrhagic shock compared with crystalloid only resuscitation.

Summary Of Background Data: Hemorrhage is the primary cause of preventable death after injury. Large volume crystalloid resuscitation can be deleterious.

Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock.

Background: After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting.

Methods: To determine the efficacy and safety of prehospital administration of thawed plasma in injured patients who are at risk for hemorrhagic shock, we conducted a pragmatic, multicenter, cluster-randomized, phase 3 superiority trial that compared the administration of thawed plasma with standard-care resuscitation during air medical transport.

Teamwork training improves the clinical care of trauma patients.

Objectives: We investigated these questions: Does formal team training improve team behaviors in the trauma resuscitation bay? If yes, then does improved teamwork lead to more efficiency in the trauma bay and/or improved clinical outcomes?

Design: This intervention study used a pretraining/posttraining design. The intervention was TeamSTEPPS augmented by simulation. The evaluation instrument, which was the Trauma Team Performance Observation Tool (TPOT), was used by trained evaluators to assess teams' performance during trauma resuscitations.

Blood transfusion, independent of shock severity, is associated with worse outcome in trauma.

Background: We have previously shown that blood transfusion in the first 24 hours is an independent predictor of mortality, intensive care unit (ICU) admission, and increased ICU length of stay in the acute trauma setting when controlling for Injury Severity Score, Glasgow Coma Scale score, and age. Indices of shock such as base deficit, serum lactate level, and admission hemodynamic status (systolic blood pressure, heart rate) and admission hematocrit were considered potential confounding variables in that study. The objectives of this study were to evaluate admission anemia and blood transfusion within the first 24 hours as independent predictors of mortality, ICU admission, ICU length of stay (LOS), and hospital LOS, with serum lactate level, base deficit, and shock index (heart rate/systolic blood pressure) as covariates.