Slit-lamp (SL) biomicroscopy is an important skill for emergency medicine (EM) clinicians. However, residents and faculty have varying levels of comfort and skill with this procedure. While some of the discomfort may be from a knowledge gap, we hypothesized that at least some difficulty came from infrequent use and forgetting which of the many knobs, levers, buttons, and switches of the SL create the desired effects. We strategically labeled a SL and tested the impact of this on the ability of 39 EM faculty and residents to identify a target on a maladjusted SL. Time to target identification was significantly lower with the labeled SL compared to the unlabeled SL, with median (IQR) time decreasing from 93 (31.5-154.5) seconds to 47 (0-141) seconds (p < 0.0001). Comfort level, as measured by a written survey and a graphic rating scale, also increased significantly with the labeled SL compared to the unlabeled SL.
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http://dx.doi.org/10.1002/aet2.10570 | DOI Listing |
Pulmonology
December 2025
Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei tintori, Monza, Italy.
Background: Non-invasive helmet respiratory support is suitable for several clinical conditions. Continuous-flow helmet CPAP systems equipped with HEPA filters have become popular during the recent Coronavirus pandemic. However, HEPA filters generate an overpressure above the set PEEP.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Clinical Product Development, Waymark, San Francisco, California.
Importance: Rising prescription medication costs under Medicaid have led to increased procedural prescription denials by health plans. The effect of unresolved denials on chronic condition exacerbation and subsequent acute care utilization remains unclear.
Objective: To examine whether procedural prescription denials are associated with increased net spending through downstream acute care utilization among Medicaid patients not obtaining prescribed medication following a denial.
JAMA Netw Open
January 2025
Ronald O. Perelman Department of Emergency Medicine, New York University Langone Health, New York.
Importance: Increasing underrepresented in medicine (URIM) physicians among historically underserved communities helps reduce health disparities. The concordance of URIM physicians with their communities improves access to care, particularly for American Indian and Alaska Native, Black, and Hispanic or Latinx individuals.
Objectives: To explore county-level racial and ethnic representation of US internal medicine (IM) residents, examine racial and ethnic concordance between residents and their communities, and assess whether representation varies by presence of academic institutions or underserved settings.
Infection
January 2025
Swiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Purpose: Bloodstream infections (BSIs) cause significant morbidity and mortality worldwide. Pseudomonas aeruginosa is an important microorganism in BSIs. The aim of this study was to analyze recent trends in the incidence and resistance rates of P.
View Article and Find Full Text PDFEur J Pediatr
January 2025
Service de Physiologie Pédiatrique-Centre du Sommeil-CRMR Hypoventilations Alvéolaires Rares, INSERM NeuroDiderot, Université Paris-Cité, AP-HP, Hôpital Robert Debré, Paris, France.
Unlabelled: It is known that in most cases of congenital central hypoventilation syndrome (CCHS), apnoeas and hypoventilation occur at birth. Nevertheless, a detailed description of initial symptoms, including pregnancy events and diagnostic tests performed, is warranted in infants with neonatal onset of CCHS, that is, in the first month of life. The European Central Hypoventilation Syndrome Consortium created an online patient registry from which 97 infants (44 females) with CCHS of neonatal onset and PHOX2B mutation from 10 countries were selected.
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