All posts; Tags Include "Clinical Research"
- August 3, 2014
- 05:00 PM
- 1,153 views
Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest
by Rogue Medic in Rogue Medic
This study is interesting for several reasons.
In a system that claims excellence, the most consistent way to identify the study group is by documentation of a protocol violation - but it is not intended as a study of protocol violations.
This may hint at some benefit from epinephrine (Adrenaline in Commonwealth countries), but that would require some study and we just don't study epinephrine. We only make excuses for not studying epinephrine.
The atropine results suggest that the ........ Read more »
Roberts, J. (2011) InFocus: Dissecting the ACLS Guidelines on Cardiac Arrest from Toxic Ingestions. Emergency Medicine News, 33(10), 16-18. DOI: 10.1097/01.EEM.0000406945.05619.ca
Koller, A., Salcido, D., Callaway, C., & Menegazzi, J. (2014) Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest. Resuscitation. DOI: 10.1016/j.resuscitation.2014.05.036
- July 31, 2014
- 11:35 PM
- 894 views
Fall With Dementia and No Change from Baseline Mental Status
by Rogue Medic in Rogue Medic
This happens many times every day. A patient falls and may have hit her head, but there is no change from her normal mental status. To complicate matter, she takes an anticoagulant.
There are no clear signs of serious trauma. so should we automatically go to the trauma center?
What can help us decide?... Read more »
Hamden K, Agresti D, Jeanmonod R, Woods D, Reiter M, & Jeanmonod D. (2014) Characteristics of elderly fall patients with baseline mental status: high-risk features for intracranial injury. The American journal of emergency medicine. PMID: 24929771
- July 30, 2014
- 11:24 AM
- 913 views
Violent Death Rates Increased After Traumatic Brain Injury
by William Yates, M.D. in Brain Posts
Anecdotal reports have linked traumatic brain injury with later violent death including death by suicide.Few large epidemiological studies have been published on this association.However, a recent Swedish population study published in JAMA Psychiatry provides valuable insight into this issue.Seena Fazel and colleagues from the University of Oxford, University College London and the Karolinksa Institute examined a large database of over 200,000 patients with TBI.Cases of TBI were identified from ........ Read more »
Fazel S, Wolf A, Pillas D, Lichtenstein P, & Långström N. (2014) Suicide, fatal injuries, and other causes of premature mortality in patients with traumatic brain injury: a 41-year Swedish population study. JAMA psychiatry, 71(3), 326-33. PMID: 24430827
- July 29, 2014
- 11:17 AM
- 673 views
Treating Sleep Problems Following Traumatic Brain Injury
by William Yates, M.D. in Brain Posts
Sleep problems are common following traumatic brain injury (TBI).In a previous post, I reviewed a study of the risk factors for sleep disorders following TBI.The most severe TBI is a risk factor for hypersomnia. Anxiety and depression following TBI increase risk for insomnia complaints.Few large studies of treatment for sleep problems after TBI exist. However, a recent manuscript outlined the potential benefit of treatment of sleep disorders in a series of 12 subjects.Catherine Wiseman-Hake........ Read more »
Wiseman-Hakes C, Murray B, Moineddin R, Rochon E, Cullen N, Gargaro J, & Colantonio A. (2013) Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI. Brain injury : [BI], 27(12), 1364-76. PMID: 24070180
- July 28, 2014
- 03:10 PM
- 1,055 views
This Month In Blastocystis Research (JUL 2014)
by Christen Rune Stensvold in Blastocystis Parasite Blog
A new study from Colombia sees Blastocystis as a quasi-ubiquitous organism.... Read more »
Londoño-Franco AL, Loaiza-Herrera J, Lora-Suárez FM, & Gómez-Marín JE. (2014) [Blastocystis sp . frequency and sources among children from 0 to 5 years of age attending public day care centers in Calarcá, Colombia]. Biomedica : revista del Instituto Nacional de Salud, 34(2), 218-27. PMID: 24967927
Klimeš V, Gentekaki E, Roger AJ, & Eliáš M. (2014) A large number of nuclear genes in the human parasite Blastocystis require mRNA polyadenylation to create functional termination codons. Genome biology and evolution. PMID: 25015079
Lukeš J, Kuchta R, Scholz T, & Pomajbíková K. (2014) (Self-) infections with parasites: re-interpretations for the present. Trends in parasitology. PMID: 25033775
Tomasini N, Lauthier JJ, Ayala FJ, Tibayrenc M, & Diosque P. (2014) How often do they have sex? A comparative analysis of the population structure of seven eukaryotic microbial pathogens. PloS one, 9(7). PMID: 25054834
- July 25, 2014
- 11:02 AM
- 647 views
Risk Factors For Sleep Disturbance After Traumatic Brain Injury
by William Yates, M.D. in Brain Posts
Sleep disturbance following traumatic brain injury (TBI) is a common clinical challenge.Hypersomnia and insomnia can both been seen in the TBI population.The risk factors related to TBI-related sleep disturbance are not well known. Identification of risk factors can provide insight into clinical assessment and management.Lijun Hou and colleagues recently examined risk factors related to subjective sleep complaints in a series of 98 TBI subjects.The study sample include adults admitted to a ........ Read more »
Hou L, Han X, Sheng P, Tong W, Li Z, Xu D, Yu M, Huang L, Zhao Z, Lu Y.... (2013) Risk factors associated with sleep disturbance following traumatic brain injury: clinical findings and questionnaire based study. PloS one, 8(10). PMID: 24098425
- July 23, 2014
- 03:43 PM
- 468 views
Physicians face difficult choices when treating patients with bipolar and obsessive compulsive disorders
by Valerie Ashton in The Molecular Scribe
New research suggests patients with both bipolar disorder and obsessive compulsive disorder should receive treatments for bipolar disorder alone. Bipolar and obsessive compulsive disorder therapies taken together can cause worsening of disease symptoms, making it difficult for physicians to treat both conditions. This is a concern as over 1 in 5 patients with bipolar disorder develop obsessive compulsive disorder during their lifetime.... Read more »
Pacchiarotti I, Bond DJ, Baldessarini RJ, & et al. (2013) The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. The American journal of psychiatry, 170(11), 1249-62. PMID: 24030475
- July 22, 2014
- 07:04 PM
- 569 views
Over the counter drug addiction
by DJMac in Recovery Review
In many countries around the world, codeine is available only on prescription. It’s a weak opioid, but can still cause addiction. Low dose codeine is also available in the UK, over-the-counter (OTC) in pharmacies. It’s sold in combination with paracetamol (co-codamol, e.g. Solpadol), in combination with ibuprofen (e.g. Nurofen Plus), and in combination with dihydrocodeine (co-dydramol, e.g. [...]
The post Over the counter drug addiction appeared first on Recovery Review.
... Read more »
Cooper, R. (2013) 'I can't be an addict. I am.' Over-the-counter medicine abuse: a qualitative study. BMJ Open, 3(6). DOI: 10.1136/bmjopen-2013-002913
- July 22, 2014
- 01:48 PM
- 1,324 views
Fasting Improves Recovery of Bone Marrow Stem Cells after Chemotherapy
by Jalees Rehman in The Next Regeneration
Fasting is defined as either completely abstaining from or minimizing food intake for a defined period time - ranging from about 12 hours to even a few weeks. Calorie restriction, on the other hand, refers to an overall reduction in the daily calorie intake by about 20%-40% without necessarily reducing the meal intake frequency. Although calorie restriction is well-suited for weight loss and thus also reduces the risk of chronic diseases such as diabetes or heart disease, proponents of fasting c........ Read more »
Cheng, C., Adams, G., Perin, L., Wei, M., Zhou, X., Lam, B., Da Sacco, S., Mirisola, M., Quinn, D., Dorff, T.... (2014) Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell, 14(6), 810-823. DOI: 10.1016/j.stem.2014.04.014
- July 14, 2014
- 10:44 AM
- 573 views
Cognitive Reserve Boosts Traumatic Brain Injury Recovery
by William Yates, M.D. in Brain Posts
Cognitive reserve (high educational attainment, high IQ) is known to reduce or delay the risk for Alzheimer's disease.However, the effect of cognitive reserve on recovery from traumatic brain injury (TBI) is less well studied.Two recent research studies support the beneficial effects of cognitive reserve on TBI.Schneider and colleagues examined a series of 769 adult TBI subjects using the TBI Model Systems Database.This cohort was followed during rehabilitation for a period of at least one year......... Read more »
Schneider EB, Sur S, Raymont V, Duckworth J, Kowalski RG, Efron DT, Hui X, Selvarajah S, Hambridge HL, & Stevens RD. (2014) Functional recovery after moderate/severe traumatic brain injury: a role for cognitive reserve?. Neurology, 82(18), 1636-42. PMID: 24759845
Fay TB, Yeates KO, Taylor HG, Bangert B, Dietrich A, Nuss KE, Rusin J, & Wright M. (2010) Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury. Journal of the International Neuropsychological Society : JINS, 16(1), 94-105. PMID: 19835663
- July 12, 2014
- 07:02 PM
- 744 views
Legal highs – not for human consumption
by DJMac in Recovery Review
Legal highs in Lothian The UK has the largest market for new psychoactive substances (NSP or “legal highs”) in Europe. Scotland is no stranger to them and, as a seminar in Edinburgh heard last week, the Lothian area is seeing a surge in demand, some worrying trends in injecting and significant new presentations due to problems [...]
The post Legal highs - not for human consumption appeared first on Recovery Review.
... Read more »
Baumann, M. (2014) Awash in a sea of ‘bath salts’: implications for biomedical research and public health. Addiction. DOI: 10.1111/add.12601
- July 9, 2014
- 12:06 PM
- 813 views
Brain Hippocampus Atrophy in Traumatic Brain Injury
by William Yates, M.D. in Brain Posts
Understanding the specific brain regions vulnerable to traumatic brain injury (TBI) is important for assessment and intervention research.Two areas of active research include studies of brain white matter using diffusion tensor imaging and assessment of regional brain atrophy using magnetic resonance imaging (MRI).Two recent MRI studies have suggested the brain hippocampus may be a region of vulnerability to TBI.A Canadian study by Robin Green and colleagues used brain MRI to examine a cohort of........ Read more »
Green RE, Colella B, Maller JJ, Bayley M, Glazer J, & Mikulis DJ. (2014) Scale and pattern of atrophy in the chronic stages of moderate-severe TBI. Frontiers in human neuroscience, 67. PMID: 24744712
Singh R, Meier TB, Kuplicki R, Savitz J, Mukai I, Cavanagh L, Allen T, Teague TK, Nerio C, Polanski D.... (2014) Relationship of collegiate football experience and concussion with hippocampal volume and cognitive outcomes. JAMA : the journal of the American Medical Association, 311(18), 1883-8. PMID: 24825643
- July 8, 2014
- 11:15 AM
- 748 views
Millions Lack Level I Trauma Care Access in the U.S.
by William Yates, M.D. in Brain Posts
Trauma results in 180,000 deaths per year in the U.S. and disproportionately affects children and young adults. The Centers for Disease Control (CDC) recently published a review highlighting unintentional injury and violence as the leading cause of death in the U.S. for those in the one to 30 year old age group. Additionally, trauma produces significant disability through residual effects such as like that often seen following traumatic brain injury.Trauma centers are hospital-affiliat........ Read more »
Haegerich, T., Dahlberg, L., Simon, T., Baldwin, G., Sleet, D., Greenspan, A., & Degutis, L. (2014) Prevention of injury and violence in the USA. The Lancet, 384(9937), 64-74. DOI: 10.1016/S0140-6736(14)60074-X
Garwe T, Cowan LD, Neas B, Cathey T, Danford BC, & Greenawalt P. (2010) Survival benefit of transfer to tertiary trauma centers for major trauma patients initially presenting to nontertiary trauma centers. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 17(11), 1223-32. PMID: 21175521
Bukur M, Felder SI, Singer MB, Ley EJ, Malinoski DJ, Margulies DR, & Salim A. (2013) Trauma center level impacts survival for cirrhotic trauma patients. The journal of trauma and acute care surgery, 74(4), 1133-7. PMID: 23511156
Prada SI, Salkever D, & Mackenzie EJ. (2014) Level-I trauma centre treatment effects on return to work in teaching hospitals. Injury. PMID: 24630835
MacKenzie, E., Weir, S., Rivara, F., Jurkovich, G., Nathens, A., Wang, W., Scharfstein, D., & Salkever, D. (2010) The Value of Trauma Center Care. The Journal of Trauma: Injury, Infection, and Critical Care, 69(1), 1-10. DOI: 10.1097/TA.0b013e3181e03a21
- July 7, 2014
- 11:05 AM
- 1,002 views
Florida Clampdown on Pain Pills Lowers Drug-Related Mortality
by Pranab Chatterjee in Scepticemia
Ever since I started working with the homeless youth of Delhi, I have noticed their drug and substance dependence issues and how, despite knowing the ill-effects, they have not been able to get out from under the chemical spell. Thus, when I came across a short report in the CDC’s Morbidity and Mortality Weekly Reports that Florida…... Read more »
Johnson H, Paulozzi L, Porucznik C, Mack K, Herter B, & Hal Johnson Consulting and Division of Disease Control and Health Promotion, Florida Department of Health. (2014) Decline in drug overdose deaths after state policy changes - Florida, 2010-2012. MMWR. Morbidity and mortality weekly report, 63(26), 569-74. PMID: 24990490
- July 7, 2014
- 10:50 AM
- 656 views
The Geography of Traumatic Brain Injury Death in U.S.
by William Yates, M.D. in Brain Posts
In the last post, I examined some recent research in the epidemiology of traumatic brain injury (TBI).Two studies showed the top two causes of TBI to be motor vehicle crashes and falls.In this post, I will review some recent data on the geographic variability of TBI in the United States.The Centers for Disease Control provides an online tool called WISQARS that allows users to search for a variety of statistics related to unintentional injury by state in the U.S.They have recently added a iPad a........ Read more »
Centers for Disease Control and Prevention (CDC). (2013) CDC grand rounds: reducing severe traumatic brain injury in the United States. MMWR. Morbidity and mortality weekly report, 62(27), 549-52. PMID: 23842444
- July 7, 2014
- 10:33 AM
- 1,290 views
MERS CoV: Can it spread from camels to man?
by Pranab Chatterjee in Scepticemia
The Middle Eastern Respiratory Syndrome coronavirus (MERS CoV) is a novel single stranded RNA virus that has been doing the rounds in the Middle East, bits of Europe and North America. Given our experiences the last time we had a new respiratory virus (remember the pandemic?), things have moved rather fast this time once the…... Read more »
Azhar, E., El-Kafrawy, S., Farraj, S., Hassan, A., Al-Saeed, M., Hashem, A., & Madani, T. (2014) Evidence for Camel-to-Human Transmission of MERS Coronavirus. New England Journal of Medicine, 370(26), 2499-2505. DOI: 10.1056/NEJMoa1401505
- July 3, 2014
- 11:50 AM
- 535 views
Epidemiology of Traumatic Brain Injury (TBI)
by William Yates, M.D. in Brain Posts
Traumatic brain injury (TBI) contributes significantly to mortality and long-term disability.In the U.S. there are an estimated 52,000 deaths yearly due to TBI with over 1,000,000 emergency room (ER) visits.Understanding the epidemiology of TBI can provides clues to designing prevention programs.Four relevant recent research studies provide insight about the epidemiology of TBI.TBI in hospitalized patients in Scotland Tara Shivaji and colleagues in Scotland examined the prevalence and patte........ Read more »
Shivaji T, Lee A, Dougall N, McMillan T, & Stark C. (2014) The epidemiology of hospital treated traumatic brain injury in Scotland. BMC neurology, 2. PMID: 24386897
Kerr ZY, Harmon KJ, Marshall SW, Proescholdbell SK, & Waller AE. (2014) The epidemiology of traumatic brain injuries treated in emergency departments in North Carolina, 2010-2011. North Carolina medical journal, 75(1), 8-14. PMID: 24487751
- June 29, 2014
- 11:55 PM
- 861 views
Safety of Intranasal Fentanyl in the Out-of-Hospital Setting - A Prospective Observational Study
by Rogue Medic in Rogue Medic
I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone.
Would first responders be safer with fentanyl?
It is not really the same question, but it does highlight the differences and why I think fentanyl is safer. The patient will be seen by someone more likely to recognize when the treatment is inappropriate. This study looked at IN (IntraNasal) fentanyl given by basic EMTs prior to transport to the E........ Read more »
Krauss, W., Shah, S., Shah, S., & Thomas, S. (2011) Fentanyl in the Out-of-Hospital Setting: Variables Associated with Hypotension and Hypoxemia. The Journal of Emergency Medicine, 40(2), 182-187. DOI: 10.1016/j.jemermed.2009.02.009
Karlsen AP, Pedersen DM, Trautner S, Dahl JB, & Hansen MS. (2014) Safety of intranasal fentanyl in the out-of-hospital setting: a prospective observational study. Annals of emergency medicine, 63(6), 699-703. PMID: 24268523
- June 29, 2014
- 11:18 AM
- 690 views
Evidence based medicine – holding things back?
by DJMac in Recovery Review
A drugs worker told me a few years back that he would never refer a patient to a recovery service on the basis that he would not be following the evidence base. I did ask him at the time ‘but what if that’s not what the client wants?’ It seemed the evidence base came first. [...]
The post Evidence based medicine - holding things back? appeared first on Recovery Review.
... Read more »
Greenhalgh T, Howick J, Maskrey N, & Evidence Based Medicine Renaissance Group. (2014) Evidence based medicine: a movement in crisis?. BMJ (Clinical research ed.). PMID: 24927763
- June 24, 2014
- 12:22 PM
- 486 views
E-cigarettes and Smoking Cessation
by William Yates, M.D. in Brain Posts
Electronic or e-cigarettes are a tobacco cigarette alternative that is growing in popularity.Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.Unfortunately, this is an area where public health trends come before scientific research data is collected. ........ Read more »
Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet, 382(9905), 1629-1637. DOI: 10.1016/S0140-6736(13)61842-5
Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R. (2013) Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10(2), 446-61. PMID: 23358230
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