Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Measuring the QT interval on an electrocardiogram (ECG) is integral to risk assessment of Torsade de Pointes (TdP). This study aimed to investigate the accuracy of the 1/2 RR rule as a risk assessment tool for drug-induced TdP, comparing it to the QT nomogram, Bazett's corrected QT (QTcB), and Fridericia's corrected QT (QTcF). ⋯ The 1/2 RR rule was not as sensitive as the QT nomogram or QTcB > 500 msec for drug-induced TdP. It had poor positive agreement in almost all overdose patients, resulting in over half of patients receiving unnecessary cardiac monitoring and repeat ECGs.
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Emergency department (ED) utilization by children is common and growing more expensive. Tracking trends and variability in ED charges is essential for policymakers who strive to improve the efficiency of the health care system and for payers who prepare health care budget forecasts. Our objective was to examine trends and variability in ED charges for pediatric patients across Massachusetts. ⋯ Charges for common pediatric emergency conditions varied widely across Massachusetts EDs, and hospital-level factors by and large could not consistently explain the variability. Although a plateau (and in some cases decrease) of statewide pediatric emergency health care charges was observed after 2007, no evidence was found that interhospital variability decreased. These data may be useful in the ongoing effort to reform the economics of health care delivery systems.
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The purpose of this study was to characterize the publication fate of a recent 2-year sample of manuscripts declined by Academic Emergency Medicine (AEM), the journal of the Society for Academic Emergency Medicine. ⋯ Nearly two-thirds of manuscripts declined by SAEM's journal are eventually published elsewhere, in a large number and wide variety of both EM and non-EM journals, in a median of 16.7 months. Authors of manuscripts declined by AEM should consider submission elsewhere, as subsequent publication of these manuscripts in another journal is probable.
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Progression of cell death after burn injury may occur by one of three mechanisms: passive necrosis, apoptosis, and programmed necroptosis that requires the receptor-interacting protein kinase-3 (RIP-3). The hypothesis was that RIP-3 is present in normal and burned skin; that necroptosis plays a role in burn injury progression; and that treatment with necrostatin-1, an inhibitor of necroptosis, would reduce burn progression. ⋯ The skin of rats contains RIP-3 necessary for necroptosis. Injection of rats with either a single intraperitoneal dose or two intravenous doses of necrostatin-1 failed to reduce burn injury progression in a rat comb burn model. This may be due to inactivity of necrostatin-1 or the lack of a role of necroptosis in burn injury progression in the rat comb burn model.