Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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While knee injuries are treated by a wide range of clinicians, patients with knee injuries frequently present to emergency departments (EDs). The knee is the most commonly injured joint by adolescent athletes with an estimated 2.5 million sports-related injuries presenting to EDs annually. ⋯ Rates and patterns of knee injuries vary by sex and age. Although knee injuries will likely continue to occur most frequently among youth and young adult athletes, anticipating and responding to trends such as an increase in the incidence of knee injuries among adult and senior patients will enable clinicians to better anticipate caseloads, allocate resources, and determine best practices for diagnosis and treatment of knee injuries in different age groups.
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Physical and molecular mechanisms for the neuroprotective effect of therapeutic hypothermia are not completely understood, and new therapeutic applications incorporating hypothermia remain to be developed and tested. Clinically relevant animal models of therapeutic hypothermia are not well established or consistent. ⋯ Like human protocols, this model incorporates sedation and analgesia, results in robust neuroprotection, is well tolerated, and offers exquisite temperature control. The system is noninvasive and inexpensive and offers a model that is similar to methods used in clinical practice. This system will be of interest to investigators using small animal models to examine neuroprotective mechanisms of hypothermia and translational strategies that combine hypothermia with targeted pharmacotherapy.
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Randomized Controlled Trial Multicenter Study
Prognostic value and agreement of achieving lactate clearance or central venous oxygen saturation goals during early sepsis resuscitation.
Lactate clearance (LC) and central venous oxygen saturation (ScvO(2)) have been proposed as goals of early sepsis resuscitation. The authors sought to determine the agreement and prognostic value of achieving ScvO(2) or LC goals in septic shock patients undergoing emergency department (ED)-based early resuscitation. ⋯ No agreement was found between LC and ScvO(2) goal achievement in early sepsis resuscitation. Achievement of a ScvO(2) ≥ 70% without LC ≥ 10% was more strongly associated with mortality than achievement of LC ≥ 10% with failure to achieve ScvO(2) ≥ 70%.
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Review
A systematic review of emergency department technology-based behavioral health interventions.
This systematic review evaluated the evidence for use of computer technologies to assess and reduce high-risk health behaviors in emergency department (ED) patients. ⋯ The number of studies identified in this review reflects recent enthusiasm about the potential of computers to overcome barriers to behavioral health screening, interventions, and referrals to treatment in the ED. The available literature suggests that these types of tools will be feasible and acceptable to patients and staff.