Latest Articles
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Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians' practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments. ⋯ Emergency physicians in Canada report low confidence in fundoscopy despite its critical role in identifying vision- or life-threatening conditions. Traditional modalities are widely used but remain challenging for non-ophthalmologists. Fundus cameras, which offer ease of use and higher diagnostic accuracy, are underutilized.
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Management of the adult airway is one of the most stressful and time-critical procedures in emergency medicine. In the Cowichan District Hospital, a rural hospital in British Columbia, Emergency Department (ED) staff were uncomfortable with acquiring the equipment needed for adult advanced airway management and the mean length of time to acquire the equipment was 319 s. The aim of this quality improvement (QI) project was to decrease the time to obtain the equipment needed for adult advanced airway management by nurses and physicians in the Cowichan District Hospital ED to less than 90 s by May 2023. ⋯ The change ideas of using a colour-coded airway cart and translational simulation were associated with a reduction in time to obtain equipment for management of the adult advanced airway as well as improved provider comfort with the procedure in a rural ED.
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Due to the increasing prevalence of depressive and anxiety disorders in youth, a growing interest in the endocannabinoid system (ECS) as a potential alternative target point for treatment arised. This study aimed to investigate whether chronic administration of escitalopram reverses behavioral changes induced by maternal separation in male adolescent Wistar rats and explore the corresponding neurochemical changes in the ECS. The pups were separated from their dams for 360 min daily from postnatal day (PND) 2 until PND 15. ⋯ Escitalopram reversed anxiety-like behavior and attenuated signs of despair behavior. The escitalopram administration has been followed by a decrease in the studied genes expression in the amygdala, the hypothalamus, and the hippocampus, what might suggest that the endocannabinoid system is involved in the mechanism of its action in adolescents. However Western blot analysis did not indicate significant alterations in the protein levels, so more detailed studies are needed to verify this hypothesis.
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Astragaloside Ⅳ (AS-Ⅳ) improved the motor behavior of PD mouse but the alteration of imaging in the PD mice brain was unclear. PD models were established by unilateral injection of ROT into the substantia nigra pars compacta (SNc) of mice. AS-Ⅳ (4 mg/kg) was intraperitoneally injected once a day for 14 days. ⋯ AS-Ⅳ administration inhibited the activation of CD4+ T cells and increased the percentage of dopaminergic neurons of burst firing. Meanwhile, AS-Ⅳ altered the brain tissue microstructure and T2 values in SN. AS-Ⅳ improved motor impairments and efficiently performed a neuroprotective function in ROT-induced mouse model.
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Internal medicine journal · Jan 2025
Appropriateness of lumbar spine imaging in patients presenting to the emergency department with low back pain in a Western Australian tertiary hospital.
The Australian Rheumatology Association identified the use of imaging in patients with low back pain without indication of serious pathology as a low-value practice. ⋯ Four in five lumbar spine imaging requests for investigating low back pain were appropriate. Of the inappropriate requests, the most common reason was the absence of alerting features, while a small number were the incorrect imaging modality.