Articles: critical-care.
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To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs. ⋯ A prospective, multicenter, and multidisciplinary TEE registry was successfully implemented, and demonstrated that focused TEE is safe and clinically impactful across multiple critical care applications. Further studies from this research network will accelerate the development of outcome-oriented research and knowledge translation on the use of TEE in emergency and critical care settings.
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Dental impressions and casts play a critical role in dental care, facilitating diagnoses and the fabrication of prostheses. Traditional methods of fabrication involve elastomeric materials that are more prone to errors and patient discomfort. Digital advancements offer promising alternatives, yet their accuracy and applicability to military dentistry remain under-explored. This study evaluates the accuracy of digital casts produced with material available in the Military Health System compared to conventional methods. ⋯ These findings validate the potential of digital workflows in enhancing the speed and accuracy of dental care in the Military Health System, while underscoring the need for further exploration and refinement in specific clinical contexts.
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The Uniformed Services University is known for its dual mission of preparing military medical officers for operational readiness and leadership roles. The Joint Expeditionary Medical Officer (JEMO) project is a novel internal program that was initiated in 2022 and aims to fortify and evaluate the essential Knowledge, Skills, and Abilities (KSAs) within the School of Medicine's Molecules to Military Medicine curriculum that are pivotal for the development of a deployment-ready military medical officer. The JEMO-KSA program identifies and deliberately develops a core set of mission-critical skills during the course of students' undergraduate medical education. ⋯ The JEMO project represents a significant stride toward optimizing the readiness of military medical officers by systematically identifying, strengthening, and assessing vital operational skills and abilities. With an ongoing commitment to excellence, the project envisages creating an even more robustly structured curriculum that is continually refined to address current operational readiness, setting a new standard for military medical education. While challenges such as accurately measuring the impact of integrated KSAs and continuously updating them to meet evolving military needs remain, the forward momentum associated with the JEMO project will help facilitate the development of military medical officers who have the KSAs to actively support mission success while simultaneously enhancing the overall effectiveness of military health care.
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Multicenter Study Observational Study
Association between delta anion gap/delta bicarbonate and outcome of surgical patients admitted to intensive care unit.
Patients undergoing high-risk surgeries with acid-based disorders are associated with poor outcomes. The screening of mixed acid-based metabolic disorders by calculating delta anion gap (AG)/delta bicarbonate (Bic) has a clinically relevant role in patients with high AG metabolic acidosis (MA), however its utility in individuals facing high-risk surgical procedures remains unclear. ⋯ In the postoperative time, patients with metabolic acidosis and no mixed disorders present higher ICU-Mortality and higher cardiovascular postoperative complications when compared with patients with combined hyperchloremia or alkalosis. Delta-AG/delta-Bic can be a useful tool to evaluate major clinical outcomes in this population.