The 'SAFE PT' Handover: A Qualitative Study for Developing an Improvised Tool Facilitating Safe Patient Handover
Ahmed Mikky, MD, Mohamed Al Busafi, MD and Issa Al Salmi, MD, PHD
Article Type: Qualitative Study | First Published: July 03, 2019
The aim of this study is to identify and establish an effective and a standardized tool that is easily reproducible for the safe handover of patients at end of shift at the emergency department (ED) for continuity of care, smooth transition and minimising errors. This tool is designed to assist emergency physician and nurses in building a safe patient culture one that is reliable and upholds the standards of quality and improvement guided by international goals....
A Heteroscedastic Accelerated Failure Time Model for Survival Analysis
Yifan Wang, Tian You and Martin Lysy
Article Type: Original Research | First Published: July 03, 2019
Nonparametric and semiparametric methods are commonly used in survival analysis to mitigate the bias due to model misspecification. However, such methods often cannot estimate upper-tail survival quantiles when a sizable proportion of the data are censored, in which case parametric likelihood-based estimators present a viable alternative. In this article, we extend a popular family of parametric survival models which make the Accelerated Failure Time (AFT) assumption to account for heteroscedasticity in the survival times. The conditional variances can depend on arbitrary covariates, thus addi...
Geriatric Presentation of Hyperleukocytosis in Setting of B-Cell Acute Lymphoblastic Leukemia, Border-Zone Ischemic Stroke and Endocarditis
Christian Cajavilca, Tina Yaqing Cai Lam, Alexandra Vaio Sykes, Shannon Wheeler and Rajan R Gadhia
Article Type: Case Report | First Published: July 04, 2019
81-year-old female presented to an outside emergency room with subacute onset of left facial weakness and right hemiparesis for 12 hours. A non-contrast CT scan of the head and CTA head and neck showed no acute findings. Laboratory results were remarkable for a leukocyte count of 245.75 k/uL. She was diagnosed with acute leukemia and transferred to a comprehensive stroke center where she was treated with leukapheresis and hydroxyurea. The patients focal deficits somewhat improved, but in the following days, became confused and aphasic. Brain MRI showed bilateral acute border-zone ischemic infa...
Caring for Meningiomas: A Multi-Disciplinary Approach
Uri P Hadelsberg, MD and Nevo Margalit, MD
Article Type: Commentary | First Published: June 29, 2019
This patient was admitted to our department and eventually underwent surgery with gross total resection after pre-operative endovascular embolization of the tumor. The patient underwent a successful recovery and was discharged without major neurological deficits to rehab. On follow up the patient is doing well and is back home with her children. On the day of surgery the patient was intubated and underwent cerebral embolization with occlusion of several tumor-feeding arteries. The patient was then transferred to the operating room while intubated and underwent craniotomy and gross total tumor ...
Evaluation and Feasibility of a Comprehensive Program for Post-Traumatic Stress Disorder in Military, Veterans, and First Responders
Michele Preyde, PhD
Article Type: Original Research | First Published: July 04, 2019
Healing Invisible Wounds-The Intensive (HIW-I) is a comprehensive program including individual and group therapies designed in the field of community nursing in Canada to expressly target all aspects of Post-Traumatic Stress Disorder (PTSD) for first responders, military personnel and veterans. In this evaluation, participants completed standardized measures of symptoms of PTSD and sequelae at baseline, post-intervention and five months follow up. Results: Participants (n = 18) reported statistically significant improvements on the severity of PTSD symptoms and many participants also had clini...
Biomechanical Factors That Influence the Bone-Implant-Interface
Mohamed Darwish Elsayed
Article Type: Original Article | First Published: June 26, 2019
Osseointegration or osteointegration refers to a direct bone-to-metal interface without interposition of non-bone tissue. This concept has been described by Branemark, as consisting of a highly-differentiated tissue making "a direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant. Through his initial observations on osseointegration, Branemark showed that titanium implants could become permanently incorporated within bone that is, the living bone could become so fused with the titanium oxide layer of the implant that the two could no...
Effect of Vitamin D on Novel Ventricular Repolarization Indices
Article Type: Research Article | First Published: July 19, 2019
Vitamin D deficiency may be the underlying cause of most health issues and diseases. There are few studies investigating the effect of low vitamin D levels on the cardiac arrhythmias. The electrocardiographic Tpeak to Tend (Tpe) interval and Tpe/QT ratio may associate with increased ventricular arrhythmias. The goal of this study was to evaluate the relationship between ventricular repolarization and vitamin D levels in apparently healthy individuals by using Tpe interval, Tpe/QT ratio and Tpe/corrected QT (cQT)....
Effect of the Peripheral Trpm8 Ion Channel Activation on the Cardiovascular Parameters
TV Kozyreva, VP Kozaruk and ES Meyta
Article Type: Research Article | First Published: July 06, 2019
The role of TRP ion channels in the physiological processes is far from clear. In this work we studied the effect of the activation of the peripheral TRPM8 ion channel by its agonist menthol on the cardiovascular parameters in normotensive and hypertensive rats when animals were coming out of anesthesia. The role of the TRPM8 ion channel in the regulation of blood pressure was clearly seen in normotensive animals: Activation of this channel by application of 1% menthol (agonist of TRPM8 ion channel) to skin significantly accelerated the increase in blood pressure and recovery of heart rate whe...
Multidirectional Spontaneous Migration of Intracranial Bullet: A Case Report and Literature Review
Matías Negrotto, MD, Ramon Figueroa, MD and Katherine Sotomayor, MD
Article Type: Case Report | First Published: June 26, 2019
Although gunshot injury to the head is usually mortal, survivors frequently show retained metal shrapnel or full bullet intracranially. An important though uncommon complication of retained bullet is that of spontaneous migration. A migrating intracranial bullet is a dilemma to neurosurgeons, as its management is challenging, since the removal of a deep-seated bullet may cause additional neurological deficit. Migration of a retained bullet may cause damage to vital structures and cranial nerves, producing significant neurological damage. ...