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What every emergency physician should know about research: Introduction to a research primer for low- and middle-income countries

Research is the search for new, generalisable knowledge (Truth in the Universe) to improve our collective ability to correctly diagnose and treat human suffering. In the formal sense, medical research implies both creating new knowledge, and also…

Tags: 2020, African Journal Of Emergency Medicine, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, emergency medicine research, Introduction, January 2021 List, journalArticle, Low budget, NEOMED College of Medicine, Overview, Simon EL, Stassen W, Totten V

Throws of Death: Traumatic Coronary Artery Dissection Resulting From Jiu Jitsu Training

BACKGROUND: The risk of cardiac injury in blunt thoracic trauma is quite rare, occurring in only 0.1% of patients. The least common cardiac injury is coronary artery dissection. Most cardiac injuries result from high-energy mechanisms such as motor…

THE OHIO & KENTUCKY ASMBS STATE CHAPTER: Building on Past History and Recent Success.

Tags: 2019, Bariatric Surgery, Bariatric Times, Cleveland Clinic Akron General Hospital, Daigle Christopher, Dan Adrian G, Department of General Surgery, Journal Article, KENTUCKY, NEOMED College of Medicine, NON-insulin-dependent diabetes, November 2019 Update, Ohio, Summa Health Sy stem Akron City Hospital

The impact of hospital boarding on the emergency department waiting room.

BACKGROUND: Patient boarding in the emergency department (ED) is a significant issue leading to increased morbidity/mortality, longer lengths of stay, and higher hospital costs. We examined the impact of boarding patients on the ED waiting room. …

The impact of covid-19 on suicidal ideation and alcohol presentations to emergency departments in a large healthcare system.

Tags: 2020, Behavioral health, Borden BL, Cleveland Clinic Akron General Hospital, coronavirus, COVID-19, Department of Emergency Medicine, Emergency departments, Fertel BS, journalArticle, July 2020 List, Malone DA, Meldon SW, Muir MR, NEOMED College of Medicine, Simon EL, Smalley CM, Suicidal Ideation, The American journal of emergency medicine

The corporatization of care in academic dermatology.

Concern over the corporatization of medicine has existed since the late 1800s and continues to grow today in the face of large-scale mergers, vertical integration of health care services, and private equity (PE) investment in dermatology practices.…

Tags: 2020, Cleveland Clinic Akron General Hospital, Clinics in dermatology, Department of Internal Medicine, DeWane ME, Grant-Kels JM, journalArticle, July 2020 List, Mostow E, NEOMED College of Medicine

The changing landscape of aortic valve replacement in the usa.

AIMS: The aim of this study was to analyse the real-world national data on parallel utilisation of transcatheter (TAVR) and surgical (SAVR) aortic valve replacement. METHODS AND RESULTS: We queried an all-payer, administrative United States …

The Case Files: A serious condition hiding behind nonspecific symptoms.

The Case Files: A Serious Condition Hiding Behind Nonspecific Symptoms

Tags: 2020, Brett S, Campbell J, Cleveland Clinic Akron General Hospital, December 2020 List, Department of Emergency Medicine, Drogell K, Emergency Medicine News, journalArticle, Luke W, NEOMED College of Medicine, NEOMED Student Publications, Simon EL

Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis

BACKGROUND: This systematic review provides practicing emergency physicians updated information regarding the role of oral and intravenous contrast in the computed tomography (CT) evaluation of acute appendicitis. METHODS: A PubMed literature search…

Tags: 2019, acute appendicitis, Cheng David, Childers Richard, Cleveland Clinic Akron General Hospital, Contrast, ct, Department of Emergency Medicine, January 2020 Update, Journal Article, NEOMED College of Medicine, Soucy Zachary, The Journal of emergency medicine, Vilke Gary M

Study design: A research primer for low- and middle-income countries

Study design is critical to ensure that research questions are answered in an appropriate and rational manner for all aspects of health, but particularly in emergency care. Appropriate study design selection is one of the most critical decisions to…

Tags: 2020, African Journal Of Emergency Medicine, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, Emergency Medicine, Graham CA, January 2021 List, journalArticle, Knott J, NEOMED College of Medicine, Research methods, Simon EL, Study Design

Structural heart disease: One valve does not fit all.

PURPOSE OF REVIEW: Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult…

Stability after initial decline in coronary revascularization rates in the united states.

BACKGROUND: It remains uncertain how advances in revascularization techniques, availability of new evidence, and updated guidelines have influenced the annual rates of coronary revascularization in the United States. METHODS: We used the …

Short-term and long-term outcomes of patients undergoing urgent transcatheter aortic valve replacement under a minimalist strategy.

OBJECTIVES: Urgent transcatheter aortic valve replacement (TAVR) is associated with worse short-term outcomes compared with elective TAVR; however, little is known about long-term outcomes or the safety of the minimalist strategy in this setting. …

Tags: 2019, Aged 80 and over, Aortic Valve Stenosis/diagnosis/mortality/surgery, Aortic Valve/diagnostic imaging/surgery, Attizzani GF, Bezerra HG, Cardiac Catheterization/methods, Cleveland Clinic Akron General Hospital, Costa MA, Davis A, Department of Internal Medicine, Echocardiography Transesophageal, Elective Surgical Procedures/methods, Female, Femoral Artery, Follow-Up Studies, Hospital Mortality/trends, Humans, Ichibori Y, journalArticle, June2020SubmittedList, Kalra A, Kobe D, Ladas T, Length of Stay, Li J, Lipinski J, Male, Markowitz AH, minimalist approach, NEOMED College of Medicine, Patel S, Patel T, Peters M, Retrospective Studies, Risk Factors, Saric P, severe aortic stenosis, Severity of Illness Index, The Journal of invasive cardiology, Time Factors, transcatheter aortic valve replacement, Transcatheter Aortic Valve Replacement/methods, Treatment Outcome, Tsushima T, United States/epidemiology, urgent procedure

SGLT-2 inhibitors and GLP-1 agonists: First-line therapy for diabetes with established cardiovascular disease.

There is a growing body of evidence that diabetes represents a significant and largely modifiable risk factor for cardiovascular disease (CVD). It is known to markedly increase the risk of CVD-with CVD accounting for 2 of every 3 deaths in …

Same provider, different location: Variation in patient satisfaction scores between freestanding and hospital-based emergency departments

Tags: 2020, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, Fertel Baruch, January 2020 Update, Journal Article, Muir McKinsey, NEOMED College of Medicine, Podolsky Seth R, Shakya Sunita, Simon Erin L, Smalley Courtney M, The American journal of emergency medicine

Safety and efficacy of transcatheter aortic valve replacement for native aortic valve regurgitation: A systematic review and meta-analysis.

OBJECTIVE: The objective of this study was to analyze the available literature on using transcatheter aortic valve replacement (TAVR) for native aortic regurgitation (AR). BACKGROUND: Surgical aortic valve replacement is the gold standard therapy…

Research skills and the data spreadsheet: a research primer for low- and middle-income countries

The specialty of Emergency Medicine continues to expand and mature worldwide. As a relatively new specialty, the body of research that underpins patient management in the emergency department (ED) setting needs to be expanded for optimum patient…

Tags: 2020, African Journal Of Emergency Medicine, Cleveland Clinic Akron General Hospital, Data, Department of Emergency Medicine, Hodkinson PW, January 2021 List, journalArticle, Khan AS, NEOMED College of Medicine, Research, Simon EL, Spreadsheet, Taylor DM

Renal manifestations of tuberous sclerosis complex.

Tuberous sclerosis complex (TSC) is a genetic condition caused by a mutation in either the TSC1 or TSC2 gene. Disruption of either of these genes leads to impaired production of hamartin or tuberin proteins, leading to the manifestation of skin…

Relation of concomitant heart failure to outcomes in patients hospitalized with influenza.

Influenza is a major public health challenge. Patients hospitalized with influenza who also have heart failure (HF) may be at risk for worse outcomes compared with patients without HF. There is a lack of large studies examining this issue. We …

Procedural frequency: Results from 18 academic, community and freestanding emergency departments

BackgroundEmergency physicians must maintain procedural skills, but clinical opportunities may be insufficient. We sought to determine how often practicing emergency physicians in academic, community and freestanding emergency departments (EDs)…

Prior admissions as a risk factor for readmission in patients surgically treated for femur fractures: Implications for a potential hip fracture bundle.

INTRODUCTION: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these …

Principles of research ethics: A research primer for low- and middle-income countries.

Ethical oversight in the form of review boards and research ethics committees provide protection for research subjects as well as guidance for safe conduct of studies. As the number of collaborative emergency care research studies carried out in…

Tags: 2020, African Journal of Emergency Medicine : Revue Africaine de la Medecine d'urgence, August 2020 List, autonomy, Beneficence, Bitter Cindy C, Cleveland Clinic Akron General Hospital, Consent, Department of Emergency Medicine, Ethics Committees, journalArticle, justice, NEOMED College of Medicine, Ngabirano AA, Simon E, Taylor D

Overview: The ongoing threat of antimicrobial resistance.

The effectiveness of antibiotics continues to erode because of the relentless spread of antimicrobial resistance (AMR). Public and private foundations, professional organizations, and international health agencies recognize the threat posed by AMR…

Tags: 2020, Antibiotics, Antimicrobial resistance, Bonomo RA, Cleveland Clinic Akron General Hospital, Department of Internal Medicine, Infectious disease clinics of North America, journalArticle, NEOMED College of Medicine, Public Health, September 2020 List, Watkins RR

Outcomes with drug-coated balloons in small-vessel coronary artery disease.

BACKGROUND: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. The use of drug-coated balloons (DCBs) in SVD has received limited study. OBJECTIVES: To assess the…

Tags: 2019, Abbott JD, Aged, Angioplasty Balloon Coronary/adverse effects/instrumentation/mortality, Brilakis ES, Cardiac Catheters, Cardiovascular Agents/administration & dosage/adverse effects, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Cleveland Clinic Akron General Hospital, Coated Materials Biocompatible, Coronary Artery Disease/diagnostic imaging/mortality/therapy, Coronary Restenosis/epidemiology, Department of Internal Medicine, drug-coated balloons, drug-eluting balloons, Drug-Eluting Stents, Female, Humans, journalArticle, June2020SubmittedList, Kalra A, Kohl LP, Male, Megaly M, Middle Aged, NEOMED College of Medicine, Observational Studies as Topic, Randomized Controlled Trials as Topic, Rezq A, Risk Assessment, Risk Factors, Rofael M, Saad M, Shishehbor M, small-vessel disease coronary disease, Soukas P, Treatment Outcome

Outcomes among patients with heart failure with reduced ejection fraction undergoing transcatheter aortic valve replacement: Minimally invasive strategy versus conventional strategy.

OBJECTIVES: To investigate the effect of TAVR technique on in-hospital and 30-day outcomes in patients with aortic stenosis (AS) and reduced ejection fraction (EF). BACKGROUND: Patients with AS and concomitant low EF may be at risk for adverse …

Tags: 2019, Aged, Aged 80 and over, Anesthesia, aortic stenosis, Aortic Valve Stenosis/diagnostic imaging/epidemiology/therapy, Attizzani GF, Cardiac Catheterization/methods, Cardiac Output Low/diagnostic imaging, Cleveland Clinic Akron General Hospital, Clevenger J, Cohort Studies, Conscious Sedation, Conscious Sedation/methods, Department of Internal Medicine, Echocardiography Transesophageal/methods, Female, Heart failure, Heart Failure/diagnosis/epidemiology/therapy, Hospital Mortality, Humans, journalArticle, June2020SubmittedList, Kalra A, Karim A, Length of Stay, Li J, Lipinski J, Logistic Models, Male, Minimally Invasive Surgical Procedures/methods, Multivariate Analysis, NEOMED College of Medicine, Panhwar MS, Patel SM, Patel TR, Prognosis, Reference Values, Retrospective Studies, Risk Assessment, Saric P, Severity of Illness Index, Surgery Computer-Assisted/methods, Survival Rate, The Journal of invasive cardiology, transcatheter aortic valve replacement, Transcatheter Aortic Valve Replacement/methods/mortality, Treatment Outcome, Zidar DA

Operational metrics, patient demographics, acuity, and treatment times at privately owned freestanding emergency departments

Tags: 2020, American Journal of Emergency Medicine, Augustine JJ, Cleveland Clinic Akron General Hospital, Dayton JR, December 2020 List, Department of Emergency Medicine, Department of Internal Medicine, Hallas O, Jouriles NJ, journalArticle, Marburger N, NEOMED College of Medicine, Schmitz G, Shakya S, Simon EL, Summa Health Akron City Hospital

Newly diagnosed diabetes and diabetic ketoacidosis precipitated by COVID-19 infection.

Tags: 2020, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, Griffin GD, Heaney AI, journalArticle, July 2020 List, NEOMED College of Medicine, Simon EL, The American journal of emergency medicine

Neuropsychiatric Symptoms of Multiple Sclerosis.

Meta-analysis comparing outcomes in patients undergoing transcatheter aortic valve implantation with versus without percutaneous coronary intervention.

Patients having transcatheter aortic valve implantation (TAVI) routinely undergo coronary angiography before the procedure to define the coronary anatomy and to evaluate the extend of coronary artery disease (CAD). Whether percutaneous coronary …

Meta-analysis comparing culprit vessel only versus multivessel percutaneous coronary intervention in patients with acute myocardial infarction and cardiogenic shock.

Cardiogenic shock (CS) after a myocardial infarction continues to be associated with high mortality. Whether percutaneous coronary intervention (PCI) of noninfarct coronary arteries (multivessel intervention [MVI]) improves outcomes in CS after …

Mentorship and how to conduct research: A research primer for low- and middle-income countries

Development of a successful research program can seem daunting when looked at from the starting line. It will take years if not decades to succeed and become sustainable. It requires local partnerships and mentoring; it mandates the establishment of…

Tags: 2020, African Journal Of Emergency Medicine, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, Ducharme J, Emergency Medicine, January 2021 List, Jouriles N, journalArticle, Kole T, Low income countries, Maharjan RK, Mentorship, NEOMED College of Medicine, Research, Simon EL, Summa Health Akron City Hospital

Measles

Tags: 2019, Balu Bharath, Cleveland Clinic Akron General Hospital, Department of Internal Medicine, JAMA dermatology, January 2020 Update, Journal Article, Mostow Eliot N, NEOMED College of Medicine, NEOMED College of Medicine Student, NEOMED Student Publications

Management of cardiogenic shock complicating acute myocardial infarction: A review.

Despite advances in percutaneous coronary interventions and their widespread use, mortality in patients presenting with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) has remained very high, and treatment options are…

Level of scientific evidence underlying the current American College of Cardiology/American Heart Association clinical practice guidelines.

Lefamulin: A Novel Semisynthetic Pleuromutilin Antibiotic for Community-Acquired Bacterial Pneumonia.

Community-acquired bacterial pneumonia (CABP) remains a significant cause of morbidity and mortality worldwide. Antimicrobial resistance, including in pathogens that cause CABP, continues to spread at an alarming rate. Because of these factors, the…

Tags: 2020, Antimicrobial resistance, Cleveland Clinic Akron General Hospital, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, community-acquired bacterial pneumonia, Department of Internal Medicine, File Thomas M, Journal Article, journalArticle, June 2020 Update I, lefamulin, NEOMED College of Medicine, Summa Health System Akron City Hospital, Watkins Richard R

Leadership in cardiovascular medicine.

Tags: 2019, Bhatt DL, Cleveland Clinic Akron General Hospital, Department of Internal Medicine, European Heart Journal, journalArticle, June2020SubmittedList, Kalra A, NEOMED College of Medicine, Shaikh AA

International Federation for Emergency Medicine global research primer.

Tags: 2021, African Journal of Emergency Medicine : Revue Africaine de la Medecine d'urgence, Cleveland Clinic Akron General Hospital, Department of Emergency Medicine, journalArticle, March 2021 List, NEOMED College of Medicine, Simon EL

Impact of residual coronary atherosclerosis on transfemoral transcatheter aortic valve replacement.

OBJECTIVES: This study reports on the clinical effects of complete vs incompletely revascularized coronary artery disease on transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a high prevalence of active coronary artery disease …

Tags: 2019, Aged, Aged 80 and over, Al-Kindi SG, Aortic Valve Stenosis/diagnostic imaging/mortality/physiopathology/surgery, Aortic Valve/diagnostic imaging/physiopathology/surgery, Attizzani GF, AVD - aortic valve disease, Bezerra HG, CAD - coronary artery disease, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Catheterization Peripheral/adverse effects/mortality, Cause of Death, Cleveland Clinic Akron General Hospital, Coronary Artery Disease/diagnostic imaging/mortality/therapy, Costa MA, Davis A, Department of Internal Medicine, Female, Femoral Artery, Hornick JM, Humans, Ichibori Y, journalArticle, June2020SubmittedList, Kalra A, Li Jun, Lipinski J, Makani A, Male, Markowitz AH, Nadeem F, NEOMED College of Medicine, Patel SM, Patel T, Patient Readmission, PCI - percutaneous coronary intervention (PCI), Percutaneous Coronary Intervention/adverse effects/mortality, percutaneous intervention, Punctures, Retrospective Studies, Risk Assessment, Risk Factors, Simon DI, Thakker P, Thomas R, Time Factors, Transcatheter Aortic Valve Replacement/adverse effects/mortality, Treatment Outcome

How Should Native Crotalid Envenomation Be Managed in the Emergency Department?

BACKGROUND: Pit vipers, also known as crotalids, are a group of snakes including rattlesnakes, copperheads, and cottonmouths (water moccasins). Crotalids have a broad geographic distribution across the United States, and bites from these snakes can…

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