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  1. Article: Long-term Efficacy of Abdominal Wall Trigger Point Injections.

    Heier, Cason / Vallalar, Bharathi / Butler, Kelsey / Singaram, Chandar

    South Dakota medicine : the journal of the South Dakota State Medical Association

    2019  Volume 72, Issue 8, Page(s) 361–366

    Abstract: Introduction: We evaluated the efficacy of abdominal wall injections in 35 retrospective patients by a single physician.: Methods: Using uniform techniques to inject both Lidocaine and Depo-Medrol in patients with moderate to severe localized ... ...

    Abstract Introduction: We evaluated the efficacy of abdominal wall injections in 35 retrospective patients by a single physician.
    Methods: Using uniform techniques to inject both Lidocaine and Depo-Medrol in patients with moderate to severe localized abdominal wall pain mostly related to laparoscopic scars.
    Results: On initial follow-up at 15.2 ± 8.5 (mean ± standard deviation) days, the pain was reduced from 7.4 ± 1.5 (mean ± standard deviation) to 2.3 ± 2.3 (mean ± standard deviation) in 34 out of the 35 retrospective patients. One patient showed no response. On long-term follow up at 26.0 ± 28.5 (mean ± standard deviation) months, the pain was reduced to 1.2 ± 2.0 (mean ± standard deviation). Five of the 35 retrospective patients required more than one injection to the same site to achieve the pain control. No major complications were noted. Average cost of the abdominal wall injection was $134.72.
    Conclusion: We propose that localized abdominal wall pain should be considered for trigger point injection early on in the management.
    MeSH term(s) Abdominal Pain/drug therapy ; Abdominal Wall ; Anesthetics, Local ; Humans ; Lidocaine/therapeutic use ; Pain Management/methods ; Pain Measurement ; Retrospective Studies ; Trigger Points
    Chemical Substances Anesthetics, Local ; Lidocaine (98PI200987)
    Language English
    Publishing date 2019-08-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2278073-7
    ISSN 0038-3317
    ISSN 0038-3317
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Derivation and Internal Validation of a Mortality Prognostication Machine Learning Model in Ebola Virus Disease Based on Iterative Point-of-Care Biomarkers.

    Bearnot, Courtney J / Mbong, Eta N / Muhayangabo, Rigo F / Laghari, Razia / Butler, Kelsey / Gainey, Monique / Perera, Shiromi M / Michelow, Ian C / Tang, Oliver Y / Levine, Adam C / Colubri, Andrés / Aluisio, Adam R

    Open forum infectious diseases

    2024  Volume 11, Issue 2, Page(s) ofad689

    Abstract: Background: Although multiple prognostic models exist for Ebola virus disease mortality, few incorporate biomarkers, and none has used longitudinal point-of-care serum testing throughout Ebola treatment center care.: Methods: This retrospective study ...

    Abstract Background: Although multiple prognostic models exist for Ebola virus disease mortality, few incorporate biomarkers, and none has used longitudinal point-of-care serum testing throughout Ebola treatment center care.
    Methods: This retrospective study evaluated adult patients with Ebola virus disease during the 10th outbreak in the Democratic Republic of Congo. Ebola virus cycle threshold (Ct; based on reverse transcriptase polymerase chain reaction) and point-of-care serum biomarker values were collected throughout Ebola treatment center care. Four iterative machine learning models were created for prognosis of mortality. The base model used age and admission Ct as predictors. Ct and biomarkers from treatment days 1 and 2, days 3 and 4, and days 5 and 6 associated with mortality were iteratively added to the model to yield mortality risk estimates. Receiver operating characteristic curves for each iteration provided period-specific areas under curve with 95% CIs.
    Results: Of 310 cases positive for Ebola virus disease, mortality occurred in 46.5%. Biomarkers predictive of mortality were elevated creatinine kinase, aspartate aminotransferase, blood urea nitrogen (BUN), alanine aminotransferase, and potassium; low albumin during days 1 and 2; elevated C-reactive protein, BUN, and potassium during days 3 and 4; and elevated C-reactive protein and BUN during days 5 and 6. The area under curve substantially improved with each iteration: base model, 0.74 (95% CI, .69-.80); days 1 and 2, 0.84 (95% CI, .73-.94); days 3 and 4, 0.94 (95% CI, .88-1.0); and days 5 and 6, 0.96 (95% CI, .90-1.0).
    Conclusions: This is the first study to utilize iterative point-of-care biomarkers to derive dynamic prognostic mortality models. This novel approach demonstrates that utilizing biomarkers drastically improved prognostication up to 6 days into patient care.
    Language English
    Publishing date 2024-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofad689
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Constructing, validating, and updating machine learning models to predict survival in children with Ebola Virus Disease.

    Genisca, Alicia E / Butler, Kelsey / Gainey, Monique / Chu, Tzu-Chun / Huang, Lawrence / Mbong, Eta N / Kennedy, Stephen B / Laghari, Razia / Nganga, Fiston / Muhayangabo, Rigobert F / Vaishnav, Himanshu / Perera, Shiromi M / Adeniji, Moyinoluwa / Levine, Adam C / Michelow, Ian C / Colubri, Andrés

    PLoS neglected tropical diseases

    2022  Volume 16, Issue 10, Page(s) e0010789

    Abstract: Background: Ebola Virus Disease (EVD) causes high case fatality rates (CFRs) in young children, yet there are limited data focusing on predicting mortality in pediatric patients. Here we present machine learning-derived prognostic models to predict ... ...

    Abstract Background: Ebola Virus Disease (EVD) causes high case fatality rates (CFRs) in young children, yet there are limited data focusing on predicting mortality in pediatric patients. Here we present machine learning-derived prognostic models to predict clinical outcomes in children infected with Ebola virus.
    Methods: Using retrospective data from the Ebola Data Platform, we investigated children with EVD from the West African EVD outbreak in 2014-2016. Elastic net regularization was used to create a prognostic model for EVD mortality. In addition to external validation with data from the 2018-2020 EVD epidemic in the Democratic Republic of the Congo (DRC), we updated the model using selected serum biomarkers.
    Findings: Pediatric EVD mortality was significantly associated with younger age, lower PCR cycle threshold (Ct) values, unexplained bleeding, respiratory distress, bone/muscle pain, anorexia, dysphagia, and diarrhea. These variables were combined to develop the newly described EVD Prognosis in Children (EPiC) predictive model. The area under the receiver operating characteristic curve (AUC) for EPiC was 0.77 (95% CI: 0.74-0.81) in the West Africa derivation dataset and 0.76 (95% CI: 0.64-0.88) in the DRC validation dataset. Updating the model with peak aspartate aminotransferase (AST) or creatinine kinase (CK) measured within the first 48 hours after admission increased the AUC to 0.90 (0.77-1.00) and 0.87 (0.74-1.00), respectively.
    Conclusion: The novel EPiC prognostic model that incorporates clinical information and commonly used biochemical tests, such as AST and CK, can be used to predict mortality in children with EVD.
    MeSH term(s) Aspartate Aminotransferases ; Child ; Child, Preschool ; Creatinine ; Disease Outbreaks ; Ebolavirus ; Hemorrhagic Fever, Ebola ; Humans ; Machine Learning ; Retrospective Studies
    Chemical Substances Creatinine (AYI8EX34EU) ; Aspartate Aminotransferases (EC 2.6.1.1)
    Language English
    Publishing date 2022-10-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0010789
    Database MEDical Literature Analysis and Retrieval System OnLINE

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