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  1. Article ; Online: Effects of Blood Flow Restriction on Balance Performance During Dynamic Balance Exercises in Individuals With Chronic Ankle Instability.

    Clark, Krista / Trickett, Justin / Donovan, Luke / Dawson, Jordan / Goetschius, John

    Journal of sport rehabilitation

    2024  Volume 33, Issue 3, Page(s) 181–188

    Abstract: Context: Blood flow restriction (BFR) is a rehabilitation tool which may introduce a constraint, similar to muscle fatigue, that challenge patients' sensorimotor system during balance exercises. The purpose of our study was to examine whether adding BFR ...

    Abstract Context: Blood flow restriction (BFR) is a rehabilitation tool which may introduce a constraint, similar to muscle fatigue, that challenge patients' sensorimotor system during balance exercises. The purpose of our study was to examine whether adding BFR to dynamic balance exercises produced a decrease in balance performance and an increase in ratings of perceived exertion and instability in individuals with chronic ankle instability (CAI) compared with dynamic balance exercises without BFR.
    Designs: Crossover design.
    Methods: Our sample included N = 25 young adults with a history of CAI. Participants completed 2 laboratory visits. At each visit, participants completed 4 sets (30×-15×-15×-15×) of dynamic balance exercises, performed similar to the modified star excursion balance test (SEBT), once with BFR and once with control (no BFR) conditions. We measured composite SEBT scores at baseline and during the final repetitions of each set of balance exercise (sets 1-4). We also measured ratings of perceived exertion and instability following each balance exercise set.
    Results: We observed no difference in composite SEBT scores between conditions at baseline; however, composite SEBT scores were significantly lower during all balance exercises sets 1 to 4 with the BFR condition compared with control. During the BFR condition, composite SEBT scores were significantly lower during all balance exercise sets compared with baseline. During the control condition, composite SEBT scores did not significantly change between baseline and each balance exercise set. Ratings of perceived exertion and instability scores were significantly greater in the BFR group compared with the control group during all balance exercise sets.
    Conclusions: Individuals with CAI demonstrated lower composite SEBT scores and greater perceived instability and exertion during dynamic balance exercise with BFR compared to without BFR. BFR introduced a novel muscle fatigue constraint during dynamic balance exercises in individuals with CAI. Additional research is needed to determine if adding BFR to balance training could improve clinical outcomes in CAI patients.
    MeSH term(s) Young Adult ; Humans ; Ankle ; Exercise Therapy ; Exercise ; Joint Instability ; Muscle Fatigue
    Language English
    Publishing date 2024-02-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1106769-x
    ISSN 1543-3072 ; 1056-6716
    ISSN (online) 1543-3072
    ISSN 1056-6716
    DOI 10.1123/jsr.2023-0182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Use of Valproic Acid for the Management of Delirium and Agitation in the Intensive Care Unit.

    Swayngim, Rebecca / Preslaski, Candice / Dawson, Jordan

    Journal of pharmacy practice

    2022  Volume 37, Issue 1, Page(s) 118–122

    Abstract: Purpose: ...

    Abstract Purpose:
    MeSH term(s) Humans ; Hypnotics and Sedatives/therapeutic use ; Valproic Acid/therapeutic use ; Retrospective Studies ; Delirium/drug therapy ; Intensive Care Units ; Respiration, Artificial ; Psychomotor Agitation/diagnosis ; Psychomotor Agitation/drug therapy
    Chemical Substances Hypnotics and Sedatives ; Valproic Acid (614OI1Z5WI)
    Language English
    Publishing date 2022-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1027474-1
    ISSN 1531-1937 ; 0897-1900
    ISSN (online) 1531-1937
    ISSN 0897-1900
    DOI 10.1177/08971900221128636
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Empirical antimicrobial prescribing for pyelonephritis in patients discharged from 15 US Emergency Departments: an opportunity for improvement.

    Rech, Megan A / Faine, Brett A / Gross, Alan E / Vakkalanka, Priyanka / Brown, Caitlin S / Harding, Stephanie J / Slocum, Giles / Zimmerman, David / Zepeski, Anne / Rewitzer, Stacey / Howington, Gavin T / Campbell, Matt / Dawson, Jordan / Treu, Cierra N / Nelson, Lucas / Jones, Mandy / Flack, Tara / Porter, Blake / Sarangarm, Preeyaporn /
    Mattson, Alicia E / Bailey, Abby / Kelly, Gregory / Talan, David A

    The Journal of antimicrobial chemotherapy

    2024  Volume 79, Issue 5, Page(s) 1038–1044

    Abstract: Background: Urinary tract infections (UTIs) are commonly treated in the emergency department (ED), and unfortunately, resistance to first-line agents is increasing.: Objectives: To characterize treatment of pyelonephritis in a nationally ... ...

    Abstract Background: Urinary tract infections (UTIs) are commonly treated in the emergency department (ED), and unfortunately, resistance to first-line agents is increasing.
    Objectives: To characterize treatment of pyelonephritis in a nationally representative sample of ED patients and to identify patient- and treatment-specific factors associated with receiving initial inactive antibiotics.
    Methods: We conducted a multicentre, observational cohort study utilizing the Emergency Medicine PHARMacotherapy Research NETwork (EMPHARM-NET), comprising 15 geographically diverse US EDs. All patients ≥18 years of age with a diagnosis of pyelonephritis between 2018 and 2020 were included. The primary endpoint was the proportion of patients who received initial inactive empirical antibiotic therapy and to identify predictive factors of inactive antibiotic therapy.
    Results: Of the 3714 patients evaluated, 223 had culture-positive pyelonephritis. Median patient age was 50.1 years and patients were mostly female (78.3%). Overall, 40.4% of patients received an IV antibiotic, most commonly ceftriaxone (86.7%). The most frequently prescribed antibiotics were cefalexin (31.8%), ciprofloxacin (14.3%), cefdinir (13.5%) and trimethoprim/sulfamethoxazole (12.6%). Overall, 10.3% of patients received initial inactive therapy. After adjustment in a multivariable analysis, long-acting IV antibiotic was predictive of inactive therapy (OR 0.23, 95% CI 0.07-0.83).
    Conclusions: In our prospective, multicentre observational study, we found that only 40.4% of patients with pyelonephritis received empirical IV antibiotics in the ED, contributing to inactive therapy. Receipt of long-acting IV antibiotics was independently associated with a decreased rate of initial inactive therapy. This reinforces guideline recommendations to administer long-acting IV antibiotics empirically in the ED upon suspicion of pyelonephritis.
    MeSH term(s) Humans ; Pyelonephritis/drug therapy ; Pyelonephritis/microbiology ; Female ; Male ; Emergency Service, Hospital/statistics & numerical data ; Middle Aged ; Anti-Bacterial Agents/therapeutic use ; Adult ; United States ; Aged ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/microbiology ; Patient Discharge ; Cohort Studies ; Practice Patterns, Physicians'/statistics & numerical data
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2024-03-13
    Publishing country England
    Document type Journal Article ; Observational Study ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkae070
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: High prevalence of fluoroquinolone-resistant UTI among US emergency department patients diagnosed with urinary tract infection, 2018-2020.

    Faine, Brett A / Rech, Megan A / Vakkalanka, Priyanka / Gross, Alan / Brown, Caitlin / Harding, Stephanie J / Slocum, Giles / Zimmerman, David / Zepeski, Anne / Rewitzer, Stacey / Howington, Gavin T / Campbell, Matt / Dawson, Jordan / Treu, Cierra N / Nelson, Lucas / Jones, Mandy / Flack, Tara / Porter, Blake / Sarangarm, Preeyaporn /
    Mattson, Alicia E / Bailey, Abby / Kelly, Gregory / Talan, David A

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2022  Volume 29, Issue 9, Page(s) 1096–1105

    Abstract: Background: Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim ... ...

    Abstract Background: Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim of our study was to determine the prevalence of FQR from a geographically diverse sample of United States emergency departments (EDs).
    Methods: We conducted a multi-center, observational cohort study using a network of 15 geographically diverse US EDs. All patients ≥18 years of age with the primary or secondary diagnosis of urinary tract infection (UTI) in the ED identified using International Classification of Diseases (ICD-10) diagnosis code of cystitis, pyelonephritis, or UTI from 2018 to 2020 were included. We calculated descriptive statistics for uropathogens and susceptibilities. Logistic regression analysis was used to identify antimicrobial resistance risk factors associated with FQR Escherichia coli.
    Results: Among 3779 patients who met inclusion criteria, median age was 62.9 years (interquartile range [IQR]: 41-77.6) and 76.3% were female. The most common diagnoses were complicated (41.2%) and uncomplicated cystitis (40.3%). E. coli was the most common pathogen (63.2%), followed by Klebsiella pneumoniae (13.2%) and Enterococcus species (5.8%). Across all sites, overall E. coli FQ-resistance prevalence was 22.1%, ranging from 10.5 to 29.7% by site. The prevalence of ESBL-producing uropathogen was 7.4%, ranging from 3.6% to 11.6% by site. Previous IV or oral antimicrobial use in the past 90-days and history of a multi-drug resistant pathogen were associated with FQ-resistant E. coli (odds ratio [OR] 2.68, 95% confidence interval [CI]: 2.04-3.51, and OR 6.93, 95% CI: 4.95-9.70, respectively). Of the patients who had FQ-resistant E. coli or an ESBL-producing uropathogen isolated, 116 (37.1%) and 61 (36.7%) did not have any documented risk factors for resistance.
    Conclusion: FQ-resistant E. coli is widely prevalent across US sites highlighting the need for ongoing monitoring of antimicrobial resistance and, at some locations, modification of empirical treatments.
    MeSH term(s) Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/therapeutic use ; Cystitis/diagnosis ; Cystitis/drug therapy ; Cystitis/epidemiology ; Drug Resistance, Bacterial ; Emergency Service, Hospital ; Escherichia coli ; Female ; Fluoroquinolones/therapeutic use ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prevalence ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/epidemiology ; beta-Lactamases/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Anti-Infective Agents ; Fluoroquinolones ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2022-08-05
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14545
    Database MEDical Literature Analysis and Retrieval System OnLINE

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