Journal of Medicine, Surgery, and Public Health最新文献

{"title":"Symptom science and post-COVID-19 conditions","authors":"Samantha A. Cintron ,&nbsp;Stuart Hitchcock ,&nbsp;Qiuhua Shen ,&nbsp;Lalon Kasuske ,&nbsp;Frances M. Yang ,&nbsp;Janet Pierce","doi":"10.1016/j.glmedi.2024.100092","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100092","url":null,"abstract":"<div><p>The prolonged symptoms and health problems that occur after acute coronavirus disease 2019 (COVID-19) are called post-COVID-19 conditions. Studies have reported different symptoms of post-COVID-19 conditions based on the person’s exposure to the type of severe acute respiratory syndrome coronavirus (SARS-CoV-2) variant. While limited interventions are currently available, clinicians can use the Symptom Science Model (SSM) 2.0 to investigate symptoms and treatments in individuals suffering from post-COVID-19 conditions. In this commentary, we will discuss post-COVID-19 conditions using the original National Institutes of Health (NIH) Symptom Science Model (SSM) and the expanded SSM 2.0. Studying post-COVID-19 conditions using the four-step investigative sequence (complex symptoms, phenotype, biobehavioral factors, and clinical applications) provides a comprehensive understanding of disease to develop personalized and precise interventions. The revised model includes social determinants of health, patient-centered experience, and policy and population health components that provide a more holistic approach to examining symptoms and symptom clusters. Post-COVID-19 conditions should be studied using the inclusive approach of the SSM 2.0 to better understand the complex symptoms, phenotypic presentation, and biobehavioral factors and develop new treatments to reduce symptom burden. More than 4 years into the COVID-19 pandemic, millions of individuals worldwide still suffer from post-COVID-19 conditions. Thus, more investigations are needed to understand this infection-associated chronic illness and provide potential interventions to improve public health and quality of life.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000458/pdfft?md5=8e8cbb7493d8c99d7dcbacb0d8cdc6a7&pid=1-s2.0-S2949916X24000458-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diminished returns of educational attainment on life satisfaction among Black and Latino older adults transitioning into retirement","authors":"Shervin Assari","doi":"10.1016/j.glmedi.2024.100091","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100091","url":null,"abstract":"<div><h3>Background</h3><p>This paper investigates the intricate relationship between race/ethnicity, educational attainment, and life satisfaction among middle-aged and older adults in the United States. Guided by the theory of Minorities' Diminished Returns (MDRs), positing that returns on educational attainment are attenuated for minoritized populations, this study aims to explore racial/ethnic disparities in the impact of educational attainment on the life satisfaction of middle-aged and older adults.</p></div><div><h3>Methods</h3><p>This was a secondary analysis of existing data. Utilizing data from the Health and Retirement Study (HRS), we employed a longitudinal design with a nationally representative sample of middle-aged and older adults in the United States. Key variables of interest included educational attainment, race/ethnicity, and average life satisfaction from wave 9–15 (20–30 years later). Statistical analysis included regression models to assess the associations between educational attainment and life satisfaction overall and by race and ethnicity.</p></div><div><h3>Results</h3><p>Overall, 5274 participants entered our analysis and were followed for up to 30 years. Our initial findings revealed a positive association between educational attainment and life satisfaction. Subsequently, we identified significant interactions between race/ethnicity and educational attainment, indicating notable racial and ethnic differences in the impact of educational attainment on life satisfaction. The effects of baseline on future educational attainment and life satisfaction were weaker for Black and Latino than non-Latino White counterparts.</p></div><div><h3>Conclusions</h3><p>In accordance with the Minorities' Diminished Returns theory, Black and Latino middle-aged and older adults experience a less pronounced positive impact of educational attainment on life satisfaction compared to their Non-Latino and White counterparts. There are non-additive complex interplay between educational attainment and race and ethnicity on subjective well-being of middle-aged and older adults. The identified disparities in the returns of educational attainment underscore the critical need to recognize and address structural barriers that contribute to the diminished returns of educational attainment for Black and Latino populations.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000446/pdfft?md5=2325f2adf118ea0060f6a0262315d478&pid=1-s2.0-S2949916X24000446-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and psychosocial correlates of hope among youth","authors":"Shervin Assari ,&nbsp;Babak Najand ,&nbsp;Izadrad Najand ,&nbsp;Stephen Grace","doi":"10.1016/j.glmedi.2024.100088","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100088","url":null,"abstract":"<div><h3>Introduction</h3><p>Hope plays a crucial role in the well-being of youth, impacting various aspects of their lives. However, less is known about the role of hope in pre-adolescents. This study aims to explore the psychosocial and behavioral correlates of hope in 9–10-year-old pre-youth transitioning into adolescence.</p></div><div><h3>Methods</h3><p>Using data from the Adolescent Brain Cognitive Development (ABCD) study, 4631 youth entered our study. The investigation follows these individuals for up to 36 months, specifically observing the initiation of marijuana and tobacco use. The methods employed include bivariate correlations.</p></div><div><h3>Results</h3><p>Baseline high hope offered protection against marijuana and tobacco use over the following 36 months. Elevated levels of hope could be seen in pre-youth with higher family income and those experienced lower levels of stressful life events and financial difficulties. High hope was also linked to lower behavioral problems, improved emotional function, lower impulsivity, lower sensation seeking, and higher cognitive function. Notably, hope was not correlated with parental education, neighborhood income, family conflict, blood pressure, body mass index, grade point average, prosocial behaviors, or puberty.</p></div><div><h3>Conclusion</h3><p>In conclusion, the findings suggest a close interplay between hope and various dimensions of resilience including lower tobacco and marijuana use. Higher levels of hope, influenced by factors such as family income and life events, may be a mechanism that connects hope to enhanced emotional and cognitive functioning and acts as a protective factor against early initiation of substance use. These findings underscore the potential utility of fostering hope as a strategy to promote positive development and reduce tobacco and marijuana use.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000410/pdfft?md5=678fdb5254d927f00ddaa9f2e3127972&pid=1-s2.0-S2949916X24000410-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The link between residential stability and youth substance use: Role of stressful life events and behavioral problems","authors":"Shervin Assari ,&nbsp;Babak Najand ,&nbsp;Hossein Zare","doi":"10.1016/j.glmedi.2024.100084","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100084","url":null,"abstract":"<div><h3>Introduction</h3><p>Residential stability is increasingly recognized as a significant factor influencing youth positive development. While the existing body of research provides valuable insights, gaps remain regarding the determinants of residential stability and how its outcomes may vary by gender and race. This study aims to investigate the relationship between residential stability, substance use, and behavioral issues among children aged 9–10 years, with a focus on the mediating role of trauma exposure.</p></div><div><h3>Methods</h3><p>This research utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal project initiated in 2016 with a sample of 11,849 participants. It explores the links between residential stability, socioeconomic factors, stress, and emotional and behavioral outcomes using the Child Behavior Checklist (CBCL). Structural equation modeling was employed to analyze the data.</p></div><div><h3>Results findings</h3><p>indicate that higher household income, living in a household with married parents, and residing in areas with greater household incomes correlate with residential stability. In turn, residential stability is linked to lower levels of life stress and reduced substance use in the future. Furthermore, the impact of residential stability on substance uses and CBCL scores was entirely mediated by trauma exposure.</p></div><div><h3>Conclusions</h3><p>The findings advocate for the implementation of economic, social, and public policies aimed at fostering stable living environments for children and families to mitigate the emotional and behavioral challenges future generations may face. Enhancing socioeconomic status and supporting structures that promote married family living arrangements emerge as effective strategies to improve residential stability and the well-being of young people in the United States.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000379/pdfft?md5=e4cd833cfc452a872f7ae6c6f840f67f&pid=1-s2.0-S2949916X24000379-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140122926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn-out among practitioners managing abdominal surgical emergencies in Senegal","authors":"Abdourahmane Ndong ,&nbsp;Lebem Togtoga ,&nbsp;Mamadou Saidou Bah ,&nbsp;Pape Djibril Ndoye ,&nbsp;Jean Augustin Diegane Tine ,&nbsp;Ibrahima Konaté ,&nbsp;Khadim Niang","doi":"10.1016/j.glmedi.2024.100087","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100087","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgery represents a distinct medical specialization that necessitates direct interaction with patients and the ability to manage complications. Burn-out is defined as a syndrome arising from persistent workplace stress that has not been effectively addressed. The objective of this work was to assess the prevalence and factors associated with burn-out among practitioners managing abdominal surgical emergencies in Senegal. A descriptive and analytical cross-sectional study was conducted; the study included healthcare professionals (general practitioners, general surgeons, anesthesiologists, nurses) involved in the management of surgical emergencies across all hospitals in Senegal. A standardized assessment of perceived stress was conducted using the Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion, depersonalization, and personal accomplishment. A multiple linear regression model was used to estimate the determinants of burn-out on the three subscales. A total of 186 observations were included in the study, for a response rate of 90.7%. The majority of participants were from the capital region of Dakar (44. 6%). There were 46 women (24. 7%) and 140 men (75. 3%). The mean age was 34 years 9 ±6.7 years, with a range of 24–59 years. The majority of participants were married (71%), followed by single individuals (26. 3%), divorced (2. 2%), and widowed (0. 5%). The majority of participants were physicians (80. 6%), followed by nurses (19. 4%). The most common medical specializations were general surgery (58.7%), anesthesia and resuscitation (22. 7%), and general medicine (18. 7%). Additionally, 46% of participants were in training (residency program). The predominant motivations included passion for the profession (75.3%), patient satisfaction (69. 9%), stimulating challenges (21%), and salary considerations (11. 8%). The overall prevalence of high burn-out (at least in one dimension) was 46.2%. A multiple linear regression model showed that the risk factors contributing to high burn-out were divorce status, being in training, and being motivated by stimulating challenges, salary considerations or passion for the profession. The protective factors were a positive perception of one's salary, a favorable physical work environment, and high-quality training. This study revealed an alarming prevalence of burn-out among surgical teams dealing with abdominal emergencies in Senegal. These findings call for immediate action to ensure the well-being of surgical teams and, by extension, the quality of healthcare delivery.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000409/pdfft?md5=7b33aec927390670a315d742c5ab7dbb&pid=1-s2.0-S2949916X24000409-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140134478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PANDAS coexisting with gastrointestinal and cerebellar manifestation","authors":"Aftab Ahmed ,&nbsp;Fatima Bint Sajid ,&nbsp;Zaib Un Nisa Mughal ,&nbsp;Wajeeha Binte Sajid ,&nbsp;Abdul Haseeb","doi":"10.1016/j.glmedi.2024.100086","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100086","url":null,"abstract":"<div><p>This case report highlights a rare condition known as PANDAS (Pediatrics Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), which is characterized by sudden-onset neuropsychiatric symptoms following a streptococcal infection. The report also describes the unusual occurrence of cerebellitis, an uncommon neurological manifestation involving inflammation of the cerebellum, along with symptoms of vomiting and cerebellitis in a 9-year-old patient. The patient exhibited sudden onset of obsessive-compulsive symptoms, tics, stomach pain, and signs of intestinal blockage, which led to cerebellar dysfunction upon neurological examination. Laboratory tests confirmed a recent streptococcal infection, suggesting a diagnosis of PANDAS, while imaging studies revealed inflammation in the cerebellum and intestinal obstruction. This case presents a challenge to our understanding of the pathophysiological processes underlying PANDAS and its relationship with gastrointestinal and cerebellar symptoms. The treatment plan included immunomodulatory therapy, antibiotics, and surgical intervention for the intestinal obstruction, which led to a gradual improvement in symptoms. The report underscores the importance of considering atypical manifestations of PANDAS and adopting a multidisciplinary approach for precise diagnosis and effective management in complex situations.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000392/pdfft?md5=7d5e660a7d19d7fe33e71aea05ff13bb&pid=1-s2.0-S2949916X24000392-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140134479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifecourse correlates of self-rated health and associations with subsequent mortality: findings from the Hertfordshire Cohort Study","authors":"Roshan Rambukwella ,&nbsp;Leo D. Westbury ,&nbsp;Cyrus Cooper ,&nbsp;Nicholas C. Harvey ,&nbsp;Elaine M. Dennison","doi":"10.1016/j.glmedi.2024.100085","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100085","url":null,"abstract":"<div><h3>Background</h3><p>Poor self-rated health (SRH) has been shown to predict adverse health outcomes among older people, however these associations have traditionally only been considered at one point in the lifecourse, usually midlife or later. Here we examined lifecourse correlates of SRH in early, mid and later life, relating these to subsequent risk of mortality in a community-dwelling cohort.</p></div><div><h3>Methods</h3><p>2989 men and women from the Hertfordshire Cohort Study (HCS) were included in this study. The HCS was initially retrospective and linked contemporary health outcome data to early life data available from health ledgers but investigations from baseline (1998–2004, aged 59–73) onwards have been prospective. At baseline, participants completed an initial clinic visit, which included questionnaire assessment of SRH, reported as 'excellent', 'very good', 'good', 'fair', or 'poor'. Socioeconomic, lifestyle, mental health and demographic information was also collected. Deaths were recorded from baseline to 31/12/2018. Baseline characteristics in relation to SRH were examined using sex-stratified ordinal logistic regression; these factors were examined in relation to mortality using sex-stratified Cox regression. Statistically significant exposures were then included in sex-stratified mutually-adjusted models.</p></div><div><h3>Results</h3><p>In mutually-adjusted analysis, numerous contemporaneous correlates of poorer SRH in the seventh decade were identified and included obesity, lower physical activity, greater comorbidity and higher levels of depression among men and women. For example, odds ratios for being in a lower category of SRH were as follows: obese (BMI≥30) vs underweight/healthy (BMI&lt;25) (men 1.60 (1.21, 2.11), women 1.65 (1.25, 2.17)) and per additional system medicated (men 1.62 (1.47, 1.77), women 1.53 (1.41, 1.66)). By contrast, factors earlier in the lifecourse (early growth, age left full-time education) were not associated with SRH in late adulthood. 36% of men and 26% of women died during follow-up. Hazard ratios (95% CI) for mortality per lower category of SRH were 1.22 (1.10,1.36) among men and 1.17 (1.01,1.35) among women after adjustment for age, BMI, smoking, physical activity, diet quality, education, home ownership status, comorbidity level and depression levels, suggesting residual confounding by other unrecorded factors that are related to SRH.</p></div><div><h3>Conclusions</h3><p>Poorer SRH in the seventh decade was a risk factor for mortality. Importantly modifiable adverse health behaviours in the seventh decade, such as low physical activity, were associated with poorer SRH and later mortality after adjustment for socioeconomic factors and comorbidity level. By contrast early growth and education were not related to later SRH. These data suggest that attention to lifestyle in late midlife may be associated with better SRH and subsequent health outcomes, highlighting the value of interven","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000380/pdfft?md5=1982fcf2e137e239a5cb51cfad66ae44&pid=1-s2.0-S2949916X24000380-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral gestational gigantomastia in the third trimester","authors":"Ahmet Necati Sanli","doi":"10.1016/j.glmedi.2024.100083","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100083","url":null,"abstract":"<div><p>Gestational gigantomastia is a sudden and rapidly developing unilateral or bilateral excessive breast enlargement during pregnancy. In this case report, we aimed to present a 27-year-old female patient who presented with the complaint of unilateral breast enlargement while she was 7 months pregnant in her second pregnancy and diagnosed with gestational gigantomastia, with clinical and treatment features. Since it is very rare, it may cause difficulties for clinicians in differential diagnosis. Although clinical and examination features suggest malignant or inflammatory processes, it is easy to exclude with radiological imaging methods. Medical or surgical treatment methods should be applied before delivery, as they may cause both psychological and physical deterioration, breast pain, or life-threatening complications such as ulceration-hematoma in the breast for the patient. Malignant and inflammatory processes should be ruled out in the case of rapidly developing breast enlargement during pregnancy, and medical or surgical treatment options should be performed based on the patient's preferences and the gestational week.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000367/pdfft?md5=33ad4c17d5ae729861e6737ff2130607&pid=1-s2.0-S2949916X24000367-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140122927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A puzzling case: A unique presentation of massive heterotopic ossification on the Spleen’s outer surface","authors":"Jayeshkumar Kanani,&nbsp;Mohammed Iliyas Sheikh","doi":"10.1016/j.glmedi.2024.100080","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100080","url":null,"abstract":"<div><p>Heterotopic ossification (HO) is defined as the development of lamellar bone growth in non-osseous tissues, such as muscles and tendons around major joints such as hip, elbow, knee, and shoulder. This article explores a unique case of heterotopic ossification (HO) on the outer surface of the spleen, presenting a rare and atypical manifestation of lamellar bone growth. The patient was a 50-year-old male who died under unclear circumstances and requested a medico-legal autopsy. Surprisingly, autopsy examination revealed a substantial, massive bone-like structure firmly attached to the spleen. Further histopathological examination revealed gamma gandy bodies, fibrosis, chronic venous congestion, and medial calcific sclerosis in the blood vessels of the spleen. The cut section of the bony structure showed areas of congestion, heterotopic ossification, and patchy calcification. The absence of a history of trauma adds complexity to the case, as ossification typically manifests in skeletal tissues. These findings underscore the rarity of HO in this anatomical location and emphasize the need for further research to unravel its causes, implications, and potential therapeutic interventions. This unique presentation highlights the importance of understanding heterotopic ossification intricacies, exploring organ-specific functions, and recognizing the role of autopsies in understanding unusual medical phenomena.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000331/pdfft?md5=a8dcca17ff166416941e0d75c4832d5f&pid=1-s2.0-S2949916X24000331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140031011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketorolac vs. Fentanyl: A retrospective chart review of analgesia in the prehospital environment","authors":"Kane Darling ,&nbsp;Brandon Wilkinson ,&nbsp;Cheyenne Wong ,&nbsp;Angela MacFarlane ,&nbsp;Camille Brummett ,&nbsp;Isain Zapata","doi":"10.1016/j.glmedi.2024.100082","DOIUrl":"https://doi.org/10.1016/j.glmedi.2024.100082","url":null,"abstract":"<div><h3>Background</h3><p>With growing concerns on the worsening opioid epidemic and provider hesitation for opioid use, opioid-sparing treatment regimens are being introduced such as ketorolac administration. The primary aims of this study are to compare the safety and efficacy of ketorolac to fentanyl in the prehospital setting and to determine ketorolac's potential as a practical alternative analgesic.</p></div><div><h3>Methods</h3><p>A retrospective chart review of patient encounters obtained from a prehospital emergency medical services agency in New Mexico was conducted to evaluate the safety and efficacy of ketorolac vs. fentanyl in the prehospital setting. Primary outcomes assessed were the reported medication complications, initial pain, last pain, and pain reduction on a Numerical Rating Scale. Data was evaluated using unadjusted and adjusted (age, gender, and weight of the patient) models.</p></div><div><h3>Results</h3><p>A total of 4102 records were evaluated (3182 fentanyl cases vs. 920 ketorolac cases). No significant differences in initial, last pain or pain reduction were seen in unadjusted models and for age, gender, or weight adjusted models. However, adjusted models displayed a difference in the number of complications that occurred while all cases of medication complications occurred within the fentanyl group (64 occurrences, P&lt;0.0001). Among the complications seen, nausea and hypoxia are the most frequent with 40.6 and 29.7% of occurrences respectively).</p></div><div><h3>Conclusion</h3><p>Findings suggest that ketorolac is both effective and safe in the prehospital environment when compared to fentanyl. These findings encourage prehospital agencies to adopt opioid-sparing treatment protocols to encourage increased treatment of pain without potentiating the current opioid epidemic.</p></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"2 ","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949916X24000355/pdfft?md5=2f325625a9381393806432e639e38e1f&pid=1-s2.0-S2949916X24000355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140042198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}