University of Missouri School of Medicine

WEDNESDAY, Dec. 18, 2024 -- Community-level social determinants of health (SDOH) are associated with less use of bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and return of spontaneous circulation (ROSC) in pediatric out-of-hospital cardiac arrest (POHCA), according to a study published in the December issue of Resuscitation Plus . Mary E. Bernardin, M.D., from the University of Missouri School of Medicine in Columbia, and colleagues explored the effect of SDOH on POHCA from 2021 to 2023 using data from the National Emergency Medical Services Information System. Outcomes included bystander CPR performance, use of AED, and ROSC. Data were included for 27,137 POHCAs. The researchers found that in communities with lower levels of minority races/ethnicities, the odds of CPR performance and obtainment of ROSC were significantly higher. Compared with the poorest communities, in the wealthiest communities, the odds of bystander CPR, AED usage, and obtainment of ROSC all increased significantly. Communities with the highest educational attainment had significantly higher odds of bystander AED usage and ROSC. There was a significant decreasing trend seen in performance of bystander CPR, AED usage, and obtainment of ROSC as minority status and poverty level of the community increased and educational attainment decreased. "Better understanding of the impact of SDOH on POHCA outcomes offers the opportunity to implement public health interventions that can address health disparities and save countless lives," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

WEDNESDAY, Nov. 13, 2024 -- Patients presenting to emergency departments with opioid overdose have high rates of hepatitis C virus (HCV) infection, according to a study recently published in Cureus . John A. Swift and Julie Stilley, Ph.D., from the University of Missouri School of Medicine in Columbia, conducted a retrospective cohort study to examine the prevalence of and testing history of HIV and HCV among opioid overdose patients from three emergency departments. One hundred thirty-four encounters for 120 patients were included in the study. Forty-eight of the patients had a history of HCV testing and 54 had a history of HIV testing. The researchers found that 20 patients tested positive for HCV antibodies and one tested positive for HIV. Eight, six, and six patients had detectable HCV viral loads, undetectable HCV viral loads, and no quantitative testing, respectively. One patient had a detectable HIV viral load. Overall, 16.7 percent of both men and women had a history of a positive HCV test; compared with men, women were more likely to have ever received an HCV test (odds ratio, 2.68). Patients aged 55 to 64 years were more likely to test positive and were least likely to be untested compared with other age groups (odds ratios, 3.889 and 0.190, respectively). "There may be potential benefits in the implementation of universal opt-out testing for HCV for patients being held for observation following an opioid overdose," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

Antibiotic treatment prior to surgical repair of a pediatric elbow fracture does not reduce the risk for post-operative infection. Antibiotic treatment prior to surgical repair of a pediatric elbow fracture does not reduce the risk for post-operative infection, according to new findings from a team of researchers and surgeons from the University of Missouri School of Medicine. A humerus bone fracture near the elbow is a common injury among children who fall. The typical surgical approach for repairing pediatric elbow fractures is a procedure called closed reduction percutaneous pinning (CRPP). It involves inserting pins or wires through the skin to promote stability and healing of the bone. CRPP is a minimally invasive, safe and effective procedure, but post-operative infections can occur in a small number of cases. As a result, some physicians will pre-treat the patient with antibiotics hoping to prevent infections from occurring after surgery. In a recent randomized trial, MU researchers tested whether preoperative, preventative treatment with antibiotics resulted in lower rates of infection following CRPP. What they found was that it didn't matter whether the patient was treated with prophylactic antibiotics or not when it came to rates of post-operative infection. Sumit Gupta, MD, division chief, Pediatric Orthopaedics and associate professor of orthopaedic surgery at the School of Medicine helped lead the study, which involved 160 patients randomly assigned to either receive pre-surgical antibiotics or a placebo. His team found that the infection rate in those treated with the placebo was only 0.1% higher than in the treatment group. In both groups the infection rate was very low; only 1.2% to 1.3% respectively. "The evidence suggests there is no need for pre-surgical antibiotic treatment in these types of cases," said Gupta. "As antimicrobial resistance continues to rise, the importance of antibiotic stewardship is essential to preserving the efficacy and benefits of these lifesaving drugs." The current clinical practice guidelines developed by a joint panel from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Surgical Infection Society, and the Society for Healthcare Epidemiology of America acknowledged that the need for pre-surgical antibiotics is not well established. "The results of our study provide important data that can be used in the development of new, evidence-based guidelines to aid surgeons in their appropriate use of antibiotics," said Daniel Hoernschemeyer, MD, medical director of Pediatric Procedural Services and associate professor of clinical orthopaedic surgery at the School of Medicine. "It is increasing clear that we should only be using antibiotics to treat infections that are actually occurring." "Effect of Antibiotic Prophylaxis on Infection Rates in Pediatric Supracondylar Humerus Fractures Treated with Closed Reduction and Percutaneous Pinning: A Prospective Double-Blinded Randomized Controlled Trial" was recently published in the Journal of the American Academy of Orthopaedic Surgeons. In addition to Gupta and Hoernschemeyer, the research team from the University of Missouri included Emily Leary, PhD, director of orthopaedic biostatistics in the Department of Orthopaedic Surgery; Ennio Rizzo Esposito, MD, Rachel Phillips, MD, and Pierre-Emmanuel Schwab, MD, also of the Department of Orthopaedic Surgery.