Dawn of a New Era for JEMS: It's About 'Time'

Today, our industry is heavily data and technology driven, with CAD systems and EPCRs almost universally used. Emergency care practices are more dynamic than ever, with critical advances in patient care occurring more frequently than a monthly print publication can possibly allow. Because technology and the Web have advanced to a point that it is both instantaneous and reliable, we feel that we can better serve the EMS community by focusing our efforts on delivering JEMS content via our website www.JEMS.com and other digital platforms to allow for a more timely – and frequent – publication. So we’ve decided to advance with the times and discontinue printing JEMS in its traditional monthly magazine format, effective with our June 2018 issue, and use our web platform and mobile technology to get information to you sooner with our new digital approach. When I started at JEMS 23 years ago (in 1995), the Internet was in its infancy, having been introduced in 1991. It was a new phenomenon. It was clunky in its infancy and many thought it was just for national security purposes. Boy were they wrong. Back in 1995, JEMS received almost all of its articles and queries via the mail. We used to have to laboriously transfer written articles and documents to text to place in the magazine. Even though we had a Web page in the mid-1990s, it was not easy to upload documents and videos. JEMS and all of our newsletters were only available in print and it took weeks for interna...
Source: JEMS Administration and Leadership - Category: Emergency Medicine Authors: Tags: News Administration and Leadership Source Type: news

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Source: Pain - Category: Anesthesiology Tags: Commentary Source Type: research
Persistent pain after lumbar surgery (failed back surgery syndrome [FBSS]) remains a leading indication for chronic analgesia. However, no analgesics have proven efficacious for this condition. Although trials have evaluated gabapentinoids for chronic low back pain, none of these trials focused solely on FBSS. This randomized, double-blind cross-over trial evaluated the efficacy of gabapentin (1800 mg/day) for FBSS. Eligible patients had a diagnosis of FBBS, an average daily pain score of at least 4 of 10, a neuropathic pain component (indicated by the PainDetect), and reported at least half of their pain radiating in thei...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Multiple sclerosis (MS) is a neurodegenerative autoimmune disease with many known structural and functional changes in the central nervous system. A well-recognized, but poorly understood, complication of MS is chronic pain. Little is known regarding the influence of sex on the development and maintenance of MS-related pain. This is important to consider, as MS is a predominantly female disease. Using the experimental autoimmune encephalomyelitis (EAE) mouse model of MS, we demonstrate sex differences in measures of spinal cord inflammation and plasticity that accompany tactile hypersensitivity. Although we observed substa...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
The taste of sucrose is commonly used to provide pain relief in newborn humans and is innately analgesic to neonatal rodents. In adulthood, sucrose remains a strong motivator to feed, even in potentially hazardous circumstances (ie, threat of tissue damage). However, the neurobiological mechanisms of this endogenous reward–pain interaction are unclear. We have developed a simple model of sucrose drinking–induced analgesia in Sprague–Dawley rats (6-10 weeks old) and have undertaken a behavioral and pharmacological characterization using the Hargreaves' test of hind-paw thermal sensitivity. Our results reve...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
In this study, we found that in the spinal dorsal horn of diabetic neuropathic pain (DNP) rats and db/db mice, decreased SIRT1 expression was accompanied by enhanced structural synaptic plasticity. The levels of postsynaptic density protein 95 (PSD-95), growth-associated protein 43 (GAP43), and synaptophysin increased in the spinal dorsal horn of DNP rats and db/db mice and in high glucose–cultured primary spinal neurons. Upregulation of spinal SIRT1 by SIRT1 activator SRT1720 relieved pain behavior, inhibited the enhanced structural synaptic plasticity in rats and db/db mice with DNP, and decreased the levels of syn...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Oxytocin reduces primary sensory afferent excitability and produces analgesia in part through a peripheral mechanism, yet its actions on physiologically characterized, mechanically sensitive afferents in normal and neuropathic conditions are unknown. We recorded intracellularly from L4 dorsal root ganglion neurons characterized as low-threshold mechanoreceptors (LTMRs) or high-threshold mechanoreceptors (HTMRs) in female rats 1 week after L5 partial spinal nerve injury or sham control (n = 24 rats/group) before, during, and after ganglionic perfusion with oxytocin, 1 nM. Nerve injury desensitized and hyperpolarized LTMRs (...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Recent studies have made significant progress in identifying distinct populations of peripheral neurons involved in itch transmission, whereas the cellular identity of spinal interneurons that contribute to itch processing is still a debate. Combining genetic and pharmacological ablation of spinal excitatory neuronal subtypes and behavioral assays, we demonstrate that spinal somatostatin-positive (SOM+) excitatory interneurons transmit pruritic sensation. We found that the ablation of spinal SOM+/Lbx1+ (SOMLbx1) neurons caused significant attenuation of scratching responses evoked by various chemical pruritogens (chemical ...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM. Introduction Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Early diagnosis of HSFI is challenging because signs and symptoms are usually nonspecific. In neutropenic children, persistent fever, back pain extending to the shoulder, widespread muscle pain, and increased serum galactomannan levels should alert clinicians. Abdominal imaging, particularly an abdominal ultrasound, which is easy to perform and available even in most resource-limited countries, should be recommended in children with prolonged neutropenic fever, even in the absence of localizing signs and symptoms.
Source: Journal of Pediatric Hematology Oncology - Category: Hematology Tags: Original Articles Source Type: research
CONCLUSIONS: Shoulder pain may associated with obesity and we recommend the addition of weight control to the treatment of patients with shoulder pain. PMID: 31006662 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
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