The Etiology of Severe Acute Gastroenteritis Among Adults Visiting Emergency Departments in the United States

Noroviruses are highly diverse viruses that are the major viral cause of acute gastroenteritis in humans. Although these viruses can infect multiple mammalian species, their potential for zoonosis is not well understood, especially within Genogroup IV (GIV), which contains viruses that infect humans, canines, and felines. The study of GIV viruses has been, in part, hindered by the limited number of complete genomes. Here, we developed a full-genome amplicon-based platform that facilitated the sequencing of canine noroviruses circulating in the United States. Eight novel nearly full-length canine norovirus genomes and two nearly complete VP1 sequences, including four GIV.2, three GVI.1, and three GVI.2 viruses, were successfully obtained. Only animal strains exhibited GVI/GIV chimeric viruses, demonstrating restrictions in norovirus recombination. Using genomic, phylogenetic, and structural analyses, we show that differences within the major capsid protein and the non-structural proteins of GIV and GVI noroviruses could potentially limit cross-species transmission between humans, canines, and felines.

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Feel the Burn! Fireworks-related Otolaryngologic Trauma

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211008100 ◽

2021 ◽

pp. 000348942110081

Author(s):

Alexander J. Straughan ◽

Luke J. Pasick ◽

Vrinda Gupta ◽

Daniel A. Benito ◽

Joseph F. Goodman ◽

...

Keyword(s):

United States ◽

Head And Neck ◽

Emergency Departments ◽

Closed Head Injury ◽

Penetrating Trauma ◽

The United States ◽

Neck Injuries ◽

Chi Square ◽

Injury Surveillance System ◽

Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

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Epidemiology of Racket and Paddle Sports-Related Injuries Treated in the United States Emergency Departments, 2007-2016

The Physician and Sportsmedicine ◽

10.1080/00913847.2021.1892467 ◽

2021 ◽

Author(s):

Bradley Changstrom ◽

Andrew McBride ◽

Morteza Khodaee

Keyword(s):

United States ◽

Emergency Departments ◽

The United States

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Epidemiology of Isolated Versus Nonisolated Mild Traumatic Brain Injury Treated in Emergency Departments in the United States, 2006-2012

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000260 ◽

2017 ◽

Vol 32 (4) ◽

pp. E37-E46 ◽

Cited By ~ 27

Author(s):

Carol Cancelliere ◽

Victor G. Coronado ◽

Christopher A. Taylor ◽

Likang Xu

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Emergency Departments ◽

The United States

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Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

International Journal of Health Services ◽

10.1177/0020731417734498 ◽

2017 ◽

Vol 48 (2) ◽

pp. 267-288 ◽

Cited By ~ 30

Author(s):

David Marcozzi ◽

Brendan Carr ◽

Aisha Liferidge ◽

Nicole Baehr ◽

Brian Browne

Keyword(s):

United States ◽

Health Care ◽

Medical Care ◽

Emergency Departments ◽

The United States ◽

National Hospital ◽

Patient Centered ◽

National Hospital Discharge Survey ◽

Delivery Of Care ◽

The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

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