Asaf Miller's research while affiliated with Rambam Medical Center and other places

Publications (27)

Article
Background Fever is a physiologic response to a wide range of pathologies and one of the most common complaints and clinical signs in the emergency medicine department (ED). The association between fever magnitude and clinical outcomes has been evaluated in specific populations with inconsistent results. Objectives In this study we aimed to invest...
Article
Objective Current guidelines advocate prehospital endotracheal intubation (ETI) in patients with suspected severe head injury and impaired level of consciousness. However, the ability to identify patients with traumatic brain injury (TBI) in the prehospital setting is limited and prehospital ETI carries a high complication rate. We investigated the...
Article
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Background: Liberation from mechanical ventilation is a cardinal landmark during hospitalization of ventilated patients. Decreased muscle mass and sarcopenia are associated with a high risk of extubation failure. A low level of alanine aminotransferase (ALT) is a known biomarker of sarcopenia. This study aimed to determine whether low levels of AL...
Article
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Over the past decade, changes in the diagnosis and management of Legionella pneumonia occurred and risk factors for severe infection and increased mortality were identified. Previous reports found that nosocomial infection is associated with higher mortality while others showed no differences. We aimed to evaluate the differences in the clinical co...
Article
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PurposeUnder-vehicle explosions caused by improvised explosive devices (IED) came to the public’s attention during armed conflicts. However, IEDs are also used by criminals in the civilian setting. This study aimed to determine the pattern of injury, medical management, and outcomes of civilians injured during under-vehicle explosions caused by IED...
Article
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Background: Spontaneous subarachnoid hemorrhage (SSAH) is associated with significant morbidity and mortality. Pathophysiological processes following initial bleeding are complex and not fully understood. In this study, we aimed to determine whether a low level of ionized calcium (Ca++), an essential cofactor in the coagulation cascade and other c...
Article
Acute non-variceal upper gastrointestinal bleeding (NV-UGIB) is associated with significant morbidity and mortality. Early and efficient risk stratification can facilitate management and improve outcomes. We aimed to determine whether the level of ionized calcium (Ca++), an essential co-factor in the coagulation cascade, is associated with the seve...
Article
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COVID-19 outbreak has a profound impact on almost every aspect of life. Universal masking is recommended as a means of source control. Routinely exercising in a safe environment is an important strategy for healthy living during this crisis. As sports clubs and public spaces may serve a source of viral transmission, masking may become an integral p...
Article
Background Postpartum haemorrhage (PPH) is often complicated by impaired coagulation. We aimed to determine whether the level of ionised calcium (Ca²⁺), an essential coagulation co-factor, at diagnosis of PPH is associated with bleeding severity. Methods This was a retrospective cohort study of women diagnosed with PPH during vaginal delivery betw...
Preprint
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Background: Liberation from mechanical ventilation is a cardinal landmark during hospitalization of ventilated patients in intensive care units. Sufficient respiratory muscle strength and function are essential for successful extubation; therefore, decreased muscle mass and sarcopenia are associated with a high risk of failure. A low level of alani...
Article
Full-text available
Statement: Shortage of personal protective equipment (PPE) for frontline healthcare workers managing the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a major, global challenge. In this pilot study, we describe a simulation-based method for evaluating the suitability and acceptability of an alternative biological...
Article
Castleman disease is a rare lymphoproliferative disorder presenting frequently with constitutional symptoms. Although pleural effusion is common, there is only one case report of an adult patient with chylous pleural effusion. We present the first case report of a hypervascular variant of Castleman disease presenting as a chylous pleural effusion a...
Article
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Introduction: Alternation in traditional vital signs can only be observed during advanced stages of hypovolemia and shortly before the hemodynamic collapse. However, even minimal blood loss induces a decrease in the cardiac preload which translates to a decrease in stroke volume, but these indices are not readily monitored. We aimed to determine w...
Article
Full-text available
Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. Methods: This...
Article
Introduction All modern military jet aircraft are equipped with rocket-assisted ejection systems. Jet aircraft operate in the majority of the conflict regions throughout the world, and in nearly all modern countries during peacetime. Civilian and military emergency services may be called upon to treat aircrews that have ejected and should be famili...
Article
Objectives: The objective of this study was to evaluate the emergency care provided by the Israeli Military Airborne Combat Evacuation Unit (MACEU) during helicopter winching operations. Methods: A retrospective cohort study was performed of all patients rescued by winching by the MACEU between December 2011 and October 2018. Data were extracted fr...
Article
Full-text available
Background Pain management and sedation are important aspects in the treatment of hospitalized patients, especially those mechanically ventilated. In many hospitals, such patients are treated not only in intensive care units, but also in other wards. In the nineteen eighties, numerous studies demonstrated a wide array of misconceptions and inadequa...

Citations

... Severe traumatic brain injury (STBI) is a common neurosurgical condition that is caused by direct or indirect violence to the head [1], and the Glasgow Coma Scale (GCS) stipulates that a person who is in a coma for more than 6 h or in a coma again after an injury is considered to be in severe traumatic brain injury (STBI). Severe traumatic brain injury (STBI) is a common acute and critical condition in neurosurgery [2,3]. Severe traumatic brain injury accounts for 13%-21% of craniocerebral injuries and is characterized by critical and dangerous conditions, complexity, high mortal-ity rate, and poor prognosis [4][5][6]. ...
... In all-comer intensive care units (ICU), patients' hypothermia was associated with a poorer survival [8][9][10]. However, the role of hyperthermia is still debated, as data showing a survival benefit in hyperthermic patients [9,11] are offset by data demonstrating a higher mortality in hyperthermic patients [10,12]. Therefore, the first aim of this study was to assess the prevalence and prognosis of fever in an unselected ED population. ...
... ALT is a transaminase enzyme found in the liver and muscle tissue (10), while aspartate aminotransferase (AST) is expressed in the liver, heart, skeletal muscle, etc. Generally, high ALT or AST values (>40 IU/L) are considered pathological and reflect liver damage, caused by hepatitis, etc. (11). Another study also reported that low ALT activity in the peripheral blood is a surrogate marker for low general body muscle mass and sarcopenia (12). ...
... [15][16][17] A recent study concurs with this study's findings, noting the similarities between terror-related and criminal explosions, but designating CIE as a distinctive group, based on the higher prevalence of leg amputations and ruptured intestines among criminal explosion victims, as well as much lower number of patients from the same event and greater frequency during weekends and after hours. 18 Another important insight from this study's comparison is the lack of almost any similarity between civilian intentional and unintentional explosions. A large part of this dissimilarity likely stems from a significant internal variance of the civilian unintentional group. ...
... Those outcomes resembled our discoveries. Nevertheless, our research merely selected 217 sufferers and neglected multiple vital confounding factors, such as hypertension (18) and GCS score (19). In this study, we conducted the largest cohort study (n = 1,230), utilized an extended model strategy to modify the latent confounding factors, and discovered a steady association between mean BG and in-hospital death. ...
... Hypocalcemia is a common biochemical abnormality and has been recognized as a prognostic marker of coronary heart disease, chronic kidney disease, acute myocardial infarction and gastrointestinal bleeding [10][11][12][13]. Furthermore, evidence is mounting that hypocalcemia is associated with short-term mortality after APE [14,15]. ...
... Skin presentations are uncommon in Legionnaires' disease and hard to diagnose, erythema, nodules, and blisters can be seen locally, while skin pathology lacks specificity (2, 7). Dagan et al. found that the mortality of HAP caused by Legionella is higher than CAP caused by the same pathogen, which may be attributed to the former's delayed diagnosis and treatment as was also seen in this case (8). In the present case, the nucleic acid of Legionella in peripheral blood was firstly detected by mNGS. ...
... Hypocalcemia is common in critically ill and bleeding patients (e.g. trauma patients and women with postpartum hemorrhage) [5,24,25]. Citrate toxicity may explain hypocalcemia during massive transfusion and intravenous colloids (but not crystalloid) induced hemodilution can lead to hypocalcemia [6,7,26]. Other proposed mechanisms include increased sympathetic activity, altered sensitivity, and impaired parathyroid gland function, endorgan resistance to parathyroid hormone, altered vitamin D synthesis and action, all induced by pro-inflammatory cytokines [5,27]. ...
... Wearing mask could reduce the risk of contracting contagious respiratory infections [3,4], but its direct physical effect hinders gas exchange at the same time, which might affect human motor performance under mask-on conditions, and even safety under high-intensity exercise. ...
... During the pandemic, novel solutions to visualize viral spread have used either airborne particle measurements or fluorescent particles such as GloGerm (Moab, UT) under blacklight [8][9][10][11]. However, the airborne particle measurements are not optimal in a room with substantial human movement such as during a resuscitation. ...