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Drug Alcohol Depend 2018 Dec 3;194:482-486. Epub 2018 Dec 3.

Department of Academic Affairs, Baystate Medical Center, 3601 Main St., Springfield, MA 01199, United States. Electronic address:

Background: Criminal justice involved (CJS) populations with opioid use disorder (OUD) have high rates of relapse, future arrests, and death upon release. While medication for OUD (MOUD) reduces opioid relapse, concerns regarding diversion and stigma limit treatment in CJS populations. Extended release naltrexone (XR-NTX), as an opioid antagonist, may be more acceptable to CJS administrators. Read More

J Hepatol 2018 Dec 3. Epub 2018 Dec 3.

AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, Liver Intensive Care Unit, Villejuif, F-94800, France; INSERM, Unité 1193, Université Paris-Saclay, Villejuif, F-94800, France; DHU Hepatinov, Villejuif, F-94800, France.

Severe acute liver injury (sALI) is a grave complication of exertional heatstroke (EH). Liver transplantation (LT) may be a therapeutic option, but the criteria for, and timing of transplantation have not been clearly established. The aim of this study was to define the profile of patients who require transplantation in this context. Read More

PLoS One 2018 6;13(12):e0208323. Epub 2018 Dec 6.

Infectious Diseases, Prince of Wales Hospital, Sydney, NSW, Australia.

Background: Treatment as prevention approaches for HIV require optimal HIV testing strategies to reduce undiagnosed HIV infections. In most settings, HIV testing strategies still result in unacceptably high rates of missed and late diagnoses. This study aimed to identify clinical opportunities for targeted HIV testing in persons at risk to facilitate earlier HIV diagnosis in New South Wales, Australia; and to assess the duration between the diagnosis of specific conditions and HIV diagnosis. Read More

Folia Med Cracov 2018 ;58(3):83-87

Department of Internal Medicine, General Hospital of Veria, Veria, Greece.

Meckel's diverticulum represents a remnant of the proximal end of the omphalomesenteric duct, which constitutes a connection between the middle intestine and the vitelline vesicle. It is the most common congenital anomaly of the gastrointestinal tract and is found in approximately 0.3-2% of the general population. Read More

Rom J Intern Med 2018 Dec;56(4):227-232

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

The prevalence of obesity is rising, becoming a medical problem worldwide. Also GERD incidence is higher in obese patients compared with normal weight, with an increased risk of 2.5 of developing symptoms and erosive esophagitis. Read More

Rom J Intern Med 2018 Dec;56(4):265-268

National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania.

Acute promyelocytic leukemia often manifests with hemorrhagic diathesis, thrombotic events being much rarer. This is the case of a 59-year-old patient with thrombotic cerebro-vascular complications as the onset manifestation of acute promyelocytic leukemia. Read More

Acta Med Port 2018 Nov 30;31(11):612-613. Epub 2018 Nov 30.

Family Medicine. University of Toronto. Toronto. Canada.

Med J Aust 2018 Dec;209(11):509-510

Nepean Hospital, Sydney, NSW.

Cancer 2018 Dec 6. Epub 2018 Dec 6.

BC Cancer-Vancouver Centre, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Abiraterone acetate plus prednisone (AA+P), when added to androgen deprivation therapy (ADT), demonstrated significant improvements in overall survival and disease progression over dual placebos added to ADT in the LATITUDE clinical trial (NCT01715285). The objective of this study was to assess event-driven medical resource utilization (MRU) of ADT plus AA+P (ADT+AA+P) versus ADT plus dual placebos (ADT+placebos) in LATITUDE.

Methods: Event-driven MRU data from LATITUDE while patients were on treatment were used for analyses. Read More

Radiat Prot Dosimetry 2018 Dec 6. Epub 2018 Dec 6.

Physics Department, University of Pavia, Pavia, Italy.

Personal radiation shielding is likely to play an important role in the strategy for radiation protection of future manned interplanetary missions. There is potential for the successful adoption of wearable shielding devices, readily available in case of accidental exposures or used for emergency operations in low-shielded areas of the habitat, particularly in case of solar particle events (SPEs). Based on optimization of available resources, conceptual models for radiation protection spacesuits have been proposed, with elements made of different materials, and the first prototype of a water-fillable garment was designed and manufactured in the framework of the PERSEO project, funded by the Italian Space Agency, leading to the successful test of such prototype for ease of use and wearability on-board the International Space Station. Read More

J Hypertens 2018 Dec 4. Epub 2018 Dec 4.

Clinical Pharmacology Research Unit (CPRU), Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami.

Objectives: Acute severe hypertension is a common problem among inner-city ethnic minority populations. Nevertheless, the effects of currently employed treatment regimens on blood pressure have not been determined in a clinical practice setting. We determined the SBP responses to acute antihypertensive drug protocols and the 2-year natural history of patients presenting with severe hypertension. Read More

Pediatr Crit Care Med 2018 Dec;19(12):1175-1176

Division of Pediatric Critical and Emergency Care, Neonatal and Pediatric Intensive Care Unit, Verona University Hospital, Verona, Italy.

Surg Laparosc Endosc Percutan Tech 2018 Dec 4. Epub 2018 Dec 4.

Department of Surgery, Royal Derby Hospital, Uttoxeter Road, Derby, UK.

Background: The incidence of common bile duct (CBD) stones is between 10% to 18% in people undergoing cholecystectomy for gallstones. Laparoscopic exploration of the CBD is now becoming routine practice in the elective setting, however its safety and efficacy in emergencies is poorly understood.

Methods: We analyzed our results for index emergency admission laparoscopic cholecystectomy within a specialist center in the United Kingdom. Read More

Acad Med 2018 Dec 4. Epub 2018 Dec 4.

K.J. Kemper is founding director, Center for Integrative Health and Wellness and professor of pediatrics, The Ohio State University, Columbus, Ohio. H. McClafferty is director, Pediatric Integrative Medicine in Residency Program and co-director, the Fellowship in Integrative Medicine, The University of Arizona Center for Integrative Medicine, The University of Arizona College of Medicine, Tucson, Arizona. P.M. Wilson is assistant professor, Division of Emergency Medicine, Children's Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, Pennsylvania. J.R. Serwint is professor emeritus of pediatrics, Johns Hopkins University, Baltimore, Maryland. M. Batra is associate program director, Pediatric Residency Program and associate professor of pediatrics, Seattle Children's Hospital and the University of Washington in Seattle, Washington. J.D. Mahan is director, Pediatric Residency Program and professor of pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio. C.J. Schubert is professor of pediatrics, Cincinnati Children's Hospital Medical Center and The University of Cincinnati, Cincinnati, Ohio. B.B. Staples is director, Pediatric Residency Program and associate professor of pediatrics, Duke University Medical Center, Durham, North Carolina. A. Schwartz is Michael Reese Endowed Professor of Medical Education and director of research, University of Illinois College of Medicine, Chicago, Illinois, and data analyst, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network.

Purpose: Burnout symptoms are common among health professionals. Gaps remain in understanding both the stability of burnout and compassion over time and relationships among burnout, self-compassion, stress, and mindfulness in pediatric residents.

Method: The authors conducted a prospective cohort study of residents at 31 U. Read More

J Am Acad Orthop Surg 2018 Dec 4. Epub 2018 Dec 4.

From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

Background: A few investigations exist which evaluate the influence of obstructive sleep apnea (OSA) on complications after arthroscopic rotator cuff repair.

Methods: A database was queried for patients undergoing rotator cuff repair with and without OSA and further subdivided into those with and without a billing code for a continuous positive airway pressure (CPAP) device. Thirty-day and 6-month adverse events were assessed. Read More

JBI Database System Rev Implement Rep 2018 Dec 4. Epub 2018 Dec 4.

School of Nursing, University of São Paulo, São Paulo, Brazil.

Review Questions: The objective of this scoping review is to explore the existing literature on the evaluation of the quality of triage for patients of all ages and medical conditions in emergency departments (ED).The question for this review is: How is triage in ED evaluated? More specifically, we are interested in answering the following sub-questions. Read More

J Neurotrauma 2018 Dec 6. Epub 2018 Dec 6.

University of Pittsburgh, Neurosurgery , 3434 Fifth Ave , Pittsburgh, Pennsylvania, United States , PA ;

New neuroprotective therapies for severe traumatic brain injury (TBI) have not translated from pre-clinical to clinical success. Numerous explanations have been suggested in both the pre-clinical and clinical arenas. Coverage of TBI in the lay press has reinvigorated interest creating a golden age of TBI research with innovative strategies to circumvent roadblocks. Read More

Ir Med J 2018 08 13;111(7):792. Epub 2018 Aug 13.

University Hospital Galway, Ireland

Introduction A 62-year-old lady presented to The Emergency Department (ED) with one-day history of dizziness, vomiting and feeling weak. ECG showed new onset Atrial Fibrillation. Four days ago, she was referred to the Cardiology team where she underwent PCI and was discharged on Apixaban and Plavix. Read More

Ir Med J 2018 08 13;111(7):788. Epub 2018 Aug 13.

Emergency Department, Beaumont Hospital, Beaumont Rd, Dublin 9

Hospital overcrowding is evidenced by Emergency Department (ED) overcrowding. The Full Capacity Protocol (FCP) is activated to move patients to temporary extra beds placed in the inpatient wards. This research aims to establish patient preferences when waiting for a ward bed in an Irish Hospital. Read More

Ir Med J 2018 08 13;111(7):793. Epub 2018 Aug 13.

Department of Emergency Medicine, University Hospital Galway, Galway

Buckle fractures are the most common wrist fractures reported in the paediatric age group. National Institute for Clinical Excellence (NICE) recommends using a non-rigid immobilisation with no follow up for these patients and appropriate discharge advice. A telephone survey was conducted to assess the variation in practice in Irish hospitals regarding the mpediatrianagement of buckle fractures. Read More

Saudi Med J 2018 Dec;39(12):1249-1252

Department of Cardiovascular Surgery, Selcuk University, Konya, Turkey. E-mail.

A mechanical heart valve thrombosis during pregnancy is one of the most lethal conditions to experience due to its detrimental effects on both mother and fetus. Cardiac surgery during pregnancy is reserved for cases where medical treatment fails due to harmful maternal and fetal effects. A 24-year-old female in the 38th week of pregnancy was admitted to the emergency room with aggravated dyspnea, tachypnea, and palpitations. Read More

Ir Med J 2018 08 13;111(7):795. Epub 2018 Aug 13.

Department of Paediatrics, Wexford General Hospital, Ireland

Ir Med J 2018 06 7;111(6):775. Epub 2018 Jun 7.

Academic Department of Paediatrics, National University of Ireland, Galway, Ireland

Oral rehydration therapy (ORT) remains the ideal first line therapy for acute gastroenteritis (AGE). Our aim was to assess the impact of introducing an Oral Fluid Challenge (OFC) protocol on outcomes such as intravenous fluid use and documentation in our institution. A single centre study with data collected retrospectively pre-implementation (April 2015) of the OFC protocol and post implementation (April 2016). Read More

Eur J Cancer Care (Engl) 2018 Dec 5:e12974. Epub 2018 Dec 5.

Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.

Introduction: Recent worldwide advances in cancer therapies have resulted in an increased number of people receiving chemotherapy in ambulatory care settings. In Spain, emergency departments are the single point of entry to acute inpatient services and they play a pivotal role in the management of chemotherapy complications. Little research exists in patterns of emergency department utilisation by oncology patients with chemotherapy-related complications. Read More

Photodermatol Photoimmunol Photomed 2018 Dec 5. Epub 2018 Dec 5.

Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.

Solar angioedema is a rare photodermatosis, with only 11 reported patients worldwide. Patients develop facial (predominately eyelids, lips) and/or acral swelling hours after sun exposure, especially while on vacation to tropical areas. Management includes photoprotection and sun avoidance; preemptive antihistamines have been tried with minimal effect. Read More

J Cell Biochem 2018 Dec 5. Epub 2018 Dec 5.

Department of Science in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Casticin (CTC), one of the major components of Vitex rotundifolia L., has been reported to exert significant beneficial pharmacological activities and can function as an antiprolactin, anticancer, anti-inflammatory, neuroprotective, analgesic, and immunomodulatory agent. This study aimed at investigating whether the proapoptotic effects of CTC may be mediated through the abrogation of signal transducers and activators of transcription-3 (STAT3) signaling pathway in a variety of human tumor cells. Read More

J Cell Biochem 2018 Dec 5. Epub 2018 Dec 5.

Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Sustained exposure to high glucose (HG) results in dysfunction of vascular endothelial cells. Hence, diabetic patients often suffer from secondary vascular damages, such as vascular sclerosis and thrombogenesis, which may eventually cause cardiovascular problems. Thus, elucidating how HG results in vascular endothelial cell damage and finding an approach for prevention are important to prevent and treat vascular damages in diabetic patients. Read More

Acta Anaesthesiol Scand 2018 Dec 6. Epub 2018 Dec 6.

Department of Anesthesia, Section 4231, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Background: Supplemental oxygen is recommended during the initial treatment of trauma patients according to several guidelines, but the supporting evidence is sparse. We aimed to describe the use of supplemental oxygen and occurrence of hyperoxemia in the initial phase of trauma management at two level 1 trauma centers, TC1 and TC2.

Methods: In this prospective, observational study we included trauma patients ≥16 years of age. Read More

Endocrine 2018 Dec 5. Epub 2018 Dec 5.

Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland.

Background: Italian consensus for the classification and reporting of thyroid cytology has proposed to discriminate the cancer prevalence of high (Tir 3B) vs. low (Tir 3A) risk indeterminate nodules. To obtain more robust evidence on this topic, we performed a meta-analysis of the Odds Ratio (OR) of malignancy of Tir 3B vs. Read More

J Clin Monit Comput 2018 Dec 5. Epub 2018 Dec 5.

Laboratory of Pharmacometrics, Centre for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.

Recently introduced Mindray "3-directional" neuromuscular transmission transducer (NMT, Shenzhen, China) acceleromyograph) claim to monitor thumb movement in 3 different directions. We compared NMT with the gold standard Relaxometer® mechanomyograph (MMG, Groningen University, Netherlands) in Study-1 and with TOF-Watch SX™ (WTCH) acceleromyograph from which it was developed in Study-2. We used first twitch (T%) and train-of-four (TOF) ratio rocuronium 0. Read More

J Gen Intern Med 2018 Dec 5. Epub 2018 Dec 5.

Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.

Background: Michigan expanded Medicaid under the Affordable Care Act (Healthy Michigan Plan [HMP]) to improve the health of low-income residents and the state's economy.

Objective: To understand HMP's impact on enrollees' health, ability to work, and ability to seek employment DESIGN: Mixed methods study, including 67 qualitative interviews and 4090 computer-assisted telephone surveys (response rate 53.7%) PARTICIPANTS: Non-elderly adult HMP enrollees MAIN MEASURES: Changes in health status, ability to work, and ability to seek employment KEY RESULTS: Half (47. Read More

World J Urol 2018 Dec 5. Epub 2018 Dec 5.

Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.

Background: Cancer-related fatigue (CRF) is a complex condition that is reported in > 50% of cancer patients. In men with castration-resistant prostate cancer (CRPC), CRF was reported in 12-21% of patients. Approved systemic therapy against CRPC is commonly administered in combination with androgen-deprivation treatment (ADT) and, in some cases, with daily, low-dose corticosteroids. Read More

Ann Hematol 2018 Dec 5. Epub 2018 Dec 5.

Department of Basic Medical Sciences, Neurosciences, and Sensory Organs, University of Bari Medical School, Piazza Giulio Cesare, 11, 70124, Bari, Italy.

Hematopoietic stem cell transplantation (HSCT) recipients have been reported to have an increased risk of chronic graft versus host disease (cGVHD) and hematological and solid cancers. Oral manifestations are the first signs of cGVHD observed in the majority of patients, and oropharyngeal cancer is the most frequent secondary malignancy occurred after HSCT. In this study, we have evaluated the inflammatory infiltrate cell content and correlated with the vascular density in patients affected by primary oral squamous cell carcinoma (OSCC) from previous healthy controls and OSCC after cGVHD. Read More

Open Med (Wars) 2018 19;13:551-555. Epub 2018 Nov 19.

Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo Japan.

Many reports focus on the probability of intracranial hemorrhage as a complication after recombinant tissue plasminogen activator (rt-PA) therapy. However, thromboembolic complications are not well discussed. We experienced a case in which severe thromboembolic complications occurred in the right radial and right ulnar artery. Read More

Cureus 2018 Sep 28;10(9):e3381. Epub 2018 Sep 28.

Department of Internal Medicine, Hospital Teodoro Maldonado Carbo / Universidad Catolica De Santiago De Guayaquil, Guayaquil, ECU.

Chordomas are rare, slow-growing, and locally aggressive malignant neoplasms derived from primitive notochord remnants. The chondroid variety represents 14% of all chordomas mainly developing in the spheno-occipital region and presenting between the third and fifth decades of life. When developing intracranially, symptoms can range from headaches and neck pain to cranial nerve neuropathies and facial numbness. Read More

Ann Med Surg (Lond) 2018 Dec 13;36:231-234. Epub 2018 Nov 13.

Department of Surgery, University Hospital Hairmyres, NHS Lanarkshire, East Kilbride, G75 8RG, Scotland, UK.

Introduction: Unexplained lactic acidosis (LA) in a critically ill patient often prompts investigations to rule out any reversible intra-abdominal cause. Equivocal results can lead to an emergency laparotomy (EL) with subsequent high morbidity and mortality rates. Our objective was to determine the clinical impact of urgent diagnostic laparoscopy (UDL) in such patients. Read More

Antimicrob Resist Infect Control 2018 29;7:148. Epub 2018 Nov 29.

3Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON Canada.

Background: Surgically-managed fractures, particularly open fractures, are associated with high rates of surgical site infections (SSIs). To reduce the risk of an SSI, orthopaedic surgeons routinely clean open fracture wounds in the emergency department (ED) and then apply a bandage to the open wound. Prior to the surgical incision, it is standard practice to prepare the fracture region with an antiseptic skin solution as an additional SSI prevention strategy. Read More

J Cancer 2018 20;9(22):4250-4254. Epub 2018 Oct 20.

Division of Urology, European Institute of Oncology, Milan, Italy.

The aim of this multi-institutional study was to identify predictors of residual high-grade (HG) disease at re-transurethral resection (reTUR) in a large cohort of primary T1 HG/Grade 3 (G3) bladder cancer patients. A total of 1155 patients with primary T1 HG/G3 bladder cancer from 13 academic institutions that underwent a reTUR within 6 weeks after first TUR were evaluated. Logistic regression analysis was performed to assess the association of predictive factors with residual HG at reTUR. Read More

World J Emerg Surg 2018 29;13:56. Epub 2018 Nov 29.

Division of Trauma and Surgical Critical Care, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558 Japan.

Background: The outcomes of multiple injury patients with concomitant torso hemorrhage and traumatic brain injury (TBI) are very poor. The hybrid emergency room system (HERS) is a trauma management system designed to complete resuscitation, computed tomography (CT), surgery, angioembolization, and intracranial pressure (ICP) monitoring all in one trauma resuscitation room without patient transfer. We aimed to review the outcomes of polytrauma patients who underwent concurrent bleeding control and ICP monitoring using the HERS. Read More

Open Access Emerg Med 2018 8;10:177-182. Epub 2018 Nov 8.

ENT Unit, Department of Surgery, Frankston Hospital. Peninsula Health, Frankston 3199, VIC, Australia,

Background: Managing patients with aural foreign body (AFB) may pose a dilemma regarding which removal technique to use for different AFB types. The current study comprises a review of all the possible methods one could employ in removing AFB. My aim was to describe the best methods for different types of AFBs, complete with a description of the method and tool(s) required, and descriptions of the AFBs for which they are best used. Read More

Int Med Case Rep J 2018 12;11:313-318. Epub 2018 Nov 12.

Department of Infectious Diseases, Regional Hospital of Bellinzona e Valli, 6500 Bellinzona, Ticino, Switzerland.

Tularemia is a zoonosis caused by the infection of (a gram-negative aerobic bacterium). Transmission to other animals or humans usually occurs through insect or tick bites, direct contact with a contaminated environment (mud or water), infected animals - mainly lagomorphs - or by ingesting undercooked meat or inhaling contaminated dust (hay or soil). This paper discusses the case of a 32-year-old man, who came to our Emergency Room presenting with persistent fever, inguinal lymphadenopathy, and an ulcer on his left lower limb on a linear morphoea lesion that had been there for some time. Read More

Clin Epidemiol 2018 8;10:1613-1626. Epub 2018 Nov 8.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Background And Aims: Canada's large geographic area and low population density pose challenges in access to specialized health care for remote and rural residents. We compared health services use, surgical rate, and specialist gastroenterologist care in rural and urban inflammatory bowel disease (IBD) patients in Canada.

Methods: We used validated algorithms that were applied to population-based health administrative data to identify all people living with the following three Canadian provinces: Alberta, Manitoba, and Ontario (ON). Read More

J Pain Res 2018 2;11:2721-2728. Epub 2018 Nov 2.

Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China,

Objective: The clinical characteristics of migraine with and without allodynia were compared to evaluate the risk factors of cutaneous allodynia in migraine. The effects of prophylactic therapy on allodynia in patients with migraine were assessed based on the change in pain threshold after therapy.

Patients And Methods: A total of 71 patients with migraine admitted to the Department of Neurology of Shandong Provincial Hospital were recruited in this study. Read More

J Inflamm Res 2018 13;11:447-456. Epub 2018 Nov 13.

Department of Emergency, Qilu Hospital, Shandong University, Jinan, China,

Background: The incidence of recurrent cardiovascular events from the progression of nontarget lesions (NTLs) is high for percutaneous coronary intervention-treated patients. However, the underlying mechanisms have not been thoroughly elucidated.

Methods: In this study, ten atherosclerotic rabbits with multiple plaques in the upper and lower segments of abdominal aorta (group A) were randomly divided into two subgroups: group A1 underwent intravascular ultrasound examination and stent implantation in the lower segments of the abdominal aorta (n=5), whereas group A2 was without stenting (n=5). Read More

Infect Drug Resist 2018 13;11:2249-2255. Epub 2018 Nov 13.

Department of Emergency, Shengjing Hospital Affiliated to China Medical University, Heping District, Shenyang, Liaoning Province 110004, People's Republic of China,

Purpose: To study the distribution of pathogenic bacteria in ventilator-associated pneumonia (VAP), and epidemiological characteristics of extended-spectrum β lactamase (ESBL)-producing bacteria.

Patients And Methods: Lower respiratory tract secretions from 156 patients with mechanical ventilation were collected using a protective specimen brush (PSB), with quantitative bacterial culture carried out and antibiotic sensitivity measured. ESBLs produced by Gram-negative bacilli were detected using the double disk diffusion method and monitored by plasmid profiles. Read More