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Wirachin Hoonpongsimanont, Miriam Kulkarni, Pedro Tomas-Domingo, Craig Anderson, Denise McCormack, Khoa Tu, Bharath Chakravarthy, Shahram Lotfipour
We evaluated the effectiveness of text messaging, versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences...
October 26, 2016: Journal of Educational Evaluation for Health Professions
Chittaranjan Andrade
Patients with schizophrenia have increased prevalence rates for many cardiometabolic risk factors; the prevalence and severity of these risks increase after the institution of antipsychotic medication. Nearly 2 dozen different pharmacologic interventions have been trialed to prevent or attenuate antipsychotic-related cardiometabolic changes. Metformin (usually 1,000-1,500 mg/d) has emerged as the best-studied intervention; in short- and intermediate-duration randomized controlled trials, it has been shown to bring about improvements in weight and other anthropometric indices, in fasting sugar and other glycemic control indices, and in total cholesterol and other lipid metabolism indices...
September 2016: Journal of Clinical Psychiatry
Wei-Hung Chan, Meei-Shyuan Lee, Chin Lin, Chang-Chieh Wu, Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chen-Hwan Cherng, Zhi-Fu Wu
We conducted a retrospective study to investigate the anesthesia-controlled time and factors that contribute to prolonged extubation in open colorectal surgery. Using our hospital database, demographic data, various time intervals (waiting for anesthesia time, anesthesia time, surgical time, emergence time, exit from operating room after extubation, total operating room time, and post-anesthesia care unit stay time), and incidence of prolonged extubation (≥ 15 mins), were compared between patients who received desflurane/fentanyl-based anesthesia and total intravenous anesthesia via target-controlled infusion with fentanyl/propofol...
2016: PloS One
Karen H Keddy, Arvinda Sooka, Anthony M Smith, Alfred Musekiwa, Nomsa P Tau, Keith P Klugman, Frederick J Angulo
BACKGROUND: Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. METHODS AND FINDINGS: Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013...
2016: PloS One
Jennifer R Honda, Nabeeh A Hasan, Rebecca M Davidson, Myra D Williams, L Elaine Epperson, Paul R Reynolds, Terry Smith, Elena Iakhiaeva, Matthew J Bankowski, Richard J Wallace, Edward D Chan, Joseph O Falkinham, Michael Strong
Lung disease caused by nontuberculous mycobacteria (NTM) is an emerging infectious disease of global significance. Epidemiologic studies have shown the Hawaiian Islands have the highest prevalence of NTM lung infections in the United States. However, potential environmental reservoirs and species diversity have not been characterized. In this cross-sectional study, we describe molecular and phylogenetic comparisons of NTM isolated from 172 household plumbing biofilms and soil samples from 62 non-patient households and 15 respiratory specimens...
October 2016: PLoS Neglected Tropical Diseases
Louise Barbier, Manuela Cesaretti, Federica Dondero, François Cauchy, Linda Khoy-Ear, Takeshi Aoyagi, Emmanuel Weiss, Olivier Roux, Safi Dokmak, Claire Francoz, Catherine Paugam-Burtz, Ailton Sepulveda, Jacques Belghiti, François Durand, Olivier Soubrane
BACKGROUND: Older liver grafts have been considered in the past decade due to organ shortage. The aim was to compare outcomes after liver transplantation with either younger or older donors. METHODS: Patients transplanted in our center between 2004 and 2014 with younger donors (younger than 60 years; n = 253) were compared with older donors (older than 75 years; n = 157). Multiorgan transplantations, split grafts, or non-heart-beating donors were not included. RESULTS: Donors in the older group were mostly women deceased from stroke, and only 3 patients had experienced cardiac arrest...
November 2016: Transplantation
See Wan Tham, Tonya M Palermo, Amy Lewandowski Holley, Chuan Zhou, Audun Stubhaug, Anne-Sofie Furberg, Christopher Sivert Nielsen
Quantitative sensory testing (QST) has been used to characterize pain sensitivity in individuals with and without pain conditions. Research remains limited in pediatric populations, hindering the ability to expand the utility of QST toward its potential application in clinical settings and clinical predictive value. The aims of this study were to examine pain sensitivity using QST in adolescents with chronic pain compared to adolescents without chronic pain and identify predictors of pain sensitivity. A population-based study conducted from 2010 to 2011 provided data on 941 adolescents, 197 were classified as having chronic pain and 744 were classified without chronic pain...
September 15, 2016: Pain
Joice Sophia Ponraj, Zai-Quan Xu, Sathish Chander Dhanabalan, Haoran Mu, Yusheng Wang, Jian Yuan, Pengfei Li, Siddharatha Thakur, Mursal Ashrafi, Kenneth Mccoubrey, Yupeng Zhang, Shaojuan Li, Han Zhang, Qiaoliang Bao
Apart from conventional materials, the study of two-dimensional (2D) materials has emerged as a significant field of study for a variety of applications. Graphene-like 2D materials are important elements of potential optoelectronics applications due to their exceptional electronic and optical properties. The processing of these materials towards the realization of devices has been one of the main motivations for the recent development of photonics and optoelectronics. The recent progress in photonic devices based on graphene-like 2D materials, especially topological insulators (TIs) and transition metal dichalcogenides (TMDs) with the methodology level discussions from the viewpoint of state-of-the-art designs in device geometry and materials are detailed in this review...
November 18, 2016: Nanotechnology
Ruby Charak, Brianna M Byllesby, Michelle E Roley, Meredith A Claycomb, Tory A Durham, Jana Ross, Cherie Armour, Jon D Elhai
The aims of the present study were first to identify discrete patterns of childhood victimization experiences including crime, child maltreatment, peer/sibling victimization, sexual violence, and witnessing violence among adult trauma victims using latent class analysis; second, to examine the association between class-membership and suicidal behavior, and third to investigate the differential role of dispositional anger on the association between class-membership and suicidal behavior. We hypothesized that those classes with accumulating exposure to different types of childhood victimization (e...
October 22, 2016: Child Abuse & Neglect
Kenneth D Birnbaum
Plants often make the same organ in different development contexts. Roots are a quintessential example, with embryonic, primary, lateral, adventitious, and regenerative roots common to many plants. The cellular origins and early morphologies of different roots can vary greatly, but the adult structures can be remarkably similar. Recent studies have highlighted the diversity of mechanisms that can initiate roots while late patterning mechanisms are frequently shared. In the middle stages when patterning emerges, evidence shows that antagonistic auxin-cytokinin interactions regulate tissue patterns in root embryogenesis, vascular organization, and regeneration but it is not yet clear if a common ontogeny for the root body plan exists...
October 22, 2016: Current Opinion in Plant Biology
J L Salzer, B Zalc
Myelin is a key evolutionary acquisition that underlay the development of the large, complex nervous systems of all hinged-jaw vertebrates. By promoting rapid, efficient nerve conduction, myelination also made possible the development of the large body size of these vertebrates. In addition to increasing the speed of nerve conduction, myelination has emerged as a source of plasticity in neural circuits that is crucial for proper timing and function. Here, we briefly describe the organization of myelin and of myelinated axons, as well as the functions of myelin in nerve conduction and neural circuits, and consider its potential evolutionary origins...
October 24, 2016: Current Biology: CB
Alexander Mildner, Goran Marinkovic, Steffen Jung
Monocytes are short-lived mononuclear phagocytes that circulate in the bloodstream and comprise two main subpopulations that in the mouse are best defined by the Ly6C marker. Intravascular functions of "classical" Ly6C+ monocytes and their interactions with other lymphoid and myeloid leukocytes in the circulation remain poorly understood. Rather, these cells are known to efficiently extravasate into tissues. Indeed, Ly6C+ monocytes and their descendants have emerged as a third, highly plastic and dynamic cellular system that complements the two classical, tissue-resident mononuclear phagocyte compartments, i...
October 2016: Microbiology Spectrum
John V Gahagan, Mark H Hanna, Matthew D Whealon, Steven Maximus, Michael J Phelan, Michael Lekawa, Cristobal Barrios, Nicole P Bernal
Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012. Patients were stratified as white or non-white. A total of 243,536 patients were analyzed: 159,901 white and 83,635 non-white. Non-white patients had significantly higher proportions of Medicaid (25% vs 9.3%), self-pay (14% vs 7...
October 2016: American Surgeon
Shawn Diamond, Hassan S Moghaddas, Stephen S Kaminski, Jonathan Grotts, Lisa Ferrigno, Wesley Schooler
Over two million Americans receive treatment for pressure ulcers (PUs) annually, but national surgical outcomes are not well described. This study investigated rates and risk factors of postoperative complications in patients with PU. The 2011 and 2012 American College of Surgeons-National Surgical Quality Improvement Project database was queried and PU patients undergoing flap closure were identified. Descriptive statistics and multivariate regression analysis was used and reported as odds ratios (ORs) if (P < 0...
October 2016: American Surgeon
Mohammed Al-Temimi, Charles Trujillo, John Agapian, Hanna Park, Ahmad Dehal, Samir Johna, Deron Tessier
Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005-2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables...
October 2016: American Surgeon
Joshua Park, Ethan Frank, Alfred Simental, Sara Yang, Christopher Vuong, Steve Lee, Pedro Andrade Filho
After thyroid surgery, protocols based on postoperative parathyroid hormone (PTH) levels may prevent symptoms of hypocalcemia, while avoiding unnecessary prophylactic calcium and/or vitamin D supplementation. We examined the value of an initial management protocol based solely on a single PTH level measured one hour after completion or total thyroidectomy to prevent symptomatic hypocalcemia by conducting a retrospective review of 697 consecutive patients treated from July 2003 to April 2015. The proportion of patients who developed symptomatic hypocalcemia was similar between those treated before (n = 155) and after (n = 542) implementation of this 1-hour PTH protocol (16...
October 2016: American Surgeon
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
Ara Ko, Megan Y Harada, Eric J T Smith, Michael Scheipe, Rodrigo F Alban, Nicolas Melo, Daniel R Margulies, Eric J Ley
Elderly trauma patients may be at increased risk for underassessment and inadequate pain control in the emergency department (ED). We sought to characterize risk factors for oligoanalgesia in the ED in elderly trauma patients and determine whether it impacts outcomes in elderly trauma patients. We included elderly patients (age ≥55 years) with Glasgow Coma Scale scores 13 to 15 and Injury Severity Score (ISS) ≥9 admitted through the ED at a Level I trauma center. Patient characteristics and outcomes were compared between those who reported pain and received analgesics medication in the ED (MED) and those who did not (NO MED)...
October 2016: American Surgeon
Monica Chahal-Kummen, Trond-Eirik Strand, Jan Ove Owe, Eigil Gulliksen, Anthony S Wagstaff
BACKGROUND: A candidate with paraplegia contacted the Institute of Aviation Medicine, Oslo, requesting a medical examination and medical certification for flying back seat on an F-16 Fighting Falcon. Thorough aeromedical examinations, including specialist evaluations, were initiated for the final decision to be made. CASE REPORT: Almost 13 yr earlier the candidate had acquired spinal cord damage at neurological level L1 after falling 4 m (13 ft) from out of a window...
2016: Aerospace Medicine and Human Performance
Alejandro Garbino, Derek M Nusbaum, Daniel M Buckland, Anil S Menon, Jonathan B Clark, Erik L Antonsen
The Stratex Project is a high altitude balloon flight that culminated in a freefall from 41,422 m (135,890 ft), breaking the record for the highest freefall to date. Crew recovery operations required an innovative approach due to the unique nature of the event as well as the equipment involved. The parachutist donned a custom space suit similar to a NASA Extravehicular Mobility Unit (EMU), with life support system mounted to the front and a parachute on the back. This space suit had a metal structure around the torso, which, in conjunction with the parachute and life support assembly, created a significant barrier to extraction from the suit in the event of a medical emergency...
2016: Aerospace Medicine and Human Performance
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