Safely gaining experience in death and dying: Simulation in palliative care and end-of-life education.

Background: Training in palliative and end-of-life (EOL) care provision represents a critical topic in health professional curricula for ensuring a workforce prepared to provide safe and person-center care at the end of one's life. This manuscript describes the incorporation of a simulation-based learning experience (SBLE) and the evolution of a professional elective course for student pharmacists related to palliative and EOL care.

Educational Activity: A SBLE was incorporated into a long-standing professional pharmacy elective course in palliative and EOL care.

Complete genome of a multiresistant isolated from a diseased Austrian bovine calf.

() plays an important role in bovine respiratory diseases. Here we describe the complete genome of a multiresistant . The strain was isolated from the lung of a diseased, 4-month old, male Fleckvieh calf with a clinical history of bronchopneumonia in Upper Austria.

A Case Report of Hypotension and Methemoglobinemia Associated With Gunshot Residue Poisoning: Nitrite-Induced Methemoglobinemia.

A patient with gunshots within inches of the skin developed intraoperative vasodilatory hypotension and methemoglobinemia, both recognized consequences of nitrite poisoning. A 1- mg/kg dose of methylene blue transiently and partially reversed methemoglobinemia, but the color of the methylene blue faded rapidly, consistent with bleaching of methylene blue by nitrite in vivo. Methylene blue did not raise blood pressure, consistent with inhibition of nitric oxide (NO) synthase.

[Surgical solutions in multivisceral arterial occlusions].

Introduction: Acute occlusions of the visceral arteries result in fulminant clinical consequences and without fast and appropriate treatment may lead to fatal outcome. If the obliterative disease has slow progression the huge capacity of the collateral circulation of the visceral arteries may remain free of symptoms at long run. By progression of the obliterative disease and extension to both, the renal arteries and the aortoiliac segment the clinical picture becomes more colourful.

[Treatment options for complex aortic aneurysms – own experiences].

Complex aortic aneurysms extend to more aortic segments, and/or include one or more orifices of highly important side branches. Meanwhile complex aneurysms need reconstructive solutions in one sitting or hybrid procedures timely close to each other, multiple aneurysms can be treated technically and timely separated. Previously, open surgery was the only opportunity to intervene, which was associated with significant surgical trauma and was not suitable for high risk patients when devastating complications were likely.

Clinical Features of COVID-19 Infection in Patients Treated at a Large Veterans Affairs Medical Center.

Introduction: During recent months, reports describing the characteristics of COVID-19 patients in China, Italy, and the United States have been published. Military veterans represent another unique population affected by COVID-19. This report summarizes the demographics and baseline clinical comorbidities in veterans testing positive for COVID-19 in Milwaukee, Wisconsin.

Simulation as a Tool to Illustrate Clinical Pharmacology Concepts to Healthcare Program Learners.

Purpose Of Review: This article provides an overview of simulation as an effective and evolving tool for teaching clinical pharmacology within the health professions. Further, opportunities for positioning this methodology to meet current educational challenges are presented.

Recent Findings: Clinical pharmacology is an essential core competency for all health professionals, correlating with ability to appropriately and safely prescribe, administer, or optimize medication regimens.

[Kommerell diverticulum – rare complications of a rare disease].

Incidence of anomalies of the aortic arch is estimated 1-2 per cent in newborn babies. Lusory artery may arise either from left sided aortic arch in 0.7–2 per cent, or from right sided aortic arch in 0.

Development of a multiplex qPCR for the species identification of Clostridium estertheticum, C. frigoriphilum, C. bowmanii and C. tagluense-like from blown pack spoilage (BPS) meats and from wild boars.

Psychrophilic and psychrotolerant clostridia (n = 110) were isolated from vacuum-packed meat (beef and lamb), fresh venison and from skin and fecal samples of wild boars. They were identified to species level using MALDI-TOF MS, sequence and phylogeny analysis of the 16S rRNA and species specific multiplex qPCR. The results of all three methods were concordant.

[Surgical treatment of atypical aortic coarctation -- long-term results].

Introduction: Aortic coarctation is a frequent congenital cardiovascular disorder representing 5-8% of all cases. It is typically localized in the isthmic region. However, in about 1% of cases coarctation may develop in atypical sites of the aorta and it is frequently complicated with severe hypertension.

Vitamin D Actions on CD4(+) T Cells in Autoimmune Disease.

This review summarizes and integrates research on vitamin D and CD4(+) T-lymphocyte biology to develop new mechanistic insights into the molecular etiology of autoimmune disease. A deep understanding of molecular mechanisms relevant to gene-environment interactions is needed to deliver etiology-based autoimmune disease prevention and treatment strategies. Evidence linking sunlight, vitamin D, and the risk of multiple sclerosis and type 1 diabetes is summarized to develop the thesis that vitamin D is the environmental factor that most strongly influences autoimmune disease development.

[Nutcracker syndrome - treated by surgery].

The nutcracker syndrome is caused by tight compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. The consequences may vary between symptomfree conditions through moderate proteinuria and hypertension to severe hematuria. All imaging modalities have been used during diagnostic workup.

["Debranching" -- a new surgical option for the aortic arch and thoracoabdominal aorta hybrid interventions].

Introduction: Endovascular techniques in vascular surgery are frequently applied to treat aortic diseases. These minimally invasive procedures changed aortic interventions remarkably. We have to be familiar with new terminology and methods.

[Late complications and treatment options of aortic coarctation operated in childhood].

Introduction: The prevalence of congenital aortic coarctation is 4 in 10 000 live birth. Aortic coarctation is typically located in the aortic isthmus, but it may occur at atypical sites. Treatment options include both surgical and endovascular interventions.

[Penetrating atheromatous ulcer of the thoracic aorta. Treatment options].

Introductions: Atherosclerosis is a generalized degenerative disease of arteries. A rare manifestation of that is the penetrating atheromatous aortic ulceration of the aortic wall which may be complicated by subintimal hematoma, dissection, false aneurysm and rupture (acute aortic syndrome).

Aim: The aim of the authors was to analyse their experience with this rare disease.

[Splenic vein aneurysm -- a case report].

Authors report a very rare case of splenic vein aneurysm in a 34-year-old female patient. She underwent investigation for upper abdominal pain which was not related to eating. Diagnostic workup revealed a thin wall saccular splenic vein aneurysm of 40 mm in diameter which caused an indentation of the posterior wall of the pancreas.

Fiber and exercise in the treatment of obese adolescents.

The changes in body weight, body fat, lean body mass, and the efficiency index were studied in a sample of 80 obese males and females undergoing four different treatments, using two treatment components: an increase in dietary fiber, and energy expenditure through exercise. In both sexes there was a significant effect of exercise upon body weight and an improvement in the efficiency index. There was also a significant interaction between fiber and exercise in girls, but not in boys.

Risk factors in childhood diabetes mellitus.

The quotients total cholesterol/HDL-cholesterol and free fatty acid/albumin in serum were examined in various groups of diabetic patients and the changes of the quotients induced by various forms of physical activity were then registered. Both total cholesterol/HDL-cholesterol and free fatty acid/albumin were increased in patients with unsatisfactory control of diabetes. Low albumin levels were only seen in cases with very poor control or in cases afflicted by complications.