Lack of impact of nil-per-os (NPO) time on goal-directed fluid delivery in first case versus afternoon case starts: a retrospective cohort study.

Background: Goal Directed Fluid Therapy (GDFT) represents an objective fluid replacement algorithm. The effect of provider variability remains a confounder. Overhydration worsens perioperative morbidity and mortality; therefore, the impact of the calculated NPO deficit prior to the operating room may reach harm.

Long-term continental changes in wing length, but not bill length, of a long-distance migratory shorebird.

We compiled a >50-year record of morphometrics for semipalmated sandpipers (), a shorebird species with a Nearctic breeding distribution and intercontinental migration to South America. Our data included >57,000 individuals captured 1972-2015 at five breeding locations and three major stopover sites, plus 139 museum specimens collected in earlier decades. Wing length increased by ca.

Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting.

Background: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol.

Feasibility of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

Purpose: The purpose of this study was to evaluate the feasibility of a new Web-based intermittent catheter self-management intervention.

Design: We tested the acceptability and usability of intervention components, which included multiple Web-based materials (an online urinary diary adapted for mobile phone use and an educational booklet), 3 phone calls with a nurse, and a peer-led discussion forum.

Subjects And Setting: Thirty adults with spinal cord injury using intermittent catheterization for bladder drainage were enrolled; 26 participants received the nurses' phone-based consultations.

Development of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

While Web-based interventions have proliferated recently, information in the literature is often lacking about how the intervention was developed. In response to that gap, this is a report of the development of a Web-based self-management intervention for intermittent urinary catheter users and pretesting with four adults with spinal cord injury living in the community. Two Web sites were created, one for recruitment and the other for the intervention itself.

A Web-Based Self-Management Intervention for Intermittent Catheter Users.

A new Web-based self-management intervention was developed for persons with spinal cord injury who use intermittent urinary catheters. Included are a description of the components, examples from the educational book, and multiple screen shots of the online urinary diary.

Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa.

Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.

Automatic discourse connective detection in biomedical text.

Objective: Relation extraction in biomedical text mining systems has largely focused on identifying clause-level relations, but increasing sophistication demands the recognition of relations at discourse level. A first step in identifying discourse relations involves the detection of discourse connectives: words or phrases used in text to express discourse relations. In this study supervised machine-learning approaches were developed and evaluated for automatically identifying discourse connectives in biomedical text.

Meningeal (postdural) puncture headache, unintentional dural puncture, and the epidural blood patch: a national survey of United States practice.

Background: Meningeal (postdural) puncture headache (MPH) is a familiar iatrogenic complication. The optimal means of prevention, management, and treatment of this disorder are uncertain. The purpose of this study was to determine current practice among United States (USA) anesthesiologists regarding MPH as well as the related issues of unintentional dural puncture (UDP), the epidural blood patch (EBP), and proposed alternatives to the EBP.

The hair collar sign as a marker for neural tube defects.

The hair collar sign has been described as a marker of cranial dysraphism, including encephaloceles, meningoceles, and heterotropic brain tissue. This report describes a male born with a hair collar sign who subsequently was found to have a Klippel-Feil anomaly, diastematomyelia, multiple segmental spine and rib anomalies, and a translocation between chromosomes 1 and 4; t(1;4) (q44;q10). While not previously documented, spine abnormalities may be an associated abnormality with the hair collar sign.

Middle ear admittance and hearing abnormalities in individuals with osteoarthritis.

In osteoarthritis, the joint cartilage breaks down. Cartilage exists within the incudomalleolar and incudostapedial joints. In addition, the cartilage-covered base of the stapes footplate is bound to the cartilage-covered rim of the oval window by the annular ligament.

Cryptosporidiosis: a brief literature review and update regarding Cryptosporidium in feces of Canada geese (Branta canadensis).

Canada geese are increasingly abundant in Ohio, with large nesting populations throughout the state, and goose feces contaminate grassy areas and pavements in many public, commercial, and residential sites. In 1999 the authors found a high prevalence of Giardia, Campylobacter, and especially Cryptosporidium in collected feces of Canada geese. The purpose of this follow-up study was to survey known Canada geese sites in three counties in Ohio (Lucas, Ottawa, and Wood) and to determine the prevalence of sites testing positive for Cryptosporidium.

Smallpox vaccine: contraindications, administration, and adverse reactions.

Since the terrorist attacks of September 11, 2001, and the anthrax exposures in the following weeks, concern that smallpox could be used as a biologic weapon has increased. Public health departments and the U.S.