Seatbelt injury resulting in functional loss of a transplanted kidney.

The transplanted kidney, lying heterotopically in the iliac fossa, is especially vulnerable to damage from blunt trauma, particularly compression by vehicle seatbelt. We present a case wherein a functioning renal allograft lying in the right iliac fossa was severely injured by seatbelt compression, resulting in significant functional compromise and eventual loss. The patient later underwent successful retransplantation with a second living donor kidney.

Risk factors, prevention, and treatment of corticosteroid-induced osteoporosis in adults.

An orthopedist can play a critical role in corticosteroid induced osteoporosis management by identifying at-risk patients and selecting appropriate prophylactic measures. This article is part two in a two-part series on osteoporosis. Part one appeared in the July 2008 issue of ORTHOPEDICS.

Understanding risk factors, screening, and treatment of postmenopausal osteoporosis.

Between 30% and 50% of American women will endure a clinical fracture during their lifetime due to the loss of bone mineral density that occurs with menopausal estrogen loss. This article is part one in a two-part series on osteoporosis. Part two will appear in the August 2008 issue of ORTHOPEDICS.

Prevalent immunosuppressive strategies in liver transplantation for hepatitis C: results of a multi-center international survey.

To determine current immunosuppression regimens and strategies for acute cellular rejection in hepatitis C virus (HCV) patients after liver transplantation (LT), questionnaires were sent to 264 LT programs worldwide. Surveys from 81 programs were reviewed. In 27 centers (33.

A pharmacoeconomic analysis of liver transplant charges.

Objective: To analyze hospital charges for all liver transplant admissions to determine major cost drivers of the total charge.

Study Design: Retrospective review of hospital billing records.

Methods: Hospital charges were collected for all liver transplant admissions between July 1995 and December 2005 and 276 billing records were included in the analysis.

Safe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps.

Postanesthesia nursing care and standards are continually evolving. ASPAN has the professional responsibility to develop standards of nursing practice to promote a safe environment of care. Currently, ASPAN's recommended staffing ratios are based on the best available evidence: expert opinion and consensus.

Patient safety: perianesthesia nursing's essential role in safe practice.

A safety culture that promotes best practices and best outcomes is important in today's healthcare environment. The perianesthesia environment of care is constantly challenged with the introduction of new technologies, improved medications, and advances in surgical and nonsurgical procedures. This practice is also marked by fast turnover, increasing volume, and, often, high-acuity patients.

Barriers to metered-dose inhaler/spacer use in Canadian pediatric emergency departments: a national survey.

Background: Metered-dose inhalers and spacers (MDI+S) are at least as effective as nebulizers for treating children with mild to moderate asthma exacerbations. Despite advantages in terms of efficacy, side effects, and ease of use, MDI+S are not used in many North American pediatric emergency departments (PEDs).

Objectives: To survey emergency physicians, emergency nurses, and respirologists in Canadian pediatric teaching hospitals regarding their practices, beliefs, and barriers to change with respect to bronchodilator delivery.

Analysis of smoking in patients referred for liver transplantation and its adverse impact of short-term outcomes.

Smoking has been reported to adversely affect the outcome of patients undergoing liver transplantation (LT). We present a clinical and demographic analysis of smoking in patients from a rural Appalachian region referred to our center for LT. We reviewed 237 consecutive patients referred for LT between January 2002 and December 2003.

Portable spectroscopic neutron probe.

Bubble Technology Industries (BTI) has built a revolutionary portable neutron scintillation spectrometer, N-Probe, designed to be used by non-specialists for measurement of low-intensity neutron doses in the mixed field environments often found in nuclear utilities, fuel storage areas, fuel and waste processing operations and military applications. It is compatible with the current generation of BTI MICROSPEC analysers and shares the philosophy of spectral dosimetry with other BTI spectroscopic probes, where the dosimetric quantities are computed from the spectrum using appropriate fluence-dose conversion functions.

Modification of ROSPEC to cover neutrons from thermal to 18 MeV.

Rotating Spectrometer (ROSPEC) is a neutron spectrometer designed to measure neutron energy distributions, and provide accurate neutron dosimetry. It is a completely self-contained unit and measures neutron energy via recoiling protons in gas proportional counters. Each of the four original gas counters is dedicated to a particular neutron energy range dictated by sensitivity to gamma rays at the low energy end of the spectrum and by proton collisions with the counter walls at the high energy end.

Wrist buckle fractures: a survey of current practice patterns and attitudes toward immobilization.

Objectives: Buckle fractures are the most common wrist fractures in children, yet there is little literature regarding their management. This study examined the management of these fractures and attitudes toward their immobilization by pediatric emergency department (ED) physicians and pediatric orthopedic surgeons.

Methods: A standardized survey was mailed to all pediatric orthopedic surgeons and pediatric ED physicians at 8 Canadian children's hospitals.

Gut osmolarity: a key environmental cue initiating the gastrointestinal phase of Listeria monocytogenes infection?

In addition to the severe invasive systemic disease of listeriosis, recent evidence suggests that the Gram-positive intracellular bacterial pathogen Listeria monocytogenes is also a causative agent of febrile gastroenteritis. We examined the listerial response to stresses normally encountered in the upper small intestine and demonstrate that osmotic stress appears to be at the top of the hierarchy of stress responses during gastrointestinal residence. Furthermore, we suggest that the increased osmolarity of the gastrointestinal lumen may be interpreted as an environmental cue signalling gut entry and that the underlying genetic element governing this response is the alternative stress sigma factor sigma(B).

Pharmacy resident participation in cardiopulmonary resuscitation events.

Purpose: An electronically administered cross-sectional survey was conducted to establish the rate of pharmacy resident participation in cardiopulmonary resuscitation (CPR) events at pharmacy residency programs throughout the United States and Puerto Rico.

Methods: A 46-item questionnaire was developed and sent by e-mail to pharmacy residency program directors. The recipients were given one month to complete the survey.

Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians.

Objectives: Elbow injuries in children are a common presenting complaint to the emergency department. Although radiography is a valuable tool in the diagnosis of this injury, x-rays of the injured elbow are inherently difficult to interpret. As a result, comparison views of the uninjured arm have traditionally been recommended to provide an anatomically "normal" radiograph.

Benefits and harms associated with the practice of bed sharing: a systematic review.

Objective: To examine evidence of benefits and harms to children associated with bed sharing, factors (eg, smoking) altering bed sharing risk, and effective strategies for reducing harms associated with bed sharing.

Data Sources: MEDLINE, CINAHL, Healthstar, PsycINFO, the Cochrane Library, Turning Research Into Practice, and Allied and Alternative Medicine databases between January 1993 and January 2005.

Study Selection: Published, English-language records investigating the practice of bed sharing (defined as a child sharing a sleep surface with another individual) and associated benefits and harms in children 0 to 2 years of age.

Relationship between personality and satisfaction with the dentition in tooth wear patients.

This study was undertaken to identify whether personality traits had any relationship with patients' satisfaction with their dentition in tooth wear cases. One hundred tooth wear patients and one hundred controls were recruited into the study. A Dental Impact on Daily Living questionnaire was used to assess impact of tooth wear on day to day life and satisfaction with the dentition.

Identification of risk factors for postoperative nausea and vomiting in the perianesthesia adult patient.

Postoperative nausea and vomiting (PONV) is a common and potentially debilitating complication of surgery. The preoperative assessment of PONV using established risk assessment tools enables the identification of patients at risk and potentially decreases the incidence of PONV in adult surgical patients. The identification of risk factors associated with PONV and the factors that are independent predictors of PONV preoperatively can facilitate the effective prophylactic treatment and management of PONV in adult surgical patients.

Impact of tooth wear on daily living.

Purpose: The aim of this study was to identify the effects of tooth wear on patients' quality of life and satisfaction with their dentition.

Materials And Methods: Seventy-six tooth wear patients and 76 control subjects were recruited for the study. A Dental Impact on Daily Living questionnaire was used to assess the affect of tooth wear on daily living and satisfaction with the dentition.

Use of single-dose activated charcoal among Canadian pediatric emergency physicians.

Objective: Gastric decontamination with single-dose activated charcoal (SDAC) is a mainstay in emergency department (ED) treatment of ingestions. Guidelines updated in 2005 encourage practitioners to use SDAC only in toxic ingestions presenting within 1 hour. Despite these guidelines, adult studies demonstrate a significant lack of consensus.

Changing patterns of initial drug therapy for the treatment of hypertension in a Medicaid population, 2001-2005.

Thiazide diuretics have been recommended as one preferred choice for the initial treatment of hypertension. This study was undertaken to determine whether Maine physicians initiating monotherapy for newly diagnosed hypertensive patients from 2001-2005 used this guideline. The Maine Medicaid database was searched for the drug classes used to initiate monotherapy for patients followed for at least 6 months.

Analysis of morbidity in liver transplant recipients following human albumin supplementation: a retrospective pilot study.

Objectives: To assess incidence of morbidity (i.e., documented infection, acute renal failure, acute graft rejection, acute cardiovascular events, and hospital readmission rates) 6 months following liver transplantation using linear regression as a function of cumulative albumin dose.