External Validation of SHAPE Score: A Score to Predict Low-Risk Lower Gastrointestinal Bleeding in the Emergency Department.

Lower gastrointestinal bleeding (LGIB) frequently leads to emergency department (ED) visits and hospitalizations, encompassing a spectrum of outcomes from spontaneous resolution to intrahospital mortality. The purpose of this study was to validate a scoring system designed to identify cases of low-risk LGIB, allowing for safe discharge from the ED. A retrospective analysis of all gastrointestinal bleeding cases presented at three EDs in 2020 was conducted, focusing specifically on patients with LGIB.

A rare case of superior mesenteric venous and portal vein thrombosis in complicated appendicitis.

Superior mesenteric venous (SMV) thrombosis is a rare complication of severe appendicitis. Early recognition is due to improved imaging modalities, which ultimately lead to more prompt intervention. Despite being an uncommon phenomenon, SMV thrombosis can have complications stemming from venous hypertension, such as gastric and esophageal varices, bowel ischemia, sepsis, and death.

Gastric intestinal metaplasia regression in United States population: A retrospective longitudinal study.

Background And Aim: Gastric cancer is a health concern and contributes to cancer-related deaths. Gastric intestinal metaplasia (GIM) is a premalignant lesion of gastric cancer. Currently, factors associated with GIM regression are under-investigated.

The posterior auricular muscle complex graft as a porous orbital implant wrap: long-term follow-up over a 31-year period.

Purpose: Orbital implant exposures, infections, and extrusions can occur many years following enucleation or evisceration. This study analyzes complication rates following porous orbital implant wrapped with a posterior auricular muscle complex graft (PAMCG).

Methods: This is a retrospective study of patients who underwent orbital implantation following enucleation using this technique between 1992 and 2013.

Whipple's disease review, prevalence, mortality, and characteristics in the United States: A cross-sectional national inpatient study.

Whipple's disease is a rare multiorgan systemic disease caused by Tropheryma whipplei infection that may present with a wide range of signs and symptoms. This study aim to comprehensively review and determine the inpatient prevalence, mortality, risk factors, and reasons for hospitalization of patients with Whipple's disease. ICD-10 codes were used to identify admissions with Whipple's disease during the years 2016 to 2018.

Gastric intestinal metaplasia development in African American predominant United States population.

Background: Gastric cancer significantly contributes to cancer mortality globally. Gastric intestinal metaplasia (GIM) is a stage in the Correa cascade and a premalignant lesion of gastric cancer. The natural history of GIM formation and progression over time is not fully understood.

Association of Federal Regulations in the United States and Canada With Potential Corneal Donation by Men Who Have Sex With Men.

Importance: Federal policy in the United States prohibits corneal donation by men who have had sex with another man (MSM) in the preceding 5 years, whereas Canada enforces a 12-month ban. The potential consequences of these policies on corneal donations should be evaluated.

Objective: To estimate the number of potential corneal donations associated with MSM deferral policies in the United States and Canada.

Residual radioactivity of treated green diamonds.

Treated green diamonds can show residual radioactivity, generally due to immersion in radium salts. We report various activity measurements on two radioactive diamonds. The activity was characterized by alpha and gamma ray spectrometry, and the radon emanation was measured by alpha counting of a frozen source.

Building the Evidence Base for Tele-Emergency Care: Efforts to Identify a Standardized Set of Outcome Measures.

Background: To enhance the quality of emergency department (ED) care, some rural hospitals have adopted the use of telemedicine (tele-ED). Without a common set of metrics, it is difficult to quantify the impact of this technology.

Introduction: To address this limitation, the Health Resources and Services Administration funded the identification and testing of a core set of measures that could be used to build a business case for the value of tele-ED care.

A new type of solar-system material recovered from Ordovician marine limestone.

From mid-Ordovician ∼470 Myr-old limestone >100 fossil L-chondritic meteorites have been recovered, representing the markedly enhanced flux of meteorites to Earth following the breakup of the L-chondrite parent body. Recently one anomalous meteorite, Österplana 065 (Öst 65), was found in the same beds that yield L chondrites. The cosmic-ray exposure age of Öst 65 shows that it may be a fragment of the impactor that broke up the L-chondrite parent body.

Temporal national trends of minimally invasive and retropubic radical prostatectomy outcomes from 2003 to 2007: results from the 100% Medicare sample.

Background: Although the use of minimally invasive radical prostatectomy (MIRP) has increased, there are few comprehensive population-based studies assessing temporal trends and outcomes relative to retropubic radical prostatectomy (RRP).

Objective: Assess temporal trends in the utilization and outcomes of MIRP and RRP among US Medicare beneficiaries from 2003 to 2007.

Design, Setting, And Participants: A population-based retrospective study of 19 594 MIRP and 58 638 RRP procedures was performed from 2003 to 2007 from the 100% Medicare sample, composed of almost all US men ≥ 65 yr of age.

Clinician feedback on using episode groupers with Medicare claims data.

CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used with fee-for-service Medicare claims except in the studies by the Medicare Payment Advisory Commission (MedPAC) and CMS.

Incidence of complications for subtotal ionized field ablation of the tonsils.

Objective: Ionized field ablation, or coblation-assisted subtotal tonsillectomy, has been described as a new alternative technique for the management of tonsillar disease. This study was designed to review the incidence of complications in patients undergoing this procedure.

Study Design: A 10-surgeon retrospective chart review of the intraoperative and postoperative complications of patients undergoing ionized field ablation subtotal removal of tonsils was performed.

Pulmonary function tests in preoperative pulmonary evaluation.

Pulmonary function testing (PFT) is used extensively by pulmonary specialists to address two common clinical questions: (1) What is the risk of a postoperative pulmonary complication in an individual with lung disease? and (2) Will the patient be able to tolerate lung resection surgery? Today, there are numerous tests available to measure pulmonary function; making judicious use of these tests essential. In this article, the authors describe significant postoperative pulmonary complications, and discuss the surgical and patient factors contributing to the risk of these complications. They provide an evidence-based approach using pulmonary function data to determine an individual patient's risk for pulmonary complications associated with three types of surgical procedures-upper abdominal, cardiac, and lung resection-and discuss recommendations for risk education.

Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

Objective: To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration.

Study Design: We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997.