Evaluating the pragmatic characteristics of advance care planning outcome measures in dementia clinical trials: A scoping review.

Background: Advance care planning (ACP) is a process that involves discussing a person's goals, values, and preferences; it is particularly important for persons living with dementia (PLWD) given that dementia is incurable and progressive. To ensure results that will impact real-world practices, ACP outcome measures must be psychometrically strong, meaningful to key partners, and pragmatic to collect. Therefore, we conducted a scoping review of outcome measures utilized in ACP randomized controlled clinical trials (RCTs) enrolling PLWD or their care partners and evaluated their pragmatic characteristics.

Timing is everything: Early versus late palliative care consults in trauma.

Background: The incorporation of dedicated palliative care (PC) services in the care of the critically injured trauma patient is not yet universal. Preexisting data demonstrate both economic and clinical value of PC consults, yet patient selection and optimal timing of these consults are poorly defined, possibly leading to underutilization of PC services. Prior studies in geriatric patients have shown benefits of PC when PC clinicians are engaged earlier during hospitalization.

FRET-based trilateration of probes bound within functional ryanodine receptors.

To locate the biosensor peptide DPc10 bound to ryanodine receptor (RyR) Ca(2+) channels, we developed an approach that combines fluorescence resonance energy transfer (FRET), simulated-annealing, cryo-electron microscopy, and crystallographic data. DPc10 is identical to the 2460-2495 segment within the cardiac muscle RyR isoform (RyR2) central domain. DPc10 binding to RyR2 results in a pathologically elevated Ca(2+) leak by destabilizing key interactions between the RyR2 N-terminal and central domains (unzipping).

[Phlebectasia of the internal jugular vein post injury (author's transl)].

The authors present the case of a 14 year-old girl having the cervical deformity developed on the background of influenza and sore throat and was caused by an apparently minor sports injury, with vertebrocervical lesion and rupture of the inner wall of the jugular vein. The painful onset symptomatology, initially attributed to exacerbation of the anginous process and cervical adenitis, evolved towards phonation, deglutition, nervous and final respiratory disturbances. The progressive evolution and gravity of the clinical picture imposed craniocervical surgery, with exclusion of the lateral intramastoid sinus and resection of the extensive ectatic cervicoprevertebral pouch.

[Injuries of the ossicle system].

On the basis of the observation of eight cases with traumatisms of the ossicular system, the authors discuss the mechanism of various forms of lesions, which may be primary represented by fractures and luxations or they may be secondary reactions following the traumatism leading to ankylosis the joins. There is underlined the frequency of the luxations of the stapes and the constant ankylosis of the footplate in these cases. The authors argue in favour of an early surgical procedure, the extent of the surgical intervention being conditioned by the lesional aspect.