Diagnostic criteria and core outcome set development for necrotising otitis externa: the COSNOE Delphi consensus study.

Objective: Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).

Methods: The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database.

Extracting Pure Circular Dichroism from Hierarchically Structured CdS Magic Cluster Films.

Chiroptically active, hierarchically structured materials are difficult to accurately characterize due to linear anisotropic contributions (i.e., linear dichroism (LD) and linear birefringence (LB)) and parasitic ellipticities that produce artifactual circular dichroism (CD) signals, in addition to chiral analyte contributions ranging from molecular-scale clusters to micron-sized assemblies.

A case report of anaplastic thyroid cancer and papillary thyroid cancer lymph node metastasis: an unusual presentation as an invasive hypopharyngeal mass.

Anaplastic thyroid carcinoma is a rare undifferentiated tumour of the thyroid follicular epithelium. It almost always develops from a pre-existing well-differentiated thyroid cancer with a co-existent thyroid malignancy varying from 5 to 17% . The co-existence of papillary thyroid cancer (PTC) with anaplastic thyroid cancer is a rare occurrence in metastases outside the primary thyroid lesion.

Quality improvement methodology can reduce hospitalisation for abscess management.

Background: Abscesses are a common reason for ED visits. While many are drained in the ED, some require drainage in the operating room (OR). We observed that a higher percentage of patients at our institution in Columbus, Ohio, were admitted to the hospital with abscesses for incision and drainage (I&D) in the OR than other institutions, including paediatric institutions.

Improving care through standardized treatment of spontaneous pneumothorax.

Purpose: The objective of this quality improvement (QI) initiative was to implement a standardized clinical treatment protocol for patients presenting with primary spontaneous pneumothorax (PSP) in order to decrease hospital length of stay (LOS), diagnostic radiation exposure, and related cost.

Methods: Baseline data from patients admitted with PSP from January 1, 2016 to July 31, 2018 were compared to data from patients managed using a newly developed evidence-based treatment pathway from August 1, 2018 to December 31, 2019. Standard QI methodology was used to track results.

Neurons in the pigeon nidopallium caudolaterale, but not the corticoidea dorsolateralis, display value and effort discounting activity.

We recorded from single neurons in two areas of the pigeon brain while birds were required to peck a stimulus indicating either a high effort task or a low effort task would follow. Upon completion of the task the birds received the same reward. We found that activity in the nidopallium caudolaterale, an area equivalent to the mammalian prefrontal cortex, was modulated by the value of the reward that would be received based on how much effort was required to obtain it.

Improving Quality of Chest Computed Tomography for Evaluation of Pediatric Malignancies.

Introduction: Atelectasis is a problem in sedated pediatric patients undergoing cross-sectional imaging, impairing the ability to accurately interpret chest computed tomography (CT) imaging for the presence of malignancy, often leading to additional maneuvers and/or repeat imaging with additional radiation exposure.

Methods: A quality improvement team established a best-practice protocol to improve the quality of thoracic CT imaging in young patients with suspected primary or metastatic pulmonary malignancy. The specific aim was to increase the percentage of chest CT scans obtained for the evaluation of pulmonary nodules with acceptable atelectasis scores (0-1) in patients aged 0-5 years with malignancy, from a baseline of 45% to a goal of 75%.

Orientation in Perpetuity: An Online Clinical Decision Support System for Surgical Residents.

Background: Limiting variability is an essential element to improving quality of care. Frequent resident turnover represents a significant barrier to clinical standardization. Trainees joining new surgical services must familiarize themselves with the guidelines and protocols that direct patient care as well as their learning objectives and expectations.

Volume of Irrigation Does Not Affect Rate of Abscess in Perforated Appendicitis.

Although previous studies have evaluated whether use of irrigation decreases postoperative intraabdominal abscess (PO-IAA) formation, these studies treated irrigation as a dichotomous variable and concluded that no irrigation resulted in a decreased incidence of PO-IAA formation. However, a recent study found decreased incidence with small aliquots to a total volume of 6 L. We hypothesized that higher volumes of irrigation would result in a lower incidence of PO-IAA.

Neurons in the Pigeon Nidopallium Caudolaterale Display Value-Related Activity.

We recorded from neurons in the nidopallium caudolaterale, the avian equivalent of the mammalian prefrontal cortex, in four birds. The birds were required to peck a stimulus that indicated the amount of reward they would receive (small or large) after a certain delay (short or long). We found that the activity of neurons in the nidopallium caudolaterale was modulated by the value of the reward that would be received based on the reward amount and the delay to reward.

Differences in Varroa destructor infestation rates of two indigenous subspecies of Apis mellifera in the Republic of South Africa.

Varroa destructor Anderson & Trueman (Varroa) is a damaging pest of the Western honey bee, Apis mellifera, in North America, Europe, and Asia. However, Varroa infestations have not produced equivalent colony losses of African subspecies of honey bee throughout Africa and parts of the Americas. We surveyed the Varroa infestation rates (number of Varroa per 100 adult honey bees) in colonies of A.

Sesamoiditis of the cyamella: imaging features of this rare presentation.

We report a unique case of sesamoiditis in an extremely rare accessory genicular ossicle. Common to lower primates, the cyamella or popliteus tendon sesamoid bone is usually absent in humans. A 19-year-old male sustained a twisting injury to the right knee and presented with mechanical symptoms of knee pseudo-locking.

Giant tonsillolith - a rare cause of dysphagia.

Tonsilloliths are calcified concretions that originate within the palatal tonsil crypts. Moreover, development of these concretions into giant tonsilloliths is exceptionally uncommon. We present a 17-year-old female with a two-year history of increasing dysphagia, persistent oral cavity swelling and speech alteration.

Loss of the astrocyte glutamate transporter GLT1 modifies disease in SOD1(G93A) mice.

Recent studies have highlighted the role of astrocytes in the development of motor neuron disease in animal models. The astrocyte glutamate transporter GLT1 is responsible for a significant portion of glutamate transport from the synaptic cleft; regulating synaptic transmission and preventing glutamate excitotoxicity. While previous studies have demonstrated reductions in GLT1 with SOD1-mediated disease progression, it is not well established whether a reduction in this astrocyte-specific transporter alters the pathobiology of motor neuron degeneration in the SOD1(G93A) mouse.

Postoperative hepatic dysfunction in perspective. 1970.

Postoperative hepatic dysfunction will remain a difficult entity to place in perspective until increased data are obtained from prospective clinical trials. Ideally these data should compare hepatic dysfunction not only to other postoperative complications, both with regard to overall incidence and to mortality, but also to the overall risks of anesthesia and surgery. The contribution of drug-induced hepatic damage to postoperative hepatic dysfunction has remained unsettled since chloroform was first incriminated during the nineteenth century.

Dissemination of fibreoptic airway endoscopy skills by means of a workshop utilizing models.

A questionnaire was mailed to 182 attendees of four practical workshops on fibreoptic endoscopy. After the workshops, 35% of the attendees were able to introduce fibreoptic intubation into their clinical practice or improve their success rate. This suggests that a new psychomotor skill can be disseminated effectively to clinicians by a practical workshop that utilizes inanimate models, and is based on sound educational principles.

Awake fibreoptic intubation in the patient at high risk of aspiration.

This report describes our experiences with 129 awake oral and nasal fibreoptic intubations in 123 patients considered to be at high risk of aspiration of gastric contents. I.v.

Learning fibreoptic intubation: use of simulators v. traditional teaching.

This study compared a graduated training programme with that of a traditional teaching method to facilitate the learning of the technique of fibreoptic nasotracheal intubation. Thirty-two anaesthesia trainees were randomly assigned to two groups. The graduated programme involved: practice on a bronchoscopy teaching model; exposure of the epiglottis and vocal cords in patients recovering from general anaesthesia; performance of fibreoptic nasotracheal intubation in awake sedated patients.

Multiple neuromuscular blocking agents and reversal in a patient with absent plasma cholinesterase.

The detailed clinical response of a patient with absent plasma cholinesterase (genotype E1s E1s) who received tubocurarine (3 mg), succinylcholine (120 mg), pancuronium (2 mg), and reversal with neostigmine (3 mg) is reported. The patient's responses were compared to the responses of a group of patients with genotype E1a E1a evaluated prospectively, and with eight other genotype E1s E1s patients reported in the literature. The present patient demonstrated evidence of a phase II block before and after attempted reversal, suggesting that free succinylcholine was present in her plasma and a mixed block was present at that time.

Statistical methods in anesthesia articles: an evaluation of two American journals during two six-month periods.

Simple criteria were used to evaluate the statistical analyses in 243 articles from two American anesthesia journals published in the latter six months of 1981 and 1983. Eighty-two percent of the articles reported the use of control measures and 37% reported randomization of treatment, where they were possible. Data were classified as nominal, ordinal, or interval; as independent or related samples; as two-sample or more-than-two-sample cases.