Patent Ductus Arteriosus Stent Versus Surgical Aortopulmonary Shunt for Initial Palliation of Cyanotic Congenital Heart Disease with Ductal-Dependent Pulmonary Blood Flow: A Systematic Review and Meta-Analysis.

Background In patients with ductal-dependent pulmonary blood flow, initial palliation includes catheter-based patent ductus arteriosus (PDA) stent or surgical aortopulmonary shunt (APS). This meta-analysis aimed to compare outcomes between PDA stent and APS. Methods and Results A comprehensive literature search yielded six retrospective observational studies.

Informationists and Nurse Educators Partner to Integrate a Virtual Dissection Table into a Nursing Curriculum.

Informationists and nurse educators launched a pilot program that integrates a Sectra Virtual Dissection Table into a Critical Care Nurse Residency Program (CCNRP) curriculum. CCNRP is a mandatory education program for novice, critical care registered nurses at the University of Cincinnati Medical Center (UCMC). After nurses complete the seven-week course, they take a post-course survey.

Evaluation of an Adrenal Incidentaloma.

Given the frequent use of cross-sectional imaging in medicine, adrenal masses are discovered at an increasing rate. Once detected, it is critical to ensure the patient undergoes the appropriate biochemical/hormonal workup to rule out any aberrant activity and ensure imaging features do not raise suspicion for a malignant neoplasm. Patients with hormonal overactivity, concerning size, and/or imaging characteristics must be referred for surgical consideration.

Intraoperative Decision Making in Parathyroid Surgery.

This article reviews intraoperative decision making related to several important aspects of parathyroid surgery. These include how to systematically identify a missing gland, when to perform a unilateral versus bilateral exploration for cure, approaches to secondary hyperparathyroidism, management of familial hyperparathyroidism, and the treatment of parathyroid cancer. The management of intraoperative complications, such as recurrent laryngeal nerve injury and devascularization of parathyroid glands, also is discussed.

Development of the Adolescent and Young Adult Activity Card Sort.

Emerging adulthood defines transition to employment, higher education, and domestic life. This study describes the development of an assessment of self-reported participation in a range of age-appropriate activities. Item selection was established from literature review, feedback from youth and professionals, the former Adolescent Activity Card Sort (AACS), and the original Activity Card Sort (ACS).

Youth with Sickle Cell Disease: Genetic and Sexual Health Education Needs.

Objectives: Assess the need for and interest in a sexual health and sickle cell disease (SCD) inheritance educational program for youth with SCD.

Methods: Using a cross-sectional approach, qualitative data were collected during interviews of youth with SCD between ages 11-19 years from an urban hospital. Inductive and emergent coding was used to identify themes.

Disseminated mucormycosis in an adolescent with newly diagnosed diabetes mellitus.

We report a 16-year-old, previously healthy female who presented with disseminated mucormycosis leading to multiorgan failure and death with newly diagnosed type 1 diabetes mellitus and ketoacidosis. We review previous reported cases of mucormycosis in children with diabetes to demonstrate that this uncommon invasive infection may cause significant morbidity and mortality in this population.

Anomalous parietal suture mimicking skull fracture.

Anomalous sutures of the parietal bone are exceedingly rare events. We present the case of a child admitted to the hospital after a near-drowning incident who subsequently expired. He was diagnosed with a parietal skull fracture by computed tomography scan before death.

A first time for everything: homicide involving the Brenneke SuperSabot shotgun slug.

Sabot shotgun slugs are not a new projectile, but the Brenneke SuperSabot shotgun slug has never been reported in a homicide. We present the case of a 28-year-old man killed with multiple gunshot wounds during an alleged "drive-by" shooting. At autopsy, a 496.

Pretrial communication with defense counsel by medical examiners' pathologists.

Forensic pathologists (FPs) form opinions in homicide trials and often are key witnesses for the prosecution. Early access to the FP by defense counsel may be strategically important, but state statutes differ regarding pretrial availability of the autopsy report to the defense, and the degree of pretrial communication that is permissible or desirable between the FP and defense is unclear. We surveyed a sample of FPs to determine their practices and opinions regarding pretrial communication with the defense.

A national survey of autopsy cost and workload.

We mailed survey questionnaires to a random sample of medicolegal offices throughout the USA. The survey asked how many forensic pathologists were used, their American Board of Pathology forensic examination (Board) status, how many autopsies they performed, and, if payment were fee-for-service, what fees were paid for medicolegal autopsies. Response rate was 61%, with 188 offices returning questionnaires.

A national survey of postmortem human immunodeficiency virus testing by medical examiners and coroners.

This article reports on a survey of a stratified random sample of medicolegal offices in the United States to find the extent of their testing for human immunodeficiency virus (HIV), using mailback questionnaires. Seventy-six percent (172) of the 225 offices queried responded. Estimates were made for the total population of medicolegal jurisdictions (U.

Oleoresin capsicum (pepper) spray and "in-custody deaths".

Increasing use of oleoresin capsicum (OC) spray devices (i.e., pepper spray, pepper mace, OC, capsaicin) by law enforcement agencies as a means of sublethal force to control suspects has brought into question whether exposure to this noxious irritant (capsaicin) can cause or contribute to unexpected in-custody deaths.

The use of next-of-kin in assessing handedness.

The present study administered a 15-item handedness questionnaire to 129 college students and their next-of-kin. This questionnaire was similar to the Edinburgh Handedness Inventory, except that a 7-point scale was used instead of a 2-choice scale. Test-retest reliability was evaluated with a second administration of the handedness questionnaire to each subject.

Estimation of stature from the length of the cervical, thoracic, and lumbar segments of the spine in American whites and blacks.

In order to estimate stature from the length of cervical, thoracic, lumbar, thoraco-lumbar (T-L) and cervico-thoraco-lumbar (C-T-L) segments of the spine, measurements were made on white and black Americans, both male and female, autopsied during 1977-1993. Sample sizes were as follows: white males = 167; white females = 58; black males = 43; black females = 31. Separate measurements were made of the vertebral segments along the anterior surface of the spine.

Postantibiotic effect of meropenem on members of the family Enterobacteriaceae determined by five methods.

The postantibiotic effect (PAE) of meropenem was determined for 11 strains, both clinical isolates and reference strains of members of the family Enterobacteriaceae. The study compares PAE results obtained by five methods used to monitor bacterial regrowth, including viable counting, alone and in combination with impedance; bioluminescence, alone and in combination with impedance; and a morphological technique. After exposure of the test organisms to meropenem (0.

Automatic procedures for measuring post-antibiotic effect and determining random errors.

Four methods are described for determining the post-antibiotic effect (PAE) automatically using the high resolution capabilities of the conductance measurement of bacterial growth. The time resolution of each method is derived by a statistical procedure for calculating random error from the component errors involved in each determination. The procedures are illustrated using data generated from the measurements of the growth of Escherichia coli NCTC 4174 after exposure of cultures to five antibiotic concentrations.

The role of the medical examiner/coroner in organ and tissue procurement for transplantation.

Facts and principles concerning the role of the medical examiner or coroner in the procurement of organs or tissue for transplantation are presented. Topics discussed are the legalities and the importance of control of the dead body, the medical examiner's or coroner's role in the determination of death, recognition of and working around procurement artifacts and resultant loss of evidence, the medical examiner's or coroner's part in determining suitability of organs for transplantation, the medical examiner or coroner's request for donation by the family, granting of permission for donation of organs or tissue by the medical examiner or coroner, and examination of the mortally injured by the medicolegal officer.

Comparison of methodologies used in assessing the postantibiotic effect.

The postantibiotic effect (PAE) of the carbapenem antibiotic meropenem was determined for the reference strains of Escherichia coli NCTC 4174 and E. coli NCTC 12210. Regrowth of bacteria after antibiotic exposure was determined by viable counting and bioluminescence alone and in combination with an impedance technique and a morphological technique was also employed.

Fatal angioedema associated with captopril.

A markedly hypertensive, 70-year-old, black man had been on captopril for 2 years when he rapidly developed obstructive angioedema. The initial sign of difficulty in understanding his speech progressed to severe laryngeal and glossal edema over a 3 1/2 h period. His airway became obstructed less than a minute after arrival at the emergency room.

Casino-related deaths in Atlantic City, New Jersey 1982-1986.

The first legalized casino-hotel opened in Atlantic City, New Jersey in 1978. Annually, more than 30 million people visit the "Gambling Capitol of the East Coast." As a result of this growing influx of people, the Atlantic County Medical Examiner's Office began compiling statistics in 1982 of casino-related deaths.