Outcome Trends after US Military Concussive Traumatic Brain Injury.

Care for US military personnel with combat-related concussive traumatic brain injury (TBI) has substantially changed in recent years, yet trends in clinical outcomes remain largely unknown. Our prospective longitudinal studies of US military personnel with concussive TBI from 2008-2013 at Landstuhl Regional Medical Center in Germany and twp sites in Afghanistan provided an opportunity to assess for changes in outcomes over time and analyze correlates of overall disability. We enrolled 321 active-duty US military personnel who sustained concussive TBI in theater and 254 military controls.

Supercooled spin liquid state in the frustrated pyrochlore Dy2Ti2O7.

A "supercooled" liquid develops when a fluid does not crystallize upon cooling below its ordering temperature. Instead, the microscopic relaxation times diverge so rapidly that, upon further cooling, equilibration eventually becomes impossible and glass formation occurs. Classic supercooled liquids exhibit specific identifiers including microscopic relaxation times diverging on a Vogel-Tammann-Fulcher (VTF) trajectory, a Havriliak-Negami (HN) form for the dielectric function ε(ω, T), and a general Kohlrausch-Williams-Watts (KWW) form for time-domain relaxation.

Prospectively assessed clinical outcomes in concussive blast vs nonblast traumatic brain injury among evacuated US military personnel.

Importance: Blast injury has been identified as the signature injury in the conflicts in Iraq and Afghanistan. However it remains to be determined whether fundamental differences may exist between blast-related traumatic brain injury (TBI) and TBI due to other mechanisms.

Objectives: To determine similarities and differences between clinical outcomes in US military personnel with blast-related vs.

Carbapenem-resistant Enterobacteriaceae rectal screening during an outbreak of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae at an acute care hospital.

We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-β-lactamase-producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.

How the Affordable Care Act can help move States toward a high-performing system of long-term services and supports.

The United States may advance toward a high-performing health care system that offers long-term services and supports for people with disabilities and chronic conditions, or it may retreat from gains achieved in recent years. Since the 1980s, policy makers and advocates for the disabled have sought to move from a system that emphasizes nursing homes and institutional care to one that includes a broader range of care options. The Affordable Care Act of 2010 gives this movement a considerable boost by offering states timely new options and enhanced federal funding to create a care system that meets the diverse needs and preferences of people with disabilities and that also recognizes the role of family caregivers.

Private long-term care insurance: the Medicaid interaction.

Does long-term care insurance help purchasers preserve their assets and avoid Medicaid? The purpose of this issue brief is to explore the complex interaction of Medicaid and private long-term care insurance and highlight the policy implications for those who may "fall through the cracks" in their coverage.

Late effects of childhood cancer therapy.

One in every 900 young adults is a survivor of childhood cancer. Survivors may experience a wide variety of late effects stemming from the treatment they received. It is estimated that a significant portion of adult survivors of childhood cancer are not followed regularly in a center familiar with the late effects of their specific therapy.

Evaluation and treatment of chemotherapy extravasation injuries.

Extravasation of chemotherapeutic vesicant agents can result in significant tissue damage, alteration in limb function, and pain. Quality of life for long-term survivors can be severely impacted by negative sequelae from vesicant extravasation. Currently, there is no known preventive therapy.

Ex vivo intracystic contrast studies of multicystic dysplastic kidneys.

Purpose: Classically cysts in multicystic dysplastic kidneys are described as noncommunicating. We determined the accuracy of this hypothesis by performing ex vivo intracystic contrast studies of the typical multicystic kidney and hydronephrotic form of the multicystic kidney.

Materials And Methods: We evaluated 7 multicystic dysplastic kidneys in patients between 2 weeks and 6 months old using intracystic injection of contrast material, including 4 that were typical and 3 with the hydronephrotic form of multicystic disease.

Infant botulism: a rare cause of colonic ileus.

We have recently seen two patients with infant botulism, one of whom had radiologic evidence of autonomic and neuromuscular dysfunction. Both infants had been fed small amounts of honey, which is often contaminated with Clostridium botulinum spores, during the Jewish New Year celebration.

Unilateral multicystic dysplasia in 1 component of a horseshoe kidney: case reports and review of the literature.

We report on 3 pediatric patients with multicystic dysplasia involving 1 component of a horseshoe kidney. Including our cases, 18 cases of unilateral multicystic dysplasia in a horseshoe kidney have been reported. The clinical, radiological and pathological features of these cases are briefly reviewed.

The Older Americans Act: should participants share in the cost of services?

Since its inception in 1965, the Older Americans Act has provided social services free of charge to older people, regardless of income. In recent years, the scarcity of resources has sparked a debate as to whether participants who can afford to pay for services should be required to do so. Of concern is whether charging fees will change the fundamental nature of these popular programs by imparting a "welfare" stigma.

Drug-related complications in infants and children: imaging features.

Iatrogenic disorders continue to be an important cause of morbidity and mortality in infants and children. Most adverse drug reactions have no distinctive radiologic features. Of those with radiologic manifestations, it is usually impossible to differentiate iatrogenic disorders from their spontaneously occurring counterparts.

Triphalangeal thumb.

Triphalangeal thumb (TPT), a rare malformation of uncertain pathogenesis, may occur as an isolated defect, in association with other malformations of the hands, or as a feature of a syndrome or sequence. Isolated TPT occurs in two functional types: opposable and non-opposable. The latter appears to be inherited as a simple autosomal dominant trait, while the former is generally sporadic.

Cohen ureteral reimplantation: sonographic appearance.

The sonographic records of 27 children who underwent a Cohen ureteroneocystostomy were reviewed. In 13 children (48%) sonograms demonstrated an echogenic, nonacoustically shadowing structure at or just above the trigone that was fixed in position within the bladder wall and covered by intact mucosa. This constellation of sonographic findings, which represent the submucosal segment of the reimplanted ureter, produces a "tunnel sign.

MR and CT demonstration of levator sling in congenital anorectal anomalies.

Demonstration of the levator ani muscle is important in evaluating children with anorectal anomalies. Using magnetic resonance and CT we have imaged the levator sling in three children prior to their definitive surgery for imperforate anus. The levator mechanism was seen as a low signal band extending from the coccyx to the pubis.

Pulmonary candidiasis in infants: clinical, radiologic, and pathologic features.

Although systemic candidiasis is common in hospitalized patients, invasive pulmonary candidiasis is rare and generally considered of secondary importance when found at autopsy. Autopsy records for a 12 year period were reviewed and 15 infants were found in whom systemic candidiasis was considered the primary or a major contributory cause of death. Significant pulmonary involvement was found in 14.

Bilateral kidney herniation: complication of cutaneous pyelostomy.

A case of bilateral kidney herniation through cutaneous pyelostomy stomas is reported. The child is doing well after successful closure of the pyelostomies and repair of both ureteropelvic junctions obstructions.

Sonographic evaluation of the chest in infants and children.

Sonography was used to evaluate 28 patients (age range, newborn to 16 years) with mediastinal and juxtacardiac masses and disease processes, partial or complete opacification of a hemithorax, and various juxtadiaphragmatic abnormalities. Technically adequate studies were obtained in 93% of the cases. Sonography was of greatest value in determining the cause of an opaque hemithorax, characterizing fluid collections, localizing fluid collections prior to percutaneous aspiration or drainage, and demonstrating the position and integrity of the diaphragm.