Optimal Blood Glucose Monitoring Interval for Insulin Infusion in Critically Ill Non-Cardiothoracic Patients: A Pilot Study.

Objective: The American Diabetes Association and the Society of Critical Care Medicine recommend monitoring blood glucose (BG) every 1-2 hours in patients receiving insulin infusion to guide titration of insulin infusion to maintain serum glucose in the target range; however, this is based on weak evidence. We evaluated the compliance of hourly BG monitoring and relation of less frequent BG monitoring to glycemic status.

Materials And Methods: Retrospective chart review performed on 56 consecutive adult patients who received intravenous insulin infusion for persistent hyperglycemia in the ICU at Saint Vincent Hospital, a tertiary care community hospital an urban setting in Northeast region of USA.

A 5-year clinical follow-up study from the Italian National Registry for FSHD.

Background: The natural history of facioscapulohumeral muscular dystrophy (FSHD) is undefined.

Methods: An observational cohort study was conducted in 246 FSHD1 patients. We split the analysis between index cases and carrier relatives and we classified all patients using the Comprehensive Clinical Evaluation Form (CCEF).

Interpretation of the Epigenetic Signature of Facioscapulohumeral Muscular Dystrophy in Light of Genotype-Phenotype Studies.

Facioscapulohumeral muscular dystrophy (FSHD) is characterized by incomplete penetrance and intra-familial clinical variability. The disease has been associated with the genetic and epigenetic features of the D4Z4 repetitive elements at 4q35. Recently, D4Z4 hypomethylation has been proposed as a reliable marker in the FSHD diagnosis.

Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost.

Purpose: To measure how an integrated smartlist developed for critically ill patients would change intensive care units (ICUs) length of stay (LOS), mortality, and charges.

Materials And Methods: Propensity-score analysis of adult patients admitted to one of 14 surgical and medical ICUs between June 2017 and May 2018. The smart list aimed to certain preventative measures for all critical patients (e.

Lower Endoscopic Diagnostic Yields Observed in Non-hematemesis Gastrointestinal Bleeding Patients.

Background: Location of bleeding can present a diagnostic challenge in patients without hematemesis more so than those with hematemesis.

Aim: To describe endoscopic diagnostic yields in both hematemesis and non-hematemesis gastrointestinal bleeding patient populations.

Methods: A retrospective analysis on a cohort of 343 consecutively identified gastrointestinal bleeding patients admitted to a tertiary care center emergency department with hematemesis and non-hematemesis over a 12-month period.

A randomized controlled trial comparing efficacy of early video capsule endoscopy with standard of care in the approach to nonhematemesis GI bleeding (with videos).

Background And Aims: Patients presenting with nonhematemesis GI bleeding (NHGIB) represent a diagnostic challenge for physicians. We performed a randomized controlled trial to assess the benefits of deployment of a video capsule soon after admission in the management of patients presenting with melena, hematochezia, or severe anemia compared with standard of care management.

Methods: Patients admitted with NHGIB were randomized and placed into 1 of 2 study groups.

Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension.

Background: The data on the association of sleep duration and blood pressure in the pediatric age group have been mixed and most studies have focused on weekday sleep duration. The purpose of this study was to compare the weekday and weekend sleep patterns between children and adolescents with newly diagnosed primary hypertension and a normotensive control group.

Methods: Children and adolescents from a pediatric nephrology clinic, aged 6-18 years with newly diagnosed primary hypertension were compared to an age and sex matched normotensive control group from a general pediatric clinic.

A Quality Improvement Initiative to Increase Scoring Consistency and Accuracy of the Finnegan Tool: Challenges in Obtaining Reliable Assessments of Drug Withdrawal in Neonatal Abstinence Syndrome.

Background: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs.

Purpose: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses.

Methods: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale.

Reducing therapeutic misconception: A randomized intervention trial in hypothetical clinical trials.

Background: Participants in clinical trials frequently fail to appreciate key differences between research and clinical care. This phenomenon, known as therapeutic misconception, undermines informed consent to clinical research, but to date there have been no effective interventions to reduce it and concerns have been expressed that to do so might impede recruitment. We determined whether a scientific reframing intervention reduces therapeutic misconception without significantly reducing willingness to participate in hypothetical clinical trials.

Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission.

Background: It is unclear whether the gold standard test for the detection of partial clinical remission (PCR) in new-onset type 1 diabetes (T1D), the insulin-dose adjusted Hemoglobin A1c (IDAA1c) of ≤9, is superior to a new tool, total daily dose of insulin (TDD) of <0.3 units/kg/day. The aim of the study was to test the superiority of IDAA1c over TDD of <0.

Health-Care Access during the Ebola Virus Epidemic in Liberia.

The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care.

Anion gap can differentiate between psychogenic and epileptic seizures in the emergency setting.

Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES.

Factors Influencing IACUC Decision Making: Who Leads the Discussions?

Decisions about the appropriate use of animals in research are largely made by Institutional Animal Care and Use Committees (IACUCs). Several commentators claim that scientists exert excessive influence on IACUC decisions. We studied 87 protocol reviews from 10 IACUCs to assess whether any group of participants appeared to dominate the protocol discussions.

A predictive model for lack of partial clinical remission in new-onset pediatric type 1 diabetes.

Importance: >50% of patients with new-onset type 1 diabetes (T1D) do not enter partial clinical remission (PCR); early identification of these patients may improve initial glycemic control and reduce long-term complications.

Aim: To determine whether routinely obtainable clinical parameters predict non-remission in children and adolescents with new-onset T1D.

Subjects And Methods: Data on remission were collected for the first 36 months of disease in 204 subjects of ages 2-14 years with new-onset type 1 diabetes.

Correction: Vitamin D status in pediatric irritable bowel syndrome.

[This corrects the article DOI: 10.1371/journal.pone.

Vitamin D status in pediatric irritable bowel syndrome.

Importance: Irritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally, the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear.

Reproducibility and repeatability of optical coherence tomography imaging of the optic nerve head in normal beagle eyes.

Objective: To assess the reproducibility and repeatability of an optical coherence tomography (OCT) device for imaging the optic nerve region of normal canines.

Animals Studied: Twelve clinically healthy beagles.

Procedures: All animals were anesthetized, and an OCT device was used to image the optic disk region.

Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments.

Study Objective: Prolonged boarding times in the emergency department (ED) disproportionately affect mental health patients, resulting in patient and provider dissatisfaction and increased patient morbidity and mortality. Our objective is to quantify the burden of mental health boarding and to elucidate the effect of insurance together with demographic, social, and comorbid factors on length of stay.

Methods: We conducted a cross-sectional observational study of 871 consecutive patients requiring an ED mental health evaluation at one of 10 unaffiliated Massachusetts hospitals.

Randomized trial of a short course of preoperative potassium iodide in patients undergoing thyroidectomy for Graves' disease.

Background: A short course of potassium iodide (SSKI) has been traditionally used to prepare patients with Graves' disease for thyroidectomy. The rationale for this treatment has evolved over time; from control of hyperthyroidism to facilitating surgery by making the gland less friable and bloody.

Methods: Randomized trial of preoperative SSKI vs no SSKI to test whether that is true.

Adiposity is associated with early reduction in bone mass in pediatric inflammatory bowel disease.

Objectives: The effect of adiposity on bone mass in the early phases of inflammatory bowel disease (IBD) in children and adolescents is unclear. The aim of this study was to determine the role of adiposity on bone mass in the first 3 y of diagnosis of IBD. The expected result is that increased adiposity will be associated with increased bone mass in both the controls and IBD subjects.

Factors influencing survival among Kenyan children diagnosed with endemic Burkitt lymphoma between 2003 and 2011: A historical cohort study.

Discovering how to improve survival and establishing clinical reference points for children diagnosed with endemic Burkitt lymphoma (eBL) in resource-constrained settings has recaptured international attention. Using multivariate analyses, we evaluated 428 children with eBL in Kenya for age, gender, tumor stage, nutritional status, hemoglobin, lactate dehydrogenase (LDH), Epstein-Barr virus (EBV) and Plasmodium falciparum prior to induction of chemotherapy (cyclophosphamide, vincristine, methotrexate and doxorubicin) to identify predictive and prognostic biomarkers of survival. During this 10 year prospective study period, 22% died in-hospital and 78% completed six-courses of chemotherapy.

Association between Responsible Pet Ownership and Glycemic Control in Youths with Type 1 Diabetes.

Type 1 diabetes mellitus (T1DM) a chronic characterized by an absolute insulin deficiency requires conscientious patient self-management to maintain glucose control within a normal range. Family cohesion and adaptability, positive coping strategies, social support and adequate self-regulatory behavior are found to favorably influence glycemic control. Our hypothesis was that the responsible care of a companion animal is associated with these positive attributes and correlated with the successful management of a chronic illness such as type 1 diabetes.

A Randomized, Double-Blind, Placebo-Controlled Trial of Adjunctive Metformin Therapy in Overweight/Obese Youth with Type 1 Diabetes.

Context: Insulin resistance has been proposed as one of the causes of poor glycemic control in overweight/obese youth with type 1 diabetes (T1D). However, the role of adjunctive metformin, an insulin sensitizer, on glycemic control in these patients is unclear.

Objective: To compare the effect of metformin vs.

The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease.

Objectives: The aim of this study was to investigate the relationships between 25-hydroxy vitamin D (25[OH]D) and markers of vitamin D status in inflammatory bowel disease (IBD).

Methods: We conducted a retrospective case-control study of 59 pediatric patients with IBD (age 16.4 ± 2.