An Assessment of Physician Well-Being and Burnout Among Army Obstetricians and Gynecologists.

Introduction: Physician burnout is associated with unsafe patient care and poor patient satisfaction. Civilian studies show burnout rates of 46% among obstetricians/gynecologists (OB/GYNs). Army Active Duty (A-AD) physician burnout rates range from 7.

The Repair of an Acute Pathological Subtrochanteric Femur Fracture Using an Adult 3.5-mm Proximal Humerus Locking Plate in an Adolescent Patient: A Case Report.

Case: We report a novel case of the successful repair of a pathological fracture of a 14-year-old boy's proximal femur using open reduction and internal fixation with an adult 3.5-mm proximal humerus locking plate.

Conclusion: Successful repair of a pediatric pathologic femur fracture due to an aneurysmal bone cyst may be achieved using an adult proximal humerus locking plate in select patients.

Consensus and Controversies Between Pain and Addiction Experts on the Prevention, Diagnosis, and Management of Prescription Opioid Use Disorder.

Objectives: Prescription opioid use disorder (POUD) is an established public health crisis in many countries, and current evidence indicates it is a growing problem in Europe. Many specialists play a role, including pain and addiction medicine specialists, in the diagnosis and management of POUD, but neither group can fully address these patients' needs alone. The purpose of this consensus process was to bring together experts from pain and addiction medicine to examine the positions of both specialties.

Recommendations for the Prevention, Detection, Treatment and Management of Prescription Opioid Analgesic Dependence: Outcomes From the Opioid Analgesic Dependence Education Nexus (OPEN) Meeting.

The global consumption of opioids continues to rise, which has led to an increasing rate of diversion, misuse, addiction, and deaths related to prescription opioids. This has been particularly well documented in the USA; however, opioid analgesic dependence (OAD) is an increasing concern in Europe. More guidance is required for European healthcare professionals in the prevention, detection, treatment and management of OAD.

In Diabetic Kidney Disease Urinary Exosomes Better Represent Kidney Specific Protein Alterations Than Whole Urine.

Background: Predicting or diagnosing underlying kidney disease by analyzing whole urine remains the mainstay of nephrology practice. However, whole urine is a poor compartment to assess many structural changes in the kidney because whole urine contains only a few proteins derived from the kidney itself. Urinary exosomes, on the other hand, which are derived from the kidney, contain proteins secreted by the kidney.

The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study.

Background: This multicenter international cross-sectional observational study characterized vascular and valvular calcification burden and correlations with pulse pressure, diabetes, hypertension, and cardiovascular diseases in prevalent hemodialysis patients.

Methods: We enrolled 275 consecutive adults with end-stage renal disease on maintenance hemodialysis for ⩾3 months. Coprimary endpoints were prevalences of: (1) echocardiographic calcification in mitral valve, aortic valve or mitral annulus; (2) aortoiliac tree vascular calcifications by plain lateral lumbar X-ray.

Resurgence of membranous nephropathy in African Americans in inner city Chicago.

Background: It is well established that the incidence of focal segmental glomerular sclerosis (FSGS) increased from 1970-1990 to become the leading primary glomerular disease in patients of African descent.

Methods: To determine whether this trend has continued in the past years in Chicago, adult, native kidney biopsies from January 2001 to December 2011 at our hospital were reviewed and collected relevant clinical information in patients with a primary glomerular disease including FSGS, membranous nephropathy (MN), minimal change disease (MCD), membranoproliferative glomerulonephritis (MPGN), and IgA nephropathy (IgAN).

Results: In the 204 patients analyzed, MN was the most prevalent (32.

Statement of the American Society Of Addiction Medicine Consensus Panel on the use of buprenorphine in office-based treatment of opioid addiction.

Objectives: Opioid addiction affects over 2 million patients in the United States. The advent of buprenorphine and the passage of the Drug Addiction Treatment Act in 2000 have revolutionized the opioid treatment delivery system by granting physicians the ability to administer office-based opioid treatment (OBOT), thereby giving patients greater access to treatment. The purpose of this consensus panel was to synthesize the most current evidence on the use of buprenorphine in the office-based setting and to make recommendations that will enable and allow additional physicians to begin to treat opioid-addicted individuals.

Culture of omentum-induced regenerating liver yielded hepatocyte-committed stem cells.

Earlier we showed that when omentum, activated by inert particles, is allowed to fuse to a wedge cut in the liver, it induces stem cell proliferation in the liver resulting in massive liver regeneration. Here, we attempt to culture stem cells from the omentum-induced regenerating liver tissue. Cells from regenerating liver tissue were harvested and cultured.

Omentum facilitates liver regeneration.

Aim: To investigate the mechanism of liver regeneration induced by fusing the omentum to a small traumatic injury created in the liver. We studied three groups of rats. In one group the rats were omentectomized; in another group the omentum was left in situ and was not activated, and in the third group the omentum was activated by polydextran particles.

Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation.

The success of tissue engineering applications can potentially be dramatically improved with the addition of adjuncts that increase the proliferation and differentiation of progenitor or stem cells. Platelet-rich plasma (PRP) has recently emerged as a potential biologic tool to treat acute and chronic tendon disorders. The regenerative potential of PRP is based on the release of growth factors that occurs with platelet rupture.

2008 update on addiction medicine/psychiatry in the State of Connecticut. Part II of II.

No other health or social problem impacts our society so widely and profoundly as substance abuse. Investment in Connecticut's substance abuse service system is an investment in improved health and wellness its cities as well as its citizens. Since 2004 Connecticut's addiction treatment and recovery community have worked together to reduce the pain and suffering of those individuals with addiction disorders.

Idiopathic hypocomplementemic immune-complex-mediated tubulointerstitial nephritis.

Background: A 42-year-old man presenting with flank pain was found to have renal failure with severe hypocomplementemia and eosinophilia.

Investigations: Physical examination, laboratory testing, renal ultrasonography, and renal biopsies.

Diagnosis: Acute immune-complex-mediated tubulointerstitial nephritis.

Medical Education About the Care of Addicted Incarcerated Persons: A National Survey of Residency Programs.

In June 1998, there were 1.8 million inmates in correctional facilities for adults; 1.2 million in state and federal prisons and 600,000 in municipal/county jails (668 persons per 100,000 U.

Hemorrhagic angiomyolipoma and tuberous sclerosis complex: a case report.

Tuberous sclerosis was first described in 1862 by von Recklinghausen. Since then there have been many advances in our understanding of the diagnosis, pathogenesis, and treatment of this disease complex, especially after it was characterized genetically. While many patients who have tuberous sclerosis present with the classic triad of mental retardation, seizures, and facial "adenoma sebaceum," most do not because of its variable penetrance.