An Atypical Case of Extrapulmonary Sarcoidosis.

Sarcoidosis is an idiopathic, inflammatory condition that affects nearly all organs in the body. Lungs are the most frequent and among the earliest sites for detecting it. The most common extrapulmonary manifestations involve the ophthalmic, cardiac, nervous, reticuloendothelial, cutaneous, hepatosplenic, and renal systems.

High-plex imaging of RNA and proteins at subcellular resolution in fixed tissue by spatial molecular imaging.

Resolving the spatial distribution of RNA and protein in tissues at subcellular resolution is a challenge in the field of spatial biology. We describe spatial molecular imaging, a system that measures RNAs and proteins in intact biological samples at subcellular resolution by performing multiple cycles of nucleic acid hybridization of fluorescent molecular barcodes. We demonstrate that spatial molecular imaging has high sensitivity (one or two copies per cell) and very low error rate (0.

Spatially resolved whole transcriptome profiling in human and mouse tissue using Digital Spatial Profiling.

Emerging spatial profiling technology has enabled high-plex molecular profiling in biological tissues, preserving the spatial and morphological context of gene expression. Here, we describe expanding the chemistry for the Digital Spatial Profiling platform to quantify whole transcriptomes in human and mouse tissues using a wide range of spatial profiling strategies and sample types. We designed multiplexed in situ hybridization probes targeting the protein-coding genes of the human and mouse transcriptomes, referred to as the human or mouse Whole Transcriptome Atlas (WTA).

Patient Heterogeneity and the J-Curve Relationship Between Time-to-Antibiotics and the Outcomes of Patients Admitted With Bacterial Infection.

Objectives: Sepsis remains a leading and preventable cause of hospital utilization and mortality in the United States. Despite updated guidelines, the optimal definition of sepsis as well as optimal timing of bundled treatment remain uncertain. Identifying patients with infection who benefit from early treatment is a necessary step for tailored interventions.

Hyperammonemia in the setting of Roux-en-Y gastric bypass presenting with osmotic demyelination syndrome.

Hyperammonemia can lead to serious outcomes including brain herniation, coma and death. It is often attributed to liver disease, specifically in association with alcohol use. However, in the absence of liver pathology, it can be difficult to diagnose the etiology.

Super fragmented: a nationally representative cross-sectional study exploring the fragmentation of inpatient care among super-utilizers.

Background: Super-utilizers with 4 or more admissions per year frequently receive low-quality care and disproportionately contribute to healthcare costs. Inpatient care fragmentation (admission to multiple different hospitals) in this population has not been well described.

Objective: To determine the prevalence of super-utilizers who receive fragmented care across different hospitals and to describe associated risks, costs, and health outcomes.

Bilateral enucleation in dogs: A review of owner perceptions and satisfaction.

Purpose: To evaluate owner perceptions of the quality of life of their dogs before and after bilateral enucleation and to assess owner satisfaction with the procedure.

Methods: Medical records of 72 dogs from the Willows Veterinary Centre and Referral Service (49 dogs) and the Royal Veterinary College (RVC, 23 dogs) that had undergone bilateral enucleation, either in one procedure or at different times, between April 2008 (Willows) or 2012 (RVC) and April 2017, were reviewed. Owners were initially telephoned to determine owner satisfaction, followed by a postal visual analogue scale (VAS) questionnaire evaluating perceptions of their dog's quality of life before and after the bilateral enucleation.

Sexually diergic hypothalamic-pituitary-adrenal axis responses to selective and non-selective muscarinic antagonists prior to cholinergic stimulation by physostigmine in rats.

Central cholinergic systems regulate the hypothalamic-pituitary-adrenal (HPA) axis differentially in males and females (sexual diergism). We previously investigated the role of muscarinic receptors in this regulation by administering physostigmine (PHYSO), an acetylcholinesterase inhibitor, to male and female rats pretreated with scopolamine (SCOP), a nonselective muscarinic antagonist. SCOP pretreatment enhanced adrenocorticotropic hormone (ACTH) and corticosterone (CORT) responses in both sexes, but males had greater ACTH responses while females had greater CORT responses.

A Case for Open Network Health Systems: Systems as Networks in Public Mental Health.

Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or "innovate." But innovation, even when pressure for change is intense, is difficult.

Matrix Effects in Quantitative Analysis of Laser-Induced Breakdown Spectroscopy (LIBS) of Rock Powders Doped with Cr, Mn, Ni, Zn, and Co.

Obtaining quantitative chemical information using laser-induced breakdown spectroscopy is challenging due to the variability in the bulk composition of geological materials. Chemical matrix effects caused by this variability produce changes in the peak area that are not proportional to the changes in minor element concentration. Therefore the use of univariate calibrations to predict trace element concentrations in geological samples is plagued by a high degree of uncertainty.

Ocular biometry by computed tomography in different dog breeds.

Objective: To (i) correlate B-mode ocular ultrasound (US) and computed tomography (CT) (prospective pilot study), (ii) establish a reliable method to measure the normal canine eye using CT, (iii) establish a reference guide for some dog breeds, (iv) compare eye size between different breeds and breed groups, and (v) investigate the correlation between eye dimensions and body weight, gender, and skull type (retrospective study).

Procedure: B-mode US and CT were performed on ten sheep cadaveric eyes. CT biometry involved 100 adult pure-bred dogs with nonocular and nonorbital disease, representing eleven breeds.

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.

Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations.

Outcome of phacoemulsification following corneal and lens laceration in cats and dogs (2000-2010).

Objective: To investigate the success rate of phacoemulsification following corneal and lens laceration in dogs and cats.

Procedure: Retrospective review of cats and dogs presenting with corneal and lens laceration and treated with phacoemulsification.

Results: The records of 33 patients (33 eyes: six feline, 27 canine) presenting to a private referral center were reviewed.

European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery.

Following an extensive literature search and a consensus conference with subject matter experts the following conclusions can be drawn: 1. Robotic surgery is still at its infancy, and there is a great potential in sophisticated electromechanical systems to perform complex surgical tasks when these systems evolve. 2.

Single-incision lift laparoscopic appendicectomy: a less expensive technique easy to learn.

Appendicectomy is the most common abdominal operation performed on an emergency basis in most parts of the world. The laparoscopic technique has many advantages over conventional open surgery especially in women and obese patients. A further improved version introduced recently is using a single-incision (SILS).

Surgical clip migration following laparoscopic cholecystectomy as a cause of cholangitis.

Gallstone disease is a common surgical presentation, and laparoscopic cholecystectomy is the favoured method of surgical management. Ligation of the cystic duct is usually performed with surgical clips, which have the potential to migrate into the common bile duct with time. This paper describes a case of cholangitis secondary to clip migration in a 42-year-old male patient 9 years after the initial laparoscopic cholecystectomy.

Can social contagion help global health 'jump the shark'? Comment on "how to facilitate social contagion?".

The instrumental use of social networks has become a central tenet of international health policy and advocacy since the Millennium project. In asking, 'How to facilitate social contagion?', Karl Blanchet of the London School of Hygiene and Tropical Medicine therefore reflects not only on the recent success, but also hints to growing challenges; the tactics of partnerships, alliances and platforms no longer seem to be delivering at the same rate and maybe reversing. A better understanding of how social networks work may therefore be needed to strengthen a tactical instrument that has been used to remarkable recent effect.

Factoring health equations comment on "do you recommend an interdisciplinary field to your graduate student?".

The International Journal of Health Policy and Management (IJHPM) is a new journal that aims to stimulate not only inter-disciplinary research relating to health, but even an entire new generation of such journals. The challenges of improving human health worldwide clearly suggest 'why' such a journal is needed, but 'how' bridges and junctions across fields of study towards this end might be found poses other questions. From the agnosticism of many sciences with respect to human health, to the great faith others place in more esoteric movements for human well-being, both suggest finding common factors in the many equations that affect human health.

A Network Based Theory of Health Systems and Cycles of Well-being.

There are two dominant approaches to describe and understand the anatomy of complete health and well-being systems internationally. Yet, neither approach has been able to either predict or explain occasional but dramatic crises in health and well-being systems around the world and in developed emerging market or developing country contexts. As the impacts of such events can be measured not simply in terms of their social and economic consequences but also public health crises, there is a clear need to look for and formulate an alternative approach.

Deadly dozen: dealing with the 12 types of thoracic injuries.

Although most thoracic trauma may be treated non-operatively, major thoracic trauma accounts for 25% of trauma deaths. Except for provision of a definitive airway and/or relief of a tension pneumothorax with a needle decompression, the vast majority of thoracic trauma is best served with "load and go," high-flow oxygen, placement of an IV line and administration of crystalloid solutions as the clinical scenario would indicate. Understanding the mechanism of injury is helpful in establishing both prehospital and in-hospital management priorities.

Minimally invasive oesophagectomy versus open surgery: is there an advantage?

Background: Oesophageal resection is the main method of curative treatment for cancer of the oesophagus. Despite advances in surgical technology and postoperative care, the survival rate and prognosis of people undergoing oesophagectomy is still poor. The use of minimally invasive techniques in oesophageal surgery offers hope of reduced recovery time due to a reduction in surgical trauma.

Influence of environmental enrichment on hypothalamic-pituitary-adrenal (HPA) responses to single-dose nicotine, continuous nicotine by osmotic mini-pumps, and nicotine withdrawal by mecamylamine in male and female rats.

In the present study, we determined the effects of environmental enrichment (EE; Kong Toys and Nestlets) on sexually diergic HPA axis responses to single-dose nicotine (NIC), single-dose NIC following continuous NIC administration for two weeks, and NIC withdrawal by single-dose mecamylamine (MEC) in male and female rats. Blood sampling occurred before and after MEC and NIC administrations for the determination of adrenocorticotropic hormone (ACTH) and corticosterone (CORT). Supporting and extending our previous findings, EE appeared to produce anxiolytic effects by reducing hormone responses: Male and female rats housed with EE had lower baseline ACTH and significantly lower HPA axis responses to the mild stress of saline (SAL) injection than did those housed without EE.