July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States.

Background: Esophagogastroduodenoscopy (EGD) is a common procedure used for both diagnosis and treatment, but carries risks such as bleeding and perforation. The "July effect"-described as increased complication rates during the transition of new trainees-has been studied in other procedures, but has not been thoroughly evaluated for EGD.

Methods: We used the National Inpatient Sample database for 2016 to 2018 to compare outcomes in EGD performed between July to September and April to June.

Independent Risk Factors for Thromboembolic Events in High-Risk Patients With Takotsubo Cardiomyopathy.

Takotsubo cardiomyopathy (TCM) is characteristically associated with left ventricular apical ballooning and regional wall motion abnormalities that predispose to the formation of left ventricular (LV) thrombi and subsequent thromboembolic events (VTE). There is limited data about the risk factors of developing stroke in the absence of LV thrombi in patients with TCM. Identify risk factors that predispose patients with TCM to develop VTE and stroke.

Non-Convulsive Status Epilepticus in Hepatic Encephalopathy: A Case Series and Review of the Literature.

Unlabelled: Hepatic encephalopathy is a common complication in chronic liver disease and cirrhosis. Here we describe two patients with hepatic encephalopathy who did not respond to standard empiric treatment and were found to have non-convulsive status epilepticus. Both patients improved with antiepileptic therapy.

Determination of Non-Recrystallization Temperature for Niobium Microalloyed Steel.

In the present investigation, the non-recrystallization temperature (T) of niobium-microalloyed steel is determined to plan rolling schedules for obtaining the desired properties of steel. The value of T is based on both alloying elements and deformation parameters. In the literature, T equations have been developed and utilized.

Acute Myeloid Leukemia: Is That All There Is?

Acute myeloid leukemia (AML) is characterized by the clonal proliferation of malignant myeloid blast cells in the marrow along with impaired normal hematopoiesis. With an almost stagnant approach for the management of patients with AML in the last three decades, the main purpose of this paper is to increase our understanding of recent scientific advancements for the enhanced diagnosis and treatment of AML. Existing research data related to different approaches for a possible improvement in AML management has been collected and discussed.

Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy: Treatment Patterns From the PROXIMA Prospective Registry.

Purpose: There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies.

Patients And Methods: PROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy.

Comparison of Nottingham Prognostic Index and Adjuvant Online prognostic tools in young women with breast cancer: review of a single-institution experience.

Objective: Accurately predicting the prognosis of young patients with breast cancer (<40 years) is uncertain since the literature suggests they have a higher mortality and that age is an independent risk factor. In this cohort study we considered two prognostic tools; Nottingham Prognostic Index and Adjuvant Online (Adjuvant!), in a group of young patients, comparing their predicted prognosis with their actual survival.

Setting: North East England

Participants: Data was prospectively collected from the breast unit at a Hospital in Grimsby between January 1998 and December 2007.

Sequential maximum androgen blockade (MAB) in minimally symptomatic prostate cancer progressing after initial MAB: two case reports.

The management of castrate-resistant prostate cancer progressing after maximum androgen blockade (MAB) has evolved in the last decade with the development of several novel therapeutic options. However, the initial therapeutic strategy in these patients usually involves withdrawal of anti-androgen that can be associated with biochemical response in approximately 20% of patients. Notably, we have observed evidence of sustained biochemical response in two patients following second- and third-line MAB using rechallenge schedule of previously administered anti-androgen after latent interval.

Evolution of the treatment paradigm for patients with metastatic castration-resistant prostate cancer.

As recently as 2004, treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) were limited, with docetaxel the only approved agent conferring a survival benefit. The therapeutic landscape is now very different, with several agents demonstrating prolonged survival since 2010. New agents for the treatment of mCRPC include sipuleucel-T, cabazitaxel, abiraterone acetate, enzalutamide and radium-223.

The posterior to anterior controlled technique of percutaneous Achilles tenotomy in the correction of idiopathic clubfoot: a technical report.

Percutaneous tenotomy of the Achilles tendon is an integral part of the Ponseti technique of clubfoot correction. Although originally described by Ponseti as an office procedure that was performed under local anaesthesia, serious neurovascular complications that include iatrogenic injury to the lesser saphenous vein, the posterior tibial neurovascular bundle, the sural artery and pseudoaneurysm formation have been reported. We describe a new tenotomy technique, the posterior to anterior controlled technique, that may decrease the possibility of neurovascular damage, does not require exposure of the Achilles tendon and can be performed as an office procedure under local anaesthesia.

A case of limbic encephalitis presenting as a paraneoplastic manifestation of limited stage small cell lung cancer: a case report.

Introduction: The differential diagnosis of altered mental status and behavioral change is very extensive. Paraneoplastic limbic encephalitis is a rare cause of cognitive impairment, which should be considered in the differential diagnosis.

Case Presentation: A 64-year-old British Caucasian woman presented to our hospital with a 12-week history of confusion and short-term memory loss.

Lateral invaginating peg (LIP) osteotomy for the correction of post-traumatic cubitus varus deformity.

Closing wedge osteotomies are the gold standard for the management of post-traumatic cubitus varus deformity. However, most of these osteotomies are fraught with complications such as lateral condylar prominence, instability, and difficulty in correcting internal rotation. We describe a new technique that provides a means for the management of all these problems simultaneously.

Complications of paediatric elbow trauma treatment by traditional bonesetters.

This is a retrospective review of paediatric elbow trauma, which was initially treated by bonesetters and subsequently reported to the hospital for management. This paper describes the pattern of trauma and the complications of unscientific management. The report also recommends a basic training program for the bonesetters so as to make them aware of the potential complications involved in managing paediatric elbow trauma.

Deformity correction and massive lengthening on a centralized fibula with the Ilizarov technique.

Lengthening beyond 25% of the original segment length is an orthopaedic challenge. Substantial lengthening is fraught with complications such as joint contractures, refractures, nerve injuries and prolonged periods of consolidation. We report a case of massive lengthening in a 17-year-old boy in whom a 20 cm lengthening (57% lengthening) and complex deformity correction was performed on a centralized fibula using the Ilizarov technique, with an excellent result.

Duloxetine in treatment of refractory chronic tennis elbow: two case reports.

Introduction: Tennis elbow is a common musculoskeletal disorder; management options include physiotherapeutic, medical, surgical, and other forms of intervention. Some patients remain symptomatic despite best efforts. We present two patients who did not respond to medical and surgical treatments, and whose symptoms were relieved with duloxetine.

Outcome of treatment of the mismanaged pediatric elbow trauma: a series of 73 cases.

Purpose: To analyze the outcome of the management of pediatric elbow trauma referred to our hospital after initial intervention by traditional bone setters.

Method: Retrospective study of 73 patients, presenting to the hospital with a complication attributable to the initial mismanagement of their injuries.

Results: The mode of presentation was directly related to the type of initial intervention on the basis of which we were able to quantify bone setters into two groups.

Delayed fixation of displaced femoral neck fractures in younger adults.

We report the results of 52 patients aged 20-55 years with displaced femoral neck fractures, in whom delayed closed reduction and internal fixation was performed. Seven patients developed avascular necrosis (AVN) and non-union was seen in five patients. Whereas most patients with non-union were subjected to repeat procedures, none of the patients with AVN required surgery.

Neurological outcome following delayed fixation of unstable thoracolumbar spinal injuries with short segment posterior fixation.

Objective: To evaluate the improvement in neurological deficit following late decompression and stabilization of the fractured thoracolumbar spine.

Methods: Between January 2001 and August 2004 neurological recovery in 120 thoracolumbar fractures was studied after posterior stabilization at the Hospital for Bone & Joint Surgery, Srinagar, India. There were 88 male and 32 female patients.

Primary intrathoracic goiter -a rare mediastinal tumor.

Primary intrathoracic goiter is a rare presentation of thyroid disease. Its removal usually necessitates thoracotomy or sternotomy. This patient having a primary intrathoracic goiter presented with posterior mediastinal mass that was removed through a right lateral thoracotomy.