Pharmacological Inhibition of Epidermal Growth Factor Receptor Prevents Intracranial Aneurysm Rupture by Reducing Endoplasmic Reticulum Stress.

Background: Multiple pathways and factors are involved in the rupture of intracranial aneurysms. The EGFR (epidermal growth factor receptor) has been shown to mediate inflammatory vascular diseases, including atherosclerosis and aortic aneurysm. However, the role of EGFR in mediating intracranial aneurysm rupture and its underlying mechanisms have yet to be determined.

A Multidisciplinary Algorithm for the Evaluation of Acute Neurologic Deficits Improves Management of Cryptogenic Stroke or Transient Ischemic Attack.

The appropriate diagnosis and management of cryptogenic stroke and transient ischemic attack (TIA) is challenging and requires multidisciplinary involvement. Joint societal guidelines exist to guide the comprehensive evaluation of these entities. This study aimed to implement a standardized multidisciplinary diagnostic algorithm for cryptogenic stroke/TIA.

Education Research: Diversity in Neurology Graduate Medical Education Leadership.

Background And Objectives: To describe the current landscape of gender and racial diversity among adult neurology residency and fellowship program directors (PDs). Diversity in medicine affects the quality of care provided to a diverse patient population. There are efforts in nearly every field of medicine to increase the diversity of the physician workforce.

The Association Between Hospital Length of Stay and Treatment With IV Magnesium in Patients With Status Migrainosus.

Status migrainosus (SM) is a subtype of migraine defined by migraine lasting >72 hours and is difficult to treat in clinical practice. Magnesium is commonly used in the treatment of migraine. We conducted a retrospective cohort study to determine if length of admission was associated with IV magnesium therapy in patients with SM.

Autoimmune Small Fiber Neuropathy Associated With Ehlers-Danlos Syndrome Treated With Intravenous Immunoglobulins.

Patients with Ehlers-Danlos syndrome (EDS) have many associated symptoms of unclear cause, most recently suggested to be due to small fiber neuropathy (SFN). Small fiber neuropathies are sorely underestimated and with minimal treatment options. We report 2 cases of patients with EDS with presumed immune-mediated SFN, successfully treated with IV immunoglobulins.

Green Synthesis of Halogenated Thiophenes, Selenophenes and Benzo[]selenophenes Using Sodium Halides as a Source of Electrophilic Halogens.

Herein, we report the first synthesis of chlorinated benzo[]selenophenes via environmentally friendly electrophilic chlorocyclization reaction using "table salt" as a source of "electrophilic chlorine" and ethanol as a solvent. In addition, the synthesis of diverse halogenated heterocycles, including 3-chloro, 3-bromo and 3-iodo thiophenes, selenophenes, and benzo[]selenophenes was successfully accomplished under the same environmentally benign reaction conditions. This methodology has several advantages over other previously reported reactions as it employs simple starting compounds, an environmentally friendly solvent, ethanol, and non-toxic inorganic reagents under mild reaction conditions, resulting in the high product yields.

PROMIS Physical Function Computer Adaptive Test Compared With Other Upper Extremity Outcome Measures in the Evaluation of Proximal Humerus Fractures in Patients Older Than 60 Years.

Objectives: To compare the PROMIS Physical Function Computer Adaptive Test (PROMIS PF CAT) to commonly used traditional PF measures for the evaluation of patients with proximal humerus fractures.

Design: Prospective.

Setting: Two Level I trauma centers.

Comparison of locked plate fixation and nonoperative management for displaced proximal humerus fractures in elderly patients.

Use of locked plate fixation for proximal humerus fractures in elderly patients has increased markedly in recent years. We conducted a study to compare outcomes of operative (locked plate fixation) and nonoperative management of these fractures. From our database, we identified 207 displaced proximal humerus fractures that met all inclusion and exclusion criteria.

Delayed Primary Closure of Fasciotomy Incisions in the Lower Leg: Do We Need to Change Our Strategy?

Objectives: The primary purpose of this study is to determine whether a strategy of bringing patients back to the operating room for successive debridements allows for the eventual delayed primary closure (DPC) of fasciotomy wounds.

Design: Retrospective cohort study. Data were collected from medical records and radiographs.

Does fluoroscopy improve acetabular component placement in total hip arthroplasty?

Background: The success of THA largely depends on correct placement of the individual components. Traditionally, these have been placed freehand using anatomic landmarks, but studies have shown poor accuracy with this method.

Questions/purposes: Specifically, we asked (1) does using fluoroscopy lead to more accurate and greater likelihood of cup placement with the Lewinnek safe zone than does freehand cup placement; (2) is there a learning curve associated with the use of fluoroscopy for cup placement; (3) does the use of fluoroscopy increase operative time; and (4) is there a difference in leg length discrepancy between freehand and fluoroscopic techniques?

Methods: This series consisted of 109 consecutive patients undergoing primary THA, conversion of a previous hip surgery to THA, and revision THA during a 24-month period.

Effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study of 454 patients.

Objectives: Controversy exists regarding the effect of operative treatment on mortality after acetabular fracture in elderly patients. Our hypothesis was that operative treatment would confer a mortality benefit compared with nonoperative treatment even after adjusting for comorbidities associated with death.

Design: Retrospective study.

Unrecognized chronic hepatitis C virus infection among baby boomers in the emergency department.

Unlabelled: The Centers for Disease Control and Prevention and U.S. Preventive Services Task Force have highlighted public screening as an essential strategy for increasing hepatitis C virus (HCV) detection in persons born between 1945 and 1965 ("baby boomers").

Automated electronic medical record sepsis detection in the emergency department.

Background. While often first treated in the emergency department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis.

Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures.

Introduction: Reported initial success rates after lateral locked plating (LLP) of distal femur fractures have led to more concerning outcomes with reported nonunion rates now ranging from 0 to 21%. Reported factors associated with nonunion include comorbidities such as obesity, age and diabetes. In this study, our goal was to identify patient comorbidities, injury and construct characteristics that are independent predictors of nonunion risk in LLP of distal femur fractures; and to develop a predictive algorithm of nonunion risk, irrespective of institutional criteria for clinical intervention variability.

Short versus long cephalomedullary nails for the treatment of intertrochanteric hip fractures in patients older than 65 years.

Objectives: To compare failure rates between short and long cephalomedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age.

Design: Retrospective cohort study. Data were collected from medical records and radiographs.

Transient osteoporosis of pregnancy.

Transient osteoporosis of pregnancy (TOP) is a rare yet perhaps under-reported condition that has affected otherwise healthy pregnancies throughout the world. The condition presents suddenly in the third trimester of a usually uneventful pregnancy and progressively immobilizes the mother. Radiographic studies detect drastic loss of bone mass, elevated rates of turnover in the bone, and oedema in the affected portion.