DISC: Describing Infections of the Spine treated with Ceftaroline.

Objectives: Infections of the spine lead to considerable morbidity and a high cost to the global healthcare system. Currently, evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited.

Methods: Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicentre, retrospective, cohort study that evaluated ceftaroline for treating spine infections.

Posted emergency department wait times are not always accurate.

Objectives: Hospitals around the United States are advertising emergency department (ED) wait times. The objective was to measure the difference between publicly posted and actual ED wait times and to compare these between ED site volumes.

Methods: This study was a retrospective consecutive sample of ED patients at one hospital system with four EDs.

21-Year-old male with severe coronary atherosclerosis.

Coronary heart disease (CHD) is not limited to middle-aged and elderly individuals; when premature CHD develops in the younger population, it has distinct characteristics in terms of lipid profile, risk factors, and clinical presentation. The following describes a 21-year-old male who presented with stable angina, underwent a full cardiac workup, and was ultimately found to have multivessel CHD. In summary, the presence of mild dyslipidemia, high blood pressure, cigarette smoking, obesity, and a family history was sufficient to induce ischemic heart disease at such a young age.

Patient preferences in choosing a primary care physician.

Background And Aims: Studies have identified factors important to patients in consideration of a primary care physician (PCP). Few have explored relevant differences in choosing between family medicine (FM) and internal medicine (IM) physicians. The objective of this study was to identify differences in rating of factors perceived to be important to racially diverse FM and IM patients in the selection of a PCP, and to determine patient knowledge of PCP training.

Perfusion pressures and distal oxygenation in individuals with diabetes undergoing chronic hemodialysis.

Background: The number of diabetic patients worldwide was estimated to be approximately 285 million in 2010. Approximately 5% of all diabetic patients have foot ulcers, often preceded by neuropathy and delayed healing resulting from peripheral vascular disease which leads to increased risk of infection. Additionally, there is a concern that blood flow to the feet may be reduced in patients with diabetes, which may be further compounded by changes in lower extremity perfusion pressure during hemodialysis.

Waldenström's macroglobulinemia and nephrotic syndrome with membranous nephropathy.

Renal complications of Waldenström's macroglobulinemia (WM) are rarely observed. Nephrotic syndrome in association with WM has most often been secondary to amyloidosis. This article reports a case of WM with nephrotic syndrome as a result of membranous nephropathy with immunoglobulin M (IgM) deposition.

Case report: anaphylactic reaction to guaifenesin.

Adverse drug reactions lead to a significant number of hospital admissions each year and thus contribute to the overall financial burden of health care. Some of these drug reactions are allergic responses. As the overall predictability of allergic responses to drugs remains low, efforts to improve our understanding of the processes underlying these responses continue as we strive toward the ultimate goal of primary prevention.

Ethanol-based cleanser versus isopropyl alcohol to decontaminate stethoscopes.

Approximately 1 in 20 hospital admissions is complicated by a health care-associated infection. Stethoscopes may play a role in spreading nosocomial infections. The objective of this study was to determine the effectiveness of an ethanol-based cleanser (EBC) compared with isopropyl alcohol pads in reducing bacterial contamination of stethoscope diaphragms.

Immune mediated neurologic dysfunction as a paraneoplastic syndrome in renal cell carcinoma.

Objective: To describe a case of cerebellar ataxia associated with renal cell carcinoma.

Case Report: A 53-year-old Caucasian male with a history of Schizophrenia presented with generalized weakness, nausea, vomiting, severe weight loss, and progressively worsening gait difficulty associated with multiple falls. Physical examination revealed profound ataxia with inability to ambulate despite normal strength.

Fibrillary glomerulonephritis with hepatitis C viral infection and hypocomplementemia.

Fibrillary glomerulonephritis (FGN) is a relatively rare cause of renal disease, found in only 0.6-1.5% of native renal biopsies.

Retrospective evaluation of a method to predict fresh-frozen plasma dosage in anticoagulated patients.

In the United States, fresh-frozen plasma (FFP) is commonly used for urgent reversal of warfarin; however, dosage recommendations are difficult to find. If validated, a proposed method that uses a nonlinear relationship between international normalized ratio (INR) and clotting factor activity (CFa) would be useful. This study retrospectively evaluated a proposed equation with adult medical inpatients who received FFP for warfarin reversal.

Use of amifostine, a novel cytoprotective, in alpha-amanitin poisoning.

Background: Mortality from ingestions of the mushroom Amanita phalloides remains as high as 20-40% with many surviving patients requiring liver transplantation. A variety of treatments for Amanita ingestion have been evaluated, yet other than supportive measures, no effective therapy has been identified. In addition, an antidote for Amanita toxicity may not be practical due to delayed patient presentation.

The effect of various insufflation gases on tumor implantation in an animal model.

Objective: The expanded use of laparoscopy has led to reports of tumor dissemination and spread to laparoscopic port sites. We previously showed that carbon dioxide insufflation produced tumor dissemination compared with laparotomy. It is unknown whether the type of gas used influences this dissemination.