Distribution of angle alpha and angle kappa offsets among adult candidates for cataract surgery.

Purpose: The current study aimed to describe the distribution of angle alpha and angle kappa offsets as well as their associated ocular biometric parameters in a large population of candidates for cataract surgery.

Methods: This cross-sectional retrospective study included 8,119 eyes of 4,781 candidates for cataract surgery (mean age 70.7 ± 12.

In vivo assessment of antimicrobial activity and toxicity of repeated 1% povidone-iodine applications vs a single 5% povidone-iodine application.

Purpose: To demonstrate the noninferiority in antimicrobial effectiveness of thrice-repeated applications of 1% povidone-iodine (PI) compared with a single application of 5% PI on the ocular surface in vivo and to evaluate potential toxicity of PI to the corneal epithelium.

Setting: Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.

Design: Prospective, randomized, double-blind study.

Adherence of caregivers of children to advice provided by a National Poison Information Center.

Introduction: Most calls to poison information centers are from the public, pertaining to young children, and due to minor or nontoxic exposures. Rational poison center consultations can prevent unnecessary visits to emergency departments (EDs), callers' adherence to such advice is required.

Objectives: Estimate adherence of callers from the public to the poison center concerning exposures of young children to the advice provided by the clinical toxicologist, estimate the number of unnecessary ED visits of these children prevented by poison center consultations.

Characteristics of Second-Line Investigations of Middle-Aged Athletes Who Failed Preparticipation Examinations.

Objective: The role of exercise testing during preparticipation examinations (PPEs) of middle-aged athletes is uncertain. This study examined the characteristics of disqualifications after an initial PPE that includes an exercise test in competitive athletes older than 30 years. We investigated disqualification rates and reasons, second-line investigations performed, and final decisions regarding competitive sports participation.

Type 2 myocardial infarction in general medical wards: Clinical features, treatment, and prognosis in comparison with type 1 myocardial infarction.

Type 2 myocardial infarction (MI) is defined as myocardial necrosis due to imbalance between myocardial oxygen supply and demand. The objective of this study was to assess the features, treatments, and outcomes of patients with type 2 MI in comparison with patients with type 1 MI hospitalized in general medical wards. A retrospective review was performed on patients admitted to general medicine wards diagnosed with MI in Sheba Medical Center between January 1, 2016 and December 31, 2016.

Poisoning in Israel: Annual Report of the Israel Poison Information Center, 2017.

Background: The Israel Poison Information Center (IPIC), Rambam Health Care Campus, provides 24-hour telephone consultations on clinical toxicology and drug and reproductive toxicology. It participates in research, teaching and regulatory activities, and provides laboratory services. In 2014, nurse specialists in poison information joined the IPIC.

Single dose oral midazolam for minor emergency department procedures in children: a retrospective cohort study.

Background: In the pediatric emergency department, patients are commonly treated with a single dose of oral midazolam for minor procedures. We sought to evaluate the effect of this treatment on procedure completion rates.

Methods: We conducted a single-center retrospective cohort study of all patients who were treated with pre-procedure oral midazolam between January 2011 and June 2016.

A Randomized Trial to Evaluate the Effect of Two Topical Anesthetics on Pain Response During Frenotomy in Young Infants.

Objective: To examine the comparative effectiveness of two topical anesthetics in controlling the pain associated with tongue-tie release (frenotomy) in young infants.

Design: Randomized trial.

Setting: A Pediatric Craniofacial Clinic.

Prediction of Antiphospholipid syndrome using Annexin A5 competition assay in patients with SLE.

A significantly high correlation between reduced activity of Annexin A5 by the flow cytometric assay (FCA) and the diagnosis of antiphospholipid syndrome (APS) has been reported. The aim of this study was to assess the clinical and laboratory significance of the Annexin A5 competition assay among patients with systemic lupus erythematosus (SLE). The FCA competition assay was performed on blood samples from 57 consecutive SLE patients.

Ceftriaxone-induced immune hemolytic anemia.

Neuman, G, Boodhan, S, Wurman, I, et al. Ceftriaxone-induced immune hemolytic anemia. Ann Pharmacother.

Counselling a patient with chronic illness before pregnancy.

As the reproductive age of women increases, women of reproductive age are exposed to more diseases and medications that are potentially related to adverse pregnancy outcomes. The approach to primary prevention of such outcomes is discussed. By minimizing the risks related to the diseases and the medications before conception, the best control of the medical condition and optimized pharmacotherapy is achieved when conception eventually occurs.

Ethics of research in pediatric emergency medicine.

Clinical research in the pediatric emergency department (ED) has been rapidly growing in the past decade, and has resulted in some of the most important milestone studies in the pediatric medical literature. However, it presents a unique ethical goal and requires that additional challenges, such as the acute medical condition, fear and anxiety, unfamiliar physician(s), fatigue, and lack of time be addressed in addition to the standard ethical requirements. These may impair several fundamental elements of research, including the patient enrollment process, informed consent/assent, randomization, and others.

Ceftriaxone-induced immune hemolytic anemia.

Objectives: To describe a case of ceftriaxone-induced immune hemolytic anemia (CIIHA) in a 6 year-old boy with sickle cell disease (SCD) and perform a systematic literature review to delineate the clinical and laboratory features of this condition.

Data Sources: EMBASE (1947-January 2014), MEDLINE (1946-January 2014), and databases from the US Food and Drug Administration and Health Canada were searched, using anemia, hemolytic anemia, hemolysis, and ceftriaxone as search terms. Additional references were identified from a review of literature citations.

Preconceptional monitoring of mercury levels in hair and blood as a tool for minimizing associated reproductive risks.

We describe the case of a 41-year-old woman, planning a pregnancy, who had a spontaneous abortion and subsequently was found to have high blood mercury levels. The source of high mercury was in her diet that contained fish as her main source of protein. Serial measurements of mercury in hair and blood allowed the team to determine the exact time when safe levels of mercury were reached, to eliminate elevated mercury levels as a potential cause of spontaneous abortion and to use preconception counseling to minimize the risk for adverse pregnancy outcome.

Bupropion and Escitalopram During Lactation.

Objective: To report a case of seizure-like symptoms in an infant exposed to bupropion and escitalopram through breastfeeding.

Case Summary: A 6.5-month-old female infant, breastfed by a mother treated with bupropion XL 150 mg/d and escitalopram 10 mg/d for depression, presented to our hospital with severe emesis and tonic seizure-like symptoms.

The differential diagnosis of fetal alcohol spectrum disorder.

Fetal Alcohol Spectrum Disorder (FASD) affects an estimated 1% of all children born in North America. FASD is a chronic disorder impacting many systems of care. Only a minority of these children exhibit the pathognomonic facial features of Fetal alcohol syndrome (FAS) that include short palpebral fissures, smooth philtrum and thin upper lip.

Implications of serum creatinine measurements on GFR estimation and vancomycin dosing in children.

Background: Different serum creatinine (sCr) assays may obtain different values in the same patient, causing discrepancies in estimated glomerular filtration rate (eGFR) and sCr-based vancomycin dosing calculations.

Objective: To identify potential discrepancies in sCr concentrations obtained by different assays, the compensated Jaffe (sCr-Jaffe) and the enzymatic (sCr-enz), and to compare between the eGFR and vancomycin daily dose, based on these sCr values.

Method: sCr-Jaffe and, sCr-enz concentrations of 890 healthy children, aged 1-18 years, were available from the Canadian Laboratory Initiative in Pediatric Reference Intervals study in Ontario.

Safety of procedural sedation in pregnancy.

Minor traumatic injuries are common in pregnancy, often subsequently requiring painful diagnostic and therapeutic procedures. Pregnant women who are experiencing significant pain, distress, or fear may benefit from procedural sedation in the emergency department. In this review we examine the fetal safety of specific drugs used for procedural sedation.

Mothersisk update: reproductive outcomes after assisted conception.

Question: Increasingly my patients are undergoing assisted conception. These patients are excitedly anticipating pregnancy, but are there risks to the fetus when using assisted reproductive technology (ART)?

Answer: The current medical literature suggests only a mild increase in preterm deliveries, low birth weight, birth defects, and genetic imprinting defects. These results might, in part, be related to the indication for ART, rather than the ART itself.

Serum glucose and electrolyte levels in alcohol-intoxicated adolescents on admission to the emergency department: an unmatched case-control study.

Aimed at examining serum glucose and electrolytes concentrations in adolescents with acute alcohol intoxication (AAI) on admission to the pediatric Emergency Department (ED), a retrospective unmatched, case-control study was conducted. Two cohorts of adolescents were compared, patients presenting with AAI and patients presenting with non-alcohol intoxication. The study group included ED patients aged 12-18 years with AAI.

Conserved host response to highly pathogenic avian influenza virus infection in human cell culture, mouse and macaque model systems.

Background: Understanding host response to influenza virus infection will facilitate development of better diagnoses and therapeutic interventions. Several different experimental models have been used as a proxy for human infection, including cell cultures derived from human cells, mice, and non-human primates. Each of these systems has been studied extensively in isolation, but little effort has been directed toward systematically characterizing the conservation of host response on a global level beyond known immune signaling cascades.

Cross-sectional analysis of cardiovascular risk factors in children with parental history of premature ischemic heart disease.

This study aimed to evaluate the presence of cardiovascular risk factors in children with a parental history of premature ischemic heart disease (two- or three-vessel disease diagnosed before the age of 55 in men and 65 in women). A prospective cross-sectional study was performed on 55 children. The following parameters were assessed: body mass index (BMI), waist and hip circumference, blood pressure, lipids profile, fasting glucose (FG), C-reactive protein (CRP), and carotid intimal-medial thickness (CIMT).

Serum inflammatory markers in overweight children and adolescents with non-alcoholic fatty liver disease.

Background: Obesity, a worldwide pandemia, is associated with a large variety of comorbidities, among which is non-alcoholic fatty liver disease. NAFLD is a complex disease that may eventually lead to cirrhosis, posing a high risk for the patient and thus necessitating early diagnosis and treatment.

Objectives: To evaluate the association between ultrasonographically diagnosed non-alcoholic fatty liver disease and the levels of serum inflammatory markers in obese children and adolescents.