Effects of Fractional Inspired Oxygen on Cerebral Oxygenation in Preterm Infants following Delivery.

Objectives: To explore regional cerebral oxygen saturations (rcSO2) in preterm neonates initially stabilized with 0.3 fractionated inspired oxygen (FiO2) concentrations. We hypothesized that those infants who received >0.

Prion Protein Protects against Renal Ischemia/Reperfusion Injury.

The cellular prion protein (PrPC), a protein most noted for its link to prion diseases, has been found to play a protective role in ischemic brain injury. To investigate the role of PrPC in the kidney, an organ highly prone to ischemia/reperfusion (IR) injury, we examined wild-type (WT) and PrPC knockout (KO) mice that were subjected to 30-min of renal ischemia followed by 1, 2, or 3 days of reperfusion. Renal dysfunction and structural damage was more severe in KO than in WT mice.

Adoption of a microbial health-based target for Australian drinking water regulation.

The health-based targets of 1 in 10,000 for infection and 10(-6) disability adjusted life years (DALYs) per person per year are increasingly being considered, or have already been adopted, to define microbial safety targets for water. The aim of this paper is to convey information about how these two targets compare by converting each of the target values to a common metric. The metric chosen for viral (rotavirus and norovirus) and protozoan (Cryptosporidium) reference pathogens is the estimated maximum number of annual drinking water-associated cases of acute diarrhoeal disease tolerated.

Delivery room end tidal CO2 monitoring in preterm infants <32 weeks.

Objectives: To determine the feasibility of end tidal (EtCO2) monitoring of preterm infants in the delivery room, to determine EtCO2 levels during delivery room stabilisation, and to examine the incidence of normocapnia (5-8 kPa) on admission to the neonatal intensive care unit in the EtCO2 monitored group compared with a historical cohort without EtCO2 monitoring.

Patients And Methods: Preterm infants (<32 weeks) were eligible for inclusion in this observational study. The evolution of EtCO2 values immediately after delivery was assessed and linear least-squares methods were used to fit a line to EtCO2 recordings.

Integrative Genomics Identifies Novel Associations with APOL1 Risk Genotypes in Black NEPTUNE Subjects.

APOL1 variants have been associated with renal phenotypes in blacks. To refine clinical outcomes and discover mechanisms of APOL1-associated kidney injury, we analyzed clinical and genomic datasets derived from 90 black subjects in the Nephrotic Syndrome Study Network (NEPTUNE), stratified by APOL1 risk genotype. Ninety subjects with proteinuria ≥0.

Evolution of regulatory targets for drinking water quality.

The last century has been marked by major advances in the understanding of microbial disease risks from water supplies and significant changes in expectations of drinking water safety. The focus of drinking water quality regulation has moved progressively from simple prevention of detectable waterborne outbreaks towards adoption of health-based targets that aim to reduce infection and disease to a level well below detection limits at the community level. This review outlines the changes in understanding of community disease and waterborne risks that prompted development of these targets, and also describes their underlying assumptions and current context.

The practice patterns of recently graduated internal medicine-pediatric hospitalists.

Objectives: To identify the current practice patterns and professional activities of internal medicine-pediatrics (med-peds) hospitalists who have graduated in the past 5 years (June 2009-June 2013).

Methods: The national Medicine-Pediatrics Program Directors Association (MPPDA) conducted a cross-sectional survey study of the 79 residency program directors who are members of the MPPDA regarding the practice patterns of recent graduates (from 2009-2013) currently practicing as hospitalists. The survey was distributed in the spring of 2014 on the MPPDA listserv.

Perfusion index in the preterm infant immediately after birth.

Aim: To evaluate PI in preterm infants during the first 10 min of life.

Design/methods: An observational study was conducted in the delivery room on preterm infants (less than 32 week gestation). PI values were obtained from a pre ductal saturation probe placed on the right wrist.

Establishing and sustaining a prospective screening program for breast cancer-related lymphedema at the massachusetts general hospital: lessons learned.

There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL) following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution.

Impact of adjuvant taxane-based chemotherapy on development of breast cancer-related lymphedema: results from a large prospective cohort.

Taxane-based chemotherapy for the treatment of breast cancer is associated with fluid retention in the extremities; however, its association with development of breast cancer-related lymphedema is unclear. We sought to determine if adjuvant taxane-based chemotherapy increased risk of lymphedema or mild swelling of the upper extremity. 1121 patients with unilateral breast cancer were prospectively screened for lymphedema with perometer measurements.

Radiation therapy risk factors for development of lymphedema in patients treated with regional lymph node irradiation for breast cancer.

Purpose: We previously evaluated the risk of breast cancer-related lymphedema (LE) with the addition of regional lymph node irradiation (RLNR) and found an increased risk when RLNR is used. Here we analyze the association of technical radiation therapy (RT) factors in RLNR patients with the risk of LE development.

Methods And Materials: From 2005 to 2012, we prospectively screened 1476 women for LE who underwent surgery for breast cancer.

The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living.

We sought to assess the association of breast cancer-related lymphedema (BCRL) with the ability to perform upper extremity activities of daily living (ADL) in our patient population. 324 breast cancer patients who had received treatment for unilateral breast cancer at our institution between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer.

High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation.

Background Context: Craniocervical dural arteriovenous fistula (dAVF) is rare as compared with the typical thoracolumbar dAVFs of the spine and usually presents with hemorrhagic manifestation, predominantly intracranial subarachnoid hemorrhage.

Purpose: We describe the first case of craniocervical dAVF with initial presentation as neck pain and spinal subdural hemorrhage.

Study Design: Case report.

Incidence of gammopathies in long-term plasmapheresis donors at Canadian Blood Services.

Background: To investigate the long-term consequences of repeated plasmapheresis on donor health, their donation histories and demographic data were reviewed to determine the frequency of development of monoclonal (Mc) gammopathies or other gamma globulin abnormalities (OGGAs).

Study Design And Methods: Samples from apheresis plasma donors collected at Canadian Blood Services were tested initially and every 4 months for total protein (TP) followed by serum protein electrophoresis (SPE). Out-of-range samples or those showing abnormal band patterns were forwarded to a hospital laboratory for additional investigation.

Immediate Implant Reconstruction Is Associated With a Reduced Risk of Lymphedema Compared to Mastectomy Alone: A Prospective Cohort Study.

Objective: We sought to determine the risk of lymphedema associated with immediate breast reconstruction compared to mastectomy alone.

Background: Immediate breast reconstruction is increasingly performed at the time of mastectomy. Few studies have examined whether breast reconstruction impacts development of lymphedema.

Neonatal EEG audification for seizure detection.

Technologies for automated detection of neonatal seizures are gradually moving towards cot-side implementation. The aim of this paper is to present an alternative way to visualize the output of a neonatal seizure detection algorithm. For this purpose audified neonatal EEG is considered.

Assessing instantaneous energy in the EEG: a non-negative, frequency-weighted energy operator.

Signal processing measures of instantaneous energy typically include only amplitude information. But measures that include both amplitude and frequency do better at assessing the energy required by the system to generate the signal, making them more sensitive measures to include in electroencephalogram (EEG) analysis. The Teager-Kaiser operator is a frequency-weighted measure that is frequently used in EEG analysis, although the operator is poorly defined in terms of common signal processing concepts.

Artefact detection in neonatal EEG.

Artefact detection is an important component of any automated EEG analysis. It is of particular importance in analyses such as sleep state detection and EEG grading where there is no null state. We propose a general artefact detection system (GADS) based on the analysis of the neonatal EEG.

Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis.

Object: Patients suffering from cervical radiculopathy in whom a course of nonoperative treatment has failed are often candidates for a single-level anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). The objective of this analysis was to identify any significant cost differences between these surgical methods by comparing direct costs to the hospital. Furthermore, patient-specific characteristics were also considered for their effect on component costs.

Changes in medical errors after implementation of a handoff program.

Background: Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff of information about patient care are lacking.

Methods: We conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals, measuring rates of medical errors, preventable adverse events, and miscommunications, as well as resident workflow.

Multidisciplinary handoffs improve perceptions of communication.

Background: Communication errors during handoffs are a leading cause of sentinel events. The Accreditation Council for Graduate Medical Education 2011 duty hour standards (DHS) increase the frequency of handoffs.

Objective: The goal of this study was to determine if a multidisciplinary group handoff bundle improves communication while working within the 2011 DHS.

Disease burden of selected gastrointestinal pathogens in Australia, 2010.

Objective: To estimate and compare disease burden attributable to six gastrointestinal pathogens (norovirus, rotavirus, Campylobacter, non-typhoidal Salmonella, Giardia, and Cryptosporidium) in Australia, 2010.

Methods: We estimated the number of acute gastroenteritis (AGE) cases and deaths, disability-adjusted life years (DALYs), and DALY/case for each pathogen. We included AGE cases that did not require medical care.