Proton Pump Inhibitor Use After Hiatal Hernia Repair: Inhibitor of Recurrent Symptoms and Potential Revisional Surgery.

Background: Hiatal hernia recurrence after hiatal hernia repair (HHR) is often underdiagnosed and underreported but may present with recurrent gastroesophageal reflux disease (GERD) symptoms. Because of their availability, proton pump inhibitor (PPI) use is common and may mask patients who would benefit from revisional surgery, which has been shown to improve symptoms and quality of life.

Methods: A retrospective analysis was performed to evaluate recurrence patterns of patients who underwent HHR, specifically for the indication of GERD, from 2007 to 2015 at a single Veterans Administration Medical Center.

Chylous jejunal cyst causing volvulus in a child: case report and literature review.

Chylous jejunal cysts are extremely rare entities and if not diagnosed promptly may lead to severe complications like bowel obstruction, loss of small bowel and even death. We present the case of a 4 year-old-male referred to our institution with severe abdominal pain, constipation, abdominal distention and radiological findings of large amount of fluid in the lower abdomen with associated bowel obstruction. Operative findings were that of large chylous jejunal cyst causing segmental volvulus.

Six rapid assessments of alcohol and other substance use in populations displaced by conflict.

Background: Substance use among populations displaced by conflict is a neglected area of public health. Alcohol, khat, benzodiazepine, opiate, and other substance use have been documented among a range of displaced populations, with wide-reaching health and social impacts. Changing agendas in humanitarian response-including increased prominence of mental health and chronic illness-have so far failed to be translated into meaningful interventions for substance use.

A situation update on HIV epidemics among people who inject drugs and national responses in South-East Asia Region.

We explore the magnitude of and current trends in HIV infection among people who inject drugs and estimate the reach of harm reduction interventions among them in seven high-burden countries of the South-East Asia Region. Our data are drawn from the published and unpublished literature, routine national HIV serological and behavioural surveillance surveys and information from key informants. Six countries (Thailand, Myanmar, Nepal, Indonesia, India, and Bangladesh) had significant epidemics of HIV among people who inject drugs.

Antiretroviral treatment for injecting drug users in developing and transitional countries 1 year before the end of the "Treating 3 million by 2005. Making it happen. The WHO strategy" ("3 by 5").

Objective: To describe and estimate the availability of antiretroviral treatment (ART) to injecting drug users (IDUs) in developing and transitional countries.

Methods: Literature review of grey and published literature and key informants' communications on the estimated number of current/former injecting drug users (IDUs) receiving ART and the proportion of human immunodeficiency virus (HIV) attributed to injecting drug use (IDU), the number of people in ART and in need of ART, the number of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) and the main source of ART.

Results: Data on former/current IDUs on ART were available from 50 countries (in 19 countries: nil IDUs in treatment) suggesting that approximately 34 000 IDUs were receiving ART by the end of 2004, of whom 30 000 were in Brazil.

Use of nebulized inhaled corticosteroids among older adult patients: an assessment of outcomes.

Background: Inhaled corticosteroids (ICSs) are used by patients of all ages, but older patients may have difficulty with conventional inhalation devices and therefore may benefit from the easy-to-use delivery mechanism of the nebulizer.

Objective: To compare the outcomes, resource use, and health care costs of patients prescribed nebulized ICSs before and after treatment.

Methods: All patients 50 years and older prescribed nebulized ICSs were identified from a nationally representative managed care claims database (1999-2003).

Rapid assessment and response studies of injection drug use: knowledge gain, capacity building, and intervention development in a multisite study.

Objectives: We evaluated the World Health Organization's rapid assessment and response (RAR) method of assessing injection drug use and its associated health problems, focusing on knowledge gain, capacity building, and whether RAR leads to the development of interventions reducing the health effects of injection drug use.

Methods: Data were derived from RAR studies conducted in Beijing, China; Bogotá, Colombia; Greater Rosario, Argentina; Hanoi, Vietnam; Kharkiv, Ukraine; Minsk, Belarus; Nairobi, Kenya; Penang, Malaysia; St. Petersburg, Russia; and Tehran, Iran.

ALS patients on TPPV: totally locked-in state, neurologic findings and ethical implications.

Seventy patients with ALS using tracheostomy positive pressure ventilation (TPPV) were evaluated for impaired communication. Severely impaired communication is divided into the totally locked-in state (TLS) and the minimal communication state (MCS). TLS occurred in 8 of 70 (11.

Home mechanical ventilation for amyotrophic lateral sclerosis: nasal compared to tracheostomy-intermittent positive pressure ventilation.

People with amyotrophic lateral sclerosis (ALS) usually die from respiratory failure unless they use mechanical ventilation (MV). Many die of respiratory failure without being adequately informed about the available options, such as MV that can provide symptomatic relief and prolong survival. The traditional method of MV used for persons with ALS has been tracheostomy-intermittent positive pressure ventilation (IPPV).

Patients with amyotrophic lateral sclerosis receiving long-term mechanical ventilation. Advance care planning and outcomes.

Objective: To examine advance care planning and outcomes of patients with amyotrophic lateral sclerosis (ALS) receiving long-term mechanical ventilation (LTMV).

Design: Case series.

Setting: Population-based study in homes and chronic care facilities in four states, and Home Ventilator Program of California Kaiser Permanente.

Quality of life and quality of care data from a 7-year pilot project for home ventilator patients.

A research demonstration pilot project for hospitalized adult and pediatric long-term ventilator-dependent patients was conducted by Kaiser Permanente Southern California Region from 1985 until 1992. The purpose of the pilot project was to investigate if home care was a realistic alternative to continued hospital care. Many aspects of home care as compared to hospital care were studied.

Decreased insulin sensitivity in prepubertal girls with premature adrenarche and acanthosis nigricans.

Benign premature adrenarche (PA) is the term used to refer to girls with the early development of pubic hair before the age of 8 yr and is characterized by mild hyperandrogenism. Hyperandrogenism in adult women is often not as benign and has been associated with insulin resistance, acanthosis nigricans (AN), and the polycystic ovary syndrome. We have seen a group of young girls with PA who have also been found to have AN.

Death and survival in a cohort of heroin addicts from London clinics: a 22-year follow-up study.

Data are presented on the 43 people who died over a 22-year follow-up period of a cohort of 128 heroin addicts drawn in 1969 from the newly opened London clinics. The main causes of death were drug-related, with 18 deaths specifically determined as due to overdose, of which the great majority were among people being prescribed opiates at the time. The mortality rate was a mean of 1.

Opiate users and the first years after treatment: outcome analysis of the proportion of follow up time spent in abstinence.

This second report on a follow-up study of drug users focuses on changes that occurred on a number of variables between intake and follow-up and during the follow-up period. The length of abstinence from opiates was considered as a proportion of the total follow-up period. Overall there was a reduction in opiate use, in injecting and sharing equipment at follow-up.

Thyrotropin-releasing hormone stimulation tests in infants.

The TSH response to TRH administration (7 micrograms/kg) was measured in 68 infants (22 premature) who had abnormal thyroid screening tests by the filter paper method and whose serum thyroid function tests were only mildly abnormal. Twenty-eight infants (12 premature) had peak TSH values of 35 mU/L or less and were considered normal (group I). Forty infants (10 premature) had peak TSH values above 35 mU/L and were considered hyperresponsive (group II).

Decision-making in the respiratory care of amyotrophic lateral sclerosis: should home mechanical ventilation be used?

As respiratory function starts to deteriorate in those with amyotrophic lateral sclerosis, one of the principal questions that has to be answered is whether it it is appropriate to provide ventilatory support. Although expensive, it is perfectly feasible to provide this at home, and this article examines many of the issues surrounding home mechanical ventilation.

X-linked nephrogenic diabetes insipidus: from the ship Hopewell to RFLP studies.

Nephrogenic diabetes insipidus (NDI; designated 304800 in Mendelian Inheritance in Man) is an X-linked disorder with abnormal renal and extrarenal V2 vasopressin receptor responses. The mutant gene has been mapped to Xq28 by analysis of RFLPs, and tight linkage between DXS52 and NDI has been reported. In 1969, Bode and Crawford proposed, under the term "the Hopewell hypothesis," that most cases in North America could be traced to descendants of Ulster Scots who arrived in Nova Scotia in 1761 on the ship Hopewell.

Hearing the noise in the system. Exploration of textural analysis as a method for studying change in drinking behaviour.

This paper explores how treatment research is to catch within its design those many unplanned influences which lie outside therapeutic control, but which may influence processes of change. These factors are excluded from the conventional controlled trial. The background literature is briefly reviewed.

Alcohol and drug misuse among women--an overview.

Most research into substance misuse has focused on men but the problem among women is considerable and the social consequences and causation differ between the sexes. In the US, one-third of alcohol abusers are women and in the UK 1% of women are estimated to be drinking at a dangerous level. Drug and alcohol misuse holds additional problems for women since abusers tend to be of childbearing age.