Geographic clustering of travel-acquired infections in Ontario, Canada, 2008-2020.

As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario's laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008-2020 to identify high-resolution geographical clusters for potential targeted pre-travel prevention. Smoothed standardized incidence ratios (SIRs) and 95% posterior credible intervals (CIs) were estimated using a spatial Bayesian hierarchical model.

Self-Directed Interactive Video-Based Instruction Versus Instructor-Led Teaching for Myanmar House Surgeons: A Randomized, Noninferiority Trial.

Objective: To compare self-directed interactive video-based instruction (IVBI) with instructor-led teaching in the acquisition of basic surgical skills by House Surgeons at University of Medicine 1, Yangon.

Design: A prospective, 1:1 randomized controlled trial was conducted. Participants were randomized into 2 teaching arms: (1) self-directed IVBI or (2) instructor-led teaching.

Bone mineral density testing after fragility fracture: Informative test results likely.

Objective: To determine the proportion of patients with fragility fractures who can be expected to have low bone mineral density (BMD) at the time of fracture and to assist FPs in deciding whether to refer patients for BMD testing.

Data Sources: MEDLINE, EMBASE, and CINAHL were searched from the earliest available dates through September 2009.

Study Selection: English-language articles reporting BMD test results of patients with fragility fractures who were managed in an orthopedic environment (eg, fracture clinic, emergency management by orthopedic surgeons, inpatients) were eligible for review.

Iron and vegetarian diets.

Vegetarians who eat a varied and well balanced diet are not at any greater risk of iron deficiency anaemia than non-vegetarians. A diet rich in wholegrains, legumes, nuts, seeds, dried fruits, iron-fortified cereals and green leafy vegetables provides an adequate iron intake. Vitamin C and other organic acids enhance non-haem iron absorption, a process that is carefully regulated by the gut.

Medication initiation rates are not directly comparable across secondary fracture prevention programs: reporting standards based on a systematic review.

Objective: To examine the methods used to calculate the reported medication initiation rates in secondary fracture prevention programs.

Study Design And Setting: A systematic review was conducted on postfracture interventions that aimed to improve osteoporosis management in an orthopedic environment. Two authors independently reviewed eligible articles to determine the numerator and denominator used to calculate the rates of antiresorptive medication initiation based on author reports.

Cardiac surgery and heparin induced thrombocytopaenia (HIT): a case report and short review.

This patient presented for emergency cardiac surgery following two episodes of thrombocytopaenia, one before and one associated with exposure to unfractionated heparin in a seven-week period of intensive care management. Although the diagnosis of heparin induced thrombocytopaenia (HIT) was uncertain on clinical grounds when assessed by current criteria, the positive antibody status directed management in accordance with the internationally recognised guidelines published by the American College of Chest Physicians (ACCP) Evidence-based Clinical Practice Guidelines. An alternative anticoagulant to unfractionated heparin was indicated for cardiopulmonary bypass.

Key outcomes are usually not reported in published fracture secondary prevention programs: results of a systematic review.

Objective: A secondary analysis of a systematic review on interventions to improve osteoporosis (OP) investigation and treatment was conducted to examine reported key outcomes: (1) the cost of the intervention; (2) the proportion of patients taking OP medication beyond 6 months of the intervention; and (3) the proportion of patients who re-fractured.

Methods: Fifty-seven articles reporting on 54 studies (64 interventions) from 11 countries were included. Intervention studies to improve OP management were eligible if they were conducted in an orthopedic setting and included primary data on ≥20 patients presenting with a hip fracture or any fragility fracture.

Appreciation of humor is decreased among patients with Parkinson's disease.

Objective: To test whether appreciation of humor might be a non-motor function affected by Parkinson's disease (PD).

Methods: Thirty-nine PD patients and 38 healthy controls participated in this study. Appreciation of humor and effect of the presentation method utilized were assessed.

Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients.

This study aims to determine osteoporosis (OP) investigation and treatment within post-fracture initiatives conducted in fracture clinics and other orthopedic environments. A systematic review was conducted. Eligibility criteria were: hip fracture patients plus all other fracture patients presenting with a fragility fracture, orthopedic setting where orthopedic physicians/staff were involved, intervention to improve OP management, primary data on ≥20 patients from randomized controlled trials (RCTs) and other study designs.

Quality of life in patients older than 75 years following major head and neck surgery.

Background: This study was designed to evaluate the quality of life (QOL) of patients older than 75 years undergoing major head and neck surgery.

Methods: Three groups of patients were included: elderly patients (>75, n = 35) and younger patients (65 to 75 years, n = 30) undergoing major head and neck surgery and healthy controls (>75, n = 40). Measurements were made using the SF-12 health survey, the University of Washington QOL questionnaire, and measurements of the "sense of burden" on the caregiver.

Factor V inhibitors: rare or not so uncommon? A multi-laboratory investigation.

Acquired deficiencies of, or inhibitors to, factor V are considered rare events. We report a series of 14 acquired factor V deficiencies, 10 of which were confirmed to have inhibitors to factor V, as identified within Australia in the past 5 years following a multi-laboratory investigation. The initial index case seen by one laboratory was followed within 4 months by a separate similar case.

Young women with PD: a group work experience.

Parkinson's Disease (PD) prior to the age of 40 affects between 5-10% of the PD population. The psychosocial changes that patients with early PD encounter, may be more devastating and disabling than the actual motor disability. The paper describes a unique experience in groupwork with young female PD patients treated in the Movement Disorders Unit of the Tel Aviv Sourasky Medical Center.

An Israeli model of a hospital emergency information center.

The Emergency Information Center model developed by the social work department of Tel Aviv Sourasky Medical Center is activated in cases of mass casualties following disasters. It aims to provide reliable information to help the public cope with confusion and uncertainty, and to enable the medical staff to concentrate on treating the casualties. The Information Center is comprised of several interrelated units within the hospital, and maintains contact with a range of community organizations.

Mass casualties: an organizational model of a hospital information center in Tel Aviv.

The article describes an organizational model of an information center, developed by the social work department of Tel Aviv Sourasky Medical Center. The information center is designed to provide information when mass casualties are brought to the hospital following terrorist attacks or other catastrophes. The information center is comprised of a number of interrelated units within the hospital and is in contact with a range of organizations in the community.

[The homeless and the health system: profile of the homeless patient].

The homeless population is mobile and does not use ambulatory health care services. Thus the major contact between the homeless and the medical establishment occurs primarily when they are treated for acute symptoms in hospital. We describe the clinical and sociodemographic profile of the homeless who require hospital services.

Autologous bone marrow transplantation for acute myeloid leukaemia in remission: a preliminary report.

Autologous bone marrow transplantation, using unpurged cryopreserved autologous marrow, was performed on ten adult patients with acute myeloid leukaemia in remission. Seven patients were in first chemotherapy-induced remission of their disease, while three were in later remission. Patients ages ranged from 24 to 52 years, with a median of 38.

Elastosis in malignant tumours.

Elastosis is common in infiltrating ductal and lobular carcinomas of the breast, occurring in approximately 90% of cases. It is also well described in some benign lesions of the breast and tumours of the salivary gland. Reports of venous elastosis in association with large-bowel carcinomas are rare.

Pyoderma gangrenosum and ulcerative colitis in black South Africans. Case reports.

Two patients with pyoderma gangrenosum and ulcerative colitis are described. To our knowledge this is the first report of such an association in Blacks. The unusual vesicopustular form of pyoderma gangrenosum was well demonstrated by one patient who also responded remarkably to clofazimine.

Malignant intra-abdominal testis. A case report.

A case of malignant change within an intra-abdominal testis is reported. The development in a Black man of a malignant testicular lesion with a mixed cellular picture on histological examination, the absence of serum tumour markers in the presence of a seminoma and the presence of local invasive spread--all uncommon features of testicular tumours--in combination make this a rare case. Orchiopexy does not reduce the risk of malignant change and in the postpubertal patient does not influence spermatogenesis.

Radiocolloid liver imaging in tuberculous hepatitis.

Twenty of 22 patients with tuberculous hepatitis had abnormal Tc-99m tin colloid liver scans. However, in the majority of the patients the changes were mild and nonspecific. The most frequent scintigraphic picture was a decreased uptake of the radiocolloid by the liver, with shunting to the spleen and bone marrow.

Isolated granulomatous pancreatitis.

Only five patients with clinically apparent noncaseating granulomatous pancreatitis have been recorded, so far as we can tell. We describe a patient with noncaseating granulomas confined to the pancreas who developed obstructive jaundice and acute abdominal pain.

Melanin-producing medullary carcinoma of the thyroid gland. A case report.

A case of melanin-producing medullary carcinoma of the thyroid gland is reported. The histological characteristics of the tumour were typical of medullary carcinoma, immunohistochemical testing for calcitonin was positive, and neurosecretory granules were found to be present on ultrastructural examination. In addition the tumour was producing melanin and melanosomes were identified in the same cells which contained neurosecretory granules, suggesting that the tumour arose from a common precursor cell of neural crest origin capable of producing both calcitonin and melanin.