Horse owner perceptions of equine veterinary nursing roles in the United Kingdom.

Background: Registered (equine) veterinary nurses (R(E)VNs) typically provide few client-facing services. Better utilising R(E)VN skills could help address workforce shortages, improve morale and benefit patient health. The aim of this study was to explore horse owner perceptions of R(E)VN roles.

Defining Terms Used for Animals Working in Support Roles for People with Support Needs.

The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users.

Turtles and Tortoises Are in Trouble.

Turtles and tortoises (chelonians) have been integral components of global ecosystems for about 220 million years and have played important roles in human culture for at least 400,000 years. The chelonian shell is a remarkable evolutionary adaptation, facilitating success in terrestrial, freshwater and marine ecosystems. Today, more than half of the 360 living species and 482 total taxa (species and subspecies combined) are threatened with extinction.

Analysis of injected cement volume and clinical outcomes following kyphoplasty for vertebral compression fractures.

Background: It has been suggested that greater volumes of cement injected during kyphoplasty correlate with improved vertebral body height restoration and kyphotic angulation correction. However, there is little evidence tying cement volume to patient outcomes. Here, we analyzed the association between cement volume and outcome utilizing indices of pain, disability, and quality of life.

Vertebral height restoration following kyphoplasty.

Background: Kyphoplasty is a minimally invasive surgery developed to restore height and stabilize painful vertebral compression fractures (VCFs). Only small retrospective studies have addressed the correlation between the degree of vertebral height restoration as it relates to pain relief and postoperative activity levels. No definitive correlations have been established.

Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury.

Objective: The aim of this study was to determine the inter-rater reliability of the modified Medical Research Council (MRC) scale for grading motor function in patients with chronic incomplete spinal cord injury (SCI).

Methods: Two neurosurgical residents and 2 faculty members performed motor examinations in 6 chronic incomplete SCI patients for a total of 156 muscle groups. Examinations were performed using the modified MRC grading scale during routine clinic visits for each patient.

Patient Expectations and Preferences in the Spinal Surgery Clinic.

Background: Managing patient expectations is essential in the treatment of patients undergoing spinal surgery. Patient satisfaction is associated with improved clinical outcomes and can be improved when patient and surgeon expectations are aligned and patient preferences are met.

Methods: Patients presenting to clinic for management of spinal disease were asked to complete a questionnaire assessing demographics, current pain, reason for visit, and expectations and preferences surrounding the clinic experience.

Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013-2014(1).

During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A.

Prevalence and distribution of MRI abnormalities in patients with psychogenic nonepileptic events.

Introduction: Both structural and functional abnormalities have been reported in patients with psychogenic nonepileptic events (PNEEs), although no truly consistent abnormalities have been found.

Methods: We retrospectively identified patients discharged from our EMU with video-EEG diagnoses of epileptic seizures, PNEEs, epileptic seizures plus PNEEs, interictal epileptiform abnormalities only, and nondiagnostic admissions. We then collected brain MRI results for analysis.

Effect of lunar phase on frequency of psychogenic nonepileptic events in the EMU.

Introduction: Studies of the effect of a full moon on seizures have yielded mixed results, despite a continuing prevailing belief regarding the association of lunar phase with human behavior. The potential effect of a full moon on psychogenic nonepileptic events has not been as well studied, despite what anecdotal accounts from most epilepsy monitoring unit (EMU) staff would suggest.

Methods: We obtained the dates and times of all events from patients diagnosed with psychogenic nonepileptic events discharged from our EMU over a two-year period.

Sustained Transmission of Pertussis in Vaccinated, 1-5-Year-Old Children in a Preschool, Florida, USA.

In September 2013, local county health officials in Tallahassee, Florida, USA, were notified of a laboratory-confirmed pertussis case in a 1-year-old preschool attendee. During a 5-month period, 26 (22%) students 1–5 years of age, 2 staff from the same preschool, and 11 family members met the national case definition for pertussis. Four persons during this outbreak were hospitalized for clinical management of pertussis symptoms.

Fasted Exercise and Increased Dietary Protein Reduces Body Fat and Improves Strength in Jockeys.

The present study assessed the effects of a diet and exercise intervention in jockeys on body composition, metabolism, bone and mental health. 10 jockeys followed an individually prescribed 6-wk diet (Carbohydrate=2.5-3.

The nonsurgical nature of patients with subarachnoid or intraparenchymal hemorrhage associated with mild traumatic brain injury.

Object: Mild traumatic brain injury (mTBI), as defined by Glasgow Coma Scale (GCS) score of 13 or higher, is a common problem in the United States and worldwide, estimated to affect more than 1 million patients yearly. When associated with intracranial hemorrhage, it is a common reason for neurosurgical consultation and transfer to tertiary care centers. The authors set out to investigate the clinical implications of subarachnoid hemorrhage (SAH) and/or intraparenchymal hemorrhage (IPH) associated with mTBI in hopes of standardization of mTBI clinical care and optimization of resource allocation.

A kindred with fish eye disease, corneal opacities, marked high-density lipoprotein deficiency, and statin therapy.

A kindred affected with fish eye disease (FED) from Oklahoma is reported. Two probands with corneal opacification had mean levels of high-density lipoprotein (HDL) cholesterol (C), apolipoprotein (apo) A-I, and apoA-I in very large alpha-1 HDL particles that were 9%, 17%, and 5% of normal, whereas their parents and 1 sibling had values that were 61%, 77%, and 72% of normal. The probands had no detectable lipoprotein-X, and had mean low-density lipoprotein cholesterol (LDL-C) and triglyceride levels that were elevated.

Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study.

Objective: Assess platelet rich plasma (PRP) injection for rotator cuff tendinopathy (RCT).

Design: Prospective open label study with 1-year follow-up.

Methods: Participants recruited from an outpatient sports medicine clinic had clinically and magnetic resonance image (MRI)-demonstrated RCT refractory to physical therapy and corticosteroid injection.

Diagnostic outcomes of inpatient video electroencephalography: nonepileptic events in South Carolina.

The Epilepsy Monitoring Unit (EMU) was established at the Medical University Hospital to assist in the diagnosis of epilepsy and the evaluation of other paroxysmal neurological symptoms, including non-epileptic events (NEEs), which are often confused with epileptic seizures. Correct diagnosis can prevent inappropriate treatment with antiepileptic drugs, avoid some of the restrictions imposed by epileptic seizures, and facilitate appropriate treatment for NEEs. A retrospective review of patients admitted to the EMU over a two year period showed the percentage of patients diagnosed with NEEs (39%) is greater than those diagnosed with epilepsy alone (36%).

Surgical manifestations of thoracic arachnoid pathology: series of 28 cases.

Object: Various pathologies involving the thoracic arachnoid mater uniformly manifest as thoracic myelopathy and may present a significant management dilemma. The authors undertook this study to assess outcome in cases of thoracic myelopathy due to thoracic arachnoid pathology.

Methods: The authors have cared for and followed 28 patients with thoracic myelopathy from thoracic arachnoid pathology over the last 17 years.

Transient osteoporosis of the hip: A case report.

We report a case of transient osteoporosis of the hip (TOH) in a 59-year-old man including the clinical presentation, diagnostic studies, management and clinical progress. TOH is a rare self-limiting condition that typically affects middle-aged men or, less frequently, women in the third trimester of pregnancy. Affected individuals present clinically with acute hip pain, limping gait, and limited ranges of hip motion.

Depression and pain interference among patients with chronic pain after ED encounters.

Introduction: Patients with chronic pain who frequent emergency departments present a challenge to health care providers. Mental health, substance abuse, and pain issues are difficult to distinguish in fast-paced clinical settings, and significant symptoms may remain unaddressed. This pilot study sought to determine whether electronically delivered screening tools measuring pain and mood could identify areas to target for improving emergency care.

Neurosurgical injuries resulting from the 2011 tornados in Alabama: the experience at the University of Alabama at Birmingham Medical Center.

Object: The April 27, 2011, tornados that affected the southeastern US resulted in 248 deaths in the state of Alabama. The University of Alabama at Birmingham (UAB) Medical Center, the largest Level I trauma center in the state, triaged and treated a large number of individuals who suffered traumatic injuries during these events, including those requiring neurosurgical assessment and treatment.

Methods: A retrospective review of all adult patients triaged at UAB Medical Center during the April 27, 2011, tornados was conducted.

Improving wait times and patient satisfaction in primary care.

A strong and inverse relationship between patient satisfaction and wait times in ambulatory care settings has been demonstrated. Despite its relevance to key medical practice outcomes, timeliness of care in primary care settings has not been widely studied. The goal of the quality improvement project described here was to increase patient satisfaction by minimizing wait times using the Dartmouth Microsystem Improvement Curriculum (DMIC) framework and the Plan-Do-Study-Act (PDSA) improvement process.

Unique case of "post-lumbar puncture headache".

Lumbar puncture (LP) is associated with complications that include post-LP orthostatic headache, local bleeding, and subdural hematoma. We report a unique case of a spontaneous frontal epidural hematoma following a therapeutic lumbar puncture in a patient with a history of idiopathic intracranial hypertension. This case highlights the importance of symptomatology in patients following LPs by revealing a rare intracranial presentation that would be devastating if not discovered promptly and appropriately managed.

Standardized database development for EEG epileptiform transient detection: EEGnet scoring system and machine learning analysis.

The routine scalp electroencephalogram (rsEEG) is the most common clinical neurophysiology procedure. The most important role of rsEEG is to detect evidence of epilepsy, in the form of epileptiform transients (ETs), also known as spike or sharp wave discharges. Due to the wide variety of morphologies of ETs and their similarity to artifacts and waves that are part of the normal background activity, the task of ET detection is difficult and mistakes are frequently made.

Lipid concentrations in postmenopausal women on letrozole after 5 years of tamoxifen: an NCIC CTG MA.17 sub-study.

To evaluate changes in serum lipid parameters (cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and lipoprotein(a) [Lp(a)]), in postmenopausal women receiving letrozole after tamoxifen therapy. MA.17L is a sub-study of MA.