Selective Androgen Receptor Modulator-Induced Liver Injury in Active Duty Male.

Selective androgenic receptor modulators (SARMs) are extensively advertised as safer and more effective analogues to traditional androgenic anabolic steroids, yet there are increasing cases of hepatotoxicity secondary to their use. We present the case of a previously healthy young active duty Marine who presented with cholestatic liver injury secondary to SARM use. This is the first reported case in a service member and contributes to the growing amount of evidence regarding the potential detrimental effects of SARMs.

Volume Resuscitation and Progression to Organ Failure in Shiga Toxin-Producing Infection in Adults.

Unlabelled: Shiga toxin-producing infection is associated with dysentery and the hemolytic uremic syndrome, marked by the triad of microangiopathic hemolytic anemia, acute kidney failure, and thrombocytopenia. Descriptions of Shiga toxin-producing outbreaks causing hemolytic uremic syndrome in adults are sparse, and management strategies are largely adapted from pediatric literature where aggressive fluid administration is recommended. However, these may not be ideal for adults.

Reevaluating Goals of Therapy in Primary Biliary Cholangitis: Is Good Enough Is Not Good Enough Anymore?

Primary biliary cholangitis (PBC) is an autoimmune-mediated inflammatory cholestatic liver disease, which can progress to cirrhosis. This issue of The American Journal of Gastroenterology features the results of the GLOBAL PBC Study Group evaluating patients with PBC over a 10-year period. Although biochemical response was evaluated in previous studies, this study showed that bilirubin levels ≤0.

The Association between Sexually Transmitted Infections, Length of Service and Other Demographic Factors in the U.S. Military.

Background: Numerous studies have found higher rates of sexually transmitted infections (STIs) among military personnel than the general population, but the cumulative risk of acquiring STIs throughout an individual's military career has not been described.

Methods: Using ICD-9 diagnosis codes, we analyzed the medical records of 100,005 individuals from all service branches, divided in equal cohorts (n = 6,667) between 1997 and 2011. As women receive frequent STI screening compared to men, these groups were analyzed separately.

Is delayed operative treatment worth the trouble with perforated appendicitis is children?

Background: Approximately 30% to 50% of appendicitis in children is already perforated at presentation. The optimal management of these children remains controversial.

Methods: Ninety-six children (aged 2 to 16 years) were treated for perforated appendicitis.

The impact of surgery on infants born at extremely low birth weight.

Purpose: The aim of this study was to determine the outcome of extremely low-birth-weight infants (ELBW) requiring surgical interventions for the complications of prematurity

Methods: One hundred eighty-seven consecutive infants with a birth weight less than 1,000 g treated over a 5-year period were reviewed. Outcome variables included number and types of surgical procedures; length of stay; survival rate and; pulmonary, neurologic, and gastrointestinal morbidity.

Results: Surgical interventions were required in 66 (35%) infants (group S) weighing less than 1,000 g at birth (33% necrotizing enterocolitis/bowel perforation, 36% patent ductus arteriosus, 56% other).