An analysis of the cost and impact of cosmetic tourism and its associated complications: A multi institutional study.

Background And Purpose: The increasing cost of cosmetic procedures, long elective waiting times in the public system and affordability of procedures offered abroad has driven the rapid growth of cosmetic tourism. The incidence and cost of patients presenting to the Irish health service with complications related to cosmetic procedures carried out in overseas institutions is largely unknown. This heterogenous group of patients is challenging to identify.

Gender-based market constraints to informal fish retailing: Evidence from analysis of variance and linear regression.

Over the last decade, Egypt's aquaculture sector has expanded rapidly, which has contributed substantially to per capita fish supply, and the growth of domestic fish markets and employment across the aquaculture value chain. Despite the growing importance of aquaculture sector in Egyptian labour force, only a few studies have explored the livelihoods of Egypt's women and men fish retailers. Even fewer studies have examined gender-based market constraints experienced by these informal fish retailers.

High-Speed Laser Image Analysis of Plume Angles for Pressurised Metered Dose Inhalers: The Effect of Nozzle Geometry.

The aim of this study is to investigate aerosol plume geometries of pressurised metered dose inhalers (pMDIs) using a high-speed laser image system with different actuator nozzle materials and designs. Actuators made from aluminium, PET and PTFE were manufactured with four different nozzle designs: cone, flat, curved cone and curved flat. Plume angles and spans generated using the designed actuator nozzles with four solution-based pMDI formulations were imaged using Oxford Lasers EnVision system and analysed using EnVision Patternate software.

Plume Characteristics of Two HFA-Driven Inhaled Corticosteroid/Long-Acting Beta2-Agonist Combination Pressurized Metered-Dose Inhalers.

Introduction: New inhalers propelled by hydrofluoroalkanes (HFAs) have improved plume characteristics: higher fine particle fraction, and warmer plumes with reduced force and velocity. Together, this may avoid reflex interruption of inhalation and improve lung deposition of the inhaled drugs. However, even with HFA-propelled pressurized metered-dose inhalers (pMDIs), there are notable differences in device properties.

Are Interprofessional Roundtable Debriefings Useful in Decreasing ED Fall Rates? Findings From a Quality-Improvement Project.

Unlabelled: There are more than 1 million patient falls each year in the United States. Falls are known to be a sign of poor health, are a marker of decline in function, and are associated with high morbidity. The objective of this study was to determine the effectiveness of a Falls Roundtable intervention for reducing the rates of patient falls in an urban academic trauma center emergency department.

Does an ED flow coordinator improve patient throughput?

Introduction: At our urban academic medical center, efforts to alleviate ED overcrowding have included the implementation of a "fast track" area, increasing the ED size, using hallway beds, and ambulance diversion. In October 2012, we began the first steps of a process that created a system in which the admission process involves equal amounts of pushing and pulling to achieve the balance necessary to accomplish optimal outcomes. The foundation of the initiative was based on the use of a BSN-educated emergency nurse as a flow coordinator; a position specifically empowered to affect patient throughput in the emergency department.

Impact of magnetic resonance enterography in the management of small bowel Crohn's disease.

Introduction: Magnetic resonance enterography (MRE) is a relatively new imaging modality that involves small bowel distension with orally administered fluid. Few studies have assessed its impact on patient management.

Aim: The aim of this study was to determine whether MRE influenced the management of patients with established small bowel Crohn's disease (CD).

Double balloon enteroscopy in Crohn's disease: background and current state of play.

Double balloon enteroscopy has been available since 2004 and is slowly emerging as a valuable procedure that has the potential to reach all parts of the small intestine, allowing biopsy and therapeutic intervention. This paper describes the background to its development, the mechanics of the procedure and the current and potential roles it has in relation to small bowel Crohn's disease.

Genes of the interleukin-18 pathway are associated with susceptibility to Barrett's esophagus and esophageal adenocarcinoma.

Objectives: To investigate the association of genetic polymorphisms of the interleukin-18 (IL-18) pathway to Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). Most cases of EAC arise in a background of reflux-induced BE. Genetic influences in this pathway are poorly understood.

Efficacy of Adalimumab as a long term maintenance therapy in ulcerative colitis.

Introduction: Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF-alpha. There are limited data with regard to its efficacy in ulcerative colitis. We report experience of adalimumab in ulcerative colitis in a single centre with a focus on the ability of this agent to maintain response and avoid colectomy in the medium to long-term.

Dietary antioxidant and mineral intake in humans is associated with reduced risk of esophageal adenocarcinoma but not reflux esophagitis or Barrett's esophagus.

The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ.

Double balloon enteroscopy in Crohn's disease: where are we now and where should we go?

Visualization of the entire small-bowel mucosa had not been possible until the development of the capsule endoscope (Pillcam, Given Imaging, Yoqneam, Israel). However, this device did not allow any endoscopic intervention. More recently, a double balloon endoscope has been developed that allows intubation of the entire small bowel.

The association between alcohol and reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.

Background & Aims: Alcohol consumption may increase gastroesophageal reflux symptoms, cause damage to the esophageal mucosa, and/or promote carcinogenesis. However, reports about the association between alcohol and reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma are conflicting.

Methods: Information relating to alcohol consumption, at age 21 and 5 years before the interview date, was collected from 230 reflux esophagitis, 224 Barrett's esophagus, and 227 esophageal adenocarcinoma patients and 260 frequency-matched population controls.

Glycemic index, carbohydrate and fiber intakes and risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.

Objective: To examine the association between dietary glycemic index (GI), glycemic load (GL), total carbohydrate, sugars, starch, and fiber intakes and the risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.

Methods: In an all-Ireland study, dietary information was collected from patients with esophageal adenocarcinoma (n = 224), long-segment Barrett's esophagus (n = 220), reflux esophagitis (n = 219), and population-based controls (n = 256). Multiple logistic regression analysis examined the association between dietary variables and disease risk by tertiles of intake and as continuous variables, while adjusting for potential confounders.

Nine-year follow-up of a patient with attenuated familial adenomatous polyposis treated with cyclo-oxygenase-2 inhibitors.

Familial adenomatous polyposis (FAP) is caused by germline mutations in the adenomatous polyposis coli (APC) gene with onset of florid polyposis in childhood and development of colorectal cancer by age 30. Colectomy is advised because of the high risk of developing colorectal cancer. Attenuated FAP (AFAP) is a variant of this condition with a later age of onset and milder clinical phenotype; however, colectomy is advised once polyposis develops and polyps cannot be managed endoscopically.

Relapses of inflammatory bowel disease during pregnancy: in-hospital management and birth outcomes.

Background: There are few studies that describe the medical treatment and colitis response rates among patients with a severe relapse of inflammatory bowel disease (IBD) during pregnancy, and few studies of the effect of such a relapse on birth outcomes in these patients.

Objectives: To describe the treatment and response rates of severe colitis in pregnancy, and to assess the effects of a severe relapse of colitis during pregnancy on birth outcomes.

Methods: We performed a case control study of pregnant patients with IBD hospitalized for a disease relapse at two large treatment centers between 1989 and 2001.

No association between hOGG1, XRCC1, and XPD polymorphisms and risk of reflux esophagitis, Barrett's esophagus, or esophageal adenocarcinoma: results from the factors influencing the Barrett's adenocarcinoma relationship case-control study.

Reflux of gastric contents can lead to development of reflux esophagitis and Barrett's esophagus. Barrett's esophagus is a risk factor for esophageal adenocarcinoma. Damage to DNA may lead to carcinogenesis but is repaired through activation of pathways involving polymorphic enzymes, including human 8-oxoguanine glycosylase 1 (hOGG1), X-ray repair cross-complementing 1 (XRCC1), and xeroderma pigmentosum group D (XPD).

Cyclooxygenase-2 and inducible nitric oxide synthase gene polymorphisms and risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma.

The incidence of esophageal adenocarcinoma has increased in recent years, and Barrett's esophagus is a recognized risk factor. Gastroesophageal reflux of acid and/or bile is linked to these conditions and to reflux esophagitis. Inflammatory disorders can lead to carcinogenesis through activation of "prosurvival genes," including cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS).

Gut microbes in Crohn's disease: getting to know you better?

Biomarkers in inflammatory bowel disease (IBD) are needed to help in disease diagnosis, prognosis, and assessment of disease activity. The best serologic markers to date measure antibody responses to normal commensal flora. These antibody responses can provide prognostic information as well as clues to disease pathogenesis.