No one data source captures all: A nested case-control study of the completeness of maternal death reporting in Banten Province, Indonesia.

Background: Indonesia's national health information systems collect data on maternal deaths but the completeness of reporting is questionable, making it difficult to design appropriate interventions. This study examines the completeness of maternal death reporting by the district health office (DHO) system in Banten Province.

Method: We used a nested-control study design to compare data on maternal deaths in 2016 from the DHO reporting system and the MADE-IN/MADE-FOR method in two districts and one municipality in Banten Province, with the aim of identifying and characterizing missed deaths in the DHO reporting system.

Multidisciplinary approaches to complication reduction in complex spine surgery: a systematic review.

Background Context: Complex spine surgery carries a high complication rate that can produce suboptimal outcomes for patients undergoing these extensive operations. However, multidisciplinary pathways introduced at multiple institutions have demonstrated a promising potential toward reducing the burden of complications in patients being treated for spinal deformities. To date, there has been no effort to systematically collate the multidisciplinary approaches in use at various institutions.

Stabilization of elongated polyglutamine tracts by a helical peptide derived from N-terminal huntingtin.

In Huntington's disease, the length of the polyglutamine tract in the mutant protein correlates positively with the formation of aggregates and disease symptoms and severity of the disease. Some disease-modifying factors exist. However, no organized study has been carried out to investigate the effect of polyglutamine length in the mutant protein on the efficacy of a therapeutic strategy.

Team Approach: Safety and Value in the Practice of Complex Adult Spinal Surgery.

Surgical management of complex adult spinal deformities is of high risk, with a substantial risk of operative mortality. Current evidence shows that potential risk and morbidity resulting from surgery for complex spinal deformity may be minimized through risk-factor optimization. The multidisciplinary team care model includes neurosurgeons, orthopaedic surgeons, physiatrists, anesthesiologists, hospitalists, psychologists, physical therapists, specialized physician assistants, and nurses.

Impact of the Patient Protection and Affordable Care Act on cost-related medication underuse in nonelderly adult cancer survivors.

Background: Cost-related medication underuse (CRMU), a measure of access to care and financial burden, is prevalent among cancer survivors. The authors quantified the impact of the Patient Protection and Affordable Care Act (ACA) on CRMU in nonelderly cancer survivors.

Methods: Using National Health Interview Survey data (2011-2017) for cancer survivors aged 18 to 74 years, the authors estimated changes in CRMU (defined as taking medication less than prescribed due to costs) before (2011-2013) to after (2015-2017) implementation of the ACA.

Triglycerides and Cardiovascular Outcomes-Can We REDUCE-IT ?

The causal linkage between triglycerides and coronary artery disease has been controversial. Most of the trials hitherto have shown marginal or no beneficial effects of reduction of triglycerides (with fibrates) on top of low-density lipoprotein (LDL) reduction. But a significant residual cardiovascular risk remains even after use of high dose of statins.

An unusual case of isolated right-sided infective endocarditis masquerading as non-resolving pneumonia.

Right-sided infective endocarditis in non-intravenous drug abusers and non-immunocompromised patients is rare. The diagnosis is difficult as it can present as a respiratory illness leading to delays in diagnosis and development of complications, which can be fatal. The standard Duke criteria may not be adequate for diagnosis.

Helping spine surgeons detect pre-surgical psychological distress in complex spine patients: an observational pilot study.

Study Design: Retrospective analysis.

Objective: Analysis of a standardized, pre-surgical psychological evaluation program for complex spine surgery. Adult spinal deformity (ASD) patients have a high rate of comorbid mental health conditions.

Tracheostomy Complications in the Emergency Department: A National Analysis of 38,271 Cases.

Background: Greater than 100,000 tracheotomies are performed annually in the USA, yet little is known regarding patients who present to the emergency department (ED) with tracheostomy complications.

Objectives: To characterize patient and hospital characteristics, outcomes, and charges associated with tracheostomy complications and to identify predictors of admission and mortality.

Methods: The 2009-2011 Nationwide Emergency Department Sample (NEDS) was queried for patients with a principle diagnosis of tracheostomy complication.

New Paradigms in the Continuum of Spine Care: From Newborns to Elderly Patients.

The evaluation and management of spinal disorders is complex and constantly evolving. Back pain and spinal deformity are substantial contributors to hospital and outpatient physician visits even for young patients. With new insights into the etiology, clinical presentation, and evaluation, children can be more accurately diagnosed and treated.

Kratom (Mitragyna speciosa): Friend or Foe?

Increased use of the opioid-related plant kratom as an alternative treatment for opioid withdrawal symptoms has raised concerns regarding its potential for abuse and severe adverse effects. A review of the literature was performed to characterize kratom's pharmacology, clinical efficacy, and adverse effects to increase understanding and evaluate potential use as an alternative treatment for opioid dependence. Kratom use initiated as self-medication for an opioid use disorder or pain syndrome in the absence of effective alternatives is associated with a risk of kratom dependence, withdrawal, and life-threatening toxicity.

Serum amyloid A (SAA) mRNA expression in chicken and quails in response to bacterial stress.

Monitoring of acute phase proteins such as serum amyloid A at gene expression level may provide quick information about immune status of the host and its susceptibility towards common infections. Present study was carried out to evaluate and compare the mRNA expression of SAA gene in Rhode Island Red chicken (RIR) and Japanese quails using real time PCR analysis in response to inactivated Salmonella gallinarum culture. The results showed that expression of SAA gene was approximately 17-33 folds higher in case of birds administered with bacterial culture when compared to un-inoculated controls and expression was higher and quicker in case of quails than RIR chicken.

Radial Forearm Free Flap for Cochlear Implant Coverage in a Post-Irradiated Field.

Objective: To describe a novel use of a radial forearm free flap (RFFF) for soft tissue coverage over a cochlear implant (CI) in a post-irradiated field.

Patients: Single patient case report of a woman with a history of radiation therapy for brainstem astrocytoma who suffered from repeated CI extrusion despite tympanomastoid obliteration and locoregional pedicled flap soft tissue coverage.

Intervention(s): Sequential bilateral, single-staged revision cochlear implantation with RFFF soft tissue coverage.

Predictive factors for prolonged operative time in head and neck patients undergoing free flap reconstruction.

Purpose: Defining the predictive factors associated with prolonged operative time may reduce post-operative complications, improve patient outcomes, and decrease cost of care. The aims of this study are to 1) analyze risk factors associated with prolonged operative time in head and neck free flap patients and 2) determine the impact of lengthier operative time on surgical outcomes.

Methods: This retrospective cohort study evaluated 282 head and neck free flap reconstruction patients between 2011 and 2013 at a tertiary care center.

Outcomes and prognostic factors in parotid gland malignancies: A 10-year single center experience.

Objectives: To describe a 10-year single center experience with parotid gland malignancies and to determine factors affecting outcomes.

Study Design: Retrospective review.

Methods: The institutional cancer registry was used to identify patients treated surgically for malignancies of the parotid gland between January 2005 and December 2014.

Azilsartan: Current Evidence and Perspectives in Management of Hypertension.

Hypertension continues to be global pandemic with huge mortality, morbidity, and financial burden on the health system. Unfortunately, most patients with hypertension would eventually require two or more drugs in combination to achieve their target blood pressure (BP). To this end, emergence of more potent antihypertensive drugs is a welcome sign.

Prevalence and incidence of hyponatremia and their association with diuretic therapy: Results from North India.

Introduction: Hyponatremia is associated with substantial morbidity and mortality. Correct estimation of their prevalence, incidence and risk factors, especially the diuretics in Indian patients is important in determining preventive strategies.

Methods: This multistage mixed methods-based study was conducted in a high-volume cardiac care center to ensure the correct estimation.

Etiological causes and epidemiological characteristics of patients with occupational corneal foreign bodies: A prospective study in a hospital-based setting in India.

Purpose: Corneal foreign bodies (CFBs) due to occupational exposure have been largely ignored in Indian literature, especially nonmetal workers. Our study looks at a broad range of occupations and settings that contribute to CFB in our local Indian population.

The Study Objective Was To: determine the occupations, level of education and demographics of patients presenting with CFB acquired during occupational work.

Short-Term Clinical Follow-Up After Thrombolytic Therapy in Patients With Prosthetic Valve Thrombosis: A Single-Center Experience.

Background: Thrombolytic therapy has evolved as an alternative to surgery for prosthetic valve thrombosis (PVT). Therefore, this retrospective, single-center study aimed to evaluate the clinical profile of PVT and the role of thrombolytic therapy in patients with PVT.

Methods: Data from a total of 16 consecutive patients with PVT enrolled between January 2017 and January 2018 at a tertiary care center in India were retrospectively evaluated.