Laparoscopic Davydov vs. laparoscopic Vecchietti neovaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome; a systematic review and meta-analysis.

Objective: To summarize the available evidence on the laparoscopic Davydov and Vecchietti methods to create a neovagina and to compare these techniques with a focus on neovaginal length, sexual function, operative time, and complications.

Design: A systematic electronic search up to August 2022 using PubMed and Embase is performed.

Setting: Not applicable.

Myalgic Encephalomyelitis-Chronic Fatigue Syndrome Common Data Element item content analysis.

Introduction: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multisystem chronic disease estimated to affect 836,000-2.5 million individuals in the United States. Persons with ME/CFS have a substantial reduction in their ability to engage in pre-illness levels of activity.

Vitelline vascular remnant causing intestinal obstruction in a patient with TARP syndrome.

Background: TARP syndrome, characterized by talipes equinovarus, atrial septal defect, Robin sequence, and persistent left superior vena cava, is an X-linked recessive condition caused by deleterious variants in RBM10. Vitelline vascular remnants (VVR) are a rare vitelline duct anomaly with approximately 26 cases previously reported. There are no previously reported cases of VVRs in patients with TARP syndrome.

The impact of COVID-19 on incidence and outcomes from out-of-hospital cardiac arrest (OHCA) in Texas.

Introduction: Emerging research demonstrates lower rates of bystander cardiopulmonary resuscitation (BCPR), public AED (PAD), worse outcomes, and higher incidence of OHCA during the COVID-19 pandemic. We aim to characterize the incidence of OHCA during the early pandemic period and the subsequent long-term period while describing changes in OHCA outcomes and survival.

Methods: We analyzed adult OHCAs in Texas from the Cardiac Arrest Registry to Enhance Survival (CARES) during March 11-December 31 of 2019 and 2020.

STEMI Mimic: Focal Myocarditis in an Adolescent Patient After mRNA COVID-19 Vaccine.

Background: In May 2021, the U.S. Food and Drug Administration expanded the Emergency Use Authorization for the Pfizer-BioNTech mRNA Coronavirus disease 2019 (COVID-19) Vaccine (BNT162b2) to include adolescents 12-15 years of age.

A Comprehensive Examination of Severely Ill ME/CFS Patients.

One in four myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients are estimated to be severely affected by the disease, and these house-bound or bedbound patients are currently understudied. Here, we report a comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls. The greatly reduced quality of life of the patients was negatively correlated with clinical depression.

Can I Send This Syncope Patient Home From the Emergency Department?

Background: Syncope is a common presentation to the emergency department (ED). A significant minority of these patients have potentially life-threatening pathology. Reliably identifying that patients require hospital admission for further workup and intervention is imperative.

Hide and Seek: Intermittent Preexcitation Wolff-Parkinson-White Syndrome Case Report and Management Overview.

Wolff-Parkinson-White (WPW) syndrome is an uncommon form of cardiac preexcitation due to an underlying structural accessory pathway, which may lead to potentially lethal arrhythmias. Classic electrocardiogram (ECG) findings of WPW include short PR interval, slurred upstroke of the QRS complex, and prolonged QRS duration. However, in intermittent preexcitation, a rare variant in contrast to continuous preexcitation, these findings are not always present, thus masking a diagnosis of WPW syndrome.

An Atypical Presentation of Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection is a rare form of acute coronary syndrome (ACS) resulting from tears in the coronary vessel lumen leading to myocardial ischemia. Historically, younger to middle-aged Caucasian females without traditional risk factors for ACS are most commonly affected. The authors present the case of an African American female with numerous traditional ACS risk factors who presented to the emergency department with chest pain.

ST-Segment Elevation in the Setting of Diabetic Ketoacidosis: Is It Acute Coronary Syndrome?

Diabetic ketoacidosis (DKA) with resulting hyperkalemia can lead to ST-segment elevations on electrocardiogram (ECG). Previous publications theorize that significant improvements in patient potassium levels lead to the resolution of this rare phenomenon, also known as "pseudo-infarct" pattern. The authors provide a unique case along with a literature review of DKA-associated ST-segment elevations.

Rodent Sperm Analysis: A rationale for and path toward acceptance and use in ecological risk assessment.

The Rodent Sperm Analysis method was devised some two decades ago to advance ecological assessment science for mammals, one of two groups of terrestrial receptors routinely evaluated at chemically contaminated sites. In part, this method recognizes that sufficient time has elapsed at sites, such that a need to anticipate or predict impacts to ecological receptors is an obsolete task. The method therefore, recommends evaluating the very receptors that occupy sites for evidence today of their displaying compromised reproduction, a toxicological endpoint of great concern within the regulatory community.

An emergency medicine approach to troponin elevation due to causes other than occlusion myocardial infarction.

Introduction: Troponin is an integral component of the evaluation for acute coronary syndrome (ACS) and occlusion myocardial infarction (OMI). However, troponin may be elevated in conditions other than OMI.

Objective: This narrative review provides emergency clinicians with a focused evaluation of troponin elevation in patients with myocardial injury due to conditions other than OMI.

Comminuted Femur Fracture in a Free Fall Jump: A Case Report.

Military free fall or high-altitude low-opening parachute jumps play a key role in special operations tactics, though injury patterns in these operators are not well characterized. In contrast to lower-altitude static line paratroopers, free fall operators require precise parachute deployment after a prolonged descent, with the potential for high-velocity trauma. This report describes a 33-year-old Marine Corps Reconnaissance operator who sustained left comminuted basicervical femoral neck fracture requiring cephalomedullary nail internal fixation with a full recovery.

Commentary: An open appeal to the EPA for Superfund ERA reform.

The ecological risk assessment guidance of virtually all federal and state agencies, private companies, and other interests can be traced to that of the essential design of the U.S. Environmental Protection Agency (EPA).

A Comparison of Prehospital Versus Emergency Department Intubations in Iraq and Afghanistan.

Background: Airway obstruction is the second most common cause of potentially preventable death on the battlefield. We compared survival in the combat setting among patients undergoing prehospital versus emergency department (ED) intubation.

Methods: Patients were identified from the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016.

Habitat selection and diurnal refugia of gray foxes in southwestern Georgia, USA.

Understanding habitat selection of gray foxes (Urocyon cinereoargenteus) is essential to evaluate their potential response to changes in land use and predator communities. Few studies have evaluated temporal habitat selection or explicitly identified habitats used by gray foxes for diurnal refugia. We used GPS collars to obtain location data for 34 gray foxes (20 males and 14 females) from February 2014 to December 2015 to evaluate temporal (seasonal and diel) habitat selection and selection of diurnal refugia in southwestern Georgia, USA.

Ingestion of a Single 2.3 mm Lead Pellet by Laying Roller Pigeon Hens Reduces Egg Size and Adversely Affects F1 Generation Hatchlings.

Many aquatic and terrestrial avian species inadvertently ingest lead (Pb) in the form of spent or fragmented ammunition, mistaking it for food or grit. Previous studies in our laboratory have shown that ingestion of even a single 45-mg pellet can significantly increase blood-Pb levels and significantly inhibit the enzyme delta aminolevulinic-acid dehydratase (δ-ALAD) for a period of greater than 4 weeks. In the current study, proven breeder pairs of domestic Roller pigeons were housed in individual cages.

Emergency department septic shock patient mortality with refractory hypotension vs hyperlactatemia: A retrospective cohort study.

Background: Our objective was to compare in-hospital mortality among emergency department (ED) patients meeting trial-based criteria for septic shock based upon whether presenting with refractory hypotension (systolic blood pressure<90mmHg after 1L intravenous fluid bolus) versus hyperlactatemia (initial lactate≥4mmol/L).

Methods: We conducted a retrospective cohort analysis by chart review of ED patients admitted to an intensive care unit with suspected infection during 1 August 2012-28 February 2015. We included all patients with body fluid cultures sampled either during their ED stay without antibiotic administration or within 24h of antibiotic administration in the ED.

Sepsis Clinical Criteria in Emergency Department Patients Admitted to an Intensive Care Unit: An External Validation Study of Quick Sequential Organ Failure Assessment.

Background: Quick Sequential Organ Failure Assessment (qSOFA) is a prognostic score for patients with sepsis.

Objective: Our aim was to compare the area under the receiver operating curve (AUROC), sensitivity, specificity, and likelihood ratios of qSOFA vs. systemic inflammation response syndrome (SIRS) in predicting in-hospital mortality among emergency department (ED) patients with suspected infection admitted to intensive care units (ICUs).

Validating mammalian resistance to stressor-mediated reproductive impact using rodent sperm analysis.

Small rodents from chemically and radiologically contaminated areas on the Savannah River Site, SC were evaluated for sensitive reproductive parameters in a dual purpose study. The primary intent was to observe if established reproductive thresholds-for effect could be exceeded in animals that, due to their restricted home ranges, are maximally exposed to local contamination. Secondarily, validation was sought for a principal element of the Rodent Sperm Analysis method that is used in support of ecological risk assessments for contaminated terrestrial properties.

Exposure Duration-Dependent Ovarian Recovery in Methoxychlor-Treated Mice.

The pesticide methoxychlor (MXC) is known to target ovarian antral follicles in the mouse. In previous in vivo studies, MXC administration for 20 days increased atresia, but did not affect female fertility immediately after dosing. Thus, we hypothesized that perhaps not enough time had elapsed between the onset of MXC-induced atresia and actual follicle loss to result in reduced fertility.