Rheumatoid myositis leading to acute lower extremity compartment syndrome: a case-based review.

Muscle pain and weakness in a rheumatoid arthritis (RA) patient has a broad differential, and myositis should be considered early in the disease course as serious limb and life-threatening sequelae may occur. A 55-year-old woman with a past medical history of methotrexate-controlled RA presented with right leg pain for 4 days. The patient suffered sensory loss in the right foot and decreased strength in the toes.

Association between coronary artery disease diagnosed by coronary angiography and breast arterial calcifications on mammography: meta-analysis of the data.

Background: Previous studies evaluating breast arterial calcifications (BAC) as a risk marker for coronary artery disease (CAD) have been limited by sample size and have yielded mixed results. Our objective was to evaluate the association of BAC and CAD.

Methods: Data sources included Medline (1970-2010), the Cochrane Controlled Trials Register electronic database (1970-2010), and CINAHL (1970-2010).

Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature.

Primary aortic graft infection early after aortic graft insertion is well described in the literature. Here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. A 63-year-old male presented for severe low back pain, constipation, and low-grade fever.

Using Six Sigma methodology to reduce patient transfer times from floor to critical-care beds.

Introduction: In response to concerns regarding delays in transferring critically ill patients to intensive care units (ICU), a quality improvement project, using the Six Sigma process, was undertaken to correct issues leading to transfer delay.

Objective: To test the efficacy of a Six Sigma intervention to reduce transfer time and establish a patient transfer process that would effectively enhance communication between hospital caregivers and improve the continuum of care for patients.

Methods: The project was conducted at a 714-bed tertiary care hospital in Staten Island, New York.

Allopurinol causing drug rash with eosinophilia and systemic symptoms syndrome: a challenging diagnosis.

Background: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by cutaneous drug eruption, eosinophilia, and systemic symptoms. The syndrome is difficult to diagnose due to its clinical heterogeneity and long latency period (2-6 weeks).

Case Report: This paper describes a 73-year-old man who presented with a rash that started 1 week prior to his presentation.

Diffuse Idiopathic Skeletal Hyperostosis (DISH)-A Rare Etiology of Dysphagia.

A 72-year-old gentleman presented to the hospital with progressively worsening dysphagia to soft foods and liquids. He was diagnosed with severe pharyngeal dysphagia by modified barium swallow. A CT scan of the neck with IV contrast showed anterior flowing of bridging osteophytes from C3-C6, indicative of DISH, resulting in esophageal impingement.

Out-of-Match Residency Offers: The Possible Extent and Implications of Prematching in Graduate Medical Education.

Background: When the data from the National Resident Matching Program (NRMP) are used to analyze trends in medical students' career preferences, positions offered outside the match are omitted. The purpose of the study was to evaluate the extent and nature of out-of-match residency offers.

Methods: We obtained total resident complements and postgraduate year-1 positions offered in 7 specialties in 2007 and compared these with the 2007 NRMP match data.

Breast cancer knowledge, attitudes and practices among Nepalese women.

Although Nepal has an epidemic of early-onset, aggressive, advanced breast cancer, breast cancer knowledge and screening practices of Nepalese women have not been assessed. This paper summarises the results of a physician-administrated survey of gynaecologic inpatients (n= 100) admitted between 1 December 2009 and 31 January 2010 at a Nepalese University. Mean knowledge score of the participants was 65%, significantly higher among highly educated women (P= 0.

Serum lipoprotein levels in takotsubo cardiomyopathy vs. myocardial infarction.

Background: In the setting of myocardial infarction (MI) or acute coronary syndrome (ACS), current guidelines recommend early and aggressive lipid lowering therapy with statins, irrespective of the baseline lipoprotein levels. Takotsubo cardiomyopathy (TCM) patients have a clinical presentation similar to myocardial infarction and thus receive early and aggressive statin therapy during their initial hospitalization. However, the pathology of TCM is not atherosclerotic coronary artery disease and hence we assumed the lipid profiles in TCM would be healthier than coronary artery disease patients.

Cardiac tamponade in acute pancreatitis.

A 47-year-old man presented with severe acute pancreatitis. On hospitalisation day 8, the patient became hypotensive and developed new-onset atrial fibrillation. Echocardiography showed significant pericardial effusion with right ventricular collapse.

Fasting hyperglycemia upon hospital admission is associated with higher pneumonia complication rates among the elderly.

Background: Hyperglycemia is an independent predictor of adverse outcomes during hospitalization. In patients who have pneumonia, significant hyperglycemia is associated with poor outcomes. This study evaluates the interaction of the degree of hyperglycemia and complication rates stratified by age in non-critically ill patients admitted to the hospital for care of community-acquired pneumonia.

Current concepts in triglyceride metabolism, pathophysiology, and treatment.

It is becoming more evident that age, gender, and race play a significant role in the metabolic profiles that are seen among individuals in a clinical setting. It is important to understand these variances in metabolic profiles; and with these variances in mind it is now possible to understand why a single diet might not decrease cardiovascular disease risk profiles uniformly for everyone. Much is now understood about triglyceride metabolism and its contribution to energy storage.

A STEMI code protocol improves door-to-balloon time on weekdays and weekends.

Primary percutaneous coronary intervention (PCI) has emerged as the standard of care for the management of ST-elevation myocardial infarctions (STEMI). Only 32% of patients with STEMI receive this procedure within the recommended 90 min for door-to-balloon time (DTB). We reviewed all STEMI cases that presented to our institution before and after the implementation of a STEMI Code protocol.

Interferon and lamivudine vs. interferon for hepatitis B e antigen-positive hepatitis B treatment: meta-analysis of randomized controlled trials.

Aims: To compare interferon monotherapy with its combination with lamivudine for hepatitis B e antigen (HBeAg)-positive hepatitis B treatment.

Methods: Two independent researchers identified pertinent randomized controlled trials. The trials were evaluated for methodological quality and heterogeneity.

Somatostatin and gabexate for post-endoscopic retrograde cholangiopancreatography pancreatitis prevention: meta-analysis of randomized placebo-controlled trials.

Background And Aim: Prior studies have suggested the efficacy of somatostatin and gabexate in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis prevention. We examined this notion in our study.

Methods: An extensive literature search led to the inclusion of seven homogeneous high-quality studies (Jadad score >or=4), involving 3,130 patients.

Music in the endoscopy suite: a meta-analysis of randomized controlled studies.

Background And Study Aim: Prior studies have suggested that music therapy can provide stress relief and analgesia. In this meta-analysis we focused on the effects of music therapy on patients undergoing gastrointestinal endoscopic procedures.

Materials And Methods: A literature search using the PubMed and Cochrane Library databases and a manual search led to the inclusion of six randomized controlled trials that examined the effects of music therapy on patients undergoing gastrointestinal endoscopic procedures.