Effectiveness of the IBCLC: Have we Made an Impact on the Care of Breastfeeding Families Over the Past Decade?

Background: International Board Certified Lactation Consultants (IBCLCs) have been in existence for over 3 decades, are currently represented in 110 countries, and have the only internationally recognized certification to provide safe and evidenced-based care for breastfeeding women and their infants.

Research Aim: To review the literature about the efficacy of IBCLCs on breastfeeding outcomes as well as studies that have examined the effectiveness of the IBCLC's role.

Methods: The design was a scoping review of the literature and critical analysis using PRISMA guidelines of existing studies published from 2008-2019.

Porphyria Cutanea Tarda Associated With Acute Hemorrhagic Pancreatitis.

Porphyria cutanea tarda (PCT) is a condition of dysregulated heme synthesis that leads to accumulation of photosensitizing precursors with resultant fragility and blistering of the skin. It can be hereditary or acquired and has been known to be associated with hepatic C virus, alcohol, HIV, and estrogen. In this article, we report an unusual presentation of PCT associated with acute hemorrhagic pancreatitis in a 57-year-old man.

Antibiotic Use and Respiratory Pathogens in Adults With Sickle Cell Disease and Acute Chest Syndrome.

Acute chest syndrome (ACS) is an acute complication of sickle cell disease (SCD). Historically, the most common pathogens were , and respiratory syncytial virus. Pediatric patients receiving guideline-adherent therapy experienced fewer ACS-related and all-cause 30-day readmissions compared with those receiving nonadherent therapy.

Primary Care Providers Welcome Smartphone Apps That Assist in Pediatric Weight Management.

Primary care providers (PCPs) have few resources to manage their overweight/obese patients. The purpose of study was to determine if technological resources, such as smartphone apps, may be useful for weight management counseling. PCPs were surveyed about their current use of resources for obesity management and whether smartphone apps would be helpful.

Drug-Induced Liver Injury Caused by Kratom Use as an Alternative Pain Treatment Amid an Ongoing Opioid Epidemic.

Kratom ( Mitragyna speciosa) is a prevalent medicinal plant used mainly for the stimulant and analgesic properties provided through multiple alkaloid compounds. Over the past decade, use of kratom has increased despite the limited knowledge of toxicities and adverse side effects. With the current opioid epidemic, both patients and providers are seeking alternative methods to treat both addiction and pain control, and kratom as an alternative means of treatment has increasingly entered the mainstream.

Systematic Review of the Clinical Utility of Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Screening for MRSA Pneumonia.

Objective: To describe the diagnostic performance characteristics of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening for patients with pneumonia.

Data Sources: PubMed and Scopus were searched from 1 January 1990 to 12 December 2018 using terms methicillin-resistant Staphylococcus aureus AND (screening OR active surveillance OR surveillance culture OR targeted surveillance OR chromogenic OR PCR OR polymerase chain reaction OR rapid test) AND (nares OR nasal) AND (pneumonia OR respiratory).

Study Selection And Data Extraction: Relevant studies in humans and English were considered.

Prognostic Impact of High-Risk Pathologic Features in HPV-Related Oropharyngeal Squamous Cell Carcinoma and Tobacco Use.

Objectives: To assess the impact of pathologic features and chronic tobacco use on human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).

Study Design: Case series with chart review.

Setting: Single tertiary care referral center.

Oral Vancomycin for Secondary Prophylaxis of Clostridium difficile Infection.

Objective: To summarize and critically appraise the evidence regarding oral vancomycin prophylaxis (OVP) to prevent recurrent Clostridium difficile infections (RCDIs), identify potential consequences of this emerging practice, and highlight future directions of study.

Data Sources: A MEDLINE literature search of English-language publications from 1947 through September 2018 was performed using the search terms vancomycin and C difficile and prophylaxis. Clinical trials were identified on the National Library of Medicine clinical trials registry.

Remote Injuries and Outcomes After Distal Radius Fracture Management.

Background: Distal radius fracture (DRF) is a common fracture of the upper extremity. The role of concurrent injuries in patients treated for DRFs is poorly elucidated. The authors sought to determine whether remote injuries were associated with worse outcomes after management of DRFs.

Mental Health Correlates of Financial Mistreatment in the National Elder Mistreatment Study Wave II.

Whereas prevalence of elder financial mistreatment has received increased attention over the past decade, health and mental health correlates are rarely studied. Thus, the potential relevance of financial abuse to mental health and perceived health is relatively unknown, and the objective of this article is to illustrate this relationship. The second wave of the National Elder Mistreatment Study used random digit dialing telephone survey methodology to assess both recent financial mistreatment and its potential mental health correlates (i.

Alteplase for the treatment of acute ischemic stroke in patients with low National Institutes of Health Stroke Scale and not clearly disabling deficits (Potential of rtPA for Ischemic Strokes with Mild Symptoms PRISMS): Rationale and design.

Rationale Over half of acute ischemic stroke patients have a low National Institutes of Health Stroke Scale of 0-5 and up to two-thirds may not appear clearly disabled at presentation. The efficacy of intravenous alteplase for the latter group is not known. Aim Potential of rtPA for Ischemic Strokes with Mild Symptoms (PRISMS) was designed to evaluate the safety and efficacy of intravenous alteplase for the treatment of acute ischemic stroke with National Institutes of Health Stroke Scale 0-5 and without clearly disabling deficits.

Interpreting Action Research Arm Test Assessment Scores to Plan Treatment.

Rasch keyforms can help interpret clinical assessment scores. The Action Research Arm Test (ARAT) is a commonly used assessment, yet no keyform currently exists. The aim is to provide a keyform for the ARAT and demonstrate how a clinician can use the keyform to design optimally challenging rehabilitation sessions.

Regulatory Support Improves Subsequent IRB Approval Rates in Studies Initially Deemed Not Ready for Review: A CTSA Institution's Experience.

We evaluated the impact of a regulatory support service (known as the Regulatory Knowledge and Support [RKS] program), part of the Medical University of South Carolina's Clinical and Translational Science Award, on the success of Institutional Review Board (IRB) applications that have previously been deemed by the IRB to be Not Ready for Review (NRR). At the time of this evaluation, 77 studies had been deemed NRR, 53 of which came from trainees and junior faculty. All the applications that received regulatory support either received IRB approval or were deemed to not be research, and therefore did not require IRB review.

REHEARSAL Using Patient-Specific Simulation to Improve Endovascular Efficiency.

Objective: To determine whether rehearsal using patient-specific information loaded onto an endovascular simulator prior to carotid stenting improves procedural efficiency and outcomes.

Methods: Patients scheduled for carotid artery stenting who had adequate preoperative computed tomography (CT) imaging were considered for enrollment. After obtaining informed consent, patients were randomized to control versus rehearsal groups.

Examining Anosognosia of Neglect.

Unilateral neglect (neglect) and anosognosia often co-occur post stroke. It is unknown whether anosognosia of neglect varies for different types of daily activities. The objective is to examine the frequency of anosognosia of neglect for items on the Catherine Bergego Scale (CBS) and to determine the level of agreement between participant/assessor item ratings and total scores.

An Examination of Sociocultural Factors Associated With Mammography Screening Among Latina Immigrants.

Introduction: The study hypothesized that sociocultural factors would be associated with breast cancer screening within the past 2 years among Latina immigrant women.

Method: This study employed a survey design and included 82 Latina immigrant female participants 40 to 64 years of age for the analysis. Two multivariable binary logistic regression models were estimated, one for the sociocultural deterrents and the other for the symptomatic deterrents from the Cultural Cancer Screening Scale.

Effects of White Noise Achilles Tendon Vibration on Quiet Standing and Active Postural Positioning.

Applying white noise vibration to the ankle tendons has previously been used to improve passive movement detection and alter postural control, likely by enhancing proprioceptive feedback. The aim of the present study was to determine if similar methods focused on the ankle plantarflexors affect the performance of both quiet standing and an active postural positioning task, in which participants may be more reliant on proprioceptive feedback from actively contracting muscles. Twenty young, healthy participants performed quiet standing trials and active postural positioning trials designed to encourage reliance on plantarflexor proprioception.

Psychosis and Sexual Offending: A Review of Current Literature.

Sexual offending is a public health concern and societal risk requiring a multi-disciplinary approach. While current data give an indication of the frequency of sexual victimization, these figures likely underestimate the severity of the concern as many of these incidents go unreported. And while sex offender research has increased over the past several decades, particular attention to those offenders with severe mental illness remains limited.

Trends in Upper Extremity Injuries Presenting to US Emergency Departments.

Background: The purpose of this study was to identify the incidence of upper extremity injuries presenting to emergency departments (EDs) nationally.

Methods: The Nationwide Emergency Department Sample (NEDS) database was queried using International Classification of Diseases, Ninth Revision (ICD-9) codes specific for hand/wrist injuries to identify national estimates of ED visits. The incidence, mean age, gender, payer mix, hospital type, location (metropolitan vs nonmetropolitan), and geographic region were recorded.

Parental Knowledge of AAP Juice Guidelines Is Associated With Parent and Children's Consumption of Juice and Sugar-Sweetened Beverages in an Underserved Population.

This study tested whether parental knowledge of the American Academy of Pediatrics' (AAP) recommendations on juice limits for children is associated with decreased consumption of juice and sugar-sweetened beverages (SSBs) among parents and children. Fifty-two parents with children 2 to 12 years old in a resident continuity clinic in East Harlem, New York, completed a survey asking about children's and parent's practice and quantitative consumption of juice and SSBs as well as parental knowledge of the AAP recommendations on juice limits. Parent's total daily consumption of juice and SSBs ( P < .

Patient-Administered Screening Tool May Improve Detection and Diagnosis of Depression Among Adolescents.

Depression among adolescents is underdiagnosed and associated with significant morbidity and mortality. The American Academy of Pediatrics endorses opportunistic depression screening beginning at age 11, implying that screening should be performed at every visit. The purpose of this quality improvement project was to determine whether a self-administered depression screen would improve the identification of major depressive disorder among adolescents in a pediatric primary care clinic.

Patient outcomes after transcatheter and surgical pulmonary valve replacement for pulmonary regurgitation in patients with repaired tetralogy of Fallot: A quasi-meta-analysis.

Background: Individuals with repaired tetralogy of Fallot develop pulmonary regurgitation that may cause symptoms (dyspnea, chest pain, palpitations, fatigue, presyncope, and syncope), impair functional capacity, and may affect health-related quality of life. Surgical pulmonary valve replacement is the gold standard of treatment although transcatheter pulmonary valve replacement is becoming more common. Patients want to know whether less invasive options are as good.