Complications Beyond Borders: A Case Study on a Retained Surgical Towel Leading to an Intra-abdominal Abscess Post-hysterectomy.

This report discusses a significant complication following a hysterectomy performed in Mexico on a 46-year-old woman who developed an intra-abdominal abscess due to a retained surgical towel - a severe but rare surgical error. Initially, her post-surgical symptoms, such as abdominal pain, fever, and malaise, were dismissed by her surgeon in Mexico as typical recovery effects. However, as her condition worsened, she sought emergency care in Arizona.

Artificial Intelligence in Multilingual Interpretation and Radiology Assessment for Clinical Language Evaluation (AI-MIRACLE).

The AI-MIRACLE Study investigates the efficacy of using ChatGPT 4.0, a large language model (LLM), for translating and simplifying radiology reports into multiple languages, aimed at enhancing patient comprehension. The study assesses the model's performance across the most spoken languages in the U.

Safety of teplizumab in patients with high-risk for diabetes mellitus type 1: A systematic review.

Background: The incidence of diabetes mellitus type 1 (DM1) has been rising worldwide because of improvements in diagnostic techniques and improved access to care in countries with lower socioeconomic status. A new anti-CD4 antibody, Tep-lizumab, has been shown to delay the progression of DM1 and is the only medication approved for this indication. However, more information is needed about the safety profile of this drug.

Evidence-based Practice Interventions for Reducing Postoperative Pulmonary Complications: A Narrative Review.

Background: Specific surgical procedures, such as upper abdominal and thoracic surgery, are connected to an increased predisposition of postoperative pulmonary complications (PPCs). The incidence of PPCs could vary approximately between 20-90% with upper abdominal surgery, which can be minimized by using treatment procedures that increase lung capacity and encourage inspiration. This review aims to examine the effectiveness of already existing evidence-based interventions that promote lung expansion, thereby preventing PPCs.

Early antiplatelet therapy used for acute ischemic stroke and intracranial hemorrhage.

In this editorial we comment on the article published by Zhang in the recent issue of . We evaluate their claims on the benefit of use of Aspirin in the early management of patients with ischemic stroke. We also comment on their contention of using aspirin in the early management of patients with intracranial hemorrhage, a practice not seen in modern medicine.

Dual Anticoagulation With Warfarin and Apixaban: A Case Report.

We report the case of a female with recurrent venous thromboembolisms (VTEs) despite being appropriately anticoagulated. Different anticoagulants were trialed and all led to treatment failure. As a result, the patient was started on dual anticoagulation with warfarin and apixaban.

Vancomycin With Concomitant Piperacillin/Tazobactam vs. Cefepime or Meropenem Associated Acute Kidney Injury in General Ward Patients: A Multicenter Propensity Score-Matched Study.

Concurrent administration of vancomycin and piperacillin/tazobactam (VAN+PTZ) may increase the risk of acute kidney injury (AKI) in hospitalized patients. Comprehensive characterization of VAN+PTZ associated AKI and recovery patterns remains lacking in previous reports. To compare the incidence of AKI associated with VAN+PTZ compared to either cefepime (CEF) or meropenem (MER) with VAN in adult general ward patients.

Severe Aplastic Anemia After Receiving SARS-CoV-2 Moderna mRNA Vaccination.

A 60-year-old male patient presented to the emergency department with complaints of easy bruising and worsening epistaxis after receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Moderna mRNA vaccination. He had no personal or family history of hematological conditions. He had bruises in various stages involving the upper and lower extremities.

Vancomycin with concomitant piperacillin/tazobactam vs. cefepime or meropenem associated acute kidney injury in the critically ill: A multicenter propensity score-matched study.

Purpose: The risk of acute kidney injury (AKI) associated with concomitant vancomycin and piperacillin/tazobactam in the intensive care unit (ICU) remains controversial. The aim of this study was to compare the AKI incidence associated with concomitant vancomycin and piperacillin/tazobactam compared to either cefepime or meropenem with vancomycin in the ICU.

Materials And Methods: A multicenter, retrospective, propensity score-matched cohort study was conducted in adult ICU patients administered vancomycin in combination with either piperacillin/tazobactam, cefepime, or meropenem were included.

Chloroquine Ingestion to Prevent SARS-CoV-2 Infection: A Report of Two Cases.

Introduction: Amid the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), chloroquine and hydroxychloroquine were being studied as agents to prevent and treat coronavirus disease 2019. Information about these agents and their effects circulated throughout the general public media, raising the concern for self-directed consumption of both pharmaceutical and non-pharmaceutical products.

Case Report: We present two cases of chloroquine toxicity that occurred after ingestion of an aquarium disinfectant that contained chloroquine phosphate in a misguided attempt to prevent infection by SARS-CoV-2.

Positive Murphy's Sign in Pericardial Hematoma from a Right Atrial Tear.

A positive Murphy's sign in a patient with right upper quadrant abdominal pain is the arrest of inspiration during deep palpation of the quadrant. It is usually suggestive of acute cholecystitis. We report an unusual case of a positive Murphy's sign not due to acute cholecystitis, but rather from a pericardial hematoma from a right atrial tear causing right heart failure.

Medical and Ethical Concerns Regarding Pacemaker Implantation in a Patient with Substance Use Disorder.

Medical and ethical dilemmas surrounding endocarditis and cardiac valve replacements related to intravenous drug use have been described often. Less well-described are dilemmas associated with pacemaker implantation in such patients. We describe a patient with a substance use disorder for whom a pacemaker was medically indicated.

Validation of a Postextubation Dysphagia Screening Tool for Patients After Prolonged Endotracheal Intubation.

Background: Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available.

Utilization of the Impella for hemodynamic support during percutaneous intervention and cardiogenic shock: an insight.

Impella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Areas Covered: Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the available literature on Impellas use in High risk settings as well as the practical aspects of its usage.

Utilization trends in inpatient endoscopic retrograde cholangiopancreatography (ERCP): A cross-sectional US experience.

 The goal of our study was to determine the current trends for inpatient utilization for endoscopic retrograde cholangiopancreatography (ERCP) and its economic impact in the United States between 2002 and 2013.  A Nationwide Inpatient Sample from 2002 through 2013 was examined. We identified ERCPs using International Classification of Diseases (ICD-9) codes; Procedure codes 51.

Seasonal Variations and Trends in Hospitalization for Peptic Ulcer Disease in the United States: A 12-Year Analysis of the Nationwide Inpatient Sample.

Background: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011.

Methods: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531.

Temporal Trends, Predictors, and Outcomes of In-Hospital Gastrointestinal Bleeding Associated With Percutaneous Coronary Intervention.

Since the introduction of new antiplatelet and anticoagulant agents in the last decade, large-scale data studying gastrointestinal bleeding (GIB) in patients undergoing percutaneous coronary intervention (PCI) are lacking. Using the Nationwide Inpatient Sample, we identified all hospitalizations from 2006 to 2012 that required PCI. Temporal trends in the incidence and multivariate predictors of GIB associated with PCI were analyzed.

Penicillin skin testing in hospitalized patients with β-lactam allergies: Effect on antibiotic selection and cost.

Background: A history of a penicillin allergy generally leads to the use of broad-spectrum antibiotics that may increase complications and cost.

Objective: To determine the cost-effectiveness of performing penicillin skin testing (PST).

Methods: A retrospective analysis was conducted on adult inpatients with a β-lactam allergy who underwent PST and oral challenge performed by an allergist.

Designing a critical care nurse-led rapid response team using only available resources: 6 years later.

Rapid response teams have been introduced to intervene in the care of patients whose condition deteriorates unexpectedly by bringing clinical experts quickly to the patient's bedside. Evidence supporting the need to overcome failure to deliver optimal care in hospitals is robust; whether rapid response teams demonstrate benefit by improving patient safety and reducing the occurrence of adverse events remains controversial. Despite inconsistent evidence regarding the effectiveness of rapid response teams, concerns regarding care and costly consequences of unaddressed deterioration in patients' condition have prompted many hospitals to implement rapid response teams as a patient safety strategy.

Chasing zero: our journey to preventing surgical site infection.

After an increase in methicillin-resistant Staphylococcus aureus infections was discovered at a health care facility in Arizona, a multidisciplinary team convened to investigate the underlying problem and work toward eliminating surgical site infections. The team investigated environmental factors, held inservice sessions to reinforce sterile technique, and made important changes to the facility culture in efforts to eliminate surgical site infections. The team's efforts were put into practice on October 30, 2008, and only one surgical site infection was identified in the following seven months.