Inverted Papilloma Originating Primarily from the Nasolacrimal Duct: A Case Report and Review of the Pertinent Literature.

Introduction. Inverted papilloma (IP) is an uncommon, benign yet aggressive neoplasm characterised by high recurrence rates and tendency towards malignant transformation. The majority of IP cases originate in the ethmoid region, lateral wall of the nasal fossa, and maxillary sinus.

Antibiotic Resistance among Clinical Ureaplasma Isolates Recovered from Neonates in England and Wales between 2007 and 2013.

Ureaplasma spp. are associated with numerous clinical sequelae with treatment options being limited due to patient and pathogen factors. This report examines the prevalence and mechanisms of antibiotic resistance among clinical strains isolated from 95 neonates, 32 women attending a sexual health clinic, and 3 patients under investigation for immunological disorders, between 2007 and 2013 in England and Wales.

Onsite training of doctors, midwives and nurses in obstetric emergencies, Zimbabwe.

Problem: In Zimbabwe, many health facilities are not able to manage serious obstetric complications. Staff most commonly identified inadequate training as the greatest barrier to preventing avoidable maternal deaths.

Approach: We established an onsite obstetric emergencies training programme for maternity staff in the Mpilo Central Hospital.

Essential steps in the performance of safe retroperitoneal aortic surgery.

Endovascular stent grafting has become the primary modality when assessing patients for treatment of abdominal aortic aneurysms (AAA). The traditional open approach is transperitoneal (TP) but many suggest the retroperitoneal method (RP) has significant benefits. Retroperitoneal aortic surgery may be unfamiliar to many surgeons as they have been trained in the TP approach.

Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression.

Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and profound intellectual disability.

Improving compliance with central venous catheter care bundles using electronic records.

Background: Health care associated infections are a major contributor to avoidable harm experienced by patients in modern health care settings. Recent reports suggest that electronic checklists for the documentation of a central line bundle may significantly enhance documented process compliance and help to reduce catheter-related bloodstream infection rates.

Aims: This paper describes the use of our electronic tool to monitor and feedback process compliance in conjunction of introducing bespoke central line insertion packs to tackle catheter-related bloodstream infections in our intensive care unit in a medium-sized district general hospital.

Automated Registration of Multimodal Optic Disc Images: Clinical Assessment of Alignment Accuracy.

Purpose: To determine the accuracy of automated alignment algorithms for the registration of optic disc images obtained by 2 different modalities: fundus photography and scanning laser tomography.

Materials And Methods: Images obtained with the Heidelberg Retina Tomograph II and paired photographic optic disc images of 135 eyes were analyzed. Three state-of-the-art automated registration techniques Regional Mutual Information, rigid Feature Neighbourhood Mutual Information (FNMI), and nonrigid FNMI (NRFNMI) were used to align these image pairs.

Megalourethra as a rare cause for erectile dysfunction.

MRI findings of megalourethra have not previously been reported. We present a case of an adult presenting with lifelong erectile dysfunction secondary to poor development of the corpus spongiosum and corpora cavernosa. The pathogenesis, typical presentation, and treatment of megalourethra, as well as the use of modern imaging techniques to aid in the diagnosis and treatment of this disease are discussed.

Effect of early tracheostomy on resource utilization and clinical outcomes in critically ill patients: meta-analysis of randomized controlled trials.

Background: Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting.

Methods: Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within 10 days of start of mechanical ventilation was compared with placement of tracheostomy after 10 days if still required. Medline, EMBASE, the Cochrane Controlled Clinical Trials Register, and Google Scholar were searched for eligible trials.

A bad workman blames his tools?

The ECG is a test that is used frequently in the acute setting. It has a significant impact on decisions regarding patient discharge and further investigations. On a single day in the ambulatory emergency care setting two patients presented with chest pain.

Accuracy of preoperative templating in total hip arthroplasty.

Purpose: To assess the accuracy of templating in total hip arthroplasty (THA).

Methods: Anteroposterior pelvic radiographs of 20 men and 33 women aged 17 to 80 (mean, 60) years who underwent uncemented THA of the right (n=24) and left (n=29) sides using a single prosthesis were reviewed. A 30-mm-diameter scaling ball was placed between the patient's legs for calculating the magnification factor (MF) of the radiographs.

Cannabis-associated myocardial infarction in a young man with normal coronary arteries.

Background: The use of cannabis is not usually regarded as a risk factor for acute coronary syndrome. However, several cases of myocardial infarction (MI) associated with cannabis use have been reported in the scientific literature. The etiology of this phenomenon is not known.

Mutational analysis of the adaptor protein 2 sigma subunit (AP2S1) gene: search for autosomal dominant hypocalcemia type 3 (ADH3).

Context: Autosomal dominant hypocalcemia (ADH) types 1 and 2 are due to calcium-sensing receptor (CASR) and G-protein subunit-α11 (GNA11) gain-of-function mutations, respectively, whereas CASR and GNA11 loss-of-function mutations result in familial hypocalciuric hypercalcemia (FHH) types 1 and 2, respectively. Loss-of-function mutations of adaptor protein-2 sigma subunit (AP2σ 2), encoded by AP2S1, cause FHH3, and we therefore sought for gain-of-function AP2S1 mutations that may cause an additional form of ADH, which we designated ADH3.

Objective: The objective of the study was to investigate the hypothesis that gain-of-function AP2S1 mutations may cause ADH3.

The incidence and 10-year survival of interval breast cancers in Wales.

Aim: To evaluate the number of interval cancers (IC) within one screening cycle and the overall 10-year survival of IC, including its four main classifications, and compare that to screen-detected cancers (SDC).

Materials And Methods: Within Breast Test Wales (BTW), all SDC between the years 1998 and 2001 were included. IC that occurred between 1998 and 2003 that had undergone screening between the years 1998 and 2001 were also included.

Case studies in therapeutics: warfarin resistance and inefficacy in a man with recurrent thromboembolism, and anticoagulant-associated priapism.

A 52 year-old male unemployed labourer was referred because of recurrent thromboembolism. An episode of thrombophlebitis migrans 3 months earlier had been followed by a pulmonary embolus a week later, and then a deep vein thrombosis despite apparently adequate anticoagulant therapy with warfarin 10 mg daily (INRs between 2 and 4). For 9 years he had suffered from hypertension for which he took lisinopril 2.