Association of Tongue Strength and Maximum Incisal Opening with Oral Intake in Persons with Head and Neck Cancer Treated with Radiotherapy: A Retrospective Study.

Persons treated with radiotherapy (RT) for cancer of the head and neck (HNC) may experience limited oral intake at treatment completion. The purpose of this retrospective study was to examine the contributions of tongue strength and maximum incisal opening (MIO) to oral intake in a cohort of veterans treated for HNC. Medical records of veterans diagnosed with HNC treated with RT who were seen by the Speech Pathology Service prior to and throughout treatment per usual care were reviewed for this study; eighty-two records met the inclusion criteria for analysis.

Dupuytren's Contracture Recurrence and Treatment Following Collagenase Clostridium Histolyticum Injection: A Longitudinal Assessment in a Veteran Population.

Introduction: Dupuytren's contracture is a connective tissue disease characterized by an abnormal proliferation of collagen in the palm and fingers, which leads to a decline in hand function because of progressive joint flexion. In addition to surgical and percutaneous interventions, collagenase clostridium histolyticum (CCH, trade name Xiaflex) is an intralesional enzymatic treatment for adults with palpable cords. The objectives of this study are to evaluate factors predictive of recurrence following treatment with CCH and to review the outcomes of repeat treatments with CCH for recurrent contracture.

Assessing Diversity in Hospital Library Collections.

Public libraries have conducted collection diversity audits, but this is the first known report of a diversity audit in the hospital library community. A two-part questionnaire was sent to hospital librarians to determine their use of diversity audits in collection management and to provide a tool for a preliminary assessment of their collections' diversity. Results of the questionnaire indicate that developing diversity within hospital library collections is important to these respondents.

A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA.

The objective of this mixed methods study is to evaluate the need for a comprehensive digital self-care support system (CDSSS) for older adults with multiple chronic conditions (MCC) and to examine whether such a system can be developed to enable daily capture of self-care data. The 3-phase study involved Phase-1: user needs assessment and prototype development; Phase-2: preliminary user evaluation of the prototype; and Phase-3: 4-week small group usability and feasibility testing of the tracking component of the prototype. Results of Phase-1 show the need for a CDSSS.

In vivo molecular imaging stratifies rats with different susceptibilities to hyperoxic acute lung injury.

Tc-hexamethylpropyleneamine oxime (HMPAO) and Tc-duramycin in vivo imaging detects pulmonary oxidative stress and cell death, respectively, in rats exposed to >95% O (hyperoxia) as a model of acute respiratory distress syndrome (ARDS). Preexposure to hyperoxia for 48 h followed by 24 h in room air (H-T) is protective against hyperoxia-induced lung injury. This study's objective was to determine the ability of Tc-HMPAO and Tc-duramycin to track this protection and to elucidate underlying mechanisms.

Depression in Primary Care, 2010-2018.

Background: Depression is common in primary care and significantly reduces quality of life. Our study aimed to examine the prevalence of depression in primary care visits, examine patterns of depression treatment and referral, and determine how often depression screening occurred over an 8-year timespan.

Methods: From the 2010-2018 National Ambulatory Medical Care Survey, a national probability sample of non-federal, ambulatory encounters, we identified adults being seen in a primary care clinic.

Tool to improve patient-provider interactions in adult primary care: Randomized controlled pilot study.

Objective: To assess whether an intervention to help patients prioritize goals for their visit would improve patient-provider communication and clinical outcomes.

Design: Randomized controlled pilot study.

Setting: Primary care clinic.

Role of Endothelin-1 in a Syndrome of Myelofibrosis and Osteosclerosis.

Context: Primary myelofibrosis is one of the chronic myeloproliferative disorders characterized by bone marrow fibrosis associated with extramedullary hematopoiesis and osteosclerosis. Endothelin-1 (ET1) is a potent vasoconstrictor that is also a key mediator of osteoblastic bone metastases by stimulating osteoblast proliferation and new bone formation.

Case Description: We report laboratory, radiographic, bone densitometry, and bone histology data of a patient presenting with newly diagnosed, biopsy-proven myelofibrosis and osteosclerosis.

Comparison of pre-existing cognitive impairment, amnesic mild cognitive impairment, and multiple domain mild cognitive impairment in men scheduled for coronary artery surgery.

Context: Preoperative cognitive impairment (PreCI), amnesic mild cognitive impairment (aMCI; a risk factor for Alzheimer's disease) and multiple domain MCI with amnesia (mdMCI+a) identify preoperative cognitive abnormalities in patients scheduled for coronary artery bypass graft surgery (CABG).

Objectives: Preoperative cognitive function is important in determining the incidence and severity of postoperative cognitive dysfunction, but the methods used to measure preoperative cognition are diverse. The incidence of preoperative cognitive abnormalities in cardiac surgical patients is unknown.

Postoperative cognitive dysfunction after noncardiac surgery: effects of metabolic syndrome.

Purpose: Vascular risk factors, including metabolic syndrome, are known to contribute to the development of cognitive dysfunction. We tested the hypothesis that patients with metabolic syndrome are more likely to develop cognitive dysfunction after noncardiac surgery.

Methods: Age- and education-balanced patients (n = 60) undergoing elective noncardiac surgery with and without metabolic syndrome and 30 nonsurgical controls were enrolled.

Extrapyramidal symptoms with concomitant use of amitriptyline and amiodarone in an elderly patient.

Background: Amitriptyline is a tricyclic antidepressant useful for the treatment of depression. Amiodarone is a class III antiarrhythmic agent used for the treatment of cardiac dysrhythmias.

Objective: The objective of the current report is to describe the case of a previously asymptomatic patient receiving amitriptyline who developed extrapyramidal symptoms within 1 month of initiating concomitant treatment with amiodarone for atrial fibrillation.

Elevated postoperative inflammatory biomarkers are associated with short- and medium-term cognitive dysfunction after coronary artery surgery.

Purpose: We tested the hypothesis that elevated postoperative interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations are associated with short- and medium-term impairment of cognitive functions in patients after coronary artery surgery using cardiopulmonary bypass.

Methods: Eighty-six age- and education-balanced patients ≥55 years of age undergoing elective coronary artery bypass surgery with cardiopulmonary bypass and 28 nonsurgical controls with coronary artery disease were enrolled. Recent verbal and nonverbal memory and executive functions were assessed before surgery and at 1 week and 3 months after surgery using a cognitive test battery.

Metabolic syndrome exacerbates short-term postoperative cognitive dysfunction in patients undergoing cardiac surgery: results of a pilot study.

Objective: The authors tested the hypothesis that patients with metabolic syndrome are more likely to develop short-term cognitive dysfunction after cardiac surgery with cardiopulmonary bypass.

Design: A prospective study.

Setting: Veterans Affairs medical center.

Postoperative delirium and short-term cognitive dysfunction occur more frequently in patients undergoing valve surgery with or without coronary artery bypass graft surgery compared with coronary artery bypass graft surgery alone: results of a pilot study.

Objective: The authors tested the hypothesis that patients undergoing valve repair or replacement surgery with or without coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB) had a greater incidence of postoperative delirium and cognitive dysfunction compared with patients undergoing CABG surgery alone.

Design: Prospective study.

Setting: Veterans Affairs medical center.

History of post-traumatic stress disorder is associated with impaired neuropsychometric performance after coronary artery surgery.

Objective: To determine if preoperative history of post-traumatic stress disorder (PTSD) is associated with postoperative cognitive impairment.

Design: An observational study.

Setting: Veterans Affairs Medical Center.

Preoperative dispositional optimism correlates with a reduced incidence of postoperative delirium and recovery of postoperative cognitive function in cardiac surgical patients.

Objective: To determine if preoperative psychosocial factors including dispositional optimism, perceived social support, and perceived stress correlate with the recovery of postoperative cognition.

Design: Observational study.

Setting: Veterans Affairs medical center.

Ketamine attenuates post-operative cognitive dysfunction after cardiac surgery.

Background: Post-operative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. Ketamine exerts neuroprotective effects after cerebral ischemia by anti-excitotoxic and anti-inflammatory mechanisms. We hypothesized that ketamine attenuates POCD in patients undergoing cardiac surgery concomitant with an anti-inflammatory effect.

Ketamine attenuates delirium after cardiac surgery with cardiopulmonary bypass.

Objective: To determine if ketamine attenuates postoperative delirium concomitant with an anti-inflammatory effect in patients undergoing cardiac surgery using cardiopulmonary bypass.

Design: A prospective randomized study.

Setting: A Veterans Affairs medical center.

The underuse of therapy in the secondary prevention of hip fractures.

There is strong evidence to indicate that individuals who sustain a hip fracture are at a greater risk of developing another. The management of such patients should include efforts to prevent future fractures, including prescribing medications that have been shown to lower hip fracture risk. Such therapies that are currently available include calcium and vitamin D supplementation, alendronic acid and risedronic acid.

Hydropneumomediastinum and bilateral hydropneumothorax as delayed complications of central venous catheterization.

A case of hydropneumomediastinum and bilateral hydropneumothorax from a central venous catheter is described. The complication is related to the position of the catheter after placement through the left internal jugular vein. Proper placement of a central venous line into the superior vena cava is essential to avoid this serious complication.

Pathogenesis of rheumatoid arthritis: basis for future therapies.

Despite an increase in the number of rheumatologists in clinical practice over the past 15 years, the outcome for patients with rheumatoid arthritis (RA) remains relatively poor. The poor prognosis for patients with this disease is due to a lack of effective therapies. Better therapies will be developed only after the cause and pathogenesis of RA are better understood.

Static versus dynamic exercise: effects on Doppler echocardiographic indices of left ventricular performance.

In order to compare the effects of static exercise with those of dynamic exercise on the Doppler echocardiographic measurements of ascending aortic blood flow velocity and acceleration, Doppler echocardiography was performed with sustained handgrip exercise and with supine bicycle exercise in 12 normal subjects, 12 patients with coronary artery disease, and 7 patients with heart failure. In normal subjects: peak velocity decreased by 16 +/- 11% with handgrip from the resting value and increased by 49 +/- 19% with bicycle exercise (p less than 0.01); mean acceleration decreased by 6 +/- 30% with handgrip and increased by 162 +/- 83% with bicycle exercise (p less than 0.