North American musculoskeletal ultrasound scanning protocol of the hip, knee, ankle, and foot: update of a Delphi consensus study.

Background/objective: A North American rheumatology consensus on tiered-mastery designation for anatomic views was developed in 2011 for course and fellowship teaching. This study updates the lower extremity joint scanning protocols aiming to inform musculoskeletal ultrasound curriculum development for the American College of Rheumatology affiliated Fellowship Programs.

Methods: Three Delphi rounds were conducted to reach consensus for tiered-level mastery designation for hip, knee, ankle, and foot scanning views.

Long-term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes.

Objective: To evaluate morbidity during long-term follow-up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major psychotic episodes.

Methods: We followed adult subjects systematically at regular intervals from hospitalization for first-lifetime episodes of major affective and schizoaffective disorders with initial psychotic features. We compiled % of days with morbidity types from detailed records and life charts, reviewed earliest antecedent morbidities, compared both with final diagnoses and initial presenting illness types, and evaluated morbidity risk factors with regression modeling.

Musculoskeletal Ultrasound Scanning Protocol Consensus Statements on Scanning Conventions and Documentation in the US.

Objective: European rheumatology and radiology-determined standards have largely driven the execution of ultrasound in rheumatology (RhUS). How this translates to American rheumatologic practice has not been examined. A rheumatology-driven consensus on documentation, scanning conventions, and tiered-mastery designation for anatomic region views was developed in 2011 and served as the framework for training and clinical research validation.

Rapid Infliximab Infusion in Children with Inflammatory Bowel Disease: A Multicenter North American Experience.

Background: Infliximab (IFX) infusion may lead to development of anti-IFX antibodies, and subsequent infusion reactions (IRs). The safety of rapid IFX infusion administered over 60 minutes has been under-investigated in children with inflammatory bowel disease. In a multicenter study, the frequency and nature of rapid infusion-associated IRs were examined.

Human Papilloma virus in Juvenile Nasopharyngeal Angiofibroma: possible recent trend.

Background: Juvenile nasopharyngeal angiofibroma (JNA) has witnessed a four-fold increase in the incidence at our facility in the current decade as compared to the 1980s. With high global incidence of human pappilloma virus (HPV) related oropharyngeal cancer in India, we hypothesize its implication in JNA as it has not yet been reported.

Methods: Clinico-Surgical variables of 6 patients of JNA were included for correlation and their tissue samples were subjected to western blotting (WB), polymerase chain reaction and immunoflorescence to demonstrate a definite association with HPV.

Clinical metagenomic identification of Balamuthia mandrillaris encephalitis and assembly of the draft genome: the continuing case for reference genome sequencing.

Background: Primary amoebic meningoencephalitis (PAM) is a rare, often lethal, cause of encephalitis, for which early diagnosis and prompt initiation of combination antimicrobials may improve clinical outcomes.

Methods: In this study, we sequenced a full draft assembly of the Balamuthia mandrillaris genome (44.2 Mb in size) from a rare survivor of PAM, and recovered the mitochondrial genome from six additional Balamuthia strains.

Military medical advances resulting from the conflict in Korea, Part II: Historic clinical accomplishments.

Throughout the recorded history of civilization, there has been armed conflict. Warfare has been associated with advances in care for the wounded. Many of these advances when shown effective on the battlefield become incorporated into civilian health care.

Military medical advances resulting from the conflict in Korea, Part I: Systems advances that enhanced patient survival.

The Korean War started several years after the World War II had ended and no recognition of the threat or preparation was made for this possibility. The military and its medical service had been downsized after World War II and had to quickly ramp up to meet the surprise attack. The war provided the laboratory for trials and experimentation with the new technological developments of the era.

Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection.

Objective: To describe and answer questions concerning the spread of contrast in patients receiving correctly placed lumbar epidural steroid injections (ESIs) under fluoroscopy.

Design: Prospective observational study.

Setting: An outpatient surgery center.

Preventing post-traumatic stress disorders in military medical personnel.

Medical personnel in military units are highly vulnerable to post-traumatic stress disorder. They are removed from their conventional identity, stature, and social support system, and are deprived of a sense of control and physical comforts. They then must witness and immerse themselves in the gruesome results of warfare.

Advanced trauma life support: is it adequate stand-alone training for military medicine?

Advanced Trauma Life Support (ATLS) is a 2-day course on handling the acutely injured patient. It has been developed by and is directed by the American College of Surgeons, and teaches a systematic approach to the care of the injured patient. It is relied upon as a teaching tool throughout the active and reserve military medical departments.