Is Ciprofloxacin in Combination With Beta-lactam Antibiotics a Recipe for Thrombocytosis?: A Case Report of Thrombocytosis in a Patient Receiving Ciprofloxacin and Ceftriaxone.

Thrombocytosis is defined as a platelet count greater than 400,000/mcL. We report the case of a patient who developed thrombocytosis after receiving ciprofloxacin and ceftriaxone therapy. A 73-year-old African-American female presented to the hospital with altered mental status attributed to sepsis and urinary tract infection.

Submersion in Industrial Powders That Lead to Tracheal Impaction and an Unusual Intubation.

Background: Silica, also known as quartz, is a naturally occurring compound that has many common uses, such as for glass, pottery, and concrete. Similarly, bentonite, another natural compound found in many clays, has been used for a variety of purposes from cat litter to bulk laxatives. Both are known for their fluid-absorptive properties.

Infantile Tumoral Calcinosis of the Cervical Spine: A Case Report.

Tumoral calcinosis (TC) is an exceedingly rare disease, significantly so when located in the spine. Here, we present a 4-month-old patient with decreased head control and range of motion of the neck for several weeks. CT and MRI demonstrated a calcified mass in the retropharyngeal area and surrounding C1/C2, and TC was suspected.

The Association Between Antenatal Maternal Self-reported Substance Use, Maternal Characteristics, and Obstetrical Variables.

Background: Substance use disorders during pregnancy are a concern both to the public and medical community, because the negative consequences can be detrimental to both mother and the fetus. The accurate identification of prenatal drug exposure is necessary to determine appropriate medical and psychosocial intervention, and to identify risk factors that may affect outcomes for the mother and her newborn. The prevalence of prenatal drug exposure is very difficult to estimate because of flaws in all methods of identification.

Exosomes from Nischarin-Expressing Cells Reduce Breast Cancer Cell Motility and Tumor Growth.

Exosomes are small extracellular microvesicles that are secreted by cells when intracellular multivesicular bodies fuse with the plasma membrane. We have previously demonstrated that Nischarin inhibits focal adhesion formation, cell migration, and invasion, leading to reduced activation of focal adhesion kinase. In this study, we propose that the tumor suppressor Nischarin regulates the release of exosomes.

An Integrative Genomics Approach for Associating Genetic Susceptibility with the Tumor Immune Microenvironment in Triple Negative Breast Cancer.

Background: Triple-negative breast cancer (TNBC) is the most aggressive form of breast cancer. It is a heterogeneous disease with poor prognosis. Contributing to the worse prognosis in TNBC is the higher rates of relapse and rapid progression to metastatic disease which is often lethal.

Predicting American Board of Emergency Medicine Qualifying Examination Passage Using United States Medical Licensing Examination Step Scores.

Background: The objective of the current study was to determine whether emergency medicine residents' United States Medical Licensing Examination (USMLE) scores are significantly associated with first-attempt passage of the American Board of Emergency Medicine (ABEM) qualifying (written) examination. We hypothesized that USMLE Step 2 Clinical Knowledge (CK) scores would be useful in predicting students who passed the ABEM qualifying examination on their first attempt.

Methods: For this retrospective cohort study, we examined the data of residents who successfully completed training at two emergency medicine residency programs between the years 2002-2013.

Value Proposition to a Hospital of Obtaining 36-inch Standing Scoliosis Film Technology.

Introduction Some hospitals do not have the technological capabilities of obtaining full 36-inch long-standing films to evaluate patients via proper sagittal balance spinal imaging protocol. Resistance from hospital administration for the purchase of proper hardware and software remains frustrating for spinal surgeons at both community and academic hospitals. Materials and methods Recurring transaction-based revenue streams were applied comparing cost with the different income generation at the hospital level.

Residents' Preferences and Performance of Three Techniques for Ultrasound-Guided Central Venous Cannulation After Simulation Training.

Background: Obtaining central venous cannulation of the internal jugular vein is an important skill for physicians to master. To our knowledge, no studies to date have examined residents' preferences or the safety of the oblique approach compared to other approaches. This study compared medical residents' preferences for and performance of ultrasound-guided central venous access using the transverse, longitudinal, and oblique approaches.

Increased Risk of Hepatocellular Carcinoma Associated With Neighborhood Concentrated Disadvantage.

Over the past three decades, Hepatocellular Carcinoma (HCC) is one of few cancers for which incidence has increased in the United States (US). It is likely social determinants at the population level are driving this increase. We designed a population-based study to explore whether social determinants at the neighborhood level are geographically associated with HCC incidence in Louisiana by examining the association of HCC incidence with neighborhood concentrated disadvantage.

Absence of Adolescent Obesity in Grenada: Is This a Generational Effect?

Low- and middle-income countries are affected disproportionately by the ongoing global obesity pandemic. Representing a middle income country, the high prevalence of obesity among Grenadian adults as compared to US adults is expected as part of global obesity trends. The objective of this study was to determine if Grenadian adolescents have a higher prevalence of overweight compared to their US counterparts, and if a disparity exists between urban and rural adolescents.

Sandwiched White Adipose Tissue: A Microphysiological System of Primary Human Adipose Tissue.

White adipose tissue (WAT) is a critical organ in both health and disease. However, physiologically faithful tissue culture models of primary human WAT remain limited, at best. In this study we describe a novel WAT culture system in which primary human WAT is sandwiched between tissue-engineered sheets of adipose-derived stromal cells.

Improving Patient Safety Communication in Residency Programs by Incorporating Patient Safety Discussions Into Rounds.

Background: Engaging residents in patient safety and quality improvement initiatives is sometimes difficult. The primary goal of the current study was to develop a standardized learning experience designed to facilitate patient safety discussions during rounds.

Methods: Residents who were on inpatient rotations during a 2-month period in 2014 were exposed to patient safety discussions on rounds.

Simulation-Based Education Enhances Patient Safety Behaviors During Central Venous Catheter Placement.

Objective: We describe the effect of simulation-based education on residents' adherence to protocols for and performance of central venous access.

Methods: Internal medicine and emergency medicine residents underwent a central venous access course that included a lecture, video presentation, readings, and simulation demonstrations presented by faculty. Baseline data were collected before the course was initiated.

The Louisiana Mental and Behavioral Health Capacity Project Trauma-Informed Integrated Care Model and Improved Posttraumatic Stress Outcomes.

Objective: The Mental and Behavioral Health Capacity Project in Louisiana has been addressing health disparities by increasing accessibility and availability through integrating services into primary care clinics. Integrated health is becoming the standard of care, providing an opportunity to address the trauma-specific needs of communities, and allowing for informed and less stigmatized services. The purpose of this study is to test the efficacy of the Mental and Behavioral Health Capacity Project in Louisiana model in the primary care settings to reduce posttraumatic stress symptoms and physical health complaints.

Lymphatic Reconstitution and Regeneration After Face Transplantation.

Background: The purpose of this study was to investigate whether lymphatic reconstitution and regeneration occurs after clinical facial transplantation using indocyanine green lymphography and immunohistochemical markers.

Methods: Allograft skin biopsies at multiple posttransplant time points were stained with Lyve1 lymphatic antibody and other endothelial antibodies. Staining intensity was interpreted on a scale of none, mild, moderate, and strong by 2 investigators and consolidated by a third party for final interpretation.

The Influence of Violence Victimization on Sexual Health Behaviors and Outcomes.

This study examines the implications of a history of personal violence on health and health behaviors. A secondary analysis of cross-sectional data involving adults (n = 214) from a semirural area in southern Louisiana between October 2008 and December 2010 was conducted to ascertain the association between a personal history of violence victimization and indicators of sexual health behaviors and outcomes: communication with sexual partners about HIV status, consistent condom use, and sexually transmitted infection (STI). While violence victimization is widely accepted as a risk factor for high-risk sex behavior, the mechanisms underlying violence victimization's influence on sexual health outcomes remain unclear.

Effect of alcohol after muscle-damaging resistance exercise on muscular performance recovery and inflammatory capacity in women.

Purpose: To investigate the effect of acute alcohol consumption on muscular performance recovery, assessed by maximal torque production, and on inflammatory capacity, assessed by lipopolysaccharide (LPS)-stimulated cytokine production, following muscle-damaging resistance exercise in women.

Methods: Thirteen recreationally resistance-trained women completed two identical exercise bouts (300 maximal single-leg eccentric leg extensions) followed by alcohol (1.09 g ethanol kg fat-free body mass) or placebo ingestion.

Avoiding Facial Incisions with Midface Free Tissue Transfer.

Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions.

Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions.

Pediatric Pulmonary Embolism: Diagnostic and Management Challenges.

A rare case of massive pulmonary embolism is presented in an oligosymptomatic teenager with predisposing factors. Computed tomography pulmonary angiography supported by three-dimensional reconstruction was diagnostic. The embolus qualified as massive by conventional anatomical guidelines, but as low risk by more recent functional criteria.

Neuroinflammation in Alzheimer's disease.

Increasing evidence suggests that Alzheimer's disease pathogenesis is not restricted to the neuronal compartment, but includes strong interactions with immunological mechanisms in the brain. Misfolded and aggregated proteins bind to pattern recognition receptors on microglia and astroglia, and trigger an innate immune response characterised by release of inflammatory mediators, which contribute to disease progression and severity. Genome-wide analysis suggests that several genes that increase the risk for sporadic Alzheimer's disease encode factors that regulate glial clearance of misfolded proteins and the inflammatory reaction.