Interpretation of Domain Scores on the EPIC-How Does the Domain Score Translate into Functional Outcomes?

Purpose: The EPIC-26 (Expanded Prostate Cancer Index Composite-Short Form) is a validated questionnaire for measuring health related quality of life. However, the relationship between domain scores and functional outcomes remains unclear, leading to potential confusion about expectations after treatment. For instance, does a sexual function domain score of 80 mean that a patient can achieve erection sufficient for intercourse? Consequently we sought to determine the relationship between the domain score and the response to obtaining the best possible outcome for each question.

Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What Do We Know?

Background: Although lesbian, gay, bisexual, and transgender (LGBT) patients are ubiquitous in emergency medicine (EM), little education is provided to EM physicians on LGBT health care needs and disparities. There is also limited information on EM physician behavior, comfort, and attitudes toward LGBT patients. The objective of this study was to assess EM residents behavior, comfort, and attitudes in LGBT health.

Evaluation of Validity and Reliability of a Revised Incontinence-Associated Skin Damage Severity Instrument (IASD.D.2) by 3 Groups of Nursing Staff.

Purpose: The purpose of this study was to evaluate a revised version of the Incontinence-Associated Skin Damage Severity instrument (IASD.D.2) using 3 different groups of nursing staff.

Notch-1-PTEN-ERK1/2 signaling axis promotes HER2+ breast cancer cell proliferation and stem cell survival.

Trastuzumab targets the HER2 receptor on breast cancer cells to attenuate HER2-driven tumor growth. However, resistance to trastuzumab-based therapy remains a major clinical problem for women with HER2+ breast cancer. Breast cancer stem cells (BCSCs) are suggested to be responsible for drug resistance and tumor recurrence.

Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases.

Objective: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections.

Study Design: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm).

Setting: tertiary-care neurotology private practice and academic practice (two centers).

Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen.

Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique.

Improving Medicaid: three decades of change to better serve women of childbearing age.

Over the past 3 decades, major changes enhanced Medicaid's role in improving the health of women and perinatal outcomes. Reforms in the 1980s and 1990s had impact not only on coverage but also on current policy debates. Whether or not states expand eligibility under the Affordable Care Act, Medicaid is important.

Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics.

Background: Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health.

Objective: To provide data on psychiatric outpatients' prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health.

Methods: We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population.

Shifts towards pediatric specialists in the treatment of appendicitis and pyloric stenosis: trends and outcomes.

Background: Little data exists on temporal changes in the care of children with common surgical conditions. We hypothesized that an increasing proportion of procedures are performed at pediatric hospitals over time, and that outcomes are superior at these centers.

Methods: We conducted a retrospective cohort study using Washington State discharge records for children 0-17years old undergoing appendectomy (n=39,472) or pyloromyotomy (n=3,500).

Persistent oro-nasal fistula after primary cleft palate repair: minimizing the rate via a standardized protocol.

Objectives: Multiple methods are described for cleft palate repair. Similarly, a wide range of postoperative oro-nasal fistula rates are described, depending on technique and series examined. We describe long-term outcomes and fistula rates for primary cleft palate repair for a single surgeon using a standardized protocol.

Practice improvement, part II: trends in employment versus private practice.

A growing percentage of physicians are selecting employment over solo practice, and fewer family physicians have hospital admission privileges. Results from surveys of recent medical school graduates indicate a high value placed on free time. Factors to consider when choosing a practice opportunity include desire for independence, decision-making authority, work-life balance, administrative responsibilities, financial risk, and access to resources.

Omega-3 fatty acid-derived resolvins and protectins in inflammation resolution and leukocyte functions: targeting novel lipid mediator pathways in mitigation of acute kidney injury.

Inflammation, in conjunction with leukocytes, plays a key role in most acute kidney injury (AKI). Non-resolving renal inflammation leads to chronic fibrosis and renal failure. Resolvin D series (RvDs) and E series (RvEs), protectins, and maresins (MaRs) are endogenous omega-3 fatty acid-derived lipid mediators (LMs) that potently promote inflammation resolution by shortening neutrophil life span and promoting macrophage (Mf) non-phelogistic phagocytosis of apoptotic cells and the subsequent exit of Mfs from inflammatory tissue.

Reconstruction of complex aplasia cutis congenita.

Aplasia cutis congenita is a rare scalp defect with occasional absence of underlying bone and dura. Patients with small defects respond well to conservative management. However, larger defects often can pose management and technical challenge.

Composite fronto-orbital reconstruction using a subscapular chimeric flap.

Composite defects of the fronto-orbital region represent a reconstructive challenge. Total autogenous reconstruction requires a thin pliable skin flap along with a bony component that can be osteotomized predictably. The thoracodorsal artery perforator/scapular bone chimeric flap provides a reliable single-stage method to cover difficult composite forehead defects where local options are unsuitable or have been exhausted.

Complications of hydroxyapatite bone cement in secondary pediatric craniofacial reconstruction.

Hydroxyapatite cement has become a popular alternative to bone grafts in reconstructing the calvarium. Although animal studies have shown promising results with use of hydroxyapatite, human clinical studies have shown mixed results including significant rates of infection. This is a retrospective chart review during a 7-year period (1997-2003) of 20 patients who underwent secondary forehead cranioplasty with hydroxyapatite cement (Norian Craniofacial Reconstruction System).

Sexual assault victims in the emergency department: analysis by demographic and event characteristics.

The objective of this study was to analyze demographic and event characteristics of patients presenting to the Emergency Department (ED) for evaluation after sexual assault, using a Sexual Assault Nurse Examiner standardized database. Data were prospectively collected as part of the Sexual Assault Nurse Examiner program at an urban teaching hospital. This study reviewed all ED patient records with a complaint of sexual assault between January 1, 2000 and December 31, 2004.