Is there consensus on the perioperative management of Xa inhibitors in patients undergoing elective spine surgery?-A survey of current spine surgeon practices.

Background: Factor Xa inhibitors (Xai) are an increasingly common consideration in perioperative anticoagulation management. However, there no existing guidelines established for use in Spine Surgery. This survey study aims to capture current practice trends regarding the perioperative management of Xai among spine surgeons.

Enhancing Patient Activation and Self-Management Activities in Patients With Type 2 Diabetes Using the US Department of Defense Mobile Health Care Environment: Feasibility Study.

Background: Past mobile health (mHealth) efforts to empower type 2 diabetes (T2D) self-management include portals, text messaging, collection of biometric data, electronic coaching, email, and collection of lifestyle information.

Objective: The primary objective was to enhance patient activation and self-management of T2D using the US Department of Defense's Mobile Health Care Environment (MHCE) in a patient-centered medical home setting.

Methods: A multisite study, including a user-centered design and a controlled trial, was conducted within the US Military Health System.

When Military Fitness Standards No Longer Apply: The High Prevalence of Metabolic Syndrome in Recent Air Force Retirees.

Background: Metabolic syndrome (MetS) is strongly associated with cardiovascular disease. With MetS prevalence rates increasing in the U.S.

Enhancing mHealth Technology in the Patient-Centered Medical Home Environment to Activate Patients With Type 2 Diabetes: A Multisite Feasibility Study Protocol.

Background: The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys. Each of these tools, used alone or in combination, have demonstrated varying degrees of effectiveness.

23-Valent Pneumococcal Polysaccharide Vaccine Uptake in the United States Air Force HIV Program.

Streptococcus pneumoniae infection is a predominant cause of bacterial infection in HIV-infected individuals. However, reported rates of pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) are variable. We evaluated uptake of PPV23 in patients diagnosed with HIV between 1996 and 2012 (n = 507) in the United States Air Force, a centralized HIV program with free access to care including vaccines and medications.

Tinnitus: Steps to take, drugs to avoid.

This algorithm will help you identify the source of your patient's tinnitus; a summary of the evidence for various treatments makes it clear which ones to avoid.

Salivary gland emergencies.

Salivary gland disorders are uncommon in the emergency department setting. Given the vast differential that spans infectious, autoimmune, neoplastic, and metabolic processes, they can pose a diagnostic challenge even to skilled clinicians. There is a paucity of evidence-based data regarding the management of these disorders with frequent incongruence between specific sources.

Shave and punch biopsy for skin lesions.

Shave and punch biopsies are essential procedures for physicians who manage skin conditions. These office-based procedures can diagnose questionable dermatologic lesions, including possible malignancies. Approaches include the superficial shave biopsy, saucerization excision, punch biopsy, and elliptical excision.

Routine screening for eosinophilic esophagitis in patients presenting with dysphagia.

Background: Eosinophilic esophagitis (EoE) is a clinicopathologic disorder first described in 1978 which has gained significant recognition over the past 10 years. Numerous prevalence studies have been performed around the globe, both in pediatric and adult populations documenting a prevalence between 0.002% and 6.

Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial.

Purpose: Multiple trials in the past have shown conflicting results of whether cinnamon lowers glucose or hemoglobin A1C (HbA1C). The purpose of this study was to determine whether cinnamon lowers HbA1C in patients with type 2 diabetes. I performed a randomized, controlled trial to evaluate whether daily cinnamon plus usual care versus usual care alone lowers HbA1c.

Significance of tertiary Gleason pattern 5 in Gleason score 7 radical prostatectomy specimens.

Purpose: The Gleason grading system in reporting prostate cancer accounts for the primary and secondary Gleason pattern. The clinical significance of a higher tertiary (third most prevalent) grade is largely unrecognized.

Materials And Methods: Radical prostatectomy specimens from 300 patients with Gleason score 7 (3 + 4 or 4 + 3) prostate cancer were pathologically reexamined for the presence of a tertiary grade 5 pattern as well as the association with pathological stage and biochemical recurrence-free survival.

The effects of intradermal and topical mitomycin C on wound healing.

Objective: To determine the effect of intradermal and topical mitomycin C (MMC) on skin wound healing.

Study Design/setting: A prospective, controlled study in a rat wound model performed in an academic medical center.

Results: Intradermal and topical MMC application decreased wound integrity when compared with saline-treated animals at 1 week, 2 weeks, 1 month, and 6 months.

Laser in situ keratomileusis flap stability during simulated aircraft ejection in a rabbit model.

Purpose: To determine the stability of the laser in situ keratomileusis (LASIK) flap in a rabbit model when subjected to vertical acceleration at nine times the force of gravity (+9 Gz) in an aircraft cockpit ejection simulator.

Methods: Thirty-six eyes from 25 New Zealand white rabbits underwent LASIK flap creation without laser photoablation. One month after surgery, the rabbits were sedated and harnessed in a cockpit ejection seat simulator used to train United States Air Force pilots.