An Assessment of the Presence of in the Soil and on Other Surfaces.

Introduction: Standard emergency medicine practice includes tetanus vaccine administration as part of wound care management for patients who are not fully immunized. Since there have been no available studies in the United States reaffirming the prevalence of since 1926, we sought to identify its prevalence in a major urban county in the US.

Methods: We sampled soil, rusted metal, concrete, and dog feces to determine the prevalence of in a single metropolitan county in the United States.

Median Nerve Measurement and Steroid Injection for Carpal Tunnel Syndrome: A Case Report.

Introduction: Carpal tunnel syndrome is an entrapment neuropathy that affects 3% of adults in the United States. The current techniques used for diagnosis have limited specificity/sensitivity, and the techniques used for treatment have limited efficacy.

Case Report: A 34-year-old female presented to the emergency department with two months of worsening painful paresthesias in her right thenar eminence.

Ultrasound-guided Supraclavicular Brachial Plexus Block for Therapeutic Management of Postoperative Compressive Brachial Plexus Neuropathy: A Case Report.

Introduction: Compressive neuropathy of the brachial plexus is a common issue following laparoscopic and robotic surgeries.

Case Report: A 71-year-old male, post-lumbar spinal surgery, presented with excruciating right upper extremity pain and paresthesias. A supraclavicular brachial plexus (SBP) block with bupivacaine provided significant pain relief, lasting 36 hours.

Functional measures and AD biomarkers among Hispanic and White non-Hispanic older adults.

Introduction: Poorer baseline functioning is associated with long-term cognitive decline among Hispanic older adults, but little is known about associations of these factors with Alzheimer's disease (AD) neuroimaging biomarkers.

Methods: A total of 461 Hispanic and White non-Hispanic (NHW) older adults who are cognitively normal ( = 76), had impaired cognition without mild cognitive impairment (MCI) ( = 41), or carried a diagnosis of MCI ( = 253) or dementia ( = 91) completed neuropsychological and functional assessment, genetic testing, and brain magnetic resonance imaging (MRI). Structural equation modeling (SEM) was used to examine predictive associations between functional and cognitive measures of AD neuroimaging biomarkers.

EMERGENCY DEPARTMENT INTRAARTICULAR CORTICOSTEROID INJECTION FOR SACROILIAC JOINT DYSFUNCTION.

Background: Sacroiliac joint (SIJ) dysfunction is a common but underrecognized source of low back pain (LBP). With provocative testing, emergency physicians can diagnose SIJ dysfunction and begin appropriate treatment in the emergency department (ED).

Discussion: For patients with significant pain from SIJ dysfunction, ultrasound-guided SIJ injection of anesthetic and corticosteroid can reduce patients' pain considerably.

Safety profile and technical success of narrow window CT-guided percutaneous biopsy with blunt needle approach in the abdomen and pelvis.

Objective: To assess success and safety of CT-guided procedures with narrow window access for biopsy.

Methods: Three hundred ninety-six consecutive patients undergoing abdominal or pelvic CT-guided biopsy or fiducial placement between 01/2015 and 12/2018 were included (183 women, mean age 63 ± 14 years). Procedures were classified into "wide window" (width of the needle path between structures > 15 mm) and "narrow window" (≤ 15 mm) based on intraprocedural images.

Low CERVICAL-2 plane block, a proposed regional anesthetic technique for acute cholecystitis.

Introduction: Acute cholecystitis is a painful inflammatory disease of the gallbladder. The Low Cervical-2 Plane Block is a retrolaminar block that targets the C3, C4, and C5 spinal nerves, which provide sensory innervation to the gallbladder, in order to potentially provide analgesia to patients with pain associated with acute cholecystitis.

Methods: In this brief report, a softly embalmed cadaver was injected with a dye mixture bilaterally.

Creating the Pick's disease International Consortium: Association study of H2 haplotype with risk of Pick's disease.

Background: Pick's disease (PiD) is a rare and predominantly sporadic form of frontotemporal dementia that is classified as a primary tauopathy. PiD is pathologically defined by argyrophilic inclusion Pick bodies and ballooned neurons in the frontal and temporal brain lobes. PiD is characterised by the presence of Pick bodies which are formed from aggregated, hyperphosphorylated, 3-repeat tau proteins, encoded by the gene.

Prognosis in Hispanic patient population with pulmonary arterial hypertension: An application of common risk stratification models.

Pulmonary arterial hypertension (PAH) is a cardiovascular disease with high mortality rate. Current guidelines propose initiation and escalation of PAH-targeted treatment based on a goal-directed approach targeting hemodynamic, functional, and biochemical variables. This approach has been successfully validated in large Caucasian cohorts.

Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review.

Background EDTA is an intravenous chelating agent with high affinity to divalent cations (lead, cadmium, and calcium) that may be beneficial in the treatment of cardiovascular disease (CVD). Although a large randomized clinical trial showed benefit, smaller studies were inconsistent. We conducted a systematic review of published studies to examine the effect of repeated EDTA on clinical outcomes in adults with CVD.

A Culinary Misadventure: A Case Report of Shiitake Dermatitis.

Unlabelled: Shiitake dermatitis is a rare cutaneous reaction that can occur after consumption of shiitake mushrooms. It is characterized by highly pruritic lesions with a distinct whip lash appearance. Management of this condition includes reassurance and providing symptomatic relief.

An analysis of social determinants of health and structural competency training in global emergency medicine fellowship programs in the United States.

Background: Clinicians must be aware of the structural forces that affect their patients to appropriately address their unique health care needs. This study aimed to assess the participation of global emergency medicine (GEM) fellowship programs in formal social determinants of health (SDH) and structural competency (SC) training to evaluate the existence and procedures of such programs.

Methods: A cross-sectional study conducted with a short, online survey with questions regarding the presence of curriculum focused on SDH, SC, educational metrics, and the desire for further formal training in this domain was sent to all 25 GEM fellowship directors through the Global Emergency Medicine Fellowship Consortium (GEMFC) email listserv.

The effects of twenty-one nutrients and phytonutrients on cognitive function: A narrative review.

Background And Aim: Brain health is becoming more important to the average person as the number of people with cognitive impairments, such as Alzheimer's disease (AD), is rising significantly. The current Food and Drug Administration-approved pharmacotherapeutics for dementia neither cure nor halt cognitive decline; they just delay the worsening cognitive impairment. This narrative review summarizes the effects of nutrients and phytonutrients on cognitive function.

The effects of twenty-four nutrients and phytonutrients on immune system function and inflammation: A narrative review.

Background And Aim: Recently, optimal immune function has become a primary focus of worldwide attention not only in the prevention of chronic disease but also as one strategy to reduce the severity of acute illness. Inflammation, a process largely controlled by the immune system, has long been studied and recognized for its role in chronic disease. Optimizing immune function or managing inflammation using individual nutrients and phytonutrients is not well understood by the average person.

A 55-year-old COVID-19-positive man managed with self-regulation of high-flow oxygen by high-velocity nasal insufflation therapy.

Management of critically ill coronavirus disease 2019 (COVID-19) patients remains both risky and technically challenging. A 55-year-old male COVID-19-positive patient with obstructive sleep apnoea (OSA), diabetes, and obesity presented with cough and shortness of breath, escalating to requiring high-flow oxygen therapy by high-velocity nasal insufflation. The patient's flow rate and oxygen fraction remained labile throughout much of the hospitalization.

Relationships Among Bone Morphological Parameters and Mechanical Properties of Cadaveric Human Vertebral Cancellous Bone.

Mechanical properties and morphological features of the vertebral cancellous bone are related to resistance to fracture and capability of withstanding surgical treatments. In particular, vertebral strength is related to its elastic properties, whereas the ease of fluid motion, related to the success of incorporation orthopedic materials (eg, bone cement), is regulated by the hydraulic permeability (K). It has been shown that both elastic modulus and permeability of a material are affected by its morphology.

High expression of polo-like kinase 1 is associated with TP53 inactivation, DNA repair deficiency, and worse prognosis in ER positive Her2 negative breast cancer.

Polo-like kinase 1 (), the most investigated member of the family, plays a pivotal role both in the p53-mediated regulation of DNA damage repair and in mitosis, especially in the G2/M phase. However, the evidence on the clinical and prognostic relevance of is limited to triple negative subtype among breast cancer (BC). We hypothesized that high expression of is associated with TP53 inactivation, DNA repair deficiency, and worse prognosis in ER positive in BC in a large-scale cohort should clarify its clinical relevance for each BC subtype.

A past medical history of heart failure is associated with less fluid therapy in septic patients.

Objective: To identify the underlying factors that affect fluid resuscitation in septic patients.

Methods: The present study was a case-control study of 181 consecutive patients admitted to a Medical Intensive Care Unit between 2012 and 2016 with a diagnosis of sepsis. Demographic, clinical, radiological and laboratory data were analyzed.