Capnocytophaga spp. infection causing chorioamnionitis: an unusual suspect.

Capnocytophaga spp. are not often considered as a cause of perinatal infection. However, Capnocytophaga spp.

Application of the Canadian Computed Tomography Head Rule to Patients With Minimal Head Injury.

Study Objective: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials.

Steering Sheath for 2-Nostril Transnasal Office Laryngoscopy.

Objective: The aim was to study the feasibility of performing office-based laryngeal procedures employing a flexible hollow steerable sheath placed contralateral to the nostril through which a standard flexible video endoscope is placed.

Methods: The study design included simulation of transnasal endoscopic laryngeal procedures evaluating the use of a flexible steering sheath in laboratory and clinic settings. Transnasal laryngeal procedures were performed in an otolaryngology office setting employing an airway-management-trainer mannequin and then repeated in a human cadaver lab with standard transnasal flexible video laryngoscopy.

P-Cadherin (CDH3) is overexpressed in colorectal tumors and has potential as a serum marker for colorectal cancer monitoring.

Introduction: Placental-Cadherin (CDH3) is a cell adhesion molecule vital to cellular localization and tissue integrity. It is highly expressed in the placenta (PLC)and is overexpressed by many types of cancer. P-cadherin levels in colorectal cancer (CRC) remains poorly characterized.

Reliability of the EchoMRI Infants System for Water and Fat Measurements in Newborns.

Objective: The precision and accuracy of a quantitative magnetic resonance (EchoMRI Infants) system in newborns were determined.

Methods: Canola oil and drinking water phantoms (increments of 10 g to 1.9 kg) were scanned four times.

Differences in Fundamental Sagittal Pelvic Parameters Based on Age, Sex, and Race.

Study Design: This is a retrospective cohort study.

Objective: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters.

Summary Of Background Data: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning.

Mitral valve coaptation and its relationship to late diastolic flow: A color Doppler and vector flow map echocardiographic study in normal subjects.

Background: Three competing theories about the mechanism of mitral coaptation in normal subjects were evaluated by color Doppler and vector flow mapping (VFM): (1) beginning of ventricular (LV) ejection, (2) "breaking of the jet" of diastolic LV inflow, and (3) returning diastolic vortices impacting the leaflets on their LV surfaces.

Methods And Results: We analyzed 80 color Doppler frames and 320 VFM measurements. In all 20 normal subjects, coaptation occurred before LV ejection, 78±16 ms before onset.

The ABMS MOC Part III Examination: Value, Concerns, and Alternative Formats.

This article describes the presentations and discussions at a conference co-convened by the Council on Medical Education of the American Medical Association (AMA) and by the American Board of Medical Specialties (ABMS). The conference focused on the ABMS Maintenance of Certification (MOC) Part III Examination. This article, reflecting the conference agenda, covers the value of and evidence supporting the examination, as well as concerns about the cost of the examination, and-given the current format-its relevance.

Racial and Socioeconomic Treatment Disparities in Adolescents and Young Adults with Stage II-III Rectal Cancer.

Introduction: Stage II-III rectal cancer requires multidisciplinary cancer care, and adolescents and young adults (AYA, ages 15-39 years) often do not receive optimal cancer therapy.

Methods: Overall, 3295 AYAs with clinical stage II-III rectal cancer were identified in the National Cancer Database. Factors associated with the receipt of adjuvant and surgical therapies, as well as overall survival (OS), were examined.

The Inter-rater Reliability of Echocardiographic Diastolic Function Evaluation Among Emergency Physician Sonographers.

Study Objectives: In a patient with dyspnea and suspected CHF, the evaluation of diastolic function involves: tissue Doppler of the mitral annulus and 2) pulsed wave Doppler of the mitral inflow. We aimed to 1) determine the inter-rater reliability for overall diastolic function and 2) evaluate the reliability of the individual Doppler measurements.

Methods: A convenience sample of adult emergency department patients was prospectively enrolled by 8 EPs who had participated in a 1-hour didactic session.

Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.

Competency to stand trial evaluations in a multicultural population: Associations between psychiatric, demographic, and legal factors.

Data were examined from an archival sample of Competency to Stand Trial (CST) reports of 200 consecutive New York City pre-trial defendants evaluated over a five-month period. Approximately a fourth of defendants in the present study were immigrants; many required the assistance of interpreters. The examiners conducting the CST evaluation diagnosed approximately half of the defendants with a primary diagnosis of a psychotic disorder and deemed over half not competent.

Aspirin use and the risk of cholangiocarcinoma.

Unlabelled: Whether aspirin use is protective against cholangiocarcinoma (CCA) remains unclear. We determined the association between aspirin use and other risk factors for each CCA subtype individually. In a hospital-based case-control study, 2395 CCA cases (1169 intrahepatic, 995 perihilar, and 231 distal) seen at the Mayo Clinic, Rochester, MN, from 2000 through 2014 were enrolled.

Physician-initiated daily verbal reminders decrease the duration of indwelling urinary catheter use compared with nurse-initiated reminders.

We compared the effectiveness of physician-initiated daily verbal reminders to primary care providers with nurse-initiated daily verbal reminders in decreasing the duration of inappropriate indwelling urinary catheter use in hospitalized patients. Catheter use duration was significantly decreased in the physician-initiated intervention group compared with the nurse-initiated intervention group (0.5 ± 0.

Ultrasound in the evaluation of penetrating thoraco-abdominal trauma: a review of the literature.

The use of ultrasound in the evaluation of blunt thoraco-abdominal trauma is well described. Evidence for the use of ultrasound in the evaluation of penetrating cardio-thoracic and abdominal trauma, however, is more limited and varied. Current literature demonstrates that ultrasound is an excellent screening tool for penetrating thoracic and cardiac injuries with a high sensitivity for detecting injury requiring acute intervention.

Surgical Treatment of Diverticulitis: Hand-Assisted Laparoscopic Resection Is Predominantly Used for Complex Cases and Is Associated With Increased Postoperative Complications and Prolonged Hospitalization.

Introduction Laparoscopic (LAP) colectomy is now the "gold" standard for diverticulitis; the role of hand-assisted LAP (HAL) and Open methods today is unclear. This study assessed the elective use of these methods for diverticulitis. Methods A retrospective review of demographic, comorbidity (Carlson Comorbidity Index [CCI]), resection type, and short-term outcomes was carried out.

Linear accelerator-based flattening-filter-free stereotactic radiosurgery for trigeminal neuralgia: Feasibility and patient-reported outcomes.

Purpose: The purpose of this study was to assess the safety and outcomes of the clinical use of LINAC (linear accelerator)-based flattening-filter-free beams for delivering ablative stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN).

Methods And Materials: Thirty-six consecutive patients (34 unique patients) followed up by a single neurosurgeon and diagnosed with medically refractory unilateral TN were treated with SRS. There were 14 left-sided cases (41%) and 20 right-sided cases (59%).

Clinical Experience and Best Practices Using Epidermal Skin Grafts on Wounds.

Over the years, autologous skin grafting has been used extensively to achieve wound closure, optimize a functional scar, and improve aesthetic outcomes for the patient. Although a vast majority of the literature is on the use of full-thickness and split-thickness skin grafts, epidermal skin grafts (ESGs) have emerged as a viable option in the reconstructive ladder when only the epidermal layer is needed. These grafts are distinct from other types of autologous skin grafts in that they can be harvested without anesthesia and leave minimal or no scarring at the donor site.