Analysis of the ROADSTER pivotal and extended-access cohorts shows excellent 1-year durability of transcarotid stenting with dynamic flow reversal.

Objective: We report the 1-year outcomes of the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial. This trial introduced a novel transcarotid neuroprotection system (NPS), the ENROUTE transcarotid NPS (Silk Road Medical Inc, Sunnyvale, Calif). Postoperative results demonstrated that the use of the ENROUTE transcarotid NPS is safe and effective.

Association of plasma nitrite levels with obesity and metabolic syndrome in the Old Order Amish.

Objectives: Plasma nitrite is a metabolite of nitric oxide and reflects endogenous nitric oxide synthase (NOS) activity. Although plasma nitrites were previously linked with obesity and metabolic syndrome (MetS), the direction of association remains inconsistent, possibly due to sample heterogeneity. In a relatively homogeneous population, we hypothesized that nitrite levels will be positively associated with overweight/obesity and MetS.

A Comparison of Adjusted Versus Unadjusted Doses of Polymyxin B Based on Renal Function and Incidence of Acute Kidney Injury.

Purpose: To determine whether or not polymyxin B needs dose adjustments based on renal function by comparing the incidence of acute kidney injury (AKI) in patients whose polymyxin B doses were adjusted versus not adjusted according to renal function.

Methods: This was a single-center, prospective study with a retrospective cohort taking place in an acute care community hospital. Forty-two patients treated with polymyxin B were evaluated between April 2012 and December 2015.

Serum Angiopoietin-2 Predicts Mortality and Kidney Outcomes in Decompensated Cirrhosis.

Acute kidney injury in decompensated cirrhosis has limited therapeutic options, and novel mechanistic targets are urgently needed. Angiopoietin-2 is a context-specific antagonist of Tie2, a receptor that signals vascular quiescence. Considering the prominence of vascular destabilization in decompensated cirrhosis, we evaluated Angiopoietin-2 to predict clinical outcomes.

X-linked adult-onset adrenoleukodystrophy: Psychiatric and neurological manifestations.

Adult-onset adrenoleukodystrophy is a rare x-linked inborn error of metabolism occurring predominantly in males with onset in early 30s. Here, we report a 34-year-old male with first signs of disease in early 20s manifesting as a pure psychiatric disorder. Prior to onset of neurological symptoms, this patient demonstrated a schizophrenia and bipolar-like presentation.

Heritability of plasma neopterin levels in the Old Order Amish.

Background: We examined the heritability of neopterin, a biomarker for cell-mediated immunity and oxidative stress, and potentially for psychiatric disorders, in the Old Order Amish.

Methods: Plasma neopterin levels were determined in 2015 Old Order Amish adults. Quantitative genetic procedures were used to estimate heritability of neopterin.

Siglec-7 as a Novel Biomarker to Predict Mortality in Decompensated Cirrhosis and Acute Kidney Injury.

Background: Patients with decompensated cirrhosis have high morbidity and are commonly hospitalized with acute kidney injury.

Aims: We examined serum levels of Siglec-7, a transmembrane receptor that regulates immune activity, as a biomarker for mortality in patients with cirrhosis and acute kidney injury.

Methods: Serum Siglec-7 was measured in hospitalized patients with cirrhosis and acute kidney injury, as well as in reference groups with acute liver injury/acute kidney injury, cirrhosis without acute kidney injury, and sepsis without liver disease.

Treatment of Refractory Status Epilepticus with Vagus Nerve Stimulator in an Elderly Patient.

Background: One of the risks of a traumatically induced intracranial bleed is development of new onset seizures. Rarely would these seizures progress to status epilepticus (SE) or refractory SE. There is a lack of literature on the use of a vagus nerve stimulator in these situations in older adults.

A new method for making treatment decisions for incapacitated patients: what do patients think about the use of a patient preference predictor?

Background: Surrogates frequently are unable to predict which treatment their charges would want and also can experience significant distress as a result of making treatment decisions. A new method, the patient preference predictor (PPP), has been proposed as a possible way to supplement the process of shared decision-making to address these two concerns. The PPP predicts which treatment the patient would want based on which treatment similar patients want in similar circumstances.

Do Patients Want their Families or their Doctors to Make Treatment Decisions in the Event of Incapacity, and Why?

Background: Current practice relies on patient-designated and next-of-kin surrogates, in consultation with clinicians, to make treatment decisions for patients who lose the ability to make their own decisions. Yet, there is a paucity of data on whether this approach is consistent with patients' preferences regarding who they want to make treatment decisions for them in the event of decisional incapacity.

Methods: Self-administered survey of patients at a tertiary care center.

Spiritual peace predicts 5-year mortality in congestive heart failure patients.

Objective: Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness.

Method: Participants were 191 CHF patients (64% male; M age = 68.

Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: Dutch nationwide retrospective cohort study.

Objectives: To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation.

Design: Nationwide retrospective cohort study.

Setting: Emergency departments and paediatric intensive care units of the eight university medical centres in the Netherlands.

Patients' priorities for treatment decision making during periods of incapacity: quantitative survey.

Objective: Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities.

Sparring and neurological function in professional boxers.

Despite increased interest regarding the potentially long-term negative impact of chronic traumatic brain injury, limited research has been conducted regarding such injuries and neurological outcomes in real world settings. To increase understanding regarding the relationship between sparring (e.g.

Effect of strabismus surgery on the reading ability of school-age children.

Aim: To evaluate if strabismus surgery on children between the ages 5 and 14 years leads to an improvement in reading ability by comparing reading performance of patients before and after surgery.

Methods: Pre- and postoperatively, the visual acuity, ocular alignment, and stereoacuity of 15 children with horizontal strabismus was recorded. The "3-Minute Reading Assessments: Word Recognition, Fluency, and Comprehension" for the appropriate age-group were used to assess children between the ages of 5 and 14 years.

Pharmacy management of postoperative blood glucose in open heart surgery patients: evaluation of an intravenous to subcutaneous insulin protocol.

Purpose: To develop and implement a protocol to improve blood glucose (BG) control during transition from intravenous (IV) to subcutaneous (SC) insulin, increase compliance with Surgical Care Improvement Project (SCIP) measures, and decrease sternal wound infections post open heart surgery (OHS).

Methods: An IV to SC protocol was developed and implemented. A retrospective chart review of patients who underwent OHS was conducted from January 2, 2009 to September 30, 2010 (pre protocol) and from October 1, 2010 to December 31, 2011 (post protocol).

Arthroscopic stabilization for voluntary shoulder instability.

Background: Voluntary shoulder instability is characterized by a patient's ability to sublux their shoulder using selective muscle contraction and relaxation. High failure rates exist with open shoulder stabilization in this group of patients. The purpose of this study was to report the outcomes for patients with voluntary instability treated arthroscopically.

Neurocysticercosis in patients presenting with epilepsy at St Elizabeth's Hospital, Lusikisiki.

Objective: To survey the prevalence of neurocysticercosis in patients treated for epilepsy in Lusikisiki, E Cape.

Design: This was a descriptive study. Variables considered were age, gender, symptoms and type of seizure, serological data, electroencephalogram and computed tomography (CT) findings, treatment, and ownership of pigs.

Detection of chromosome aneuploidies in chorionic villus samples by multiplex ligation-dependent probe amplification.

The objective of this study was to examine the suitability of multiplex ligation-dependent probe amplification (MLPA) in chorionic villus samples as a replacement for traditional karyotyping for the detection of (an)euploidies of chromosomes 21, 18, 13, X, and Y. Chorionic villus samples were diagnosed by traditional karyotyping using short-term cultures (STC) and long-term cultures (LTC), and by MLPA using kit P095. DNA was extracted after digestion of whole villi with proteinase K and/or trypsin and collagenase.

Innovations in postoperative pain management: continuous infusion of local anesthetics.

Patients and health care providers alike struggle with alleviating postoperative pain. Patients with unrelieved pain are less likely to cough, breathe deeply, or move easily after surgery, which adversely affects their recovery. Innovations in technology, such as continuous infusion of local anesthetics, have revolutionized postoperative pain management.