Deriving life-course residential histories in brain bank cohorts: A feasibility study.

Introduction: The exposome is theorized to interact with biological mechanisms to influence risk for Alzheimer's disease but is not well-integrated into existing Alzheimer's Disease Research Center (ADRC) brain bank data collection.

Methods: We apply public data tracing, an iterative, dual abstraction and validation process rooted in rigorous historic archival methods, to develop life-course residential histories for 1254 ADRC decedents.

Results: The median percentage of the life course with an address is 78.

Multi-disciplinary assessment of the entrustable professional activities of surgery residents.

Purpose: Medicine is practiced in a collaborative and interdisciplinary manner. However, medical training and assessment remain largely isolated in traditional departmental silos. Two Entrustable Professional Activities (EPAs) developed by the American Board of Surgery are multidisciplinary in nature and offer a unique opportunity to study interdisciplinary assessment.

Stakeholder Perspectives in Anticipation of Sharing Physicians' Notes With Parents of Hospitalized Children.

Objective: Elicit stakeholder perspectives on the anticipated benefits and challenges of sharing hospital physicians' admission and daily progress notes with parents at the bedside during their child's hospitalization and identify strategies to aid implementation of inpatient note sharing.

Methods: Five semistructured focus groups were conducted with 34 stakeholders (8 parents, 8 nurses, 5 residents, 7 hospitalists, 6 administrators) at a tertiary children's hospital from October to November 2018 to identify anticipated benefits, challenges, and implementation strategies prior to sharing inpatient physicians' notes. A facilitator guide elicited participants' perspectives about the idea of sharing notes with parents during their child's hospitalization.

Surgical planning for living donor liver transplant using 4D flow MRI, computational fluid dynamics and in vitro experiments.

This study used magnetic resonance imaging (MRI), computational fluid dynamics (CFD) modeling, and in vitro experiments to predict patient-specific alterations in hepatic hemodynamics in response to partial hepatectomy in living liver donors. 4D Flow MRI was performed on three donors before and after hepatectomy and models of the portal venous system were created. Virtual surgery was performed to simulate (1) surgical resection and (2) post-surgery vessel dilation.

Encapsulated follicular variant of papillary thyroid cancer: are these tumors really benign?

Background: Recent studies suggest that the encapsulated form of follicular variant of papillary thyroid cancer (eFVPTC) behaves more similarly to benign lesions and can be treated with thyroid lobectomy alone instead of total thyroidectomy. To distinguish aggressive cancers from more benign lesions more clearly, the objective of this study was to determine if the eFVPTC behaves less aggressively than the nonencapsulated variant (neFVPTC).

Methods: A prospectively collected endocrine surgery database in our institution was reviewed for all patients with FVPTC on surgical pathology from 1999 to 2012.

Administration of CroFab Antivenom by a Helicopter Emergency Medical Service Team.

The case presented here highlights an unconventional use of a helicopter emergency medical service (HEMS) to provide a specialized medication to a critically ill patient when definitive transport was delayed. A 39-year-old man presented to a rural hospital 1 hour after sustaining a copperhead envenomation. He developed severe symptoms and was intubated.

Role of anaplastic lymphoma kinase inhibition in the treatment of non-small-cell lung cancer.

Purpose: Published data on the clinical efficacy, safety, dosage and administration, and costs of the anaplastic lymphoma kinase (ALK) inhibitors crizotinib and ceritinib in the treatment of non-small-cell lung cancer (NSCLC) are reviewed and compared.

Summary: The ALK protein functions as a transmembrane receptor tyrosine kinase; rearrangements of the ALK gene are associated with the development of NSCLC with adenocarcinoma histology. Crizotinib is an oral tyrosine kinase inhibitor approved in 2011 as a first-line therapy for patients with metastatic ALK mutation-driven NSCLC.

Potential cytochrome P-450 drug-drug interactions in adults with metastatic solid tumors and effect on eligibility for Phase I clinical trials.

Purpose: Potential cytochrome P-450 (CYP) drug-drug interactions in adults with metastatic solid tumors and their effect on eligibility for Phase I clinical trials were characterized.

Methods: This study included adult patients with metastatic solid tumors seen by a medical oncologist from January 2008 through July 2011. The medications used by these patients were identified.

Development of recommendations for dosing of commonly prescribed medications in critically ill obese children.

Purpose: The development and use of a decision support tool to help formulate recommendations for dosing of commonly prescribed medications in critically ill obese children are described.

Methods: Medications prescribed in 2010 to critically ill infants and children (younger than 18 years) were identified from the Pediatric Health Information System. The most commonly prescribed and therapeutically monitored medications were extracted.

Glucarpidase for the management of elevated methotrexate levels in patients with impaired renal function.

Purpose: The pharmacology, pharmacokinetics, clinical efficacy, safety, dosage, administration, and current role in therapy of a recently approved agent for controlling methotrexate toxicity are reviewed.

Summary: Glucarpidase is a bacterial enzyme useful in reversing toxicity induced by the widely used antineoplastic agent methotrexate. Glucarpidase gained U.

New treatment options for castration-resistant prostate cancer.

Purpose: Published efficacy and safety data from clinical trials of three recently approved agents for the management of metastatic castration-resistant prostate cancer (CRPC) are reviewed.

Summary: Sipuleucel-T is approved by the Food and Drug Administration (FDA) for the treatment of asymptomatic or minimally symptomatic patients with CRPC. In a placebo-controlled Phase III clinical trial, the use of sipuleucel-T was associated with an average improvement in median overall survival of 4.

Skill acquisition, credentialing, and maintenance of skills in surgical treatment of pelvic organ prolapse and urinary incontinence.

Female pelvic medicine and reconstructive surgery, or urogynecology, has undergone a unique evolution with recent recognition as a subspecialty of Obstetrics and Gynecology and Urology. It has never suffered from a shortage of innovation nor of innovators, and thus new treatments and therapeutic options are regularly being introduced. Who is best to perform or prescribe new, therapeutic options and their implementation in a responsible manner is controversial.

Pseudo-myocardial infarction in diabetic ketoacidosis with hyperkalemia.

Hyperkalemia-induced electrocardiogram changes such as dysrhythmias and altered T wave morphology are well described in the medical literature. Pseudo-infarction hyperkalemia-induced changes are less well known, but present a unique danger for the clinician treating these critically ill patients. This article describes a case of pseudo anteroseptal myocardial infarction in a type 1 diabetic with hyperkalemia.

An investigation into the mechanisms causing antipodean strabismus.

Background: Antipodean strabismus is a rare clinical entity in which a patient manifests an esotropia when fixating with one eye and an exotropia when fixating with the other eye. It has been described in the settings of marked uncorrected anisometropia, dissociated strabismus or combinations of paresis, and mechanical restriction of eye movement.

Methods: A retrospective review of four patients with antipodean strabismus.

Quantification of basal and stimulated ROS levels as predictors of islet potency and function.

We have developed a luminol-based assay using intact islets, which allows for quantification of reactive oxygen species (ROS). In addition, an index capable of characterizing metabolic and mitochondrial integrity prior to transplantation was created based on the capacity of islets to respond to high glucose and rotenone (mitochondrial respiratory chain complex I inhibitor) by production of ROS. To validate this assay, lipid peroxidation and antioxidative defense capacity were evaluated by detection of malondialdehyde (MDA) levels and glutathione peroxidase activity (GPx), respectively.

Limb salvage angioplasty in poor surgical candidates.

This study was conducted to evaluate the potential for percutaneous catheter based limb salvage angioplasty in patients who have no surgical bypass option. Twenty patients, 12 males and 8 females, with end-stage limb ischemia (Rutherford category 4 and 5) were treated with balloon angioplasty. Antegrade femoral access, coronary guidewire, and balloons were used.

Constructing muscle flap coverage for vascular grafts in the groin.

Groin wound infections can jeopardize patency and function of vascular bypass grafts anastomosed to the femoral artery. Attempts to salvage vascular reconstructions threatened by perigraft infection often fail because of inadequate debridement of surrounding infected soft tissue or because of an inability to cover an exposed graft with sufficient healthy tissue. In selected circumstances, use of rotational myocutaneous flaps makes it possible to salvage vascular grafts threatened by localized wound infection.

Position-related changes in voiding dynamics in men.

Objectives: To investigate by urodynamic study position-related changes in uroflowmetry and postvoid residual urine volume (PVR) in men because altered bladder function in the supine position may be a predisposing factor for urinary tract infections in the institutionalized elderly.

Methods: Two healthy men, 34 and 59 years of age and living at home, and 53 nursing home residents (mean age 71.8 years, range 46 to 92) were evaluated with uroflowmetry in the standing and recumbent positions (lying on the left or right side); corresponding PVRs were measured by transabdominal ultrasonic bladder scanning.

Controversies about the clinical assessment of benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is a common disorder which places a considerable burden on older men and health care expenses. With advances in medical technologies and the foreseeable demographic changes in the Western world, the financial and epidemiological impact of this chronic disease is expected to increase further. The management of BPH is controversial, and this article critically reviews the clinical applicability and validity of the various measures available for assessment.