Massage increases oxytocin and reduces adrenocorticotropin hormone in humans.

Context: Human beings are highly social creatures who often touch each other during social interactions. Although the physiologic effects of touch are not understood fully, it appears to sustain social bonds and to increase cooperative behaviors. Oxytocin (OT) is a hormone known to facilitate social bonding, and touch may affect OT release.

Development of a pharmacist-psychiatrist collaborative medication therapy management clinic.

Objective: To describe a needs assessment, practice description, practice innovation and reimbursement of a psychiatric pharmacist medication therapy management (MTM) clinic with related challenges and opportunities.

Setting: An MTM clinic established in collaboration with the Outpatient Psychiatric Services (OPS) at the University of California San Diego (UCSD), under contract with the San Diego County Health and Human Services Agency Adult and Older Adult Mental Health Services (A/OAMHS).

Practice Description: Two board-certified psychiatric pharmacists provided direct patient care using a collaborative practice protocol 3 days per week.

Pulmonary giant cell carcinoma associated with pseudomyxoma peritonei.

Pulmonary giant cell carcinoma is a rare subtype of sarcomatoid carcinoma. Pseudomyxoma peritonei (PMP) is a rare condition in which gelatinous material accumulates within the peritoneal cavity. It is believed PMP arises from a primary appendiceal mucinous neoplasm that perforates the gut, causing mucinous ascites.

Electrocardiogram provides a continuous heart rate faster than oximetry during neonatal resuscitation.

Objective: To compare the time required to obtain a continuous audible heart rate signal from an electrocardiogram (ECG) monitor and pulse oximeter (PO) in infants requiring resuscitation.

Methods: Infants who had both ECG and PO placed during resuscitation were analyzed using video and analog recordings. The median times from arrival until the ECG electrodes and PO sensor were placed, and the time to achieve audible tones from the devices, were compared.

Pooling expressed breastmilk to provide a consistent feeding composition for premature infants.

Objective: We hypothesized that pooling a mother's expressed breastmilk for 24 hours compared with individual pump session collection of milk would provide a more consistent caloric product without increasing bacterial contamination.

Study Design: We investigated 24-hour pooled breastmilk collection by enrolling 19 mothers who were expressing milk for their infants. Mothers followed a standardized milk collection protocol for 4 study days: daily milk was pooled in a sterile 1-L bottle on Day 1, and on Day 2 milk was aliquoted for each pump session into a sterile 120-mL container.

Surgical advances in burn and reconstructive plastic surgery: new and emerging technologies.

This article introduces and discusses several biophysical and cellular modalities that are being tested or used in clinical practice to optimize wound bed preparation, effect soft tissue coverage, and improve the quality of the inevitable and resultant scar. Among these promising technologies is the use of electrical stimulation to mimic a physiologic current of injury in an effort to accelerate re-epithelialization and the wound healing process. Over the past several years an on-site individualized regenerative medicine kit has become commercially available (ReCell, Avita Medical), utilizing well-established laboratory techniques of cell separation without the need for cell cultivation in an effort to expand and promote wound coverage and end result.

Randomized controlled trial of emergency transjugular intrahepatic portosystemic shunt versus emergency portacaval shunt treatment of acute bleeding esophageal varices in cirrhosis.

Background: Emergency treatment of bleeding esophageal varices (BEV) in cirrhosis is of paramount importance because of the resultant high mortality rate. Emergency therapy today consists mainly of endoscopic and pharmacologic measures, with use of transjugular intrahepatic portosystemic shunt (TIPS) when bleeding is not controlled. Surgical portosystemic shunt has been relegated to last resort salvage when all other measures fail.

Delivery room respiratory management of the term and preterm infant.

The immediate newborn transition is a time of great physiologic adjustments and many infants need assistance to make a successful transition to newborn life. Assisted ventilation is the most important intervention performed during this transitional period. Noninvasive ventilation is a necessary skill for all pediatric providers because it is the most frequently required lifesaving measure provided in the delivery room.

Plerixafor as first- and second-line strategies for autologous stem cell mobilization in patients with non-Hodgkin's lymphoma or multiple myeloma.

Study Objective: To describe the institutional experience of plerixafor plus filgrastim as the initial peripheral blood stem cell (PBSC) mobilization (first-line strategy) and as rescue therapy after failure with filgrastim plus cyclophosphamide (second-line strategy).

Design: Retrospective medical record review.

Setting: Academic medical center.

Does radical nephrectomy increase the risk of erectile dysfunction compared with partial nephrectomy? A cohort analysis.

Unlabelled: Study Type - Therapy (prospective cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Erectile dysfunction (ED) is a form of endothelial dysfunction that is prevalent in patients with chronic kidney disease (CKD). We hypothesized that partial nephrectomy (PN) would limit development of ED compared with radical nephrectomy (RN), primarily due to renal function preservation, and found that patients undergoing RN had significantly higher de novo ED compared with a contemporary, well-matched cohort undergoing PN; in addition to RN, hypertension, CKD and diabetes mellitus were associated with developing ED. To our knowledge, this is the first study demonstrating an increased risk of ED after RN compared with PN.

Venous thromboembolism in the elderly: the result of comorbid conditions or a consequence of injury?

Background: Venous thromboembolism (VTE) is a common complication in trauma patients. Several risk factors have been identified that may place patients at in increased risk for VTE including preexisting medical conditions, iatrogenic factors, and injury-related factors. Advanced age has also been implicated as a risk factor for VTE.

Pulmonary endarterectomy: recent changes in a single institution's experience of more than 2,700 patients.

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a known sequela of acute pulmonary embolic disease and yet remains underdiagnosed. Although nonsurgical options for patients with CTEPH have become increasingly available, including pulmonary artery hypertensive medical therapy, surgical endarterectomy provides the most appropriate intervention as a potential cure for this debilitating disorder. This article summarizes the most recent outcomes of pulmonary endarterectomy at a single institution over the past 12 years, with emphasis on the surgical approach to segmental-level chronic thromboembolic disease.

Disability index in a randomized controlled trial of emergency sclerotherapy versus portacaval shunt for bleeding varices in cirrhosis.

Background: Disability has not been studied after emergency treatment of bleeding esophageal varices (BEV). We created a disability index (DI) in a randomized controlled trial comparing emergency endoscopic therapy (EST) versus emergency portacaval shunt (EPCS).

Methods: There were 211 unselected, consecutive patients with cirrhosis and acute BEV who were randomized to EST (n = 106) or EPCS (n = 105).

Penile Kaposis sarcoma in the state of California.

Introduction: Penile Kaposi's sarcoma (PKS) is a rare and poorly characterized disease. Kaposi's sarcoma is common in HIV disease and is an AIDS-defining illness. This study aimed to review epidemiologic characteristics and changes in the incidence of PKS using a total population-based database.

Ureteral intussusception: a case report and literature review.

We present the case of a 64-year-old man with intussusception of the right ureter as a complication of an underlying transitional cell carcinoma. To our knowledge, this is the first case report that illustrates ureteral intussusception by both multidetector computerized tomography and magnetic resonance imaging. Although ureteral intussusceptions are thought to be associated with benign masses, our comprehensive review of the literature demonstrates that almost half of the cases are associated with underlying malignancy.

Effects of endotracheal intubation and surfactant on a 3-channel neonatal electroencephalogram.

Objective: To evaluate the effects of surfactant administration on the neonatal brain using 3-channel neonatal electroencephalography (EEG).

Study Design: A prospective cohort of 30 infants had scalp electrodes placed to record brain waves using 3-channel EEG (Fp1-O1, C3-C4, and Fp2-O2). Sixty-second EEG epochs were collected from a 10-minute medication-free baseline, during premedication for endotracheal intubation, at surfactant administration, and at 10, 20, and 30 minutes after surfactant administration for amplitude comparisons.

Congenital cardiac anomalies: prenatal readings versus neonatal outcomes.

Objective: The purpose of this study was to determine the variation between prenatal and postnatal diagnosis of congenital cardiac lesions diagnosed by both fetal center primary physicians and fetal pediatric cardiologists at a single tertiary referral center in the United States and evaluate why cases were misdiagnosed.

Methods: A retrospective review of all cardiac abnormalities identified prenatally by level II sonography at a tertiary referral fetal center between January 2006 and December 2008 was performed to include any patient with a fetal cardiac abnormality and with a documented autopsy or neonatal follow-up. Congenital heart disease diagnoses were classified as correct, incorrect, or incorrect but within the same spectrum of disease.

Predicting adverse outcomes following trauma in pregnancy.

Objective: To identify variables predicting adverse maternal or fetal outcome following trauma and to establish a composite morbidity model to predict poor obstetrical outcomes.

Study Design: A retrospective study of pregnant women following major and minor trauma from a single institution from 1985-2007 was performed. Abstracted data included maternal demographics, Injury Severity Score (ISS), laboratory and radiology studies,fetal monitoring and delivery information.

Is contrast exposure safe among the highest risk trauma patients?

Background: Despite improvements in the diagnosis and management of acute kidney injury (AKI), posttraumatic renal dysfunction continues to be associated with increased morbidity and mortality. Intravenous (IV) contrast is known to induce AKI in high-risk groups including the elderly and critically ill. We sought to determine whether IV contrast exposure among high-risk trauma patients resulted in renal dysfunction as defined by the Acute Kidney Injury Network criteria.

Endpoints for hemodialysis access procedures: correlation between fistulography and intraaccess blood flow measurements.

Purpose: The success of percutaneous interventions on stenotic hemodialysis prosthetic grafts and autogenous fistulas is assessed by comparing vessel diameter before and after treatment. These changes do not correlate with gold standard access blood flow (ABF) measurements obtained during hemodialysis. The AngioFlow (AngioDynamics, Inc, Queensbury, New York) calculates real-time blood flow through access circuits and may provide more physiologically relevant data in the interventional suite.

Updating the role of natriuretic peptide levels in cardiovascular disease.

Heart disease affects 1 in 3 individuals in the United States, and the prevalence of heart failure (HF) is increasing exponentially. Although our understanding of the disease progression of congestive HF (CHF) has advanced, refining the areas of diagnosis, risk stratification, prognosis, and treatment is still needed. The natriuretic peptides, specifically B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), have shown promise in clinical practice.

Budd-Chiari syndrome revisited: 38 years' experience with surgical portal decompression.

Objective: Ten years ago, we reported our results with what remains as the largest clinical experience with surgical portal decompression for Budd-Chiari syndrome (BCS) in the West. Since then, our series has expanded to 77 patients, and there has been an explosion of interest in and publications about BCS. The objectives of this study are to assess the validity of our observations and conclusions regarding BCS reported 10 years ago by expansion of our series of patients and observations of outcomes over an additional decade of close follow-up.

Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy.

Objective: To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease.

Patients And Methods: The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.

Imaging of the rotator cuff.

The imaging evaluation of the rotator cuff augments the clinical evaluation. Radiography, computed tomography, and magnetic resonance imaging all have various roles in the assessment of the rotator cuff, which can be combined with arthrography for added detail. Furthermore, ultrasound is a very useful technique that provides functional information that is not offered by simple anatomic imaging.