Mind the gut: Navigating the complex landscape of gastroprotection in neurosurgical patients.

Neurosurgical patients, including those with severe traumatic brain injury, spinal cord injury, stroke, or raised intracranial pressure, are at heightened risk for stress ulcers and aspiration pneumonitis, leading to significant morbidity and mortality. These patients are typically managed through both pharmacological interventions [, proton pump inhibitors (PPIs), histamine 2 (H2) antagonists, sucralfate] and non-pharmacological measures (, nasogastric decompression, patient positioning) to mitigate adverse outcomes. The pathogenesis of stress ulcers in neurosurgical patients is multifactorial, but the routine use of stress ulcer prophylaxis remains controversial.

Comparison of the Efficacy and Safety of Apixaban and Warfarin in the Prevention of Stroke in Patients With Non-valvular Atrial Fibrillation: A Meta-Analysis.

Atrial fibrillation is an irregular heart rhythm, and it is one of the most common cardiac arrhythmias. It is associated with a five times increase in the risk of stroke. Anti-coagulants are prescribed routinely to prevent strokes, especially in patients with atrial fibrillation for many years decreasing the risk of stroke among patients with atrial fibrillation.

Case of emphysematous pyelonephritis in a renal allograft.

Emphysematous pyelonephritis is a rare, but serious complication after renal transplantation. This is a case report of a 49-yr-old female who had a renal transplant for diabetic nephropathy. She presented to ER with about 1 wk history of right lower abdominal pain and fever 15 months after the transplant.

Evidence-based data for the hemodialysis access surgeon.

The National Kidney Foundation Dialysis Outcomes Quality Initiative Clinical Practice Guidelines for Vascular Access (DOQI) have defined the access-related care for patients with end-stage renal disease (ESRD). However, the standard of care across the country has fallen short of the DOQI targets. One potential explanation for these shortcomings is the lack of compelling evidence in the literature to support the recommendations.

Using the Internet to enable access to medical conferences.

Objective: The goal of expanding access to individuals with disabilities to scientific and medical conferences is supported by both the Americans with Disabilities Act and the National Institutes of Health.

Design: Live-streaming video broadcast over the internet is widely available, although it has been used only in a limited fashion by the medical community. A consumer-oriented medical and rehabilitation conference concerning the rare disabling disease, fibrodysplasia ossificans progressiva, was broadcast via the world wide web.

The impact of polyamine analogues on the blood pressure of normotensive and hypertensive rats.

The impact of the antineoplastic polyamine analogues N1N14-diethylhomospermine (DEHSPM) and N1N11-diethylnorspermine (DENSPM) on the blood pressure and heart rate of normotensive and hypertensive rats are described. DEHSPM was administered to both normotensive and spontaneously hypertensive rats (SHR), while the DENSPM analogue was given only to the normotensive animals. The intravenous administration of DEHSPM at doses of 5 or 10 mg/kg resulted in a profound and long-lasting drop in the test animals' blood pressure, with no appreciable change in their heart rate.

A trial of labor complicated by uterine rupture following amnioinfusion.

Amnioinfusion has become accepted in the management of intrapartum cord compression, meconium-stained fluid, and oligohydramnios. Limited experience exists regarding amnioinfusion in patients undergoing a trial of labor after cesarean section and its potential complications. We report a case of trial of labor in which uterine rupture occurred following intrapartum amnioinfusion.