Defining Renal Recovery in Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies.

Introduction: The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.

Methods: A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of > 30% improvement in SCr and its association with clinical outcomes.

When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta-analysis of randomized controlled trials.

Background: Initiation of feeding after percutaneous endoscopic gastrostomy (PEG) placement has been debated. Randomized controlled trials (RCTs) have been performed on early feeding compared with delayed feeding after PEG placement with varying results. Therefore, a meta-analysis was conducted examining early vs delayed feeding after placement of a PEG.

The clinical findings to notice mild elevation of intracranial pressure in an otology clinic.

Mildly elevated intracranial pressure appears to be a distinct pathology separate from idiopathic increased intracranial pressure and migraine. Many patients present with head fullness-pressure and dizziness, which is often suggestive of a clinical diagnosis of vestibular migraine. These patients may additionally have episodic vertigo as seen in endolymphatic hydrops and positional vertigo in addition to feeling dizzy.

Conversion to Glaucoma in Pediatric Glaucoma Suspects.

Prcis: In this retrospective review of pediatric glaucoma suspects, 11.5% of eyes progressed to glaucoma over an average of 6.5 years; eyes with ocular hypertension had an 18-fold increased risk of progression compared with eyes with suspicious disc appearance.

Transverse sinus pathologies, vestibular migraine and intracranial hypertension without papilledema.

Background: In the absence of papilledema, the presentation of migraine and idiopathic intracranial hypertension (IIH) is very similar. In this respect, an IIH could be presented as a vestibular migraine. Our main objective in this case report is to demonstrate the similarities between IIH and vestibular migraine.

Trends in Technology for Pedicle Screw Placement: A Temporal Meta-Analysis.

Study Design: Systematic Review.

Objective: We sought to determine which method of the pedicle screw (PS) placement is most accurate and understand how the development of subsequent generations of robotic systems has changed placement accuracy over time.

Summary Of Background Data: Previous studies have demonstrated the success of robotic PS placement, but how this accuracy compares to other methods is unclear.

A Rare Presentation of Penile Calciphylaxis Requiring Partial Penectomy.

Calciphylaxis is a rare disease and carries high morbidity and mortality rates. It's characterized by microvascular calcification and occlusion, which leads to a life-threatening disease characterized by skin necrosis and ulceration. Calciphylaxis is classified as uremic, which occurs in patients with end-stage renal disease and who are non-uremic.

Early late cholecystectomy in mild gall stone pancreatitis: An updated meta-analysis and review of literature.

Background: Gallstone pancreatitis is one of the most common causes of acute pancreatitis. Cholecystectomy remains the definitive treatment of choice to prevent recurrence. The rate of early cholecystectomies during index admission remains low due to perceived increased risk of complications.

Cost comparison of gynecologic procedures between the US and a developing country: an observational study.

The Unites States spends on healthcare, with women's health being included, more than what middle-to-low-income countries, such as Lebanon, do. Compared to the United States, Lebanon has negligible data on the amounts spent on healthcare including female health services. In this study, we try to assess the cost differences of common gynecologic procedures between Lebanon and the United States, trying to fill the gap of missing data in Lebanon and identifying potential factors that can lead to high healthcare cost in the United States.

Impact of an Electronic App on Resident Responses to Simulated In-Flight Medical Emergencies: Randomized Controlled Trial.

Background: Health care providers are often called to respond to in-flight medical emergencies, but lack familiarity with expected supplies, interventions, and ground medical control support.

Objective: The objective of this study was to determine whether a mobile phone app (airRx) improves responses to simulated in-flight medical emergencies.

Methods: This was a randomized study of volunteer, nonemergency resident physician participants who managed simulated in-flight medical emergencies with or without the app.

Simulation-based Remediation in Emergency Medicine Residency Training: A Consensus Study.

Introduction: Resident remediation is a pressing topic in emergency medicine (EM) training programs. Simulation has become a prominent educational tool in EM training and been recommended for identification of learning gaps and resident remediation. Despite the ubiquitous need for formalized remediation, there is a dearth of literature regarding best practices for simulation-based remediation (SBR).

Sphingomonas paucimobilis presenting as acute phlebitis: A case report.

Sphingomonas paucimobilis is a strictly aerobic, non-spore-forming Gram-negative bacillus, ubiquitous bacterium, thought to be an opportunistic pathogen and is rarely reported in clinical settings. Here in, is the first case report of Acute Sphingomonas phlebitis secondary to intravenous (IV) drug use. We present the case of a 39-year-old male who initially presented with pain in his right upper extremity, fevers and chills of three week duration.

Treatment of orofacial granulomatosis: a case report.

Background: Orofacial granulomatosis is a relatively recent term coined by Wiesenfield et al. in 1985 to define granulomatous lesions of oral mucosa without intestinal involvement. When it presents in a triad encompassing facial nerve palsy, lip swelling, and fissured or furrowed tongue it is called Melkersson-Rosenthal syndrome while monosymptomatic or oligosymptomatic forms are referred to as granulomatous cheilitis.

Role of albumin in cirrhosis: from a hospitalist's perspective.

Albumin, a negatively charged globular protein encoded on chromosome 4, is one of the most abundant proteins in the plasma and accounts for approximately 75% of plasma oncotic pressure. The role of albumin in the management of various disease states has shown to be beneficial historically. Low serum albumin is a predictor of mortality and poor outcomes.

OTX2 expression contributes to proliferation and progression in Myc-amplified medulloblastoma.

Medulloblastoma is one of the most prevalent pediatric brain malignancies, accounting for approximately 20% of all primary CNS tumors in children under the age of 19. OTX2 is the member of a highly conserved family of bicoid-like homeodomain transcription factors responsible for the regulation of cerebellar development and of current investigational interest in the tumorigenesis of medulloblastoma. Recent studies have revealed that Group 3 and Group 4 medulloblastomas show marked overexpression of OTX2 with a concurrent amplification of the MYC and MYCN oncogenes, respectively, correlating with anaplasticity and unfavorable patient outcomes.