Comprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study.

Introduction: This study aims to describe laboratory and clinical factors associated with thrombotic events during prolonged pediatric extracorporeal membrane oxygenation.

Methods: A secondary analysis of a multi-center prospective study performed between 2012 and 2014. Patients under the age of 19 years that received extracorporeal membrane oxygenation for at least 4 days of therapy were included ( = 385).

Long-Term Survival of Patients With Cancer, Sepsis, and Vasopressor Requirements Based on Lactate Levels.

A prospective cohort study was conducted to evaluate the 1-year survival of cancer patients with sepsis and vasopressor requirements. Eligible patients were admitted a Comprehensive Cancer Center's ICU and were compared based on their admission lactate levels. Of the 132 included patients, 87 (66%) had high lactate (HL; > 2.

Vitamin C Deficiency Masquerading as Vasculitis in a Patient With Crohn's Disease.

This case study features a 40-year-old male with Crohn's disease (CD) who was initially misdiagnosed with vasculitis but was later shown to have scurvy owing to vitamin C deficiency. The patient's diet was nearly exclusively made up of highly processed fast food, with no fresh fruits or vegetables. A mildly sensitive, violaceous rash on his lower legs, mild gingival hemorrhage and enlargement, and muscle soreness were among his symptoms.

Rectus Urinoma Leading to Abscess Following Urethral Perforation From Self-Catheterization: A Case Report.

Urinomas are an accumulation of urine in the perirenal or paraureteral space due to urinary tract leakage. Stimulation of an inflammatory response results in the formation of a thick wall that encapsulates the urine. Etiologies of urinomas include trauma, surgery, or spontaneous occurrence.

Differences in Perceptual and Attitudinal Body Image Between White and African-American Adults Matched for Sex, Age, and Body Composition.

Purpose: The purpose of this study was to evaluate the differences in perceptual and attitudinal body image between White and African-American males and females matched for sex, age, BMI, and other body composition components using a combination of 3-dimensional mobile digital imaging analysis (DIA) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS).

Methods: One-hundred non-Hispanic White (n=50) and non-Hispanic African-American (n=50) adults (M=34, F=66) matched for sex, age, BMI, and body composition components completed this cross-sectional study. Participants underwent several anthropometric assessments, completed the MBSRQ-AS, and rated their perceived appearance, ideal appearance, and the appearance they believed a partner would find societally attractive using a state of the art mobile 3-dimensional DIA produced using broad developmental populations.

Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors in Solid Organ Transplant Recipients.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may be effective in reducing body weight and hemoglobin A1c (HbA1c) post-kidney transplantation. Limited literature exists on use of these agents outside of kidney transplant. The purpose of this program evaluation was to evaluate the safety and efficacy of SGLT2i in kidney, liver, and lung transplant recipients.

Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury.

Purpose: The purpose of this study is to develop a model to predict re-injury after being cleared to return to full duty from an initial injury.

Methods: This was a prediction model derivation cohort study. Military service members cleared for unrestricted full duty after sustaining a musculoskeletal injury were enrolled from three large military hospitals.

Pilot study evaluating feasibility and utility of pharmacist-driven oral antineoplastic agent monitoring program.

Introduction: Oncologists are increasingly prescribing oral antineoplastic agents which have benefits and challenges impacting patient outcomes. Practice guidelines recommend monitoring symptoms and adherence without outlining any specific tools or methods for monitoring. Pharmacists are successful in monitoring patients on therapy and improving outcomes.

A Peculiar Case of Idiopathic Herpes-Zoster-Like Stevens-Johnson Syndrome (SJS).

Epidermal necrolysis is a severe dermatological condition usually associated with adverse drug reactions involving the mucosa. Stevens-Johnson syndrome (SJS) is clinically diagnosed when an epidermal detachment of less than 10% of body surface area (BSA) is involved. In contrast, toxic epidermal necrolysis (TEN) is characterized when there is an epidermal detachment of more than 30% BSA.

Gender Discrepancies in Middle Author Publications in US Academic General Surgery.

Introduction: To explore gender discrepancies in publications at general surgery departments, we performed a cross-sectional comparing the number of women and men at each academic rank and their number of first author (FA), middle author (MA), last author (LA), and total publications.

Methods: Thirty academic general surgery departments were randomly selected. For each faculty, we tabulated: first, middle, last names, gender, academic rank, educational leadership, year of medical school graduation, and additional graduate degrees.

A Narrative Review of Traumatic Pneumothorax Diagnoses and Management.

Correct identification and rapid intervention of a traumatic pneumothorax is necessary to avoid hemodynamic collapse and subsequent morbidity and mortality. The purpose of this clinical review is to summarize the evaluation and best treatment strategies to improve outcomes in combat casualties. Blunt, explosive, and penetrating trauma are the 3 etiologies for causing a traumatic pneumothorax.

Single-center Evaluation of Safety & Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Solid Organ Transplantation.

Given the negative outcomes associated with uncontrolled diabetes mellitus, non-insulin therapies with glycemic, cardiovascular, and weight-loss benefits in the general population, such as the glucagonlike peptide-1 receptor agonists (GLP1-RA) have become a more alluring therapeutic option in transplant populations. However, limited evidence exists to demonstrate its safety and efficacy in solid organ transplant. This program evaluation included adult kidney, liver, lung transplant recipients initiated on a GLP1-RA for diabetes mellitus management for a minimum of 3 months, had at least one follow-up visit after starting therapy, and had at least one hemoglobin A1c (HbA1c) level drawn between 3-12 months after GLP1-RA initiation.

Pediatric hematidrosis - A case report and review of the literature and pathogenesis.

Hematidrosis is a disorder in which blood-tinged fluid exudes from uninjured skin or mucosa. It is often classified as an eccrine sweat disorder, though the precise mechanism-including involvement of sweat glands-has yet to be proven. In contemporary case reports, hematidrosis appears most frequently in the pediatric population, with 83% of cases in the literature since 2008 occurring in individuals 18 years old or younger.

COVID-19-associated familial acute disseminated encephalomyelitis (ADEM): A case report.

Background: Several neurological complications are being reported in hospitalized patients with severe COVID-19 infection. This is presumed due to direct spread of infection or due to immunological response. Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory and demyelinating disorder of the central nervous system that is often preceded by infection or vaccination.

Hue discrimination in jewellery appraisers exceeds normal performance.

Purpose: The FM-100 Hue test is used for vocational purposes where hue discrimination is of the upmost importance, such as in jewellery appraisals where small errors in hue discrimination can lead to significant differences in gemstone valuation. The purpose of this study was to determine if the cone contrast test (CCT) could predict performance on the FM-100 Hue, providing a potential alternative test for screening of jewellery appraisers.

Methods: Members of the National Association of Jewelry Appraisers (NAJA; n = 18, ages 34 to 76 years) requiring colour vision certification with the FM-100 Hue were invited to participate in a study to assess performance on the Ishihara test, FM-100 Hue, Lanthony Desaturated D-15 and the CCT.

The Best of Both Worlds: Eliminating Creatine Kinase-Muscle/Brain (CK-MB) Testing in the Emergency Department Leads to Lower Costs Without Missed Clinical Diagnoses.

The 2014 American Heart Association/American College of Cardiology (AHA/ACC) clinical guidelines recommend cardiac troponin as a superior biomarker to creatine kinase (CK) and creatine kinase-muscle/brain (CK-MB) for the detection of acute coronary syndrome (ACS), namely myocardial infarction and unstable angina. In April 2018, our Emergency Department (ED) transitioned from using standard troponin to using high-sensitivity troponin T, and adopted a clinical guideline consistent with the AHA/ACC. The guideline recommended high-sensitivity troponin T without CK/CK-MB testing in the majority of clinical situations, limiting CK/CK-MB testing to two specific clinical cases: 1) estimated glomerular filtration rate (eGFR) value <15 mL/min, or 2) recent acute coronary syndrome (ACS) event.

Cocaine-Induced Bronchial Laceration: A Rare Incidence.

Tracheobronchial injuries are either traumatic or iatrogenic but can be lethal in a high dependency setting if not managed promptly. There are few reported cases of cocaine-induced airway damage and barotrauma due to thermal or ischemic injury and increased intra-alveolar pressure. We present a sui generis case of cocaine-induced bronchial laceration with pneumomediastinum which was challenging to diagnose based on the patient's recent history of hospitalization, as well as the patient's reluctance to share the history of cocaine use.

Foreign Body Aspiration Getting Weird: Crack Pipe Aspiration.

Inhalation of cocaine derivatives is associated with a number of pulmonary and systemic complications. We report a case of less recognized complication, the aspiration of a metallic object used as a screen for crack cocaine abuse. A 42-year-old female presented with a two-day history of gradually worsening cough and a history of "food aspiration.