Implementation of an Opt-out and Rapid Point-Of-Care Syphilis Testing Program for Pregnant Patients Presenting to the Emergency Department.

Background: Adult and congenital syphilis rates are rising in the US. The aim of this pre- and post-implementation study was to determine whether implementation of an opt-out laboratory-based and rapid syphilis point-of-care testing program in the emergency department (ED) improves the detection and treatment of syphilis during pregnancy in a high-prevalence region.

Methods: This pre-and post-implementation study was conducted at the University of Texas Health Science Center, Houston, TX.

Predicting Performance in the Physical Medicine and Rehabilitation Part II Certification Oral Examination Based On Milestone Ratings.

The Accreditation Council for Graduate Medical Education (ACGME) introduced the Milestones to document learner development within a competency-based framework. On the other hand, board certifying examinations serve as a summative evaluation of a learner's readiness for independent medical practice. Scores in Part I of the American Board of Physical Medicine and Rehabilitation (ABPMR) examination, which measures medical knowledge, has been shown to correlate only with Milestones ratings in medical knowledge.

Recent Advances in the Diagnosis and Management of Congenital Heart Disease.

Congenital heart defects (CHDs) are structural abnormalities of the heart or blood vessels that occur while cardiac structures are being formed in utero [...

Advances in the Diagnosis and Management of Congenital Heart Disease in Children.

The last five decades have witnessed an inordinate number of advances in the diagnosis and management of congenital heart defects (CHDs), as reviewed elsewhere [...

Oral Janus kinase inhibitors in the treatment of atopic dermatitis: A systematic review and meta-analysis.

Background: Janus kinase (JAK) inhibitors are being evaluated as promising upcoming treatments for atopic dermatitis (AD).

Objectives: To systematically assess the efficacy of oral JAK inhibitors in patients with AD and provide comparisons among JAK inhibitors.

Methods: A systematic literature review of JAK inhibitors in the treatment of AD was conducted and reported based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses using PubMed, ClinicalTrials.

Women in Hand Surgery: Leadership and Legacy.

Although women have existed in medicine and surgery for thousands of years, challenges continue to persist to date. Despite being discouraged and excluded from training, sponsorship, and opportunities, throughout the history of Hand Surgery, female surgeons have found ways to contribute significantly to science, our organizations, each other, changing the culture, and engaging the next generation of female trainees. This article integrates historical facts with oral history about Hand Surgery training, national societies, interest groups, achievements, and lived experiences to tell the history and legacy of women in Hand Surgery.

Utilization of Robotic Exoskeleton for Overground Walking in Acute and Chronic Stroke.

Stroke commonly results in gait deficits which impacts functional ambulation and quality of life. Robotic exoskeletons (RE) for overground walking are devices that are programmable to provide high dose and movement-impairment specific assistance thus offering new rehabilitation possibilities for recovery progression in individuals post stroke. The purpose of this investigation is to present preliminary utilization data in individuals with acute and chronic stroke after walking overground with an RE.

The Proportion of Preventable Thrombectomy Procedures with Improved Atrial Fibrillation Stroke Prevention.

Background: Large vessel occlusion (LVO) strokes can in part be prevented with better atrial fibrillation (AF) stroke prevention strategies; thus we evaluated the rate of AF in patients presenting with acute LVO strokes undergoing mechanical thrombectomy (MT) and assessed patterns of oral anticoagulant (OAC) use prior to the index stroke.

Methods And Results: We identified 347 MT cases from February 2015 to September 2018. A retrospective chart review was conducted to identify patient sociodemographics, presence of AF, use of anticoagulation, stroke severity, CHADS-VASc scores, and functional outcomes.

Do Milestone Ratings Predict Physical Medicine and Rehabilitation Board Certification Examination Scores?

The Accreditation Council of Graduate Medical Education developed the Milestones to assist training programs in assessing resident physicians in the context of their participation in Accreditation Council of Graduate Medical Education-accredited training programs. Biannual assessments are done over a resident's entire training period to define the trajectory in achieving specialty-specific competencies. As part of its process of initial certification, the American Board of Physical Medicine and Rehabilitation requires successful completion of two examinations administered approximately 9 mos apart.

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study Design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

Outcomes of Device Closure of Atrial Septal Defects.

Several devices have been designed and tried over the years to percutaneously close atrial septal defects (ASDs). Most of the devices were first experimented in animal models with subsequent clinical testing in human subjects. Some devices were discontinued or withdrawn from further clinical use for varied reasons and other devices received Food and Drug Administration (FDA) approval with consequent continued usage.

Preventing and Managing Operating Room Fires in Otolaryngology-Head and Neck Surgery.

Otolaryngologists are at high risk of surgical fire. During surgery in the head and neck region there is close proximity of 3 essential elements: an ignition source, a fuel, and an oxidizing agent. In this article, the authors highlight the scenarios where fire may occur and offer steps that surgeons can take to minimize risk for their patients.

Acquired Versus Congenital Neonatal Purpura Fulminans: A Case Report and Literature Review.

Neonatal purpura fulminans (PF) is a life-threatening disorder caused by congenital or acquired deficiencies of protein C (PC) or S. PF presents as a cutaneous manifestation of disseminated intravascular coagulation. We describe a case of PF in a newborn with left leg ischemia and undetectable PC levels soon after birth.

The Successful Treatment of Elephantiasis Nostras Verrucosa With Ablative Carbon Dioxide Laser.

Background And Objective: Elephantiasis nostras verrucosa (ENV) is a disfiguring skin condition that is difficult to treat. Existing treatment modalities serve to improve cosmesis or treat symptoms. Herein, we report a case of ENV with lymphocutaneous fistula successfully treated with ablative carbon dioxide laser.

Poststroke epilepsy following transient unilateral middle cerebral and common carotid artery occlusion in young adult and aged F344 rats.

The mechanisms of injured brain that establish poststroke seizures and epilepsy are not well understood, largely because animal modeling has had limited development. The main objective of this study was to determine whether an arterial occlusion model of cortical stroke in young adult and aged rats was capable of generating either focal or generalized epileptic seizures within 2 months of lesioning. Four- and 20-month-old male Fischer 344 (F344) sham-operated controls and those lesioned by transient (3 h) unilateral middle cerebral artery (MCA) and common carotid artery (CCA) occlusion (MCA/CCAo) were studied by video-EEG recordings up to 2 months post-procedure.

Plasmodium Falciparum Recurrence Two Years after Exposure in Endemic Country: A Case Report.

Plasmodium falciparum typically manifests as a severe, symptomatic infection due to the high parasitemia and increased adherence of infected cells to blood vessel endothelium. However, there have been previous reports of P. falciparum recrudescence months to years after exposure.

Hemostasis in Pediatric Surgery.

Hemostasis is an important concept in pediatric otolaryngologic surgery. This article details the considerations the otolaryngologist should take when it comes to clinical evaluation and surgical technique. It begins with the preoperative evaluation, and evolves into the use of different mechanical and chemical methods of operative hemostasis.