Labyrinthine concussion: Historic otopathologic antecedents of a challenging diagnosis.

Objective: The term "labyrinthine concussion" has evolved to mean audiovestibular dysfunction in the absence of a temporal bone fracture (TBF). Despite a multitude of case descriptions of labyrinthine concussion, the precise pathophysiology remains poorly understood. Herein, we explore the historical otopathologic underpinnings of the diagnosis of labyrinthine concussion with a focus on the auditory pathway during the late 19th to the mid-20th centuries and conclude with a discussion of its contemporary relevance.

Incorporating Sex and Gender-based Medical Education Into Residency Curricula.

Background: Emergency medicine (EM) residents do not generally receive sex- and gender-specific education. There will be increasing attention to this gap as undergraduate medical education integrates it within their curriculum.

Methodology: Members of the Sex and Gender in Emergency Medicine (SGEM) Interest Group set out to develop a SGEM toolkit and pilot integrating developed components at multiple residency sites.

Internalizing symptoms and sleep outcomes in urban children with and without asthma.

Study Objectives: This study examines associations between internalizing symptoms and sleep in a sample of urban children with and without asthma, whether asthma status moderates these associations, and whether associations differ by ethnic group.

Methods: Participants were Latino, African American (AA), and non-Latino white (NLW) urban 7- to 9-year-olds with (n = 259) and without (n = 122) persistent asthma. Teacher-reported internalizing symptoms (anxiety, depressive, and somatic) were assessed using the Behavioral Assessment System for Children-2.

Safety, tolerability and efficacy of a novel self-use biodegradable device for management of obesity.

Objective: Obesity is a major public health issue with significant impact on quality of life, morbidity and mortality rates. It is estimated that if the current trends continue, 18% of men and 21% of women worldwide will be obese by 2025. All the current therapies are not optimal due to limited efficacy or safety; thus, there is a need for additional devices for the treatment of obesity.

Factors associated with early non-response within an Internet-based behavioural weight loss program.

Objective: While behavioural weight loss interventions are effective overall, many individuals fail to achieve a clinically significant weight loss. Given that 4-week weight loss has been shown to predict longer term outcomes, one potential strategy for improving rates of success is to provide additional support to early non-responders. To inform these early rescue efforts, it is important to first identify how they may differ from their more successful peers.

Association Between Left Ventricular Ejection Fraction, Wall Motion Abnormality, and Embolic Stroke of Undetermined Source.

Background It is uncertain whether there is an association between left ventricular (LV) ejection fraction ( LVEF ) or LV wall motion abnormality and embolic stroke of undetermined source ( ESUS ). Methods and Results We performed a retrospective, cross-sectional study of patients with acute ischemic stroke enrolled in the CAESAR (Cornell Acute Stroke Academic Registry) from 2011 to 2016. We restricted this study to patients with ESUS and, as controls, those with small- and large-artery ischemic strokes.

Critical Analysis of Hematology and Oncology Fellowship Web Sites in the United States.

Purpose: Prospective hematology-oncology fellowship applicants use program Web sites as a critical source of information. The purpose of this study was to evaluate the current content and comprehensiveness of hematology-oncology fellowship Web sites and to identify specific areas for improvement.

Methods: This study assessed the presence of 27 commonly evaluated program and application and curriculum and training informational items for Web sites of all accredited hematology-oncology fellowship programs in 2018.

The BIT:S (Bronchopulmonary Dysplasia Interdisciplinary Team: Severe) Initiative at Women and Infants Hospital of Rhode Island.

Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and mortality in surviving extremely preterm infants, with long-term morbidity disproportionately affecting children with severe BPD (sBPD). Infants with sBPD experience multiple organ system dysfunction. To best treat these complicated patients, we created a multidisciplinary team in 2011 consisting of multiple pediatric subspecialists with a specific interest in sBPD.

Is There a Neurologist in the House? A Summary of the Current State of Neurovascular Rotations for Emergency Medicine Residents.

Objectives: Neurovascular and neurocritical care emergencies constitute a leading cause of morbidity/mortality. There has been great evolution in this field, including but not limited to extended time-window therapeutic interventions for acute ischemic stroke. The intent of this article is to evaluate the goals and future direction of clinical rotations in neurovascular and neurocritical care for emergency medicine (EM) residents.

Duration of Heightened Ischemic Stroke Risk After Acute Myocardial Infarction.

Background The duration of heightened stroke risk after acute myocardial infarction ( MI ) remains uncertain. Methods and Results We performed a retrospective cohort study using claims between 2008 and 2015 from a nationally representative 5% sample of Medicare beneficiaries aged ≥66 years. Both acute MI and ischemic stroke were ascertained using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification ( ICD-9-CM), diagnosis codes.

Hemorrhagic Transformation in Patients With Acute Ischemic Stroke and Atrial Fibrillation: Time to Initiation of Oral Anticoagulant Therapy and Outcomes.

Background In patients with acute ischemic stroke and atrial fibrillation, early anticoagulation prevents ischemic recurrence but with the risk of hemorrhagic transformation ( HT ). The aims of this study were to evaluate in consecutive patients with acute stroke and atrial fibrillation (1) the incidence of early HT, (2) the time to initiation of anticoagulation in patients with HT , (3) the association of HT with ischemic recurrences, and (4) the association of HT with clinical outcome at 90 days. Methods and Results HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset.

Fifteen-Year Trends in Management and Outcomes of Non-ST-Segment-Elevation Myocardial Infarction Among Black and White Patients: The ARIC Community Surveillance Study, 2000-2014.

Background Standardization of evidence-based medical therapies has improved outcomes for patients with non- ST -segment-elevation myocardial infarction ( NSTEMI ). Although racial differences in NSTEMI management have previously been reported, it is uncertain whether these differences have been ameliorated over time. Methods and Results The ARIC (Atherosclerosis Risk in Communities) Community Surveillance study conducts hospital surveillance of acute myocardial infarction in 4 US communities.

Mild Pulmonary Hypertension Is Associated With Increased Mortality: A Systematic Review and Meta-Analysis.

Background Recent studies have demonstrated a continuum in clinical risk related to mean pulmonary artery pressure that begins at >19 mm Hg, which is below the traditional threshold used to define pulmonary hypertension ( PH ) of 25 mm Hg. Because of the implications on patient diagnosis and prognosis, the generalizability and validity of these data need further confirmation. Methods and Results Databases were searched from inception through January 31, 2018, to identify studies comparing all-cause mortality between patients with mildly elevated mean pulmonary artery pressure near but <25 mm Hg versus the referent group.

Quality of life outcomes in transcatheter aortic valve replacement patients requiring pacemaker implantation.

Background: Permanent pacemaker implantation is the most common complication after Transcatheter aortic valve replacement (TAVR) and is associated with worse outcomes and mortality. However, its impact on quality-of-life (QoL) outcomes remains unknown.

Methods: We included 383 consecutive patients undergoing TAVR from January 2012 to 2016 who completed a baseline Kansas City Cardiomyopathy Questionnaire (KCCQ-12) health survey.