Rejected

Despite the successful establishment of endovascular techniques, colonic ischemia continues to be a serious complication of aortic surgery.The risk factors for colonic ischemia include aortic aneurysm rupture, prolonged aortic clamping, perioperative hypotension, the need for catecholamine therapy, occlusion of the hypogastric arteries and renal insufficiency.The clinical presentation of postoperative colonic ischemia is often unspecific. Classic symptoms include abdominal pain, diarrhea, peranal bleeding and rise of inflammatory parameters. A specific laboratory parameter for colonic ischemia does not exist. The diagnostic gold standard is endoscopy. Imaging methods such as sonography or computer tomography play only a supportive role. Transmural ischemia resulting in bowel wall necrosis is an indication for emergency surgery, predominantly colonic resection with creation of artificial anus.

Pulmonary function testing (PFT) is required to diagnose chronic obstructive pulmonary disease (COPD) but is completed for only 30-50% of patients with the disease. We determined patient factors associated with (i.e. underutilization) in the United States Veterans Affairs (VA) health care system.We performed a retrospective analysis of Veterans who survived a VA-based COPD hospitalization between 2012 and 2015. COPD was identified using International Classification of Disease (ICD)-9 codes. Our primary outcome was PFT acquisition, using Current Procedural Terminology (CPT) codes any time prior to the index hospitalization. We compared patients with and without PFTs and used logistic regression to identify associations with PFT underutilization.Of the 48,888 Veterans included, 78% underwent PFTs prior to hospitalization. Patients without PFTs were younger and more likely to be: women (4.2% vs. 3.6%;  = 0.01), nonwhite (22% vs. 19%;  < 0.0001), and current smokers (66% vs 61%;  < 0.0001). PFT acquisition was less likely in Veterans with alcohol and drug use disorders. Using logistic regression, Veterans who were women (Odds Ratio (OR) = 1.17 [95% confidence limit 1.03-1.32]), nonwhite (OR 1.12 [1.06-1.20]), and with a history of alcohol (OR = 1.07 [1.00-1.14]) or drug use disorders (OR = 1.15 [1.06-1.24]) were less likely to undergo PFTs.Though most Veterans hospitalized for COPD had PFTs prior to admission, PFTs are underutilized in Veterans who are: women, younger, nonwhite, and have alcohol or drug use disorders. These groups may be "at-risk" for delayed diagnosis or substandard COPD quality care.

Chronic pain is the third main problem of global health and the most common cause of long-term disabilities. The duration that patients suffer from chronic pain is directly proportional to the extent of the suffering and to the amount of health care resources allocated to this problem. There is no research that has studied the risk factors associated with the long pain duration in chronic pain patients.

Annular lesions are a peculiar type of presentation of various skin disorders. The primary efflorescence can be either macule, papule, plaque, urticaria or vesicle. Depending on the primary efflorescence involved, the differential diagnoses can be delimited. It is important to identify secondary features such as scaling and discolorations. Additional symptoms may include pruritus, burning sensations or hypoesthesia. Depending on the clinical findings and medical history, confirmation of suspected working diagnosis is achieved by laboratory work-up, including histology and microbiology (mycology) studies.

Catecholamine-induced cardiomyopathy (CIC) and pheochromocytoma are both rare entities, and their exact incidence and prevalence are unknown. Pheochromocytoma has been implicated as one of the causes of CIC or Takotsubo syndrome (TTS) by means of case reports and retrospective reviews. However, the evaluation of any patient with TTS and pheochromocytoma is often faced with multiple challenges due to its rarity and atypical presentations, which subsequently leads to delay in diagnosis. Here, we present a case of a 51-year old female who had three distinct episodes of TTS and now presented in a hypertensive emergency with angina, palpitations, headache, nausea, and vomiting. She was treated for non-ST elevation myocardial infarction (NSTEMI) but coronary angiogram revealed patent coronary arteries. Due to the paroxysmal nature of her hypertensive emergencies and variable blood pressure response, pheochromocytoma was suspected. On further evaluation, she was found to have elevated metanephrines and a 6.3 cm left adrenal mass on CT scan. This case emphasizes the importance of considering or identifying pheochromocytoma as an underlying primary etiology for recurrent episodes of TTS and related concerns such as choice of anti-hypertensive agents.

This trial investigated the post operative analgesic efficacy of oarl etoricoxib 90 mg and 120 mg and a placebo in mandibular fracture pain model.

Illustrated health resources are useful for people who have limited English linguistic ability. The aim was to compare the preferences of resettled refugees from Africa and non-African countries, on pictograms describing common symptoms of illness. Data were collected in two cities in Queensland, Australia. Participants indicated their preference for three types of pictograms depicting seven symptoms. Pictogram sources included the International Pharmaceutical Federation, royalty-free stock images, and pictograms designed in South Africa. For all ailments, participants (n = 81) from Africa preferred the African pictograms more than participants not from Africa (n = 61). A significant association was found between pictogram preference and where respondents were from for each ailment except headache (p = 0.375). African refugees showed a significant preference for pictograms which had been culturally adapted for an African population; however, some other refugees also preferred certain African pictograms. Pictograms for resettled refugees should be pre-tested to determine acceptability, as they should be culturally relevant.

Pain-perceptual nociceptors (PPN) are essential sensory neurons that recognize harmful stimuli and can empower the human body to react appropriately and perceive precisely unusual or dangerous conditions in the real world. Furthermore, the sensitization-regulated nociceptors (SRN) can greatly assist pain-sensitive human to reduce pain sensation by normalizing hyperexcitable central neural activity. Therefore, the implementation of PPNs and SRNs in hardware using emerging nanoscale devices can greatly improve the efficiency of bionic medical machines by giving them different sensitivities to external stimuli according to different purposes. However, current most-normal organic/oxide transistors face a great challenge due to channel scaling, especially in the sub-10 nm channel technology. Here, a sub-10 nm indium-tin-oxide transistor with an ultrashort vertical channel as low as ≈3 nm, using sodium alginate bio-polymer electrolyte as gate dielectric, is demonstrated. This device can emulate important characteristics of PPN such as pain threshold, memory of prior injury, and pain sensitization/desensitization. Furthermore, the most intriguing character of SRN can be achieved by tuning the channel thickness. The proposed device can open new avenues for the fascinating applications of next-generation neuromorphic brain-like systems, such as bio-inspired electronic skins and humanoid robots.