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Epidemiological Investigation of the Outbreak of Acute Respiratory Infection caused by Adenovirus Type B55 in a Physical Education School in 2017.

On May 19, 2017, the cluster of 6 acute respiratory infections due to adenovirus in the swimming department of a physical education school (School J) was reported to Korea Centers for Disease Control and Prevention. An epidemiological investigation was conducted to identify the transmission route of the infection and to control the outbreak.

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Dietary Oxidative Balance Score and Disease Characteristics in Patients with Rheumatoid Arthritis (P01-036-19).

Rheumatoid arthritis (RA) is an autoimmune disease accompanied by pain, joint stiffness, and swelling, impacting quality of life. RA is also an articular disorder affecting multiple organ systems. Oxidative stress and antioxidants may play a role in the disease process. The oxidative balance score (OBS) is a composite estimate of exogenous dietary, lifestyle, and medication factors associated with antioxidant and pro-oxidant properties. This study examined the relationship between OBS and disease activity in RA.

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A 2-Year Cost Analysis of Maximum Nonoperative Treatments in Patients With Symptomatic Lumbar Stenosis or Spondylolisthesis That Ultimately Required Surgery.

Retrospective cohort study.

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Is an Acetabular Cage and Cement Fixation Sufficiently Durable for the Treatment of Destructive Acetabular Metastases?

Destructive bony acetabular metastases cause pain, pathological fractures, and loss of mobility. Although multiple fixation options are available, we have favored a rigid stainless steel partial pelvic cage for acetabular fixation in these patients; however, little is known about the durability of this approach. QUESTION/PURPOSES: (1) How common was loss of fixation in a small series of metastatic acetabular defects treated with an acetabular cage and cemented total hip replacement? (2) What is the implant survival free from reoperation or revision at 2 and 4 years using a competing-risks survivorship estimator in patients thus treated? (3) What complications were associated with the treatment? (4) What level of postoperative mobility was achieved?

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Case of metastatic glioblastoma with primitive neuronal component to the lung.

Glioblastoma (GBM) with primitive neuronal component (GBM-PNC) is a rare GBM subtype recently categorized by the World Health Organization in the revised classification system of 2016. Extracranial metastases originating from GBM-PNC are rare and metastasis to solid organs has never been reported. Herein, we present the first case of metastasis of GBM-PNC to the lung. A 49-year-old man presenting with headache was diagnosed with multiple tumors adhering to the dura matter in the right temporal lobe. Despite surgery and chemoradiotherapy, 2 months after the initial therapy, the patient presented with CSF dissemination and lung metastases. The patient succumbed to the disease 12 months after the first surgery. We discuss the possibility that GBM-PNC may constitute a subtype of glioma with particularly poor prognosis, tending to dissemination and metastasis. Our results suggest that a complementary regular inspection of the whole body via CT may be recommended for the follow-up of patients with GBM- PNC.

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Application of Dextroscope in a Rare Type of Angiomatous Meningioma Characterized With Coral-Like Vessels.

A 43-year-old female diagnosed with meningioma was admitted to our department. Preoperative imaging revealed a spherical lesion located in the sphenoid ridge with obvious enhancement and inhomogeneous density into 3 layers on magnetic resonance (MR) images, coral-like vessel images inside the tumor was obtained after the raw computed tomography angiography data were imported into the Dextroscope virtual-reality system. Due to her progressive headache and visual deterioration, surgery was performed after comprehensive study in the Dextroscope system, details about the correlation among skull base, lesion, branches of internal carotid artery, and vessels inside the tumor were well demonstrated in this system. It is diagnosed as a rare type of angiomatous meningioma, based on the abnormal manifestation on images, which even make it important to make further evaluation before making any surgical plan. Surgical resection has been the optimal treatment for most meningiomas and is meticulously performed accordingly. The patient is doing fine with no evidence of tumor recurrence on recent MR scans.

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Editorial overview: Dermatology is moving forward.

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Adverse Childhood Experiences and Trauma-Informed Care in Rehabilitation Clinical Practice.

Adverse childhood experiences (ACEs) contribute to physical, behavioral, and mental health issues throughout the lifespan and, because of their prevalence, constitute a significant public health issue. Practitioners in all health care disciplines need to be knowledgeable about ACEs and prepared to address them. ACEs can contribute to conditions that lead patients to seek rehabilitation care, and therefore a framework is needed that enables rehabilitation professionals to understand the effects of ACEs and how to discuss them with patients. This article summarizes ACE research and its clinical relevance, presents an overview of the related topic of trauma-informed care, and introduces rehabilitation professionals to practical tools for incorporating ACE- and trauma-informed care into clinical practice. There is growing acknowledgement across all health care disciplines of the impact of ACEs. ACEs are understood as stressful, potentially traumatic events that may have lasting negative effects on health and well-being. Since the 1990s, when landmark research found striking associations between early life stress and adversity and a wide range of chronic physical, behavioral, and mental health issues, international attention to ACEs as a major public health issue has grown.1, 2 ACE-related research has identified strong correlations between chronic disease, stress, and prior experience. Eighty-six percent of health care dollars in the United States are spent on chronic diseases, and a population health strategy should include empowering, person-centered, low-risk, low-cost, self-management skill-building practices to help patients manage the stress response. Though a relevant consideration for all care provision, the biopsychosocial framework may be particularly important for understanding and working with chronic health conditions.4, 5, 6, 7 For example, chronic pain affects 116 million in the United States and may be a key force in driving patients to seek rehabilitation services. Patients need their providers to skillfully and comprehensively navigate the intersection of mental, emotional, and physical components of their healing process. Given the prevalence of ACEs and their potential contribution to chronic pain, among other conditions, rehabilitation professionals should be prepared to address ACEs in the clinical setting as a possible underlying contributor to the condition for which treatment is sought. This article provides an overview of ACEs research and the health effects that can result from ACEs and introduces a trauma-informed practical guide for rehabilitation professionals to use in clinical encounters.

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Beyond Opioids for Pain Management in Adult Critically Ill Patients.

Critically ill patients commonly experience pain, and the provision of analgesia is an essential component of intensive care unit (ICU) care. Opioids are the mainstay of pain management in the ICU but are limited by their adverse effects, risk of addiction and abuse, and recent drug shortages of injectable formulations. A multimodal analgesia approach, utilizing nonopioid analgesics as adjuncts to opioid therapy, is recommended since they may modulate the pain response and reduce opioid requirements by acting on multiple pain mediators. Nonopioid analgesics discussed in detail in this article are acetaminophen, α-2 receptor agonists, gabapentinoids, ketamine, lidocaine, and nonsteroidal anti-inflammatory drugs. This literature review describes the clinical pharmacology, supportive ICU and relevant non-ICU data, and practical considerations associated with the administration of nonopioid analgesics in critically ill adult patients.

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Public Health Burden of E-waste in Africa.

Environmental impacts from informal e-waste recycling are increasing in Africa. E-waste handling and disposal exposes people to highly toxic cocktails of heavy metals, brominated flame retardants, non-dioxin-like polychlorinated biphenyls (PCB), polycyclic aromatic hydrocarbons (PAH), polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PBDF) and dioxin-like polychlorinated biphenyls (DL-PCB). Most of these compounds are endocrine disrupters, and most are neuro- and immune-toxic as well.

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