Concept: Clinical death
Health insurance has many benefits including improved financial security, greater access to preventive care, and better self-perceived health. However, the influence of health insurance on major health outcomes is unclear. Sudden cardiac arrest prevention represents one of the major potential benefits from health insurance, given the large impact of sudden cardiac arrest on premature death and its potential sensitivity to preventive care.
Osteoporosis is a debilitating condition characterized by fractures, pain and premature death. Risk factors for osteoporosis predict the risk of fragility fractures.
The accuracy of prostheses affects clinical success and is, in turn, affected by the accuracy of the scanner and CAD programs. Thus, their accuracy is important. The first aim of this study was to evaluate the accuracy of an intraoral scanner with active triangulation (Cerec Omnicam), an intraoral scanner with a confocal laser (3Shape Trios), and an extraoral scanner with active triangulation (D810). The second aim of this study was to compare the accuracy of the digital crowns designed with two different scanner/CAD combinations. The accuracy of the intraoral scanners and extraoral scanner was clinically acceptable. Marginal and internal fit of the digital crowns fabricated using the intraoral scanner and CAD programs were inferior to those fabricated using the extraoral scanner and CAD programs.
The clinical presentation and course of Crohn’s disease (CD) is highly variable. We sought to better understand the cellular and molecular mechanisms that guide this heterogeneity, and characterise the cellular processes associated with disease phenotypes.
Two cases in which patients have been determined to be dead according to neurologic criteria (“brain death”) have recently garnered national headlines. In Oakland, California, Jahi McMath’s death was determined by means of multiple independent neurologic examinations, including one ordered by a court. Her family refused to accept that she had died and went to court to prevent physicians at Children’s Hospital and Research Center in Oakland from discontinuing ventilator support. Per a court-supervised agreement, the body was given to the family 3 weeks after the initial determination. The family’s attorney stated that ventilatory support was continued and nutritional support . . .
Patients who develop relapsing-remitting multiple sclerosis (MS) present with a first clinical demyelinating event. In this double-blind, multicentre, randomised, phase 3 study we investigated the effect of oral cladribine on conversion to clinically definite MS in patients with a first clinical demyelinating event, when given at the same doses shown to be effective in relapsing-remitting MS.
Early rapid fluid resuscitation (boluses) in African children with severe febrile illnesses increases the 48-hour mortality by 3.3% compared with controls (no bolus). We explored the effect of boluses on 48-hour all-cause mortality by clinical presentation at enrolment, hemodynamic changes over the first hour, and on different modes of death, according to terminal clinical events. We hypothesize that boluses may cause excess deaths from neurological or respiratory events relating to fluid overload.
When investigators enroll patients in a clinical study, they make an implicit contract with each participant. Through the data and safety monitoring board (DSMB) mechanism, they fulfill the first part of the contract - protecting the participant from avoidable harm that might result from participation in the trial. They fulfill the second part of the contract - the commitment to honor the time at risk that the participant spent in the trial - by deriving the clearest and most clinically directive information possible from the data gathered during the trial. This task takes tremendous time and energy. The SPRINT (Systolic . . .
Hypopituitarism is associated with higher prevalence of cardiovascular risk factors and premature death. Furthermore, some clinical and therapeutic features of hypopituitarism have been associated with a worse prognosis.
BACKGROUND: The lack of well-established diagnostic criteria for pigmented solar (actinic) keratosis (PSK) along with its poorly understood etiopathogenesis has contributed to underrecognition. OBJECTIVE: The clinical, dermatoscopic, and histopathologic features of PSK and the cause of the pigmentation are elucidated. METHODS: In all, 167 histologic specimens, 22 clinical images, and 17 dermatoscopic images of PSK were reviewed. In 38 cases, Melan-A-stained sections were available for analysis. RESULTS: The majority of the lesions were located on the head and neck (84%). A separate pigmented lesion was adjacent to or admixed within PSK in 138 (83%) of the cases indicating that PSK represents a collision between a nonpigmented solar keratosis and a pigmented lesion. Solar lentigo (72%) was the most commonly associated pigmented lesion followed by seborrheic keratosis and melanoma. PSK was suspected clinically in 17% of the cases. There were no significant differences in the quality and quantity of the melanocytes between pigmented and nonpigmented solar keratosis. LIMITATIONS: This was a single-center retrospective study. The sample sizes were small for the clinical and dermatoscopic images and Melan-A stains. CONCLUSION: In the majority of the cases, a collision between a nonpigmented solar keratosis and a separate coexistent pigmented lesion, primarily a solar lentigo, accounts for the pigmentation in PSK rather than from any fundamental changes in the quantity or quality of the melanocytes. The collision phenomenon accounts for the spectrum of the clinical and dermatoscopic features observed in PSK and its underrecognition.