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Analgesic use among athletes who participated at the 2018 PyeongChang Winter Paralympics was high. Para-snowboarders and athletes with limb deficiency declared the most analgesics. The new OPMF adequately addressed the medication needs of the athletes attending the 2018 Games.

Analgesic use among athletes who participated at the 2018 PyeongChang Winter Paralympics was high. Para-snowboarders and athletes with limb deficiency declared the most analgesics. The new OPMF adequately addressed the medication needs of the athletes attending the 2018 Games.

The objective of this retrospective, longitudinal study was to investigate the prevalence of drinking within the recommended limits (i.e., low-risk drinking) following moderate/severe traumatic brain injury (TBI). Data were drawn from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Model Systems National Database (TBIMS), a longitudinal dataset closely representative of the U.S. adult population requiring inpatient rehabilitation for TBI. The sample included 6,348 adults with moderate or severe TBI (injured October 2006 - May 2016) who received inpatient rehabilitation at a civilian TBIMS center and completed the alcohol consumption items for pre-injury, and 1- and 2-year post-injury. National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines define low-risk drinking as no more than 4 drinks per day for men or 3 drinks per day for women, and no more than 14 drinks per week for men, or no more than 7 drinks per week for women. Low-risk drinking was common S center and completed the alcohol consumption items for pre-injury, and 1- and 2-year post-injury. National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines define low-risk drinking as no more than 4 drinks per day for men or 3 drinks per day for women, and no more than 14 drinks per week for men, or no more than 7 drinks per week for women. AG-270 supplier Low-risk drinking was common both before and after TBI, with more than 30% drinking in the low-risk level pre- injury, and more than 25% at 1- and 2-years post-injury. Post-injury, the majority of drinkers consumed alcohol in the low-risk level regardless of pre-injury drinking level. Definitive research on the long-term outcomes of low-risk alcohol consumption following more severe TBI should be a high priority.

To understand the frequency of whether patients receiving rehabilitation services at various periods after stroke and possible medical barriers to receiving rehabilitation.

Retrospective cohort study using a nationally representative sample in Taiwan. 14,600 stroke patients between 2005 and 2011 were included. Utilization of physical therapy (PT) or occupational therapy (OT) at different periods after stroke onset was outcome variables. Individual and geographic characteristics were investigated to determine their effect on patients' probability of receiving rehabilitation.

More severe stroke or more comorbid diseases increased the odds of receiving PT and OT; older age was associated with decreased odds. Notably, gender and stroke type only influenced the odds of rehabilitation in the early period. Co-payment exemption lowered the odds of rehabilitation in the first 6 months but increased the odds in later periods. Rural and suburban patients had significantly lower odds of receiving PT and OT, as did patients living in areas with fewer rehabilitation therapists.

Besides personal factors, geographic factors such as urban-rural gaps and number of therapists were significantly associated with the utilization of post-stroke rehabilitation care. Furthermore, the influence of certain factors, such as gender, stroke type, and co-payment exemption type, changed over time.

Besides personal factors, geographic factors such as urban-rural gaps and number of therapists were significantly associated with the utilization of post-stroke rehabilitation care. Furthermore, the influence of certain factors, such as gender, stroke type, and co-payment exemption type, changed over time.

To investigate the association of body mass index (BMI) with Fuchs endothelial corneal dystrophy (FECD) severity and TCF4 CTG18.1 expansion.

A total of 343 patients with FECD were enrolled from the Mayo Clinic. FECD severity was graded by slit-lamp biomicroscopy. BMI values were obtained from the electronic medical records. DNA extracted from leukocytes was analyzed for CTG18.1 expansion length, with ≥40 repeats considered expanded. Wilcoxon signed-rank tests were used to compare FECD grade and CTG18.1 expansion length in patients by BMI (<25, ≥25 to <30, and ≥30 kg/m2). FECD grade was regressed on age, sex, BMI, and CTG18.1 expansion and, separately, BMI on CTG18.1 expansion. Models were investigated for effect modification by age and sex with an interaction term of P < 0.05 considered statistically significant.

When examining the association between BMI and FECD, there was a significant interaction between BMI and sex (P for interaction = 0.004). When controlling for age and CTG18.1 expansion, a positive association was observed between BMI and FECD grade in women, but not in men. In addition, BMI was not associated with CTG18.1 expansion when controlling for age and sex.

BMI was positively associated with FECD severity among women but not men. There was no significant association between BMI and CTG18.1 expansion. These findings suggest that increased BMI is potentially a modifiable risk factor for FECD disease progression among women.

BMI was positively associated with FECD severity among women but not men. There was no significant association between BMI and CTG18.1 expansion. These findings suggest that increased BMI is potentially a modifiable risk factor for FECD disease progression among women.

The purpose of this study was to report a novel clinical entity characterized by bilateral calcium deposits in the flap interface after uncomplicated laser in situ keratomileusis (LASIK).

Slit-lamp examination, anterior segment optical coherence tomography imaging, and histopathologic analysis of an interface opacity were performed to characterize and identify the origin of the interface opacities.

Two unrelated healthy young men who underwent LASIK in both eyes at 20 (case 1) and 44 (case 2) years of age were diagnosed with bilateral, white anterior stromal opacities 5 years after LASIK surgery. Slit-lamp examination and anterior segment optical coherence tomography imaging demonstrated that the opacities were located at the level of the LASIK interface in both eyes of both cases, with most of the opacities located at the temporal edge of the flap in each eye of case 2. An opacity from case 2 demonstrated birefringence using polarization microscopy and staining with Alizarin red, indicative of calcium lar genetic analysis.

Microsporidial stromal keratitis is a rare form of infectious keratitis, with only 7 cases reported in the United States to date. This study was performed to evaluate risk factors, clinical features, and response to therapy.

A retrospective review of the medical records of all patients diagnosed with microsporidial stromal keratitis seen in the practices of the authors between 1999 and 2020 was performed. Diagnosis was determined by cytology or histopathology in corneal specimens. Risk factors, presence or absence of distinctive clinical features, and response to medical and surgical therapies were recorded.

Nine patients-7M2F, aged 7 to 99 years-with microsporidial stromal keratitis were identified. Exposures to recreational water and hymenopteran insect bites, both epidemiologically linked risk factors for systemic microsporidial infection, were identified in our patients. Presence of stromal edema with features of disciform keratitis and a distinctive granular keratitis were observed in 6 of 9 and 5 enetrating keratoplasty should be considered if prompt response to medical therapy is not noted.

To describe a surgical technique for the diagnosis and treatment of post-Descemet stripping automated endothelial keratoplasty (DSAEK) infectious interface keratitis presenting as a cold abscess.

This study included 2 eyes of 2 patients that developed delayed-onset interface infections after DSAEK. Through an anterior keratotomy, diagnostic samples for microbial culture and histopathology examination were collected, and empiric antibiotic therapy was delivered directly to the site of the infection at the graft-host interface.

In both cases, microbiological examinations confirmed a fungal etiology consistent with Candida. Resolution of infection was achieved, and no signs of posterior segment involvement or recurrence of infection were observed. Both corneas remained clear with final visual acuity of 20/25 and 20/32. No case required additional surgical intervention or repeat keratoplasty after more than 15 months of follow-up.

Interface drainage with antimicrobial irrigation may be considered for the management of post-DSAEK interface infections presenting as a peripheral cold abscess. By avoiding intraocular seeding of infectious pathogens, the anterior approach can achieve clinical resolution of infection, maintain visual function, and preserve the DSAEK graft, thereby obviating the need for a therapeutic keratoplasty.

Interface drainage with antimicrobial irrigation may be considered for the management of post-DSAEK interface infections presenting as a peripheral cold abscess. By avoiding intraocular seeding of infectious pathogens, the anterior approach can achieve clinical resolution of infection, maintain visual function, and preserve the DSAEK graft, thereby obviating the need for a therapeutic keratoplasty.Diagnosing delirium in hospice patients is challenging owing to the multifactorial causes and symptoms of delirium that can mimic natural end-of-life processes. When delirium goes unrecognized in hospice patients, preventable causes can be left untreated, leading to sequelae that are misaligned with the principles of hospice care. We conducted an evidence-based quality improvement project on a 10-bed inpatient hospice unit aimed at increasing nursing staff knowledge about assessing delirium, with a focus on preventable causes. Nurses were trained in use of the Nursing Delirium Screening Scale, which was implemented over a 5-week period. Increases in knowledge were evaluated with a pretest and posttest. We used a paired t test to determine knowledge improvement. Use of the tool was evaluated using a survey. Nurses demonstrated significantly improved knowledge after the educational session (P = .009). Survey results indicated overwhelmingly that nurses valued having an easy-to-use tool to assess delirium in their patients. Because we used a paper-based tool during the project, which was found to be cumbersome by staff, our next steps are to determine the feasibility of implementing the tool into the electronic medical record.Metastatic breast cancer (MBC) carries unique disease burdens with potential for poor-quality end-of-life (EOL) care. It is the purpose of this article to explore the association of poor-quality EOL care indicators according to key tumor, demographic, social, and clinical factors. End-of-life quality indicators were based on Emanuel and Emanuel's good death model in conjunction with Earle et al (2003). A single-institution retrospective chart review of women deceased from MBC between November 2016 and November 2019 with double-verification chart review was completed. Data were analyzed with descriptive, correlative, and comparative statistics. Total sample was N = 167 women, with 14.4% (n = 24) Black and 85.6% (n = 143) White. Mean (SD) age was 55.3 (11.73) years. Overall, MBC survival was 3.12 years (SD, 3.31) White women, 41.2 months (3.4 years), and Black women, 19 months (1.6 years). A total of 64.1% (n = 107) experienced 1 or more indicators of poor-quality EOL care. Patients more likely to experience poor-quality EOL care were older (P = .