Is Aprepitant Effective in Preventing Postoperative Nausea and Vomiting?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aprepitant is effective in preventing postoperative nausea and vomiting. STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012-2014. DATA SOURCES: Three double-blind, randomized controlled trials comparing oral aprepitant with placebo. All articles were found using PubMed. OUTCOMES MEASURED: The three studies measured nausea severity using a verbal rating system and number of episodes of nausea and vomiting recorded by a blinded study investigator. RESULTS: Vallejo et al found that 29.7% of the patients in the placebo group vomited compared to 9.3% of the patients who received aprepitant (p = 0.003). They also found that the worst VRS nausea score was a 5 out of 10 in the group of patients who received aprepitant versus 8 out of 10 for the placebo group (p = 0.014). Jung et al found that the groups that received aprepitant had a 35% incidence of nausea compared to 63% in the placebo group (p = 0.0025). In addition, the aprepitant groups both had 0% incidence of vomiting compared to the placebo group, which had a 20% incidence (p = 0.005). Sinha et al found that incidence of vomiting at 72 hours was 3.1% in the experimental group and 15.0% in the placebo group (p = 0.021). In all of the studies, mean VRS nausea scores were lower but were not found to be statistically significant. CONCLUSIONS: Aprepitant is effective in preventing incidence of nausea and vomiting, but is not found to significantly decrease average nausea rating scores

Contemporary Seismicity in and Around the Yakima Fold-and-Thrust Belt in Eastern Washington

We examined characteristics of routinely cataloged seismicity from 1970 to the present in and around the Yakima fold-and-thrust belt (YFTB) in eastern Washington to determine if the characteristics of contemporary seismicity provide clues about regional-scale active tectonics or about more localized, near-surface processes. We employed new structural and hydrologic models of the Columbia River basalts (CRB) and found that one-third to one-half of the cataloged earthquakes occur within the CRB and that these CRB earthquakes exhibit significantly more clustered, and swarmlike, behavior than those outside. These results and inferences from published studies led us to hypothesize that clustered seismicity is likely associated with hydrologic changes in the CRB, which hosts the regional aquifer system. While some general features of the regional groundwater system support this hypothesis, seismicity patterns and mapped long-term changes in groundwater levels and present-day irrigation neither support nor refute it. Regional tectonic processes and crustal-scale structures likely influence the distribution of earthquakes both outside and within the CRB as well. We based this inference on qualitatively assessed alignments between the dominant northwest trends in the geologic structure and the seismicity generally and between specific faults and characteristics of the 2009 Wooded Island swarm and aseismic slip, which is the only cluster studied in detail and the most vigorous since regional monitoring began.USGS-NAGTGeological Science

On Gender, Labor, and Inequality Ruth Milkman Urbana: University of Illinois Press, 2016 viii + 308 pp., 95.00(cloth);95.00 (cloth); 28.00 (paper); $25.20 (e-book)

In this scholarly tour de force, Ruth Milkman brings together four decades of sociological research on women workers to paint a portrait of gendered labor patterns from the Great Depression of the 1930s to the Great Recession of 2007–9. With meticulous research, careful argumentation, and effective writing, Milkman shows how economic actors—especially women workers, unions, and employers—shaped women\u27s employment and key industries of the US economy. As they managed changes in the labor and job markets, these actors both maintained strict job segregation by gender and transformed it, with implications for the dynamism and rigidity of gender roles in society more widely

Review Essay: Law and Migrant Labor in the 20th Century: Ghost Workers and Global Capitalism

Large-scale movements of workers, production lines, commodities, and centers of power have been integral to capitalist development since its earliest stages (see Mintz 1986; Wallerstein 2011; Wolf 1997). Today, mobility continues to uphold global capitalism in important respects (Sassen 1988). In particular, the capacity to move production across nation-state borders has allowed capitalist industries to take advantage of post-colonial inequalities as they reorganize production in ways and places that reduce manufacturing costs and enhance corporate profit..

Long-term results of the DelIVery for Pulmonary Arterial Hypertension trial

BACKGROUND: The DelIVery for Pulmonary Arterial Hypertension clinical trial was a multi-center, prospective, single arm, Investigational Device Exemption study utilizing a fully implantable, programmable intravascular delivery system consisting of a pump and a catheter for intravenous treprostinil. The study met its primary endpoint and demonstrated that the intravascular delivery system significantly reduced catheter related complications at 22,000 subject-days of follow-up compared with a predefined objective performance criterion. Here we summarize the results obtained during a 6.4-year follow-up period. METHODS: Throughout study follow-up, participants had clinic visits and medication refills at least every 12 weeks (dependent on the subjects\u27 dose). All adverse events and intravascular delivery system complications were evaluated and recorded. RESULTS: Sixty pulmonary arterial hypertension subjects were followed post device implantation for approximately 282 patient-years (range 87 days to 6.4 years). Of the 60 subjects, 14 died (1 related to intravascular delivery system pump failure), 2 withdrew after lung transplants, and 2 withdrew due to pump pocket infection. No catheter-related bloodstream infections, catheter thrombosis or occlusions, or catheter kinks occurred through 282 patient-years. Two participants had adverse events of abdominal pain, rash, due to subcutaneous treprostinil leaks after one catheter puncture and one catheter laceration during pump refill and replacement, respectively. Eight pump failure events occurred: seven pump motor stalls and one early replacement (faulty battery). CONCLUSION: Delivery of treprostinil with an intravascular delivery system is a safe alternative to an external delivery system, while providing enhanced life experiences. To preserve the risk-benefit ratio, treatment at specialized pulmonary arterial hypertension centers is recommended until training is disseminated at other sites

Evidence for Anthropogenic Surface Loading as Trigger Mechanism of the 2008 Wenchuan Earthquake

Two and a half years prior to China's M7.9 Wenchuan earthquake of May 2008, at least 300 million metric tons of water accumulated with additional seasonal water level changes in the Minjiang River Valley at the eastern margin of the Longmen Shan. This article shows that static surface loading in the Zipingpu water reservoir induced Coulomb failure stresses on the nearby Beichuan thrust fault system at <17km depth. Triggering stresses exceeded levels of daily lunar and solar tides and perturbed a fault area measuring 416+/-96km^2. These stress perturbations, in turn, likely advanced the clock of the mainshock and directed the initial rupture propagation upward towards the reservoir on the "Coulomb-like" Beichuan fault with rate-and-state dependent frictional behavior. Static triggering perturbations produced up to 60 years (0.6%) of equivalent tectonic loading, and show strong correlations to the coseismic slip. Moreover, correlations between clock advancement and coseismic slip, observed during the mainshock beneath the reservoir, are strongest for a longer seismic cycle (10kyr) of M>7 earthquakes. Finally, the daily event rate of the micro-seismicity (M>0.5) correlates well with the static stress perturbations, indicating destabilization.Comment: 22 pages, 4 figures, 3 table

Interim prostacyclin therapy for an isolated disconnected pulmonary artery: a case report

Introduction: Disconnected pulmonary arteries are unusual and may result in pulmonary hypertension with acute right heart failure. Case presentation: We report a case of a three-month-old Asian girl who presented with heart failure and severe pulmonary hypertension due to a disconnected right pulmonary artery. An epoprostenol (prostacyclin) infusion was instrumental in lowering pulmonary artery pressures and stabilizing the child prior to surgery. Conclusions: This is, to the best of our knowledge, the first report of successful prostacyclin usage in such a situation.peer-reviewe

The Relationship Between Alcohol Symptoms and Consumption Among Older Drinkers

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66310/1/j.1530-0277.1996.tb01104.x.pd

Toward an Integrative Geological and Geophysical View of Cascadia Subduction Zone Earthquakes

The Cascadia subduction zone (CSZ) is an exceptional geologic environment for recording evidence of land-level changes, tsunamis, and ground motion that reveals at least 19 great megathrust earthquakes over the past 10 kyr. Such earthquakes are among the most impactful natural hazards on Earth, transcend national boundaries, and can have global impact.Reducing the societal impacts of future events in the US Pacific Northwest and coastal British Columbia, Canada, requires improved scientific understanding of megathrust earthquake rupture, recurrence, and corresponding hazards. Despite substantial knowledge gained from decades of research, large uncertainties remain about the characteristics and frequencies of past CSZ earthquakes. In this review, we summarize geological, geophysical, and instrumental evidence relevant to understanding megathrust earthquakes along the CSZ and associated uncertainties. We discuss how the evidence constrains various models of great megathrust earthquake recurrence in Cascadia and identify potential paths forward for the earthquake science community