Transthoracic approach is an independent risk factor for the development of new-onset AF after esophagectomy. New-onset AF is associated with severe post-operative complications and longer hospital stay. Minimally invasive approach does not decrease the incidence of new-onset AF.

Yersinia pestis is the cause of plague, an illness that may manifest in bubonic, pneumonic, or septicemic form. Plague has killed an estimated 200 million humans throughout history, and plague is endemic in many areas of the world. Approximately 2,000 cases of plague are reported each year to the World Health Organization, and concern has been raised about the possible use of Y pestis as an agent of bioterrorism. The genome of Y pestis has been sequenced, including the 3 virulence plasmids, pPst, pLcr, and pFra, and advances have been made in understanding the bacterial pathogenesis of Y pestis infection. Advances also have been made in rapid diagnosis, the understanding of immune responses during plague, and vaccine development.

No abstract

All-terrain vehicle (ATV) safety laws, including helmet use, vary by state and are sporadically enforced. Kentucky state laws require safety helmets only for younger riders. We hypothesized that ATV riders injured in Kentucky and seen at a Tennessee trauma center would more likely be unhelmeted, have more severe head injuries, and have higher mortality rates than those injured in Virginia or Tennessee. A Trauma Registry review of 750 injured ATV riders from June 1, 2005, through June 1, 2015 examined state location of accident, helmet use, markers of injury severity, and outcomes. Multiple logistic regression analysis examined predictors of severe head injuries and death with P < 0.05 significant. Unhelmeted ATV rider status predicted more severe head injuries (relative risk 23.5, P < 0.001) and death (relative risk 4.6, P < 0.001). ATV riders injured in the state of Kentucky were twice as numerous. In addition, they were more likely than ATVriders injured in Tennessee or Virginia to be unhelmeted, to have severe head injuries, and to sustain fatal injuries (all P < 0.001). This single trauma center study lends support for maintaining and enforcing current universal helmet laws for ATVriders of all ages in states where they are in effect and highlights the need to upgrade helmet laws that apply only to some riders.