Assessing concordance of financial conflicts of interest disclosures with payments' databases: a systematic survey of the health literature.

OBJECTIVES: The objective of the study is to review the literature for studies that assessed the concordance of financial conflicts of interest disclosures with payments' databases and evaluate their methods. STUDY DESIGN AND SETTING: We conducted a systematic survey of the health literature to identify eligible studies. We searched both Medline and EMBASE up to February 2017. We conducted study selection, data abstraction, and methodological quality assessment in duplicate and independently using standardized forms. We subcategorized 'nonconcordant disclosures' as either 'partially nonconcordant' or 'completely nonconcordant'. The main outcome was the percentage of authors with 'nonconcordant' disclosures. We summarized results by three levels of analysis: authors, companies, and studies. RESULTS: We identified 27 eligible journal articles. The top two types of documents assessed were published articles (n = 13) and published guidelines (n = 9). The most commonly used payment database was the Open Payments Database (n = 16). The median percentage of authors with 'nonconcordant' disclosures was 81%; the median percentage was 43% for 'completely nonconcordant' disclosures. The percentage of 'nonconcordant' conflict of interest (COI) reporting by companies varied between 23% and 85%. The methods of concordance assessment, as well as the labeling and definitions of assessed outcomes varied widely across the included studies. We judged three of the included studies as high-quality studies. CONCLUSION: Underreporting of health science researchers' financial COIs is pervasive. Studies assessing COI underreporting suffer from a number of limitations that could have overestimated their findings.

Efficacy of a povidone iodine preparation in reducing nasal methicillin-resistant Staphylococcus aureus in colonized patients.

In a randomized, nonblinded, placebo-controlled trial, a single application of a 10% povidone iodine preparation significantly reduced nasal methicillin-resistant Staphylococcus aureus at 1 and 6 hours after application, but suppression was not sustained at 12 or 24 hours. Twice-daily treatment for 5 days did not reduce nasal methicillin-resistant S aureus measured 12 hours postdosing in comparison to controls. These results suggest that single preoperative applications of povidone iodine will be effective for short-term suppression of S aureus during the perioperative period.

Celiac Crisis in a 64-Year-Old Woman: An Unusual Cause of Severe Diarrhea, Acidosis, and Malabsorption.

Celiac disease (CD) rarely presents with life-threatening complications in older individuals. We report a 64-year-old woman who presented with profuse diarrhea, weight loss, hemodynamic instability, hypokalemia, hypoproteinemia, acidosis, and vitamin and iron deficiency. Pathologic and serologic studies confirmed CD presenting with celiac crisis with extensive and severe intestinal disease. Although celiac crisis occurs mostly in childhood and early adulthood, it should be considered in adults presenting with acute severe diarrheal illness, electrolyte abnormalities, and malabsorption.

Description of blast injuries and predictors of admission to hospital in blast victims in an urban civilian setting.

INTRODUCTION: Blast injuries characteristics and outcomes are not well described in urban civilian settings. OBJECTIVES: To describe blast injuries characteristics and to identify predictors of hospital admission after sustaining a blast injury. METHODS: Retrospective chart review study of blast victims who presented to the Emergency Department (ED) of a tertiary care center in Beirut, Lebanon, over 8 years. The authors conducted a descriptive analysis, followed by a multivariate analysis to identify predictors. RESULTS: A total of 59 patients were included. They were mostly males (81.4 percent) with a mean age of 35.4 (± 15) years with high rate of admission to the hospital (71.2 percent). Surface injury (mainly open wounds) was most common (91.5 percent). Injuries involved mainly the face (45.8 percent) and thigh/knee (33.9 percent). Significant associations were identified between different injury locations. Significant predictors of hospital admission in blast victims were internal injury (odds ratio [OR] = 11.6, 95% confidence interval [CI; 1.7, 79.9]), orthopedic injury (OR = 41.1, 95% CI [3.4, 496.2]), and undergoing a chest X-ray in the ED (OR = 14.3, 95% CI [2.2, 93.3]). CONCLUSION: Blasts in a civilian setting result in a wide range of injuries. Facial injuries were most common in our setting with close associations between injuries of different organ systems. Identified predictors of hospital admission can help guide disposition decision for blast victims in the ED.