Impact of a Physician-Led Social Media Sharing Program on a Medical Journal's Web Traffic.

PURPOSE: The use of social media by health professionals and medical journals is increasing. The aim of this study was to compare online views of articles in press (AIPs) released by Annals of Emergency Medicine before and after a nine-person social media team started actively posting links to AIPs using their personal Twitter accounts. METHODS: An observational before-and-after study was conducted. Web traffic data for Annals were obtained from the publisher (Elsevier), detailing the number of page views to annemergmed.com by referring websites during the study period. The preintervention time period was defined as January 1, 2013, to June 30, 2014, and the postintervention period as July 1, 2014, to July 31, 2015. The primary outcome was page views from Twitter per AIP released each month to account for the number of articles published each month. Secondary outcomes included page views from Facebook (on which there was no article-sharing intervention) and total article views per month. RESULTS: The median page views from Twitter per individual AIP released each month increased from 33 in the preintervention period to 130, for an effect size of 97 (95% confidence interval, 56-111; P < .001). There was a smaller increase in median page views from Facebook per individual AIP of 21 (95% confidence interval, 10-32). There was no significant increase in these median values for total page views per AIP. CONCLUSIONS: Twitter sharing of AIPs increased the number of page views that came from Twitter but did not increase the overall number of page views.

The Effects of Perioperative Tamoxifen Therapy on Microvascular Flap Complications in Transverse Rectus Abdominis Myocutaneous/Deep Inferior Epigastric Perforator Flap Breast Reconstruction.

BACKGROUND: Tamoxifen is an important adjunct therapy in breast cancer treatment; however, it has been implicated in increasing microvascular flap complications. Current recommendations on stopping tamoxifen are conflicting and do not address tamoxifen therapy that is continued perioperatively. The purpose of this study is to determine whether tamoxifen taken at the time of free transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric perforator (DIEP) flap breast reconstruction affects thrombotic complication rates. METHODS: A retrospective review of microvascular breast reconstruction with TRAM/DIEP flaps over the last 20 years was carried out at a single institution. Patients were divided into 2 cohorts: those receiving tamoxifen at the time of reconstruction (tamoxifen cohort) and those not taking tamoxifen (control). Demographic information, procedural characteristics, and rates of microvascular flap complications were compared. RESULTS: Forty-three patients (56 flaps) received tamoxifen at the time of microvascular breast reconstruction, and 185 patients (267 flaps) did not. Patients in the tamoxifen cohort had a lower mean age of 48.9 years (P = 0.013). A greater percentage of patients in the tamoxifen cohort had preoperative radiation (P < 0.0001) and chemotherapy (P = 0.018) and underwent delayed reconstruction (P < 0.0001). There were no significant differences between the 2 cohorts with regard to flap complications including both arterial and venous thrombosis, flap failure, and other local flap complications. CONCLUSIONS: Patients receiving tamoxifen during TRAM/DIEP flap breast reconstruction did not have increased rates of flap thrombosis or failure; therefore, stopping tamoxifen prior to these procedures may not be necessary.

Evidence-based review of manual therapy efficacy in treatment of chronic musculoskeletal pain.

Chronic musculoskeletal pain contributes greatly to the community's disability and morbidity. Although many interventions are employed for treating chronic musculoskeletal pain, few have been proven in randomized controlled trials. Manual therapy is a widely used method for managing such conditions, but to date, its efficacy has not been established. This evidence-based review aims to assess the efficacy of manual therapy interventions for chronic musculoskeletal pain. MEDLINE, CINAHL, EBM Reviews (Cochrane DSR, ACP Journal Club, DARE, and CCTR), Ovid Healthstar, and PsycINFO databases were searched from 1961 to March 2009 using keywords of interest. Potential studies for inclusion were reviewed independently by two reviewers. Methodological quality was assessed based on the Physiotherapy Evidence Database scale. Trials were quantitatively categorized according to the Modified Oxford Centre for Evidence-based Medicine Levels of Evidence. Meta-analysis was not possible due to heterogeneity of outcome measures. Evidence supports some manual therapy techniques in chronic low back and knee pain.

Striatal dopamine d2/d3 receptor availability is reduced in methamphetamine dependence and is linked to impulsivity.

While methamphetamine addiction has been associated with both impulsivity and striatal dopamine D(2)/D(3) receptor deficits, human studies have not directly linked the latter two entities. We therefore compared methamphetamine-dependent and healthy control subjects using the Barratt Impulsiveness Scale (version 11, BIS-11) and positron emission tomography with [(18)F]fallypride to measure striatal dopamine D(2)/D(3) receptor availability. The methamphetamine-dependent subjects reported recent use of the drug 3.3 g per week, and a history of using methamphetamine, on average, for 12.5 years. They had higher scores than healthy control subjects on all BIS-11 impulsiveness subscales (p < 0.001). Volume-of-interest analysis found lower striatal D(2)/D(3) receptor availability in methamphetamine-dependent than in healthy control subjects (p < 0.01) and a negative relationship between impulsiveness and striatal D(2)/D(3) receptor availability in the caudate nucleus and nucleus accumbens that reached statistical significance in methamphetamine-dependent subjects. Combining data from both groups, voxelwise analysis indicated that impulsiveness was related to D(2)/D(3) receptor availability in left caudate nucleus and right lateral putamen/claustrum (p < 0.05, determined by threshold-free cluster enhancement). In separate group analyses, correlations involving the head and body of the caudate and the putamen of methamphetamine-dependent subjects and the lateral putamen/claustrum of control subjects were observed at a weaker threshold (p < 0.12 corrected). The findings suggest that low striatal D(2)/D(3) receptor availability may mediate impulsive temperament and thereby influence addiction.