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Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule MD 2014 Thomas Jefferson University

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule Md

Department of Emergency Medicine Faculty Papers

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a ...


Infectious Diseases, Bert Chapman 2014 Purdue University

Infectious Diseases, Bert Chapman

Libraries Faculty and Staff Scholarship and Research

Provides information about the role of infectious diseases in the early years of U.S. History, with particular emphasis on how they impacted injuries sustained in military conflict.


Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary 2014 Himmelfarb Health Sciences Library, The George Washington University

Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary

Exercise Science Faculty Publications

Diagnostic musculoskeletal ultrasound has potential clinical utility in characterizing pathological muscle tissue. Sonography has been long proposed as method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy, and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia. The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Operator-dependent technique and variation are critical considerations when obtaining measures of echointensity (i.e., tissue composition estimates) and tissue dimensions (i.e., muscle thickness) – key elements of the ultrasound ...


Gene Sleuth, Kevin Cool 2014 Colby College

Gene Sleuth, Kevin Cool

Colby Magazine

Patricia Davis Murphy '68 tracks down a cancer-causing genetic mutation.


The Vitamin D Status In Inflammatory Bowel Disease, Lauren Veit, Louise Maranda, Jay G. Fong, Benjamin U. Nwosu 2014 University of Massachusetts Medical School

The Vitamin D Status In Inflammatory Bowel Disease, Lauren Veit, Louise Maranda, Jay G. Fong, Benjamin U. Nwosu

Endocrinology/Diabetes

CONTEXT: There is no consensus on the vitamin D status of children and adolescents with inflammatory bowel disease (IBD).

AIM: To determine the vitamin D status of patients with IBD by comparing their serum 25(OH)D concentration to that of healthy controls.

HYPOTHESIS: Serum 25(OH)D concentration will be lower in patients with IBD compared to controls.

SUBJECTS AND METHODS: A case-controlled retrospective study of subjects with IBD (n = 58) of 2-20 years (male n = 31, age 16.38±2.21 years; female n = 27, age16.56±2.08 years) and healthy controls (n = 116; male n = 49 ...


Influence Of Infertility Diagnosis On Pregnancy Outcome In Art, Erin E. Eppsteiner, Barbara J. Stegmann, Mark K. Santillan 2014 University of Iowa

Influence Of Infertility Diagnosis On Pregnancy Outcome In Art, Erin E. Eppsteiner, Barbara J. Stegmann, Mark K. Santillan

Proceedings in Obstetrics and Gynecology

Abstract

Objective: To determine the influence of the infertility diagnosis on gestational age (GA) and birth weight (BW) of children conceived using assisted reproductive technology (ART).

Design: Retrospective cohort.

Setting: University-affiliated infertility clinic.

Patients: Women with a singleton live birth following their first fresh ART cycle with autologous oocytes.

Interventions: Patients were stratified into groups based on infertility diagnosis. GA and BW of their infants were compared.

Main Outcome Measures: GA and BW of children conceived using ART.

Results: 397 women were included. Average GA in the cohort was 38.7±2.3 weeks and average BW was 3301.5 ...


Ruptured Heterotopic Pregnancy Presenting As Hemorrhagic Shock, Hannah R. Hoffman, Kristina A. Lynch, Hayden L. Smith, Michael C. Mintzer, Sheryl M. Sahr 2014 University of Iowa

Ruptured Heterotopic Pregnancy Presenting As Hemorrhagic Shock, Hannah R. Hoffman, Kristina A. Lynch, Hayden L. Smith, Michael C. Mintzer, Sheryl M. Sahr

Proceedings in Obstetrics and Gynecology

Background: Heterotopic pregnancy is a rare event consisting of simultaneous intrauterine and extrauterine pregnancies. If undiagnosed, it is probable the patient will present to an Emergency Department and require emergent care.

Case Report: A 25 year-old woman arrived at the Emergency Department at 14 weeks gestation reporting sharp abdominal cramping and pelvic pain with a history of current tobacco use. Trans-abdominal ultrasound revealed a viable intrauterine pregnancy consistent with 14 weeks, closed cervix with free fluid noted in pelvis, and no evidence of ovarian torsion. Over the next three hours, the patient’s condition deteriorated and hemoglobin levels dropped. The ...


An Undiagnosed Case Of Placenta Percreta Presenting As A Massive Hemoperitoneum In Obstetric Emergency, Shamim Khandaker 2014 University of Iowa

An Undiagnosed Case Of Placenta Percreta Presenting As A Massive Hemoperitoneum In Obstetric Emergency, Shamim Khandaker

Proceedings in Obstetrics and Gynecology

Placenta accreta and placenta percreta are rare causes of serious obstetric hemorrhage. Here we report an undiagnosed case of placenta percreta presenting to the emergency department with shock in the third trimester of pregnancy. Emergency laparotomy with caesarean hysterectomy and blood transfusion are the key steps in successful management.


Feasibility Of Diagnosis Of Postcardiotomy Tamponade By Miniaturized Transesophageal Echocardiography., Hitoshi Hirose, MD, Shreya Gupta, BS, Harrsion Pitcher, MD, Joseph Miessau, MS, Qiong Yang, MD, Jenny Yang, MD, Nicholas Cavarhocchi, MD 2014 Thomas Jefferson University

Feasibility Of Diagnosis Of Postcardiotomy Tamponade By Miniaturized Transesophageal Echocardiography., Hitoshi Hirose, Md, Shreya Gupta, Bs, Harrsion Pitcher, Md, Joseph Miessau, Ms, Qiong Yang, Md, Jenny Yang, Md, Nicholas Cavarhocchi, Md

Department of Surgery Faculty Papers

BACKGROUND: Pericardial tamponade after cardiac surgery is a critical diagnosis that can be difficult to diagnose using conventional cardiac monitoring. Transesophageal echocardiography can provide comprehensive information to make the diagnosis but is not always available, whereas transthoracic echocardiography has its utility limited because of the body habitus or other surgical effects. New monitoring devices, miniaturized hemodynamic transesophageal echocardiography (hTEE), which allows point of care assessment of cardiac filling and functions, may aid in diagnosis of postcardiotomy tamponade.

METHODS: From May 2011 to July 2013, 21 patients underwent hTEE to rule out pericardial tamponade for clinical suspicion of tamponade after open ...


Definition Of Periprosthetic Joint Infection, Javad Parvizi, MD, FRCS, Thorsten Gehrke, MD 2014 Thomas Jefferson University

Definition Of Periprosthetic Joint Infection, Javad Parvizi, Md, Frcs, Thorsten Gehrke, Md

Rothman Institute

Diagnosis of periprosthetic joint infection (PJI) remains challenging as no “gold standard” for diagnosis exists [3]. The challenge is then what test(s) or criterion (ia) can be used to define PJI. In an effort to standardize the definition of PJI, Musculoskeletal Infection Society (MSIS) convened a workgroup in 2011 to issue diagnostic criteria for PJI [1]. The MSIS definition of PJI consists of two major criteria, when the presence of either criterion would indicate PJI, and six minor criteria, when the presence of four or more would indicate PJI.


Frontal White Matter Integrity In Adults With Down Syndrome With And Without Dementia, David K. Powell, Allison Caban-Holt, Greg A. Jicha, William C. Robertson, Roberta Davis, Brian T. Gold, Frederick A. Schmitt, Elizabeth Head 2014 University of Kentucky

Frontal White Matter Integrity In Adults With Down Syndrome With And Without Dementia, David K. Powell, Allison Caban-Holt, Greg A. Jicha, William C. Robertson, Roberta Davis, Brian T. Gold, Frederick A. Schmitt, Elizabeth Head

Magnetic Resonance Imaging and Spectroscopy Center Faculty Publications

Adults with Down syndrome (DS) are at high risk for developing Alzheimer's disease after the age of 40 years. To detect white matter (WM) changes in the brain linked to dementia, fractional anisotropy (FA) from diffusion tensor imaging was used. We hypothesized that adults with DS without dementia (DS n = 10), DS with dementia (DSAD n = 10) and age matched non-DS subjects (CTL n = 10) would show differential levels of FA and an association with scores from the Brief Praxis Test and the Severe Impairment Battery. WM integrity differences in DS compared with CTL were found predominantly in the ...


Gonadotropin-Releasing Hormone Agonist And Depot Medroxyprogesterone Acetate Following Uterine Artery Embolization In The Management Of Uterine Arteriovenous Malformation, Padma Krishnaswamy, Indushekar Subbanna, Gayatri Devi Sivasambu, Urvashi Thukral 2014 University of Iowa

Gonadotropin-Releasing Hormone Agonist And Depot Medroxyprogesterone Acetate Following Uterine Artery Embolization In The Management Of Uterine Arteriovenous Malformation, Padma Krishnaswamy, Indushekar Subbanna, Gayatri Devi Sivasambu, Urvashi Thukral

Proceedings in Obstetrics and Gynecology

A young woman presenting with recurrent episodes of uterine bleeding due to an extensive uterine arteriovenous malformation was treated with two sessions of uterine artery embolization. Further bleeding was managed with a combination of gonadotropin-releasing hormone and depot medroxyprogesterone acetate. The patient remains asymptomatic with a significant decrease in uterine and pelvic vascularity at one year follow-up.

These drugs may decrease the need for repeat embolization.


Metastatic Renal Cell Carconima To The Thyroid 23 Years After Nephrectomy, Carrie Valdez, M. Katayoon Rezaei, Frederick Hendricks, Stanley M. Knoll 2014 Himmelfarb Health Sciences Library, The George Washington University

Metastatic Renal Cell Carconima To The Thyroid 23 Years After Nephrectomy, Carrie Valdez, M. Katayoon Rezaei, Frederick Hendricks, Stanley M. Knoll

Pathology Faculty Publications

Thyroid carcinoma is an uncommon form of human cancer, with an outstanding overall cure rate. This excellent prognosis is based on the fact that well over 99% of thyroid cancers are primary tumors. Metastatic cancer to the thyroid remains very rare. We report a case of clear cell renal carcinoma metastatic to the thyroid gland 23 years after nephrectomy.


The Effects Of Pregnancy On The Sexual Life Of Turkish Women, Hasan Efe, Murat Bozkurt, Levent Sahin, Mehmet Fırat Mutlu, Murat Api, Ahmet Çetin 2014 University of Iowa

The Effects Of Pregnancy On The Sexual Life Of Turkish Women, Hasan Efe, Murat Bozkurt, Levent Sahin, Mehmet Fırat Mutlu, Murat Api, Ahmet Çetin

Proceedings in Obstetrics and Gynecology

Aim: To investigate the effects of pregnancy on the sexual life of Turkish women

Materials and Methods: One thousand twenty six pregnant women were included in the study. The Libido Scoring System, which is a questionnaire consisting of four questions about the frequency of intercourse, the partner initiating the intercourse, orgasm and masturbation status of the pregnant women, was completed by all patients. Both pre-pregnancy and pregnancy sexuality was evaluated independently using this scale.

Results: The frequency of sexual intercourse during pregnancy significantly decreased from 3.07/week to 2.40/week (p<0.05). The masturbation rate during pregnancy was significantly lower than the pre-pregnancy period (3.6% vs 4.9 %, p<0.001). The percentage of pregnant women who never had an orgasm was significantly higher compared to the pre-pregnant period (21.7 % vs 10.8 %, p<0.01). The rates of initiation of sexual intercourse in the pre-pregnancy period by men and by women were 94.5% (970/1026) and 5.3% (54/1026) respectively. In pregnancy period the rates of initiation of sexual intercourse by man and woman were 93.4% (904/968) and 6.6% (64/968) respectively (p=0.0001). The mean libido scores during pregnancy were statistically lower than the pre-pregnancy period (6.38±0.04 vs 7.31±0.04, p<0.001).

Conclusion: Pregnancy has a negative effect on ...


Evaluation Of Ct Images Created Using A New Metal Artifact Reduction Reconstruction Algorithm For Radiation Therapy Treatment Planning, John Niemkiewicz, Andrew G. Palmiotti, Marc S. Miner, Lee E. Stunja, Jenelle Bergene 2014 Lehigh Valley Health Network

Evaluation Of Ct Images Created Using A New Metal Artifact Reduction Reconstruction Algorithm For Radiation Therapy Treatment Planning, John Niemkiewicz, Andrew G. Palmiotti, Marc S. Miner, Lee E. Stunja, Jenelle Bergene

Department of Radiation Oncology

No abstract provided.


Safety Of Hexaminolevulinate For Blue Light Cystoscopy In Bladder Cancer. A Combined Analysis Of The Trials Used For Registration And Postmarketing Data., J Alfred Witjes, Leonard G. Gomella, Arnulf Stenzl, Sam S. Chang, Dirk Zaak, H Barton Grossman 2014 Thomas Jefferson University

Safety Of Hexaminolevulinate For Blue Light Cystoscopy In Bladder Cancer. A Combined Analysis Of The Trials Used For Registration And Postmarketing Data., J Alfred Witjes, Leonard G. Gomella, Arnulf Stenzl, Sam S. Chang, Dirk Zaak, H Barton Grossman

Department of Urology Faculty Papers

OBJECTIVE: To detail and put into perspective, safety of hexaminolevulinate blue light cystoscopy (HAL-BLC), including repeated use, based on combined data of controlled trials used for registration of HAL and postmarketing experience.

METHODS: Safety data of 2 randomized comparative studies (group 1) and 4 within patient control studies (group 2) were combined. Postmarketing data from >200,000 patients were analyzed.

RESULTS: In group 1, 533 patients were examined with HAL-BLC and 499 with white light (WL) cystoscopy. In group 2, 791 patients were examined with both WL and HAL-BLC. Between 73% and 93% of these patients had concomitant diseases. Between ...


The Impact Of Patellar Resurfacing In Two-Stage Revision Of The Infected Total Knee Arthroplasty., Aaron Glynn, Ronald Huang, Javad Mortazavi, Javad Parvizi MD 2014 Thomas Jefferson University

The Impact Of Patellar Resurfacing In Two-Stage Revision Of The Infected Total Knee Arthroplasty., Aaron Glynn, Ronald Huang, Javad Mortazavi, Javad Parvizi Md

Rothman Institute

Evidence for optimal management of the patellofemoral joint in revision surgery for the infected TKA is limited. We reviewed 69 infected TKAs undergoing two-stage revision. Fifty four patellae were resurfaced, 11 had patelloplasty performed, two were augmented with trabecular metal, one had impaction grafting, and one knee underwent patellectomy. Average follow-up was 4.5years. The patients that received patellar resurfacing at re-implantation experienced statistically significant improvements in KSS pain score, functional KSS, and patellar score (P


Preoperative And Operative Factors Associated With Complications Following Radical Nephroureterectomy, A. Arnouk, C. Lallas, E. Trabulsi, J. Raman 2014 Thomas Jefferson University

Preoperative And Operative Factors Associated With Complications Following Radical Nephroureterectomy, A. Arnouk, C. Lallas, E. Trabulsi, J. Raman

Sigma Xi

Abstract

Radical nephroureterectomy (RNU) is the gold standard for managing upper-tract urothelial carcinoma. We review preoperative, operative, and pathologic characteristics of patients undergoing RNU to identify factors associated with perioperative complications. A retrospective review of institutional databases from 8 academic centers identified 732 patients who underwent RNU. Data on preoperative, operative, and pathologic indices were collected. Almost 40% of patients in our cohort experienced a complication within 30 days of RNU. Increasing age, higher Charlson score, and lower baseline renal function were independently associated with patients developing complications. Longer OR duration and intraoperative transfusion requirement were also associated with post-RNU ...


Utility Of Pelvic Examination In Lower Abdominal Pain Without Vaginal Complaints, L. Sharan, J. Chien, T. Maiers, WB Lau 2014 Thomas Jefferson University

Utility Of Pelvic Examination In Lower Abdominal Pain Without Vaginal Complaints, L. Sharan, J. Chien, T. Maiers, Wb Lau

Sigma Xi

Abstract

Abdominal pain is the most common presenting ED complaint. ED texts advocate speculum bimanual pelvic exam to differentiate pathology of abdominal versus pelvic etiology in women of childbearing age. However, the exam is invasive and requires significant ED resources. We hypothesize that routine pelvic exams of females complaining of abdominal pain without vaginal complaints in the ED does not alter clinical management. We performed a retrospective observational study of ED patients in an urban Level 1 trauma center for all non-pregnant women seen from January 2013 to July 2013, aged 18-50, with a chief complaint of isolated lower abdominal ...


Utility Of The Stop-Bang Questionnaire For Identifying Obstructive Sleep Apnea In Patients Undergoing Bariatric Surgery, Karen Jablonski, MD, Ritu G. Grewal, MD, Ramya Punati,, Shivam Saxena, Karl Doghramji, MD, Alec Beekley, MD, David S. Tichansky, MD 2014 Thomas Jefferson University

Utility Of The Stop-Bang Questionnaire For Identifying Obstructive Sleep Apnea In Patients Undergoing Bariatric Surgery, Karen Jablonski, Md, Ritu G. Grewal, Md, Ramya Punati,, Shivam Saxena, Karl Doghramji, Md, Alec Beekley, Md, David S. Tichansky, Md

Department of Surgery Faculty Papers

Introduction

Patients undergoing bariatric surgery are at high risk for obstructive sleep apnea (OSA).

OSA has been associated with an increased risk of perioperative complications, but is under-recognized and underdiagnosed in the bariatric population.

It is currently recommended that all patients considering bariatric surgery for obesity should be evaluated for OSA.

In the general pre-surgical population, the STOP-BANG questionnaire is a validated screening tool for identifying OSA.

We hypothesize that in bariatric patients the STOP-BANG questionnaire plus other clinical variables can predict OSA.


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