Delaware Medical Journal

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Psychiatric treatment prior to 1955 seemed to be at a standstill. All kinds of treatments, including surgical ones, were used ineffectively. Then suddenly, out of nowhere, a new treatment -chlorpromazine - created a worldwide revolution. Here is what we saw in Delaware. It was not much different in the rest of the world. Patients improved and were rapidly dischargedfrom mental institutions causing workforce reductions. I was sitting on a state employee job application evaluation committee and witnessed these events...

OBJECTIVE: To determine if patients elect molecular testing over diagnostic surgery or repeat fine needle aspiration for indeterminate thyroid nodules. Can ThyroSeq v2.1 molecular testing reduce diagnostic thyroid surgery and rule out cancer? STUDY DESIGN: Retrospective review Setting: Single institution, single-practice surgeon. SUBJECTS AND METHODS: Fifteen month retrospective review of indeterminate thyroid nodules that went on to ThyroSeq v2...

BACKGROUND: Consumption of diverse and nutritious food is challenging for children diagnosed with Autism Spectrum Disorder. OBJECTIVE: We created the Good Nutrition Game and implemented the intervention among students diagnosed with Autism Spectrum Disorder at a therapeutic after-school socialization program. METHOD: We divided students into two teams in each session. The team earned one point per bite of fruit or vegetables by a teammate...

BACKGROUND: Although total hip arthroplasty (THA) has become standard procedure to manag the symptoms of end-stage osteoarthritis (OA), there are multiple surgical approaches to acceE the hip joint. To date, there is limited information on the effect of surgical approach on muscle strength and performance-based measures of functional ability after THA. QUESTIONS/PURPOSES: The purpose of this study was to compare the effect of posterior or anterolateral surgical approaches on strength and function after THA...

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The patient is a unique case presenting with presumed Restrictive Dermopathy (RD) and intracranial and adrenal calcifications, an association not previously described in the literature. This case postulates the possibility of additional radiographic features that can be included in the spectrum of RD or as secondary events from the underlying pathophysiology of RD.

BACKGROUND: How the existence of trauma systems affects the care of less severely injured patients has received little attention. OBJECTIVE: The current study examines the longitudinal effect on the care of children with traumatic brain injuries (TBIs) of the incorporation of a pediatric trauma center into a regional trauma system. METHODS: The Delaware Trauma System provided registry data from 2000 to 2014. Inclusion criteria were age less than 18 years and ICD9 diagnostic coding for any head injury...

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No abstract text is available yet for this article.

Crohn's disease is a disorder characterized by transmural inflammation which can potentially affect any part of the gastrointestinal tract from the mouth to the perianal area. Cohn's disease is a systemic disease characterized by a relapsing remitting course, with variable intestinal and extra-intestinal complications. Abdominal and pelvic abscesses are not an uncommon complication of Crohn's disease occurring in 10-30 percent of all patients. We present the case of a 21-year-old male with Crohn's disease presenting with a massive abdominal abscess, whose diagnosis was delayed given lack of typical symptoms...

Stump appendicitis is a delayed complication of appendectomy. Patients present with symptoms similar to an initial presentation for appendicitis. Diagnosis is often delayed as history of appendectomy often precludes focused workup for an appendiceal source of infection. A 39-year-old female presented to our emergency department with worsening abdominal pain and fever. Se had a past surgical history of a laparoscopic appendectomy approximately 14 months prior to presentation. During her admission, she was diagnosed with ruptured stump appendicitis by computerized tomography (CT) imaging...

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BACKGROUND: Accurate assessment of cardiac output (CO) is essential for the hemodynamic assessment of aortic valve area (AVA). Estimation of oxygen consumption (VO2) and Thermodilution (TD) is employed in many cardiac catheterization laboratories (CCL) given the historically cumbersome nature of direct continuous VO2 measurement, the "gold standard" for this technique. A portable facemask device simplifies the direct continuous measurement of VO2, allowing for relatively rapid and continuous assessment of CO and AVA...

Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a catheter delivery system with a reshaped tip in a patient with a PFO, recurrent stroke, recurrent gastrointestinal bleeding, bilateral deep venous thrombosis and thrombosed bilateral inferior vena cava filter.

BACKGROUND: Review the radiologic findings and clinical significance of tension pneumoperitoneum. CASE REPORT: Imaging case presented to radiology during patient's prolonged and complicated hospital stay. CONCLUSIONS: Tension pneumoperitoneum associated with barotrauma is a rare, but potentially life threatening complication of mechanical ventilation. The radiologist should be able to recognize the imaging findings associated with tension pneumoperitoneum in order to assist in diagnosis of this potentially reversible entity...

BACKGROUND: Pediatric pedestrian motor vehicle-associated of injuries correlated with a particular census tract's trauma is a significant public health concern for children. demographic composition. GIS mapping software was used We aimed to use geographic information systems (GIS) to examine the relationship between motor vehicle pedestrian injuries in children and the demographics of the region in which they occurred for the state of Delaware. METHODS: This is a retrospective analysis of collected data from the Delaware State Trauma Registry form January 1, 2002, to December 31, 2012...

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BACKGROUND: Accurate assessment of Cardiac Output (CO) is a critical measurement in the calculation of aortic valve area (AVA). Due to the known inaccuracy of estimated Fick calculations, many measure thermodilution (TD) CO as well due to previous studies showing better correlation with the gold standard direct CO. Previous studies showed suboptimal correlation between both methods. Most physicians assume that the TD CO is chosen by catheterization laboratory software for AVA evaluation...

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