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Rhode Island Medical Journal

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https://www.readbyqxmd.com/read/28564671/effects-of-smoking-and-smoking-cessation-during-pregnancy-on-adverse-birth-outcomes-in-rhode-island-2012-2014
#1
Hyun Hanna Kim, Karine Monteiro, Elsa Larson, Dana McCants Derisier
No abstract text is available yet for this article.
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564670/current-concepts-in-the-pathogenesis-diagnosis-and-management-of-type-i-chiari-malformations
#2
Cody A Doberstein, Radmehr Torabi, Petra M Klinge
Type 1 Chiari malformations (CMs) are a group of congenital or acquired disorders which include the abnormal presence of the cerebellar tonsils in the upper spinal canal, rather than the posterior fossa. The resulting anatomic abnormality causes crowding of the structures at the craniocervical junction and can impair the normal flow of cerebral spinal fluid (CSF) in this region. This impairment in CSF flow dynamics can led to the development of syringomyelia or hydrocephalus. Type 1 CMs have been associated with a wide array of symptoms resulting from either cerebellar and brainstem compression and distortion or disturbances in CSF dynamics, and can affect both children and adults...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564669/recent-advances-in-the-treatment-of-gliomas-comprehensive-brain-tumor-center
#3
Steven A Toms, Nikolaos Tapinos
Gliomas are a class of primary brain tumors arising from the supporting structures of the brain, the astrocytes and oligodendrocytes, which range from benign lesions to its most malignant form, the glioblastoma. Treatment for these lesions includes maximal surgical resection, radiotherapy, and chemotherapy. Recently, novel therapies such as immune modulatory therapies and electrical field treatment of the most malignant form, the glioblastoma, have shown promise in improving survival. We will review recent advances in clinical trials, explore the role of multimodal care in brain tumor therapy, as well as explore advances in molecular biology and nanotechnology which offer new hope for treatment of this class of disease...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564668/updates-on-chimeric-antigen-receptor-mediated-glioblastoma-immunotherapy
#4
George Mao, Prakash Sampath, Sadhak Sengupta
Glioblastoma multiforme (GBM) is the most malignant of the primary central nervous system (CNS) neoplasms, accounting for nearly 80% of all primary brain tumors and is associated with high morbidity and mortality. Immunotherapy is proving to be a fertile ground for next-generation GBM therapy, with large translational research projects and clinical trials currently underway. One particularly promising area is the chimeric antigen receptors (CARs) in the context of lymphocyte adoptive cell therapy (ACT), which has achieved success in the treatment of hematological malignancies...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564667/rhode-island-hospital-s-contribution-to-the-field-of-endoscopic-spine-surgery
#5
Albert E Telfeian, Adetokunbo A Oyelese, Ziya L Gokaslan
The first academic program in endoscopic spine surgery in the United States opened its doors at Rhode Island Hospital in 2012. Published advances in the field since its inception have included treatments for a myriad of pathologies including lumbar and thoracic disc herniations, spondylolisthesis, spine tumors as well as treatments for complications of other spinal procedures including spinal fusion, kyphoplasty, and total disc replacement. In this issue of the Rhode Island Medical Journal we summarize the history of the procedure as well as some of the interesting progress going on in this field in Rhode Island...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564666/a-comprehensive-approach-to-deep-brain-stimulation-for-movement-disorders
#6
Umer Akbar, Wael F Asaad
Deep brain stimulation (DBS) is a well-established form of neuromodulation, used primarily for movement disorders such as Parkinson's disease (PD) and Essential Tremor (ET). The selection of patients who will benefit most from DBS depends on a team of clinicians from various disciplines, including neurology, neurosurgery, psychiatry, neuropsychology and rehabilitation specialists. The actual surgical procedure can take many forms. We apply a combination of multidisciplinary, team-based evaluations and intra-operative neurophysiology, test stimulation and imaging to optimize DBS therapy for individual patients...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564665/current-strategies-in-the-surgical-management-of-ischemic-stroke
#7
Cody A Doberstein, Radmehr Torabi, Sandra C Yan, Ryan McTaggart, Curtis Doberstein, Mahesh Jayaraman
Stroke is a major cause of death and disability in the United States and rapid evaluation and treatment of stroke patients are critical to good outcomes. Effective surgical treatments aim to restore adequate cerebral blood flow, prevent secondary brain injury, or reduce the likelihood of recurrent stroke. Patient evaluation in centers with a comprehensive stroke program and a dedicated neuro- vascular team is recommended. [Full article available at http://rimed.org/rimedicaljournal-2017-06.asp].
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564664/the-role-of-radiation-therapy-in-the-treatment-of-metastatic-brain-disease
#8
Kunal Sindhu, Sohail Syed, Deus Cielo
Brain metastasis is the most frequent central nervous system malignancy. Although surgery and chemotherapy have roles to play in the treatment of brain metastasis, radiation therapy remains a mainstay of therapy. We will review the role of fractionated radiotherapy and stereotactic radiosurgery in the treatment of newly diagnosed and recurrent brain metastasis. [Full article available at http://rimed.org/rimedicaljournal-2017-06.asp].
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564663/current-treatment-of-metastatic-spine-tumors-surgery-and-stereotactic-radiosurgery
#9
Jared S Fridley, Jaroslaw T Hepel, Adetokunbo A Oyelese
There has been significant progress and innovation in the treatment of patients with metastatic spinal tumors over the last two to three decades that has impacted our ability to provide individualized care that improves a patient's quality of life and degree of neurologic impairment. Advances in surgical techniques and radiation delivery modalities have dramatically improved our ability to decrease local tumor recurrence rates, improve pain control, and provide more durable spinal stability. Modern day spine tumor resection and reconstruction techniques have been shown to improve and prolong patients' ability to ambulate, maintain continence, and reduce the need for pain medications...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564662/introduction-to-recent-advances-in-neurosurgery
#10
Ziya L Gokaslan
No abstract text is available yet for this article.
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564661/workplace-violence-in-hospitals-and-measures-to-address-it
#11
Herbert Rakatansky
No abstract text is available yet for this article.
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28564660/crimes-against-humanity
#12
Joseph H Friedman
No abstract text is available yet for this article.
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459921/disparities-in-secondhand-smoke-exposure-among-nonsmoking-adults-in-rhode-island-tobacco-control-s-pro-equity-approach
#13
Elsa Larson, Benvinda Santos
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459920/chronic-venous-insufficiency-novel-management-strategies-for-an-under-diagnosed-disease-process
#14
Omar N Hyder, Peter A Soukas
Chronic venous insufficiency is an often-missed diagnosis that results in a variety of clinical manifestations that may severely compromise quality of life. Prompt recognition is important to provide symptomatic relief and prevent disease progression. Most patients can be treated with a comprehensive plan of conservative measures. However, it is important for providers to recognize those patients who require referral to a vascular specialist for more invasive therapies. Over the past 2 decades, a variety of endovenous strategies have demonstrated effective and lasting results in treatment of severe symptomatic venous insufficiency...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459919/the-arm-is-not-the-leg-pathophysiology-diagnosis-and-management-of-upper-extremity-deep-vein-thrombosis
#15
Adam M Noyes, John Dickey
Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459918/pulmonary-embolism-in-2017-increasing-options-for-increasing-incidence
#16
William Prabhu, Peter A Soukas
Scope of the problem - An increasing burden of disease Acute pulmonary embolism (PE) is a problem encountered by a majority of medical and surgical specialties in their scope of practice. Acute PE is currently the 3rd leading cause of cardiovascular death in the United States, resulting in 100,000 deaths annually as estimated by the Centers for Disease Control (CDC (1). There is a paucity of data and a broad range of estimates for both incidence and morbidity due to acute PE. The mortality of all patients presenting with acute PE is estimated between 10-30% at 90 days utilizing current treatment regimens (2)...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459917/minimally-invasive-closure-of-the-left-atrial-appendage-a-non-pharmacologic-approach-to-prevention-of-stroke-in-patients-with-atrial-fibrillation
#17
Brian D McCauley, Antony F Chu
Atrial Fibrillation's (AF) role in the pathogenesis of thromboembolic stroke has been well established, with estimates from trials of approximately 15-20% of all strokes in the U.S. Research shows more than 90% of atrial thrombi originate from the left atrial appendage (LAA). Traditionally, oral anticoagulants (OACs) have been the keystone of management for AF in reducing the risk of thromboembolic stroke. However, OACs also pose a non-negligible risk of bleeding with between 30-50% of eligible patients not receiving OACs due to absolute contraindications or perceived increased bleeding risk...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459916/direct-oral-anticoagulants-doacs-current-status-among-distinct-patient-subgroups
#18
Peter Riley, Abhishek Maan, Kenneth S Korr
The landscape of anticoagulant therapy for atrial fibrillation and deep-vein thrombosis has evolved considerably in the last decade with the advent of Novel or Direct-Acting Oral Antiocoagulants (DOACs). The initial phase III randomized controlled trials established the individual DOACs as viable alternatives to warfarin for thromboprophylaxis but generalizations to the larger population were limited by the small number of protocol subjects with renal insufficiency, congestive heart failure, advanced age and other comorbidities...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459915/the-evolving-landscape-of-thromboembolic-disease-diagnostic-and-management-strategies
#19
Kenneth S Korr
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459914/providing-non-emergency-healthcare-for-undocumented-immigrants-raises-issues
#20
Herbert Rakatansky
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
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