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Allen G Murga, Jason Chiriano, Sharon C Kiang, Sheela Patel, Christian Bianchi, Ahmed M Abou-Zamzam, Theodore H Teruya
INTRODUCTION: The patency of long-term hemodialysis access in end-stage renal disease (ESRD) patients remains a significant challenge. Often these patients are affected with limited venous outflow options, requiring limb abandonment and creation of new access in the contralateral arm. Vascular surgeons are familiar with the exposure of the proximal axillary artery via an infraclavicular incision. The axillary vein is easily exposed through this technique. The use of the hybrid Gore graft can make the venous anastomosis easier...
March 23, 2017: Annals of Vascular Surgery
Sarah A Moore, Nicolas Granger, Natasha J Olby, Ingo Spitzbarth, Nick D Jeffery, Andrea Tipold, Yvette S Nout-Lomas, Ronaldo C da Costa, Veronika M Stein, Linda J Noble-Haeusslein, Andrew R Blight, Robert G Grossman, D Michele Basso, Jonathan M Levine
Translation of therapeutic interventions for spinal cord injury (SCI) from laboratory to clinic has been historically challenging, highlighting the need for robust models of injury that more closely mirror the human condition. The high prevalence of acute, naturally occurring SCI in pet dogs provides a unique opportunity to evaluate expeditiously promising interventions in a population of animals that receive diagnoses and treatment clinically in a manner similar to persons with SCI, while adhering to National Institutes of Health guidelines for scientific rigor and transparent reporting...
March 22, 2017: Journal of Neurotrauma
Valentina Giacometti, Vladimir A Bashkirov, Pierluigi Piersimoni, Susanna Guatelli, Tia E Plautz, Hartmut F-W Sadrozinski, Robert P Johnson, Andriy Zatserklyaniy, Thomas Tessonnier, Katia Parodi, Anatoly B Rosenfeld, Reinhard W Schulte
PURPOSE: Proton computed tomography (pCT) is a promising imaging technique to substitute or at least complement x-ray CT for more accurate proton therapy treatment planning as it allows calculating directly proton relative stopping power from proton energy loss measurements. A proton CT scanner with a silicon-based particle tracking system and a five-stage scintillating energy detector has been completed. In parallel a modular software platform was developed to characterize the performance of the proposed pCT...
March 2017: Medical Physics
A Mandapaka, A Ghebremedhin, B Patyal, Loma Linda
PURPOSE: To validate the treatment planning system predicted proton dose beyond a heterogeneity (n-BCA glue) by making a measurement in a custom acrylic phantom. METHODS: A custom cubic acrylic phantom was designed for this experiment. A container was designed to fit in the phantom. This container was filled with TRUFILL™ n-Butyl Cyanoacrylate(n-BCA) glue. When the container was placed in the phantom, its center was at a distance of 7.4cm from the entrance. This depth allows us to make measurements around the center of modulation of a 126 MeV proton beam with a 3cm spread-out-Bragg peak...
June 2016: Medical Physics
T T Nguyen, G A McAuley, S Heczko, J Slater, A Wroe
PURPOSE: To investigate magnetic focusing for small volume proton targets using a doublet combination of quadrupole rare earth permanent magnet Halbach cylinder assemblies METHODS: Monte Carlo computer simulations were performed using the Geant4 toolkit to compare dose depositions of proton beams transported through two focusing magnets or in their absence. Proton beams with energies of 127 MeV and initial diameters of 5, 8 and 10 mm were delivered through two identical focusing magnets similar to those currently in experimental use at Loma Linda University Medical Center...
June 2016: Medical Physics
H F-W Sadrozinski, T Geoghegan, E Harvey, R P Johnson, T E Plautz, A Zatserklyaniy, V Bashkirov, R F Hurley, P Piersimoni, R W Schulte, P Karbasi, K E Schubert, B Schultze, V Giacometti
We report on the operation and performance tests of a preclinical head scanner developed for proton computed tomography (pCT). After extensive preclinical testing, pCT is intended to be employed in support of proton therapy treatment planning and pre-treatment verification in patients undergoing particle-beam therapy. In order to assess the performance of the scanner, we have performed CT scans with 200 MeV protons from both the synchrotron of the Loma Linda University Medical Center (LLUMC) and the cyclotron of the Northwestern Medicine Chicago Proton Center (NMCPC)...
September 21, 2016: Nuclear Instruments & Methods in Physics Research. Section A, Accelerators, Spectrometers, Detectors and Associated Equipment
S D Clarke, E Pryser, B M Wieger, S A Pozzi, R A Haelg, V A Bashkirov, R W Schulte
PURPOSE: The primary objective of this work is to measure the secondary neutron field produced by an uncollimated proton pencil beam impinging on different tissue-equivalent phantom materials using organic scintillation detectors. Additionally, the Monte Carlo code mcnpx-PoliMi was used to simulate the detector response for comparison to the measured data. Comparison of the measured and simulated data will validate this approach for monitoring secondary neutron dose during proton therapy...
November 2016: Medical Physics
Sean Maroney, Carlos Chavez de Paz, Marjunphilip Duldulao, Tracey Kim, Mark E Reeves, Kevork K Kazanjian, Naveenraj Solomon, Carlos Garberoglio
There have been few studies directly comparing the postoperative complications in patients with a diverting ileostomy to patients who were not diverted after low anterior resection (LAR) for rectal carcinoma. This study is a retrospective chart review of all rectal carcinoma patients (99) who underwent a LAR from January 2009 to December 2014 at Loma Linda University Medical Center and Veterans Affairs Loma Linda Healthcare System. A majority of patients were diverted (58% vs 42%). The diverted patients were more likely to have a low tumor location (P < 0...
October 2016: American Surgeon
Thomas von Arx
The objective of apical surgery is to retain teeth with persistent apical pathosis following orthograde root canal treatment if endodontic non-surgical revision is difficult or associated with risks, or is even declined by the patient. Since the most frequent cause of recurrent apical disease is bacterial reinfection from the (remaining) root canal system, the bacteria-tight root-end filling is the most important step in apical surgery. In the early 1990s, mineral trioxide aggregate (MTA) was developed at the Loma Linda University in California/USA...
2016: Swiss Dental Journal
Eliza M Orzylowska, John D Jacobson, Gihan M Bareh, Edmund Y Ko, Johannah U Corselli, Philip J Chan
OBJECTIVES: The study examined the effect the life-long vegetarian diet on male fertility and focused on vegetarians living in the Loma Linda blue zone, a demographic area known for life longevity. The objective was to compare sperm characteristics of vegetarian with non-vegetarian males. STUDY DESIGN: The cross-sectional observational study was based on semen analyses of 474 males from 2009 to 2013. Patients categorized themselves as either life-long lacto-ovo vegetarians (N=26; vegetable diet with dairy and egg products), vegans (N=5; strictly vegetables with no animal products) or non-vegetarians (N=443; no diet restrictions)...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jenny H Lee, Quynh-Nhu Nguyen, Quang A Le
BACKGROUND: Bariatric surgery is associated with improved co-morbidities, quality of life, and survival in severely obese patients. Common bariatric surgery procedures include Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric band (LAGB), and sleeve gastrectomy (SG). Currently, literature studying comparative effectiveness on different bariatric surgery procedures in veterans is limited. OBJECTIVES: To compare effectiveness of 3 bariatric surgery procedures performed in veterans...
June 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Laura L Hoon-Hanks, Emily D Rout, Linda M Vap, Tawfik A Aboellail, Diana M Hassel, Yvette S Nout-Lomas
A 20-year-old gelding was diagnosed with peritonitis and severe reactive mesothelial hyperplasia. Exploratory laparotomy findings were suggestive of a neoplastic etiology; however, additional diagnostics ruled this out and the horse made a full recovery. This report demonstrates the difficulty and value of differentiating between reactive and neoplastic mesothelial processes.
May 2016: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Robert P Johnson, Vladimir Bashkirov, Langley DeWitt, Valentina Giacometti, Robert F Hurley, Pierluigi Piersimoni, Tia E Plautz, Hartmut F-W Sadrozinski, Keith Schubert, Reinhard Schulte, Blake Schultze, Andriy Zatserklyaniy
We report on the design, fabrication, and first tests of a tomographic scanner developed for proton computed tomography (pCT) of head-sized objects. After extensive preclinical testing, pCT is intended to be employed in support of proton therapy treatment planning and pre-treatment verification in patients undergoing particle-beam therapy. The scanner consists of two silicon-strip telescopes that track individual protons before and after the phantom, and a novel multistage scintillation detector that measures a combination of the residual energy and range of the proton, from which we derive the water equivalent path length (WEPL) of the protons in the scanned object...
February 2016: IEEE Transactions on Nuclear Science
Kathleen McMillan
In order to provide whole-person care for patients and families, Loma Linda University Health recognizes the importance of supporting employee wholeness. The Employee Spiritual Care department helps create and support an environment that nurtures the spiritual health and wholeness of employees, and provides employees tools and knowledge about providing whole-person care to patients and colleagues.
April 2016: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
Harmony F Carter, Carol Lau, David Juma, Briana Wells, Richard L Applegate
BACKGROUND: Red blood cell (RBC) transfusion is common during infant cardiac surgery. A previous report of pediatric heart transplant recipients showed that increased RBC transfusion volume was independently associated with increased length of intensive care unit stay. It is unclear whether transfusion to infants as a subgroup carries similar risks. This study investigated relationships between intraoperative RBC transfusion during heart transplantation and postoperative length of stay (LOS), morbidity, and mortality in infants...
May 2016: Anesthesia and Analgesia
V A Bashkirov, R W Schulte, R F Hurley, R P Johnson, H F-W Sadrozinski, A Zatserklyaniy, T Plautz, V Giacometti
PURPOSE: Proton computed tomography (pCT) will enable accurate prediction of proton and ion range in a patient while providing the benefit of lower radiation exposure than in x-ray CT. The accuracy of the range prediction is essential for treatment planning in proton or ion therapy and depends upon the detector used to evaluate the water-equivalent path length (WEPL) of a proton passing through the object. A novel approach is presented for an inexpensive WEPL detector for pCT and proton radiography...
February 2016: Medical Physics
Carol Lee, Elizabeth Walters, Rodney Borger, Kathleen Clem, Gregory Fenati, Michael Kiemeney, Sakona Seng, Ho-Wang Yuen, Michael Neeki, Dustin Smith
On December 2, 2015, a terror attack in the city of San Bernardino, California killed 14 Americans and injured 22 in the deadliest attack on U.S. soil since September 11, 2001. Although emergency personnel and law enforcement officials frequently deal with multi-casualty incidents (MCIs), what occurred that day required an unprecedented response. Most of the severely injured victims were transported to either Loma Linda University Medical Center (LLUMC) or Arrowhead Regional Medical Center (ARMC). These two hospitals operate two designated trauma centers in the region and played crucial roles during the massive response that followed this attack...
January 2016: Western Journal of Emergency Medicine
Stephen Wasemiller, Tiffany Earle, Michael Kashner, Gary Foster, Helme Silvet
The relation between the etiology of cardiomyopathy and the function of the right ventricle (RV) has not been well described in the current era of 3-dimensional cardiac imaging. New advances in cardiac imaging with computed tomography (CT) have allowed accurate measurements of ejection fraction (EF), often a challenging task considering the unique RV shape. We evaluated 130 patients at the Loma Linda Veterans Affairs Healthcare System with cardiomyopathy and a left ventricular (LV) EF ≤ 40%. Etiology of cardiomyopathy was determined by CT angiography as ischemic (n = 56) or nonischemic (n = 74)...
January 15, 2016: American Journal of Cardiology
Kristen Arthur, Juan Carlos Belliard, Steven B Hardin, Kathryn Knecht, Chien-Shing Chen, Susanne Montgomery
Studies have shown a high prevalence (40-83%) of complementary and alternative medicine (CAM) use among cancer patients in the U.S.A cross-sectional, mixed-methods pilot study was completed. This paper focuses on the quantitative analysis conducted on demographic predictors of complementary medicine (CM) use, reasons to use CM, and disclosure to healthcare provider data. Surveys were interview-administered at the Loma Linda University Medical Center Cancer Center. Participants, 18 years or older, were selected from a convenient sample...
November 2013: Cancer and Clinical Oncology
Dt R Howarth, Sharon S Lum, Pamela Esquivel, Carlos A Garberoglio, Maheswari Senthil, Naveenraj L Solomon
Multigene panel testing for hereditary cancer risk has recently become commercially available; however, the impact of its use on patient care is undefined. We sought to evaluate results from implementation of panel testing in a multidisciplinary cancer center. We performed a retrospective review of consecutive patients undergoing genetic testing after initiating use of multigene panel testing at Loma Linda University Medical Center. From February 13 to August 25, 2014, 92 patients were referred for genetic testing based on National Comprehensive Cancer Network guidelines...
October 2015: American Surgeon
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