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"Brigham and Women's"

Allison R Schulman, Walter Chan, Aiofe Devery, Michele B Ryan, Christopher C Thompson
BACKGROUND AND AIMS: Marginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) are frequently prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules, OCs) might be more easily absorbed than intact capsules (IC)...
October 20, 2016: Clinical Gastroenterology and Hepatology
Leo F Buckley, Enrique Seoane-Vazquez, Judy W M Cheng, Ahmed Aldemerdash, Irene M Cooper, Lina Matta, Danika S Medina, Mandeep R Mehra, Kristina Navarro-Velez, Elaine L Shea, Joanne R Weintraub, Lynne W Stevenson, Akshay S Desai
Innovative treatment strategies for decompensated heart failure (HF) are required to achieve cost savings and improvements in outcomes. We developed a decision analytic model from a hospital perspective to compare 2 strategies for the treatment of decompensated HF, ambulatory diuretic infusion therapy, and hospitalization (standard care), with respect to total HF hospitalizations and costs. The ambulatory diuretic therapy strategy included outpatient treatment with high doses of intravenous loop diuretics in a specialized HF unit whereas standard care included hospitalization for intravenous loop diuretic therapy...
November 1, 2016: American Journal of Cardiology
Megan A Rocchio, James W Schurr, Aaron P Hussey, Paul M Szumita
BACKGROUND: In October 2010, a pharmacist-driven stewardship program was implemented at the Brigham and Women's Hospital to ensure continued adherence to the prescribing guideline, focusing on indications for intravenous immune globulin (IVIG) use and dosing per ideal body weight. OBJECTIVE: The primary objective was to describe an IVIG stewardship program at a tertiary academic medical center. METHODS: This was a prospective, observational study from January 2013 through December 2014...
October 6, 2016: Annals of Pharmacotherapy
Harriet Kiwanuka, Mario A Aycart, David F Gitlin, Elaine Devine, Bridget J Perry, Thet-Su Win, Ericka M Bueno, Muayyad Alhefzi, Nicco Krezdorn, Bohdan Pomahac
BACKGROUND: Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Emily Stamell Ruiz, Pritesh S Karia, Frederick C Morgan, Chrysalyne D Schmults
BACKGROUND: There is limited evidence on the utility of radiologic imaging for prognostic staging of cutaneous squamous cell carcinoma (CSCC). OBJECTIVE: Review utilization of radiologic imaging of high-stage CSCCs to evaluate whether imaging impacted management and outcomes. METHODS: Tumors classified as Brigham and Women's Hospital (BWH) tumor (T) stage T2B or T3 over a 13-year period were reviewed to identify whether imaging was performed and whether results affected treatment...
October 1, 2016: Journal of the American Academy of Dermatology
Elisabeth F Beaber, Anna N A Tosteson, Jennifer S Haas, Tracy Onega, Brian L Sprague, Donald L Weaver, Anne Marie McCarthy, Chyke A Doubeni, Virginia P Quinn, Celette Sugg Skinner, Ann G Zauber, William E Barlow
PURPOSE: Although United States clinical guidelines differ, the earliest recommended age for average risk breast cancer screening is 40 years. Little is known about factors influencing screening initiation. METHODS: We conducted a cohort study within the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We identified 3413 women on their 40th birthday in primary care networks at Geisel School of Medicine at Dartmouth (DH) and Brigham and Women's Hospital (BWH) during 2011-2013 with no prior breast imaging or breast cancer...
November 2016: Breast Cancer Research and Treatment
Jesmond Dalli, Romain A Colas, Carolina Quintana, Diana Barragan-Bradford, Shelley Hurwitz, Bruce D Levy, Augustine M Choi, Charles N Serhan, Rebecca M Baron
OBJECTIVE: To identify and measure recently described chemical mediators, termed specialized pro-resolving mediators that actively regulate the resolution of acute-inflammation, and correlate measurements with clinical outcomes. DESIGN: Herein, deidentified plasma was collected from sepsis patients (n = 22 subjects) within 48 hours of admission to the ICU and on days 3 and 7 thereafter and subjected to lipid mediator profiling. SETTING: Brigham and Women's Hospital Medical Intensive Care Unit...
September 14, 2016: Critical Care Medicine
M F Vázquez-Alonso, C Abdala-Dergal
The frequent causes of relapsing carpal tunnel syndrome were analyzed. Nine patients were followed-up from January 1st to December 31st, 2011. They underwent a physical exam and imaging tests. Pain was measured in all of them with the VAS, and the Brigham and Womens Hospital questionnaire was used to assess disability. Patients included seven females and two males; mean age was 52 years. Major causes for relapse included postoperative fibrosis with incomplete release in seven patients and incomplete release in two patients in whom minimally invasive approaches were used...
January 2016: Acta Ortopédica Mexicana
Sara Tejani, Ahmed Sultan, Ivan Stojanov, Sook-Bin Woo
OBJECTIVES: To determine (1) the prevalence of candidal carriage in patients with oral mucosal disease to be treated with topical immunosuppressive therapy, and (2) the incidence of oral candidiasis among carriers and noncarriers after initiation of therapy to assess any correlation between carriage and the development of candidiasis. STUDY DESIGN: Records of patients who underwent swab cultures for Candida between January 2009 and October 2014 at the Brigham and Women's Hospital in Boston, Massachusetts, were retrospectively reviewed...
October 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Natasha Kekre, Francisco J Marquez-Malaver, Monica Cabrero, Jl Piñana, Albert Esquirol, Robert J Soiffer, Dolores Caballero, M J Terol, Rodrigo Martino, Joseph H Antin, L Lopez-Corral, Carlos Solano, Philippe Armand, Jose A Pérez-Simon
There is at present little data to guide the choice of conditioning for patients with lymphoma undergoing reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (SCT). In this study, we compared the outcomes of patients undergoing RIC SCT who received fludarabine and melphalan (FluMel), the standard RIC regimen used by the Spanish Group of Transplantation, and fludarabine and busulfan (FluBu), the standard RIC regimen used by the Dana-Farber Cancer Institute/Brigham and Women's Hospital. We analyzed 136 patients undergoing RIC SCT for lymphoma with either FluBu (n = 61) or FluMel (n = 75) conditioning between 2007 and 2014...
October 2016: Biology of Blood and Marrow Transplantation
K E Joung, H H Burris, L J Van Marter, T F McElrath, Z Michael, P Tabatabai, A A Litonjua, S T Weiss, H Christou
OBJECTIVE: Vitamin D deficiency is associated with asthma and reactive airway disease in childhood but its potential contribution to bronchopulmonary dysplasia (BPD) in preterm infants is unknown. Preterm infants have lower levels of 25-hydroxyvitamin D (25(OH)D) at birth and are at risk for nutritional deficiencies after birth. The objective of the study was to evaluate the association of 25(OH)D concentrations at birth and at 36 weeks' corrected gestational age with BPD in preterm infants born before 29 completed weeks of gestation...
October 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Mary L Stevenson, Randie Kim, Shane A Meehan, Anna C Pavlick, John A Carucci
BACKGROUND: While infrequent, nodal metastases in cutaneous squamous cell carcinoma (cSCC) can result in death from disease. Identification of those at risk for metastases is key to improved prognostication and treatment. OBJECTIVE: To review metastatic cSCC at the study institution. METHODS AND MATERIALS: Sixteen patients with metastatic cSCC were identified at the New York University Dermatologic Associates and Cancer Associates from 1998 to 2013...
August 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Ryan P Lee, Garrett T Venable, Mallory L Roberts, Kara A Parikh, Douglas R Taylor, Nickalus Khan, L Madison Michael, Paul Klimo
BACKGROUND: We recently performed a comprehensive bibliometric analysis of 103 US neurosurgical departments and found the ih(5)-index as meaningful and reproducible using public data. The present report expands this analysis by adding 14 Canadian and 2 additional US programs. METHODS: Departments were included if listed on the American Association of Neurological Surgeons residency directory. Each institution was considered a single entity, and original research articles with neurosurgeon faculty authors were only counted once per institution, although a single article may have been credited toward multiple institutions, if applicable...
July 25, 2016: World Neurosurgery
Michael Klompas, Lingling Li, Ken Kleinman, Paul M Szumita, Anthony F Massaro
IMPORTANCE: Ventilator bundles, including head-of-bed elevation, sedative infusion interruptions, spontaneous breathing trials, thromboprophylaxis, stress ulcer prophylaxis, and oral care with chlorhexidine gluconate, are ubiquitous, but the absolute and relative value of each bundle component is unclear. OBJECTIVE: To evaluate associations between individual and collective ventilator bundle components and ventilator-associated events, time to extubation, ventilator mortality, time to hospital discharge, and hospital death...
September 1, 2016: JAMA Internal Medicine
Giulia M Stella, Elisabetta Balestro, Donato Lacedonia, Simonetta Baraldo
Growing evidence demonstrates that a number of clinical disorders may be related to genetic defects in telomere replication and extension. Overall, these syndromes are referred to as "telomeropathies" or "telomere disorders/syndromes"; they are increasingly being identified. In adulthood, idiopathic pulmonary fibrosis (IPF) is the most common symptom of telomeropathy. IPF is a progressive and fatal disease characterized by scarring of the lungs that thickens the interstitium ultimately leading to irreversible respiratory failure...
February 2016: Minerva Medica
Neelam H Shah, Thomas R Schneider, Doreen DeFaria Yeh, Katherine N Cahill, Tanya M Laidlaw
BACKGROUND: Some patients with aspirin-exacerbated respiratory disease (AERD) and eosinophilia report angina-type chest pain that occurs at rest and responds to corticosteroid therapy. The frequency of eosinophilia-associated coronary artery vasospasm in patients with AERD, a disease characterized by blood and respiratory tissue eosinophilia, however, is unknown. OBJECTIVE: The objective of this study was to understand the cause of the chest pain described above and determine the most appropriate treatment for it...
July 7, 2016: Journal of Allergy and Clinical Immunology in Practice
Randi H Goldman, Ruth E Tuomala, Joan M Bengtson, Amy R Stagg
OBJECTIVE: Assessment tools that accrue data for the Accreditation Council for Graduate Medical Education Milestones must evaluate residents across multiple dimensions, including medical knowledge, procedural skills, teaching, and professionalism. Our objectives were to: (1) develop an assessment tool to evaluate resident performance in accordance with the Milestones and (2) review trends in resident achievements during the inaugural year of Milestone implementation. DESIGN: A novel venue and postgraduate year (PGY) specific assessment tool was built, tested, and implemented for both operating room and labor and delivery "venues...
July 6, 2016: Journal of Surgical Education
Kyle A Burton, Kurt A Ashack, Amor Khachemoune
Non-melanoma skin cancer represents one-third of all malignancies and its incidence is expected to rise until the year 2040. Cutaneous squamous cell carcinoma (cSCC) represents 20 % of all non-melanoma skin cancer and is a deadly threat owing to its ability to metastasize to any organ in the body. Therefore, a better understanding of cSCC is essential to strengthen preventative measures and curable treatment options. Currently, research demonstrates that cSCC is diagnosed at a rate of 15-35 per 100,000 people and is expected to increase 2-4 % per year...
June 29, 2016: American Journal of Clinical Dermatology
Jo Shapiro, Pamela Galowitz
Burnout is plaguing the culture of medicine and is linked to several primary causes including long work hours, increasingly burdensome documentation, and resource constraints. Beyond these, additional emotional stressors for physicians are involvement in an adverse event, especially one that involves a medical error, and malpractice litigation. The authors argue that it is imperative that health care institutions devote resources to programs that support physician well-being and resilience. Doing so after adverse and other emotionally stressful events, such as the death of a colleague or caring for victims of a mass trauma, is crucial as clinicians are often at their most vulnerable during such times...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Shannon Stock, Katie Rubino, Sook-Bin Woo, Arthur Margolis, Irena Thomas, Ali Aboalela, thomas Ali, Nathaniel Treister
For many oral medicine conditions, the use of compounded topical therapies that are locally absorbed and act directly at the affected site can provide greater efficacy compared with systemically delivered medications while minimizing systemic side effects. The objective of this study was to characterize the utilization and costs associated with the use of compounded medications in an academic, hospital-based oral medicine practice. This was a retrospective analysis of outpatients treated at the Center for Oral Disease at Brigham and Women's Hospital (Boston, Massachusetts) during the five-year period from November 2006 through November 2011...
March 2016: International Journal of Pharmaceutical Compounding
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