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Case records massachusetts general

Curtis R Heberle, Amir-Houshang Omidvari, Ayman Ali, Sonja Kroep, Chung Yin Kong, John M Inadomi, Joel H Rubenstein, Angela C Tramontano, Emily C Dowling, William D Hazelton, E Georg Luebeck, Iris Lansdorp-Vogelaar, Chin Hur
BACKGROUND & AIMS: It is important to identify patients with Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma (EAC). Patients with BE are usually identified by endoscopy, which is expensive. The cytosponge, which collects tissue from the esophagus non-invasively, could be a cost-effective tool for screening individuals with gastroesophageal reflux disease (GERD), who are at increased risk for BE. We developed a model to analyze the cost effectiveness of using cytosponge in first-line screening of patients with GERD for BE with endoscopic confirmation, compared to endoscopy screening only, METHODS: We incorporated data from a large clinical trial of cytosponge performance into 2 validated microsimulation models of EAC progression (the esophageal adenocarcinoma model from the Massachusetts General Hospital and the microsimulation screening analysis model from Erasmus University Medical Center)...
February 23, 2017: Clinical Gastroenterology and Hepatology
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
2017: Cerebrovascular Diseases
Julie Guilmette, Gunnlaugur P Nielsen, William C Faquin, Martin Selig, Vânia Nosé, Anthony W S Chi, Peter M Sadow
Mammary analogue secretory carcinoma (MASC) of the salivary glands is a recently described neoplasm of the salivary glands with a characteristic morphology complemented by a specific cytogenetic translocation and gene rearrangements. Although immunophenotypic and cytogenetic differences allow for a more reliable distinction, ultrastructural features can also provide important information about the relationship between MASC, classic acinic cell carcinoma (AciCC), and AciCC intercalated duct cell-predominant variant...
February 13, 2017: Head and Neck Pathology
Olivia R Grocott, Katherine S Herrington, Heidi H Pfeifer, Elizabeth A Thiele, Ronald L Thibert
The low glycemic index treatment, a dietary therapy that focuses on glycemic index and reduced carbohydrate intake, has been successful in reducing seizure frequency in the general epilepsy population. Epilepsy is a common feature of Angelman syndrome and seizures are often refractory to multiple medications, especially in those with maternal deletions. Dietary therapy has become a more frequently used option for treating epilepsy, often in combination with other antiepileptic drugs, due to its efficacy and favorable side effect profile...
January 18, 2017: Epilepsy & Behavior: E&B
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
Shafaq Khairi, Babak Torabi Sagvand, Karen J Pulaski-Liebert, Nicholas A Tritos, Anne Klibanski, Lisa B Nachtigall
OBJECTIVE: The aim of this study was to evaluate the proportion of patients with acromegaly who remained on long-term lanreotide depot after completion of an open-label multicenter phase III clinical trial (SALSA: A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel), compare baseline and long-term follow-up symptoms scores, and correlate scores with individual longitudinal clinical outcomes. METHODS: Records of all subjects previously enrolled at the Massachusetts General Hospital site of SALSA were reviewed...
January 2017: Endocrine Practice
Thomas H McCoy, Victor M Castro, Ashlee M Roberson, Leslie A Snapper, Roy H Perlis
Importance: Suicide represents the 10th leading cause of death across age groups in the United States (12.6 cases per 100 000) and remains challenging to predict. While many individuals who die by suicide are seen by physicians before their attempt, they may not seek psychiatric care. Objective: To determine the extent to which incorporating natural language processing of narrative discharge notes improves stratification of risk for death by suicide after medical or surgical hospital discharge...
October 1, 2016: JAMA Psychiatry
Jessica A Zeidman, Paul C Shellito, Benjamin T Davis, Lawrence R Zukerberg
Presentation of Case. Dr. Robert H. Goldstein (Medicine): A 33-year-old man was seen in the surgery clinic of this hospital because of painful bowel movements and rectal bleeding. The patient had been well until approximately 4 months before this presentation, when pain with defecation developed...
August 18, 2016: New England Journal of Medicine
Hasan Bazari, William E Palmer, Jason M Baron, Katrina Armstrong
Presentation of Case. Dr. Shruti Gupta (Medicine): A 66-year-old man was admitted to this hospital because of malaise, weakness, and hypercalcemia. Thirty-five hours before admission, the patient was seen in an outpatient clinic affiliated with this hospital for evaluation of multiple problems,..
August 11, 2016: New England Journal of Medicine
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July 28, 2016: New England Journal of Medicine
Dean Eliott, George N Papaliodis, Marlene L Durand, Sarah E Turbett
Presentation of Case. Dr. Eric D. Gaier (Ophthalmology): A 50-year-old man with psoriatic arthritis and human immunodeficiency virus (HIV) infection was seen at the Massachusetts Eye and Ear Infirmary because of cloudy vision. The patient had been in his usual state of health until 3 days before..
June 30, 2016: New England Journal of Medicine
Cory M Resnick, Gino Inverso, Mariusz Wrzosek, Bonnie L Padwa, Leonard B Kaban, Zachary S Peacock
PURPOSE: Virtual surgical planning (VSP) and 3-dimensional printing of surgical splints are becoming the standard of care for orthognathic surgery, but costs have not been thoroughly evaluated. The purpose of this study was to compare the cost of VSP and 3-dimensional printing of splints ("VSP") versus that of 2-dimensional cephalometric evaluation, model surgery, and manual splint fabrication ("standard planning"). MATERIALS AND METHODS: This is a retrospective cohort study including patients planned for bimaxillary surgery from January 2014 to January 2015 at Massachusetts General Hospital...
September 2016: Journal of Oral and Maxillofacial Surgery
M K Wrzosek, Z S Peacock, A Laviv, B R Goldwaser, R Ortiz, C M Resnick, M J Troulis, L B Kaban
Virtual surgical planning (VSP) is a tool for predicting complex surgical movements in three dimensions and it may reduce preoperative laboratory time. A prospective study to compare the time required for standard preoperative planning versus VSP was conducted at Massachusetts General Hospital from January 2014 through January 2015. Workflow data for bimaxillary cases planned by both standard techniques and VSP were recorded in real time. Time spent was divided into three parts: (1) obtaining impressions, face-bow mounting, and model preparation; (2) occlusal analysis and modification, model surgery, and splint fabrication; (3) online VSP session...
September 2016: International Journal of Oral and Maxillofacial Surgery
Kevin R Schwartz, Chadi M El Saleeby, Katherine Nimkin, Alison M Friedmann, Aeri Moon, Lawrence R Zukerberg
Presentation of Case. Dr. Katherine L. Tuttle (Pediatrics): A 12-year-old boy was admitted to this hospital because of malaise, fevers, abdominal pain, and worsening pallor. The patient had been well until 1 month before admission, when headache and abdominal pain developed. Examination by a school..
April 14, 2016: New England Journal of Medicine
Kai Saukkonen, Amita Sharma, Eugene J Mark
Presentation of Case. Dr. Jason P. Cooper (Medicine): A 71-year-old man was admitted to this hospital because of recurrent fevers, dyspnea, and hypoxemia, with associated fluctuating pulmonary infiltrates. The patient had reportedly been well until approximately 6 months before this admission, when..
March 17, 2016: New England Journal of Medicine
Jeffrey A Biller, S Reha Butros, Gayun Chan-Smutko, Annah N Abrams, Daniel C Chung, Catherine E Hagen
Presentation of Case. Dr. Hasan Merali (Pediatrics): A 10-year-old boy was seen in the gastroenterology clinic of this hospital because of intermittent abdominal cramping and fevers. The patient had been well until approximately 3 weeks before this presentation, when intermittent fevers to a..
February 25, 2016: New England Journal of Medicine
Shravan Renapurkar, Mark S Pasternack, G Petur Nielsen, Leonard B Kaban
PURPOSE: To document outcomes of management of juvenile mandibular chronic osteomyelitis (JMCO) using a standardized treatment protocol including open biopsy, decortication, microbial culture, and long-term antibiotic therapy. MATERIALS AND METHODS: This was a retrospective case study of pediatric patients with JMCO treated at Massachusetts General Hospital for Children from 1996 through 2014. Inclusion criteria included age younger than 18 years, diagnosis of JMCO, management by the protocol, adequate clinical and radiographic data in the record, and follow-up of at least 1 year after initial treatment...
July 2016: Journal of Oral and Maxillofacial Surgery
Meridale V Baggett, R Gilberto Gonzalez, Roby P Bhattacharyya, Michael A Mahowald
Presentation of Case. Dr. Jacob Lazarus (Medicine): A 58-year-old woman was admitted to this hospital during the summer because of an ulcerated lesion on the forehead, fever, and cervical lymphadenopathy. The patient had been well until 8 days before admission, when she noted a pimplelike lesion on..
February 11, 2016: New England Journal of Medicine
Nancy Berliner, Chandana Kurra, David Chou
Presentation of Case. Dr. Emily R. Lynch (Pediatrics): An 18-year-old man was admitted to this hospital because of fever and pain in the lower abdomen, groin, and scrotum. The patient had been well until 4 days before admission, when fatigue, subjective fever, and chills developed. The next day, he..
January 14, 2016: New England Journal of Medicine
Derri L Shtasel, Oliver Freudenreich, Travis P Baggett
Presentation of Case. Dr. Alex S. Keuroghlian (Psychiatry): A 40-year-old woman with a history of psychosis was admitted to this hospital from a homeless shelter because of headache and hypertension. One week before admission, the patient had accepted placement in a homeless shelter, after spending..
December 24, 2015: New England Journal of Medicine
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