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Madison B Schwartz, Jason A Ferreira, Patrick M Aaronson
BACKGROUND: The utilization of bolus-dose phenylephrine (PHE) has transitioned to the emergency department (ED) for the treatment of acutely hypotensive patients, despite a paucity of literature in this setting. METHODS: This was a single center retrospective chart review of the utilization of bolus-dosed PHE for acute hypotension in the ED at an academic non-forprofit hospital. The primary objective of this study is to report the frequency of patients that were initiated on a continuous vasopressor infusion (CVI) within 30 minutes after the first administration of bolus-dose PHE...
September 22, 2016: American Journal of Emergency Medicine
Marc S Schwartz, Eric P Wilkinson
OBJECTIVE: Auditory brainstem implants (ABIs), which have previously been used to restore auditory perception to deaf patients with neurofibromatosis type 2 (NF2), are now being utilized in other situations, including treatment of congenitally deaf children with cochlear malformations or cochlear nerve deficiencies. Concurrent with this expansion of indications, the number of centers placing and expressing interest in placing ABIs has proliferated. Because ABI placement involves posterior fossa craniotomy in order to access the site of implantation on the cochlear nucleus complex of the brainstem and is not without significant risk, we aim to highlight issues important in developing and maintaining successful ABI programs that would be in the best interests of patients...
September 26, 2016: Laryngoscope
Sanjiv M Baxi, Makeda L Robinson, Marie F Grill, Brian S Schwartz, Sarah B Doernberg, Catherine Liu
Little is known about the clinical presentation and outcomes associated with spinal implant infections. Here, we describe a single center's experience in a retrospective cohort of 109 individuals with spinal implant infections, including clinical, microbiological, therapeutic, and outcome data.
September 2016: Open Forum Infectious Diseases
Allison B Dart, Michael Zappitelli, Manish M Sood, R Todd Alexander, Steven Arora, Robin L Erickson, Kristine Kroeker, Andrea Soo, Braden J Manns, Susan M Samuel
BACKGROUND: Data guiding the timing of dialysis initiation in children are limited. We sought to determine current practice and secular trends in Canada with respect to the timing of dialysis initiation in children based on estimated glomerular filtration rate (eGFR). METHODS: This observational study included incident chronic dialysis patients aged ≤21 years identified from the Canadian Organ Replacement Register who started dialysis in Canada between January 2001 and December 2010 at any of the nine participating Canadian centers (n = 583)...
October 1, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Sivraj Muralikrishnan, Christos Hatzis, Andrea Katz, Alessandro Santin, Peter E Schwartz, Maysa M Abu-Khalaf
OBJECTIVE: Ovarian cancer is the most lethal cancer involving the female pelvic reproductive system. Its incidence increases with age and with an aging population, its prevalence should also increase. The goal of our retrospective study is to report our experience in treating women over 65 years of age, with a diagnosis of primary ovarian cancer, using standard intravenous chemotherapy. METHODS: The medical records of 78 patients>65 years of age diagnosed with primary ovarian cancer at the Yale Cancer Center between 1996-2006 were retrospectively reviewed and included in our analysis...
August 2016: Gynecology & Obstetrics: Current Research
Robert P Schwartz, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Devang Gandhi, Yngvild Olsen, Jerome H Jaffe
BACKGROUND AND AIMS: Methadone patients who discontinue treatment are at high risk of relapse, yet a substantial proportion discontinue treatment within the first year. We investigated whether a patient-centered approach to methadone treatment improved participant outcomes at 12-months following admission, compared with methadone treatment-as-usual. DESIGN: Two-arm open-label randomized trial. SETTING: Two methadone treatment programs (MTPs) in Baltimore, Maryland, USA...
September 23, 2016: Addiction
Stephen G Schwartz, Ingrid U Scott, Michael W Stewart, Harry W Flynn
Diabetic macular edema (DME) remains an important cause of visual loss. Although anti-vascular endothelial growth factor (VEGF) agents are generally used as first-line treatments for patients with center-involving DME, there is an important role for corticosteroids as well. Corticosteroids may be especially useful in pseudophakic patients poorly responsive to anti-VEGF therapies, in patients wishing to reduce the number of required injections, and in pregnant patients. Intravitreal triamcinolone acetonide has been used for many years but is not approved for this indication...
2016: Clinical Ophthalmology
Joseph Safdieh, Andrew Wong, Joseph P Weiner, David Schwartz, David Schreiber
PURPOSE: Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. MATERIAL AND METHODS: Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database...
August 2016: Journal of Contemporary Brachytherapy
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: The rise in atypical antipsychotic prescribing increases the risk of pediatric exposures. Published studies in children are limited. OBJECTIVE: The objectives are to evaluate national poison center data on atypical antipsychotic exposures in young children and compare toxicity amongst selected agents. MATERIALS AND METHODS: A retrospective study of U.S. National Poison Data System single substance exposures, from 2005 to 2013, of five atypical antipsychotics in children <6 years old, followed to known outcome was performed...
September 20, 2016: Clinical Toxicology
Alyce J M Anderson, Benjamin Click, Claudia Ramos-Rivers, Dmitriy Babichenko, Ioannis E Koutroubakis, Douglas J Hartman, Jana G Hashash, Marc Schwartz, Jason Swoger, Arthur M Barrie, Michael A Dunn, Miguel Regueiro, David G Binion
BACKGROUND: Inflammatory bowel disease (IBD) is a heterogeneous collection of chronic inflammatory disorders of the digestive tract. Clinical, genetic, and pathological heterogeneity makes it increasingly difficult to translate efficacy studies into real-world practice. Our objective was to develop a comprehensive natural history registry derived from multi-year observational data to facilitate effectiveness and clinical phenotypic research in IBD. METHODS: A longitudinal, consented registry with prospectively collected data was developed at UPMC...
November 2016: Digestive Diseases and Sciences
Lauren N Whiteman, Carlton Haywood, Sophie Lanzkron, John J Strouse, Adrian H Batchelor, Anthony Schwartz, Rosalyn W Stewart
OBJECTIVES: Poor oral health can have a negative impact on overall health. This is especially concerning for individuals with sickle cell disease (SCD), an inherited blood disorder that affects hemoglobin and can lead to an increased risk of infection and hyperalgesia. Because the majority of individuals with SCD have Medicaid insurance and no dental coverage, we provided free basic dental care to individuals with SCD to determine whether it decreased overall healthcare utilization. METHODS: Through a contract with a private dental office, we provided free basic dental care (eg, cleanings, fillings, x-rays) to individuals with SCD...
September 2016: Southern Medical Journal
Henriette Engberg, Sonja Wehberg, Claus Bistrup, James Heaf, Søren Schwartz Sørensen, Helle Charlotte Thiesson, Jesper Melchior Hansen, My Svensson, Anders Green, Peter Marckmann
BACKGROUND: Kidney recipients receive immunosuppression to prevent graft rejection, and long-term outcomes such as post-transplant cancer and mortality may vary according to the different protocols of immunosuppression. METHODS: A national register-based historical cohort study was conducted to examine whether post-transplant cancer and all-cause mortality differed between Danish renal transplantation centres using standard immunosuppressive protocols including steroids (Centres 2, 3, 4) or a steroid-free protocol (Centre 1)...
September 1, 2016: Nephrology, Dialysis, Transplantation
William Moir, Rachel Zeig-Owens, Robert D Daniels, Charles B Hall, Mayris P Webber, Nadia Jaber, James H Yiin, Theresa Schwartz, Xiaoxue Liu, Madeline Vossbrinck, Kerry Kelly, David J Prezant
BACKGROUND: We previously reported a modest excess of cancer in World Trade Center (WTC)-exposed firefighters versus the general population. This study aimed to separate the potential carcinogenic effects of firefighting and WTC exposure by comparing to a cohort of non-WTC-exposed firefighters. METHODS: Relative rates (RRs) for all cancers combined and individual cancer subtypes from 9/11/2001 to 12/31/2009 were modeled using Poisson regression comparing 11,457 WTC-exposed firefighters to 8,220 urban non-WTC-exposed firefighters...
September 2016: American Journal of Industrial Medicine
Benjamin L Schwartz, Ziying Yin, Richard L Magin
Cylindrical homogenous phantoms for magnetic resonance (MR) elastography in biomedical research provide one way to validate an imaging systems performance, but the simplified geometry and boundary conditions can cloak complexity arising at tissue interfaces. In an effort to develop a more realistic gel tissue phantom for MRE, we have constructed a heterogenous gel phantom (a sphere centrally embedded in a cylinder). The actuation comes from the phantom container, with the mechanical waves propagating toward the center, focusing the energy and thus allowing for the visualization of high-frequency waves that would otherwise be damped...
September 21, 2016: Physics in Medicine and Biology
Jonas Schwartze, Harald Schrom, Klaus-Hendrik Wolf, Michael Marschollek
Current Ambient Assisted Living (AAL) environments lack integration of sensors and actuators of other sub-domains. Creating technical and organizational integration is addressed by the BASIS project (Build Automation by a Scalable and Intelligent System), which aims to build a cross-domain home bus system. The main objective of this paper is to present an overview of design, architecture and state of realization of BASIS by describing the requirements development process, underlying hardware design and software architecture...
2016: Studies in Health Technology and Informatics
Fati Sidikou, Maman Zaneidou, Ibrahim Alkassoum, Stephanie Schwartz, Bassira Issaka, Ricardo Obama, Clement Lingani, Ashley Tate, Flavien Ake, Souleymane Sakande, Sani Ousmane, Jibir Zanguina, Issaka Seidou, Innocent Nzeyimana, Didier Mounkoro, Oubote Abodji, Xin Wang, Muhamed-Kheir Taha, Jean Paul Moulia-Pelat, Assimawe Pana, Goumbi Kadade, Olivier Ronveaux, Ryan Novak, Odile Ouwe Missi Oukem-Boyer, Sarah Meyer
BACKGROUND: To combat Neisseria meningitidis serogroup A epidemics in the meningitis belt of sub-Saharan Africa, a meningococcal serogroup A conjugate vaccine (MACV) has been progressively rolled out since 2010. We report the first meningitis epidemic in Niger since the nationwide introduction of MACV. METHODS: We compiled and analysed nationwide case-based meningitis surveillance data in Niger. Cases were confirmed by culture or direct real-time PCR, or both, of cerebrospinal fluid specimens, and whole-genome sequencing was used to characterise isolates...
August 23, 2016: Lancet Infectious Diseases
Michael J Bax, Timothy M Johnson, Paul W Harms, Jennifer L Schwartz, Lili Zhao, Douglas R Fullen, May P Chan
Importance: It is unclear why some patients with in situ melanoma develop metastases. Few reports demonstrate occult invasion with immunohistochemistry staining, which were discordant with reports interpreting such staining as false-positive. Objective: To investigate the occurrence of occult invasive disease within in situ melanoma by using methods to circumvent potential limitations in prior study designs. Design, Setting, and Participants: Unequivocal in situ melanoma without associated nevi or regression was identified using a consecutive sample of 33 cases plus 1 index case in an academic medical center...
August 10, 2016: JAMA Dermatology
Gina L Stassinos, Wendy Klein-Schwartz
OBJECTIVES: Bupropion use to obtain nonmedical psychoactive effects has been reported. The objective was to determine the prevalence, characteristics, clinical effects, and outcomes of bupropion "abuse." METHODS: A 14-year retrospective review was conducted of single substance bupropion cases with "intentional abuse" as the coded reason for exposure in individuals 13 and older reported to the National Poison Data System. Data were evaluated for prevalence, demographics, clinical effect, route, final management site, and coded outcome...
September 2016: Journal of Addiction Medicine
Jan Gryczynski, Kevin E O'Grady, Shannon Gwin Mitchell, Steven J Ondersma, Robert P Schwartz
OBJECTIVE: Computerized brief interventions are a promising approach for integrating substance use interventions into primary care settings. We sought to examine the effectiveness of a computerized brief intervention for illicit drug misuse, which prior research showed performed no worse than a traditional in-person brief intervention. METHODS: Community health center patients were screened for eligibility using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)...
September 2016: Journal of Addiction Medicine
Ian Jeffery Constable, Mark Scott Blumenkranz, Steven D Schwartz, Sam Barone, Chooi-May Lai, Elizabeth Piroska Rakoczy
The purpose of this article was to evaluate safety and signals of efficacy of gene therapy with subretinal rAAV.sFlt-1 for wet age-related macular degeneration (wet AMD). A phase 1 dose-escalating single-center controlled unmasked human clinical trial was followed up by extension of the protocol to a phase 2A single-center trial. rAAV.sFlt-1 vector was used to deliver a naturally occurring anti-vascular endothelial growth factor agent, sFlt-1, into the subretinal space. In phase 1, step 1 randomized 3 subjects to low-dose rAAV...
July 2016: Asia-Pacific Journal of Ophthalmology
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