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Cleveland clinic

Debabrata Bandyopadhyay, Tanmay S Panchabhai, Navkaranbir S Bajaj, Pradnya D Patil, Matthew C Bunte
BACKGROUND: Primary pulmonary artery sarcoma (PPAS) is a rare tumor that mimics pulmonary thromboembolism (PE). Similarities to PE can delay the diagnosis and misguide the treatment of PPAS. This study aimed to evaluate tumor characteristics and outcome predictors among those diagnosed with PPAS and misdiagnosed as PE. METHODS: From 1991-2010, 10 PPAS cases were available from the Cleveland Clinic (CC) institutional database and another 381 cases were reported in the literature...
September 2016: Journal of Thoracic Disease
Meghan R Longacre, Keith M Drake, Linda J Titus, Jennifer Harris, Lauren P Cleveland, Gail Langeloh, Kristy Hendricks, Madeline A Dalton
Breakfast cereals represent the most highly advertised packaged food on child-targeted television, and most ads are for cereals high in sugar. This study examined whether children's TV exposure to child-targeted, high-sugar breakfast cereal (SBC) ads was associated with their consumption of those SBC brands. Parents of 3- to 5-year-old children were recruited from pediatric and Women, Infants, and Children (WIC) clinics in Southern New Hampshire, USA, and completed a cross-sectional survey between April-December 2013...
October 13, 2016: Appetite
Erika E Doxtader, Jennifer A Brainard, Dawn Underwood, Deborah J Chute
BACKGROUND: Because of cervical cancer screening recommendations and forthcoming first-line human papillomavirus (HPV) screening, many Papanicolaou (Pap) tests will be performed in patients with known concurrent HPV results. This study was designed to evaluate whether knowledge of the HPV status affects cytotechnologists' interpretation of Pap tests. METHODS: A retrospective search of cervical screening Pap tests with known concurrent HPV results provided 250 ThinPrep Pap tests, which were chosen to reflect an atypical rate similar to the rate of the Cleveland Clinic's normal practice...
October 12, 2016: Cancer
Matthias Heringlake, Efstratios I Charitos, Kira Erber, Astrid Ellen Berggreen, Hermann Heinze, Hauke Paarmann
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is an emerging humoral marker for risk stratification in cardiovascular disease. Cardiac-surgery-associated acute kidney injury (CSA-AKI), an important complication in patients undergoing cardiac surgery, is associated with poor prognosis. The present secondary analysis of an observational cohort study aimed to determine the role of GDF-15 in predicting CSA-AKI compared with the Cleveland-Clinic Acute Renal Failure (CC-ARF) score and a logistic regression model including variables associated with renal dysfunction...
October 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Katie M Hallahan, Brian Cost, Jeff M Goshe, William J Dupps, Sunil K Srivastava, Justis P Ehlers
PURPOSE: To correlate intraoperative interface fluid dynamics during Descemet stripping automated endothelial keratoplasty (DSAEK) surgery using intraoperative optical coherence tomography (iOCT) in the PIONEER (Prospective Intraoperative and Perioperative Ophthalmic ImagiNg with Optical CohEncE TomogRaphy) study with postoperative outcomes. DESIGN: Prospective consecutive, interventional, comparative case series PARTICIPANTS: One hundred and seventy-eight eyes of 173 patients undergoing DSAEK from the Cole Eye Institute, Cleveland, USA...
October 1, 2016: American Journal of Ophthalmology
Ricardo Riveros, Stephen Kimatian, Pilar Castro, Vipul Dhumak, Hooman Honar, Edward J Mascha, Daniel I Sessler
STUDY OBJECTIVE: To assess professionalism in anesthesiology residents, it is important to obtain evaluations from people with whom they interact on daily basis. The purpose of this study was to evaluate the effect of a Multisource feedback (MSF) on resident's professional behavior and to assess the effect of faculty feedback on resident performance. DESIGN: This study was a two-group randomized clinical trial. SETTING: Residents were recruited from Cleveland Clinic Children's Hospital...
November 2016: Journal of Clinical Anesthesia
Carol F Farver, Susan Smalling, James K Stoller
OBJECTIVES: Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. METHODS: To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence...
October 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Sarah J Ozinga, Susan M Linder, Jay L Alberts
OBJECTIVE: To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson's disease (PD). DESIGN: Criterion standard. SETTING: Motor control laboratory at Cleveland Clinic. PARTICIPANTS: Fourteen mild to moderate individuals with PD and 14 healthy age-matched community dwelling controls completed the project...
September 23, 2016: Archives of Physical Medicine and Rehabilitation
Samantha H Weed-Pfaff, Benjamin Nutter, James F Bena, Jennifer Forney, Rosemary Field, Lynn Szoka, Diana Karius, Patti Akins, Christina M Colvin, Nancy M Albert
BACKGROUND: A seven-item cancer-specific fall risk tool (Cleveland Clinic Capone-Albert [CC-CA] Fall Risk Score) was shown to have a strong concordance index for predicting falls; however, validation of the model is needed. OBJECTIVES: The aims of this study were to validate that the CC-CA Fall Risk Score, made up of six factors, predicts falls in patients with cancer and to determine if the CC-CA Fall Risk Score performs better than the Morse Fall Tool. METHODS: Using a prospective, comparative methodology, data were collected from electronic health records of patients hospitalized for cancer care in four hospitals...
October 1, 2016: Clinical Journal of Oncology Nursing
Gabriel Loor, Sara J Shumway, Kenneth R McCurry, Suresh Keshavamurthy, Syed Hussain, Garry D Weide, John R Spratt, Mazin Al Salihi, Colleen G Koch
BACKGROUND: Donor organs are often procured by junior staff in stressful, unfamiliar environments where a single adverse event can be catastrophic. A formalized checklist focused on preprocedural processes related to thoracic donor organ procurement could improve detection and prevention of near miss events. METHODS: A checklist was developed centered on patient identifiers, organ compatibility and quality, and team readiness. It went through five cycles of feedback and revision using a panel of expert procurement surgeons...
September 19, 2016: Annals of Thoracic Surgery
Jason K Hsieh, Jarrod E Dalton, Dongsheng Yang, Ehab S Farag, Daniel I Sessler, Andrea M Kurz
BACKGROUND: Intraoperative hypotension may contribute to perioperative strokes. We therefore tested the hypothesis that intraoperative hypotension is associated with perioperative stroke. METHODS: After institutional review board approval for this case-control study, we identified patients who had nonneurological, noncardiac, and noncarotid surgery under general anesthesia at the Cleveland Clinic between 2005 and 2011 and experienced a postoperative stroke. Control patients not experiencing postoperative stroke were matched in a 4-to-1 ratio using propensity scores and restriction to the same procedure type as stroke patients...
October 2016: Anesthesia and Analgesia
Moshe C Ornstein, Laura Wood, Paul Elson, Kimberly Allman, Jennifer Beach, Allison Martin, Timothy Gilligan, Jorge A Garcia, Brian I Rini
BACKGROUND: Given the variability in drug levels with tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC), dose escalation at the occurrence of progressive disease (PD) might have antitumor effects. PATIENTS AND METHODS: The data from patients with mRCC who were treated at the Cleveland Clinic with TKIs and received a dose escalation after PD in accordance with Response Evaluation Criteria In Solid Tumors (RECIST), version 1...
August 18, 2016: Clinical Genitourinary Cancer
Fabio G Rodrigues, Sami A Chadi, Alejandro J Cracco, Dana R Sands, Massarat Zutshi, Brooke Gurland, Giovanna Da Silva, Steven D Wexner
AIM: Sphincteroplasty (SP) is used to treat faecal incontinence (FI) in patients with a sphincter defect. Sacral nerve stimulation (SNS) is now the form of interventional treatment used in most patients, but in those with a sphincter defect its outcome has not been definitively evaluated. We compared the results of SP and SNS for FI associated with a sphincter defect. METHOD: Patients treated by SNS or SP for FI with an associated sphincter defect were retrospectively identified from an IRB-approved prospective database...
September 12, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Ronald M Epstein, Paul R Duberstein, Joshua J Fenton, Kevin Fiscella, Michael Hoerger, Daniel J Tancredi, Guibo Xing, Robert Gramling, Supriya Mohile, Peter Franks, Paul Kaesberg, Sandy Plumb, Camille S Cipri, Richard L Street, Cleveland G Shields, Anthony L Back, Phyllis Butow, Adam Walczak, Martin Tattersall, Alison Venuti, Peter Sullivan, Mark Robinson, Beth Hoh, Linda Lewis, Richard L Kravitz
Importance: Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. Objective: To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life...
September 9, 2016: JAMA Oncology
Jason W D Hearn, Ghada AbuAli, Chad A Reichard, Chandana A Reddy, Cristina Magi-Galluzzi, Kai-Hsiung Chang, Rachel Carlson, Laureano Rangel, Kevin Reagan, Brian J Davis, R Jeffrey Karnes, Manish Kohli, Donald Tindall, Eric A Klein, Nima Sharifi
BACKGROUND: HSD3B1 (1245A>C) has been mechanistically linked to castration-resistant prostate cancer because it encodes an altered enzyme that augments dihydrotestosterone synthesis from non-gonadal precursors. We postulated that men inheriting the HSD3B1 (1245C) allele would exhibit resistance to androgen-deprivation therapy (ADT). METHODS: In this multicohort study, we determined HSD3B1 genotype retrospectively in men treated with ADT for post-prostatectomy biochemical failure and correlated genotype with long-term clinical outcomes...
October 2016: Lancet Oncology
Jinqiang Chen, Guanxin Zhang, Chong Wang, Yang Liu, Lin Han, Fanglin Lu, Zhiyun Xu
OBJECTIVES: Acute kidney injury requiring renal replacement therapy is an infrequent but dangerous complication of cardiac surgery. Different clinical prediction scores have been developed and validated in American and European countries. Due to the lack of validation in China, the purpose of our study was to validate and compare two clinical scores externally in a Chinese valve surgery population. METHODS: A retrospective analysis was conducted using data obtained from the database of all cardiac valve operations performed during a 5-year period (2010-2014) at a university hospital in Shanghai, China...
August 29, 2016: Interactive Cardiovascular and Thoracic Surgery
Carlo Ratto, Francesco Litta, Lorenza Donisi, Angelo Parello
AIM: To evaluate the safety of the implantation of a new device for the treatment of anal fistulas. The short-term clinical efficacy was also assessed. METHODS: This study took place at a tertiary care university hospital. Patients with a complex anal fistula of cryptoglandular origin were enrolled in the study and were treated with insertion of the new device. All patients were evaluated by clinical and physical examination, including an endoanal ultrasound at the baseline, and then at the 2 wk and 1, 2, 3 and 6-mo follow-up visits...
August 14, 2016: World Journal of Gastroenterology: WJG
Hiroatsu Murakami, Zhong I Wang, Ahmad Marashly, Balu Krishnan, Richard A Prayson, Yosuke Kakisaka, John C Mosher, Juan Bulacio, Jorge A Gonzalez-Martinez, William E Bingaman, Imad M Najm, Richard C Burgess, Andreas V Alexopoulos
Magnetoencephalography and stereo-electroencephalography are often necessary in the course of the non-invasive and invasive presurgical evaluation of challenging patients with medically intractable focal epilepsies. In this study, we aim to examine the significance of magnetoencephalography dipole clusters and their relationship to stereo-electroencephalography findings, area of surgical resection, and seizure outcome. We also aim to define the positive and negative predictors based on magnetoencephalography dipole cluster characteristics pertaining to seizure-freedom...
August 26, 2016: Brain: a Journal of Neurology
Kanhaiya L Poddar, Dhruv K Modi, Siddharth Wayangankar, Badal Thakkar, Amar Krishnaswamy, Meera Kumari, Hazem Bdair, Karan Sud, Akhil Parashar, Mohammad Qasim Raza, Raquib Faruqui, Shikhar Agarwal, Kinjal Banerjee, E Murat Tuzcu, Samir R Kapadia
Data are limited about the prevalence trends of risk factors, lesion morphology, and clinical outcomes of coronary artery disease in patients, aged ≤45 years, undergoing percutaneous coronary intervention (PCI), between the bare-metal stent (BMS; 1994 to 2002) and drug-eluting stent (DES; 2003 to 2012) eras. From the PCI database at the Cleveland Clinic, we identified 1,640 patients aged ≤45 years and without a history of coronary artery bypass grafting who underwent PCI from 1994 to 2012. There were 883 patients in the BMS era cohort with a mean follow-up period of 13...
October 1, 2016: American Journal of Cardiology
Yu Kuei Lin, Charles Faiman, Philip C Johnston, R Matthew Walsh, Tyler Stevens, Rita Bottino, Betul A Hatipoglu
CONTEXT: Spontaneous hypoglycemia has been reported in patients after total pancreatectomy (TP) and islet autotransplantation (IAT) with maintained insulin independence. Details surrounding these events have not been well described. OBJECTIVE: The objective of the study was to determine the frequency and characteristics of spontaneous hypoglycemia in patients undergoing TP-IAT and/or to ascertain predictive or protective factors of its development. DESIGN: This was an observational cohort study in 40 patients who underwent TP-IAT from August 2008 to May 2014, with a median follow-up of 34 months...
October 2016: Journal of Clinical Endocrinology and Metabolism
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