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case reports of the massachusetts general hospital

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https://www.readbyqxmd.com/read/28614077/structure-operation-and-experience-of-clinical-ethics-consultation-2007-2013-a-report-from-the-massachusetts-general-hospital-optimum-care-committee
#1
Ellen M Robinson, Wendy Cage, Kimberly Erler, Sharon Brackett, Julia Bandini, Alexandra Cist, M Cornelia Cremens, Eric L Krakauer, Andrew Courtwright
We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation's first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was consulted, and salient features of the consults themselves...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28544102/a-multicenter-retrospective-case-cohort-study-of-the-epidemiology-and-risk-factors-for-clostridium-difficile-infection-among-cord-blood-transplant-recipients
#2
Carolyn D Alonso, David A Braun, Ishan Patel, Mona Akbari, Daniel Jungmyung Oh, Tomi Jun, Malgorzata McMasters, Sarah P Hammond, Brett Glotzbecker, Corey Cutler, Daniel A Leffler, Karen K Ballen, Ciarán P Kelly
BACKGROUND: Clostridium difficile infection (CDI) is the leading cause of health-care associated infectious diarrhea. The aim of this study was to evaluate the epidemiology and risk factors for CDI in the 100 days following umbilical cord blood transplantation (UCBT) at three Boston hospitals. METHODS: We performed a multicenter, retrospective, case-cohort study of 226 UCBT recipients at Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Dana Farber/Brigham and Women's Cancer Center from 2003 to 2012...
August 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28431236/unicystic-ameloblastoma-revisited-comparison-of-massachusetts-general-hospital-outcomes-with-original-robinson-and-martinez-report
#3
COMPARATIVE STUDY
Anne-Frédérique Chouinard, Zachary S Peacock, William C Faquin, Leonard B Kaban
PURPOSE: Robinson and Martinez established unicystic ameloblastoma (UA) as a distinct pathologic entity in 1977. Using their original description, the aims of this study were to compare the clinical presentation and outcomes of UA treated at Massachusetts General Hospital (MGH) with outcomes reported in the original article. PATIENTS AND METHODS: This was a retrospective cohort study of MGH patients treated for UA during a 15-year period. Patients were included if they had a confirmed clinical and histologic diagnosis of UA...
November 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28192645/cytological-molecular-and-clinical-features-of-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-versus-invasive-forms-of-follicular-variant-of-papillary-thyroid-carcinoma
#4
COMPARATIVE STUDY
Liena Zhao, Dora Dias-Santagata, Peter M Sadow, William C Faquin
BACKGROUND: The noninvasive follicular variant of papillary thyroid carcinoma (PTC) has an indolent clinical behavior in comparison with other PTCs, including the invasive follicular variant of papillary thyroid carcinoma (IFVPTC). Recently, the term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced to emphasize the low biological potential of these tumors. This study compares clinical, cytological, and molecular features of NIFTP and IFVPTC...
May 2017: Cancer
https://www.readbyqxmd.com/read/28158168/ultrasound-guided-radiofrequency-lesioning-of-the-articular-branches-of-the-femoral-nerve-for-the-treatment-of-chronic-post-arthroplasty-hip-pain
#5
David J Kim, Shiqian Shen, George M Hanna
BACKGROUND: Total hip arthroplasty (THA) is a common surgical treatment for several conditions of the hip. While the majority of patients obtain satisfactory results, many develop chronic post-arthroplasty hip pain that can be difficult to treat. OBJECTIVE: We evaluate the effectiveness of cooled (60°C) radiofrequency lesioning of the articular branches of the femoral nerve (ABFN) as a minimally invasive treatment for patients suffering from chronic post-arthroplasty hip pain...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28104099/coexisting-systemic-infections-in-patients-who-present-with-a-fall
#6
Alex Blair, Farrin A Manian
BACKGROUND: Although the causes of falls are legion, infectious disease-related factors are not commonly reported in the published literature. We investigated the characteristics of patients presenting to the hospital because of a fall and who were subsequently found to have a coexisting systemic infection (CSI). MATERIALS AND METHODS: This was a retrospective study performed at Massachusetts General Hospital, using the electronic database of adult patients receiving care during the period January 1, 2000 through December 31, 2014...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28048080/su-f-t-80-a-mobile-application-for-intra-operative-electron-radiotherapy-treatment-planning
#7
C Williams, E Crowley, J Wolfgang
PURPOSE: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27682353/clinical-outcomes-and-self-reported-symptoms-in-patients-with-acromegaly-an-8-year-follow-up-of-a-lanreotide-study
#8
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
https://www.readbyqxmd.com/read/27626235/improving-prediction-of-suicide-and-accidental-death-after-discharge-from-general-hospitals-with-natural-language-processing
#9
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
https://www.readbyqxmd.com/read/27551012/metastatic-breast-cancer-with-esr1-mutation-clinical-management-considerations-from-the-molecular-and-precision-medicine-map-tumor-board-at-massachusetts-general-hospital
#10
Aditya Bardia, John A Iafrate, Tilak Sundaresan, Jerry Younger, Valentina Nardi
UNLABELLED: : The last decade in oncology has witnessed impressive response rates with targeted therapies, largely because of collaborative efforts at understanding tumor biology and careful patient selection based on molecular fingerprinting of the tumor. Consequently, there has been a push toward routine molecular genotyping of tumors, and large precision medicine-based clinical trials have been launched to match therapy to the molecular alteration seen in a tumor. However, selecting the "right drug" for an individual patient in clinic is a complex decision-making process, including analytical interpretation of the report, consideration of the importance of the molecular alteration in driving growth of the tumor, tumor heterogeneity, the availability of a matched targeted therapy, efficacy and toxicity considerations of the targeted therapy (compared with standard therapy), and reimbursement issues...
September 2016: Oncologist
https://www.readbyqxmd.com/read/27459530/dopamine-agonists-can-reduce-cystic-prolactinomas
#11
Alexander Faje, Paweena Chunharojrith, Joshipura Nency, Beverly M K Biller, Brooke Swearingen, Anne Klibanski
CONTEXT: Cystic prolactinomas are considered resistant to volume reduction by dopamine agonists (DAs). Although several individual case reports and small case series have suggested that DAs may reduce these lesions, larger series using standardized imaging metrics are lacking. OBJECTIVE: The objectives of the study were to assess the efficacy of DAs on cyst size in patients with predominantly cystic prolactinomas and to characterize the clinical course and treatment outcomes in these patients...
October 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27239388/teaching-by-teleconference-a-model-for-distance-medical-education-across-two-continents
#12
Adeline Boatin, Joseph Ngonzi, Leslie Bradford, Blair Wylie, Annekathryn Goodman
INTRODUCTION: In Uganda, an estimated 120 obstetrician/gynecologists serve a population of 30 million people demonstrating the need to train additional skilled clinician leaders in reproductive health. In 2012, a partnership was formed with the Mbarara Regional Referral Hospital (MRRH) in southwest Uganda and the Massachusetts General Hospital (MGH) in Boston, USA, in part to increase access to specialist training. This report presents an update in the development of a teaching conference between the institutions...
November 2015: Open Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27099333/implementation-and-assessment-of-a-required-transitions-of-care-residency-rotation
#13
Kanizeh Visram, Laura S Carr, Joanne Doyle Petrongolo
PURPOSE: The implementation of a required residency rotation in transitions of care (TOCs) and the resulting resident-led clinical interventions and learning experiences are described. SUMMARY: A newly required four-week TOC rotation was implemented for postgraduate year 1 (PGY1) pharmacy residents at Massachusetts General Hospital (MGH). Unlike acute care rotations, this learning experience encouraged residents to focus on providing direct patient care in a holistic manner and use pharmacologic and nonpharmacologic strategies to improve patient outcomes...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27064228/uniting-evidence-based-evaluation-with-the-acgme-plastic-surgery-milestones-a-simple-and-reliable-assessment-of-resident-operative-performance
#14
Edward M Kobraei, Jordan D Bohnen, Brian C George, John T Mullen, Keith D Lillemoe, William G Austen, Eric C Liao
BACKGROUND: Milestones evaluations in plastic surgery reflect a shift toward competency-based training but have created a number of challenges. The authors have incorporated the smartphone application evaluation tool, System for Improving and Measuring Procedural Learning (SIMPL), that was recently developed by a multi-institutional research collaborative. In this pilot study, the authors hypothesize that SIMPL can improve resident evaluation and also collect granular performance data to simplify compliance with the plastic surgery Milestones...
August 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27054058/retrosigmoid-craniotomy-for-auditory-brainstem-implantation-in-adult-patients-with-neurofibromatosis-type-2
#15
Sidharth V Puram, Barbara Herrmann, Fred G Barker, Daniel J Lee
Objective To report our technique and experience using a retrosigmoid craniotomy approach for auditory brainstem implantation (ABI) placement in adult neurofibromatosis type 2 (NF2) patients. Design Retrospective case series. Setting Single-center study, Boston, Massachusetts, United States. Participants All NF2 patients who underwent evaluation at Massachusetts Eye and Ear Infirmary and surgery at Massachusetts General Hospital from 2009 to 2013 were reviewed. Six cases of retrosigmoid craniotomy for ABI surgery in five adult NF2 patients were identified...
December 2015: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/26909650/impact-of-nonvascular-thoracic-mr-imaging-on-the-clinical-decision-making-of-thoracic-surgeons-a-2-year-prospective-study
#16
Jeanne B Ackman, Henning A Gaissert, Michael Lanuti, Subba R Digumarthy, Jo-Anne O Shepard, Elkan F Halpern, Cameron D Wright
Purpose To determine the impact of nonvascular thoracic magnetic resonance (MR) imaging on the clinical decision making and diagnostic certainty of thoracic surgeons. Materials and Methods Seven thoracic surgeons at Massachusetts General Hospital, an academic quaternary referral hospital, participated in this 2-year, prospective, institution review board-approved, HIPAA-compliant pre- and post-MR imaging survey study after completing a one-time demographic survey. Between July 16, 2013, and July 13, 2015, each time a thoracic surgeon ordered a nonvascular thoracic MR imaging study via radiology order entry, he or she was sent a link to the pre-test survey that ascertained the clinical rationale for MR imaging, the clinical management plan if MR imaging was not an option, and pre-test diagnostic certainty...
August 2016: Radiology
https://www.readbyqxmd.com/read/26682520/the-diagnostic-accuracy-of-incisional-biopsy-in-the-oral-cavity
#17
Sara Chen, Michael Forman, Peter M Sadow, Meredith August
PURPOSE: To determine the accuracy of incisional biopsy examination to diagnose oral lesions. MATERIALS AND METHODS: This retrospective cohort study was performed to determine the concordance rate between incisional biopsy examination and definitive resection diagnosis for different oral lesions. The study sample was derived from the population of patients who presented to the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital (Boston, MA) from January 2005 through December 2012...
May 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/26475298/differences-among-cardiologists-in-rates-of-positive-coronary-angiograms
#18
COMPARATIVE STUDY
Jason H Wasfy, Michael K Hidrue, Robert W Yeh, Katrina Armstrong, G William Dec, Eugene V Pomerantsev, Michael A Fifer, Timothy G Ferris
BACKGROUND: Understanding the sources of variation for high-cost services has the potential to improve both patient outcomes and value in health care delivery. Nationally, the overall diagnostic yield of coronary angiography is relatively low, suggesting overutilization. Understanding how individual cardiologists request catheterization may suggest opportunities for improving quality and value. We aimed to assess and explain variation in positive angiograms among referring cardiologists...
October 16, 2015: Journal of the American Heart Association
https://www.readbyqxmd.com/read/25981860/the-accuracy-of-clinical-diagnosis-of-oral-lesions-and-patient-specific-risk-factors-that-affect-diagnosis
#19
Michael S Forman, Sung-Kiang Chuang, Meredith August
PURPOSE: To examine the rate of discrepancy between clinical impression and histologic diagnosis of oral lesions in patients undergoing biopsy examination and to determine whether there are patient-specific variables associated with a higher rate of discrepancy. MATERIALS AND METHODS: The authors designed and implemented a retrospective cohort study that consisted of patients who underwent biopsy examination of oral lesions from 2005 through 2013 by oral and maxillofacial surgeons at the Massachusetts General Hospital...
October 2015: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/25818572/marfan-syndrome-is-associated-with-recurrent-dissection-of-the-dissected-aorta
#20
Leon M Ptaszek, Kibeom Kim, Amy E Spooner, Thomas E MacGillivray, Richard P Cambria, Mark E Lindsay, Eric M Isselbacher
BACKGROUND: Recurrent dissection of a previously dissected aortic segment has been reported as a rare, late complication in single case reports. The infrequency of this event makes informed risk assessment in an individual patient challenging. METHODS: To investigate this issue we examined the database of the Massachusetts General Hospital Thoracic Aortic Center between January 1, 2003 and December 31, 2012. A retrospective review was performed to identify patients with both (1) an acute aortic dissection after a prior aortic dissection and (2) evidence of a new dissection within a previously dissected aortic segment creating a triple lumen aorta...
May 2015: Annals of Thoracic Surgery
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