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case reports of the massachusetts general hospital

Shafaq Khairi, Babak Torabi Sagvand, Karen J Pulaski-Liebert, Nicholas A Tritos, Anne Klibanski, Lisa B Nachtigall
OBJECTIVES: 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), compare symptom score at long-term follow-up with baseline and correlate these with individual longitudinal clinical outcomes. METHODS: Records of all subjects previously enrolled at the Massachusetts General Hospital site of SALSA were reviewed. Those who remained on lanreotide were interviewed and asked to complete a questionnaire that they had completed in SALSA in 2007 regarding their current symptomatology and injection side effects as well as to complete the Acromegaly Quality of life questionnaire...
September 28, 2016: 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
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
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
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
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
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
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
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
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
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 2015: Journal of the American Heart Association
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
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
William M Lin, Su Luo, Alona Muzikansky, Alice Z C Lobo, Kenneth K Tanabe, Arthur J Sober, A Benedict Cosimi, Hensin Tsao, Lyn M Duncan
BACKGROUND: Prior reports indicate a wide range of melanomas in histopathologic contiguity with a nevus, and an associated nevus has unclear prognostic implications in melanoma. OBJECTIVE: We sought to investigate the relationship among nevus-associated melanomas, sentinel lymph node status, and overall survival. METHODS: We conducted a retrospective analysis of 850 patients with cutaneous melanoma and sentinel lymph node removed at Massachusetts General Hospital from 1998 through 2008 and meta-analysis of the literature...
January 2015: Journal of the American Academy of Dermatology
Abdallah K Alameddine, Paul Visintainer, Sharon-Lise T Normand, Robert E Wolf, Yvonne A Alameddine
BACKGROUND: The postprocedural state after cardiac revascularization interventions is characterized by intense inflammation and activation of inflammatory cytokines due to myonecrosis and ischemia/reperfusion injury. Involvement of similar processes also participates in cellular malignant transformation. In this study, the association between cardiac interventions and subsequent cancer risk development was therefore evaluated. METHODS: The 5-year cumulative incidence of cancer was examined in 2 cardiac care cohorts: all patients undergoing either open heart surgery or percutaneous coronary interventions (PCI) at hospitals in the commonwealth of Massachusetts...
September 5, 2014: American Journal of Clinical Oncology
Randa A El-Zein, Mirtha S Lopez, Anthony M D'Amelio, Mei Liu, Reginald F Munden, David Christiani, Li Su, Paula Tejera-Alveraz, Rihong Zhai, Margaret R Spitz, Carol J Etzel
BACKGROUND: There is an urgent need to improve lung cancer outcome by identifying and validating markers of risk. We previously reported that the cytokinesis-blocked micronucleus assay (CBMN) is a strong predictor of lung cancer risk. Here, we validate our findings in an independent external lung cancer population and test discriminatory power improvement of the Spitz risk prediction model upon extension with this biomarker. METHODS: A total of 1,506 participants were stratified into a test set of 995 (527 cases/468 controls) from MD Anderson Cancer Center (Houston, TX) and a validation set of 511 (239 cases/272 controls) from Massachusetts General Hospital (Boston, MA)...
November 2014: Cancer Epidemiology, Biomarkers & Prevention
Timothy Judson, Mark Haas, Tara Lagu
BACKGROUND: Medical identity theft refers to the misuse of another individual's identifying medical information to receive medical care. Beyond the financial burden on patients, hospitals, health insurance companies, and government insurance programs, undetected cases pose major patient safety challenges. Inaccuracies in the medical record may persist even after the theft has been identified because of restrictions imposed by patient privacy laws. Massachusetts General Hospital (MGH; Boston) has conducted initiatives to prevent medical identity theft and to better identify and respond to cases when they occur...
July 2014: Joint Commission Journal on Quality and Patient Safety
Alexandra L Geffrey, Julianna E Shinnick, Brigid A Staley, Susana Boronat, Elizabeth A Thiele
Congenital lymphedema has been described as a possible rare association of tuberous sclerosis complex (TSC), with only six previous cases reported in the literature. TSC is an autosomal dominant, multisystem disorder connected to aberrant regulation of the mammalian target of rapamycin (mTOR) pathway. The aim of this study is to review cases of lymphedema in a large cohort of TSC patients. The medical records of 268 patients seen at The Herscot Center for Children and Adults with Tuberous Sclerosis Complex at the Massachusetts General Hospital from 2002 to 2012 were retrospectively reviewed for reports of lymphedema or edema of unknown etiology...
June 2014: American Journal of Medical Genetics. Part A
Susan K Mathai, Eli M Miloslavsky, Fernando M Contreras-Valdes, Tanya Milosh-Zinkus, Emily M Hayden, James A Gordon, Paul F Currier
Mannequin-based simulation in graduate medical education has gained widespread acceptance. Its use in non-procedural training within internal medicine (IM) remains scant, possibly due to the logistical barriers to implementation of simulation curricula in large residency programs. We report the Massachusetts General Hospital Department of Medicine's scale-up of a voluntary pilot program to a mandatory longitudinal simulation curriculum in a large IM residency program (n = 54). We utilized an eight-case curriculum implemented over the first four months of the academic year...
April 2014: Medical Teacher
Kathryn Giblin, Jordan L Newmark, Gary J Brenner, Brian J Wainger
OBJECTIVE: To describe a case of cervicogenic headache with associated autonomic features and pain in a trigeminal distribution, all of which responded to third occipital nerve radiofrequency ablation. DESIGN: Single case report. SETTING: Massachusetts General Hospital Center for Pain Medicine. PATIENTS: A 38-year-old woman with history of migraines and motor vehicle accident. INTERVENTIONS: Right third occipital nerve diagnostic blocks and radiofrequency lesioning...
March 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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