Alignment of the Cervix with the Vagina in Uterine Retroversion: A Possible Risk Factor in Uterine Prolapse.

Multiple observational studies have found an association of uterine prolapse with uterine retroversion. Mechanisms proposed to explain this apparent association assume that the cervix of a retroverted uterus will usually insert at the apex of the vagina, with resultant alignment of the cervix with the vagina. The angle of the axis of the cervix with the axis of the vagina was measured by two readers on 323 sagittal pelvic MRI scans and sagittal reconstructions of pelvic CT scans performed for clinical purposes.

Liver Imaging Reporting and Data System in Patients at High Risk for Hepatocellular Carcinoma in the Memphis Veterans Affairs Population.

Although hepatocellular carcinoma can be difficult to detect, use of the LI-RADS algorithm could lead to earlier identification in at-risk patients.

Vaginal Anatomy on MRI: New Information Obtained Using Distention.

Objectives: To demonstrate and confirm the presence of three anatomic zones of the vagina (a superficial sphincteric zone; a central wedge shaped transition zone; and a deep, expanded forniceal zone) using pelvic magnetic resonance imaging with contrast distention of the vagina.

Methods: A total of 107 consecutive female pelvic magnetic resonance imaging scans using vaginal contrast distention were retrospectively reviewed. The images were observed for the three-zone configuration.

Development of autonomy: role of walking onset and its timing.

The observations of psychoanalytically oriented clinicians such as Mahler, Pine, and Bergman and Greenacre were descriptive of intriguing aspects of the infant's transition to upright locomotion. Yet, research on how walking creates changes in the infant and in the family have scarcely been studied. In this naturalistic home study, 46 infants were designated "earlier" (13 girls and 10 boys) and "later" (12 girls and 11 boys) walkers based on their relative timing of entry into this developmental transition.

Supportive psychoanalytic psychotherapy for borderline patients: an empirical approach.

The author describes a reformulation for research purposes of a supportive psychoanalytic therapy for patients with borderline personality disorder. The major influences on the thinking that led to the modification of prior formulations and the historical background of treatment manuals are described. Supportive treatment is contrasted with transference-focused psychotherapy and dialectic behavior therapy in the interest of creating a clear comparison that lends itself to empirical study.

Employee screening today: the information is there, but be careful how you use it.

Doing a good job of conducting thorough reference checks and background investigations of job applicants has become increasingly important in healthcare in preventing personnel-related crime and the legal consequences of negligence in hiring people who commit such crimes. However, there are many obstacles to obtaining information on applicants. In this report, we'll explore in depth the current state of background checking as described by an official of a company which provides background checking services, as well as the latest in legal practices from a leading attorney in the field.

Ketamine attenuates neutrophil activation after cardiopulmonary bypass.

Unlabelled: Surgery is associated with activation of neutrophils and their influx into affected tissue. The pathogenic role of superoxide production generated by activated neutrophils has been documented repeatedly. Ketamine suppresses neutrophil oxygen radical production in vitro.

Meeting the major threats to hospital security within a budget.

Despite the need to meet growing threats within a facility, cutbacks in hospital income and the resultant budget restraints continue to challenge hospital security departments to do more with less. This article reports on a number of approaches being employed to successfully meet the challenges.

Effectiveness and safety of image-directed biopsies: coaxial technique versus conventional fine-needle aspiration.

Background: We compared the effectiveness and safety of image-guided biopsies done with coaxial guides versus fine-needle aspiration done without coaxial guides.

Methods: With the use of hospital computer records and chart reviews, all image-guided biopsies done during a 4-year period at our institution were assessed for adequacy and complications. For each biopsy, the use of a coaxial guide, the site, and the imaging modality were recorded.

The drug thief at Georgetown U Medical Center.

The article gives the anatomy of a $2 billion class-action lawsuit. A drug-abusing hospital employee may have exposed hundreds of patients to HIV, hepatitis, and other viruses during his period of employment. Not only has the episode been embarrassing for the prestigious medical center, but it also has focused attention on the potential consequences for hospitals that do not screen employees for drug use.

Significance of balloon imprint during coronary angioplasty.

Balloon imprint during angioplasty is often seen, but not at all inflations. We prospectively studied 235 consecutive patients undergoing 282 PTCAs during a 4-month period, who were divided into two groups: those with balloon imprint during inflation (159 patients, 190 lesions; 67%) and those without (76 patients, 92 lesions; 33%). Clinical and lesion characteristics and immediate outcome were compared.

The diagnostic accuracy of mammography in the evaluation of male breast disease.

Background: The role of mammography in the evaluation of male patients presenting with breast disease is controversial. This controversy is a function of the lack of specific data concerning the diagnostic accuracy of mammography when used in this clinical setting. The purpose of this study was to define the diagnostic accuracy of mammography in the evaluation of male breast disease.

Infant kidnapping: a tragic incident provokes a new HCFA response.

The death of a newborn successfully kidnapped from a hospital nursery overshadowed a recent record of fewer or no abductions compared to prior years. In this case, for the first time in hundreds of fatal or non-fatal kidnappings, HCFA made serious threats to cut off the hospital's Medicare funding.

Dealing with school violence: how hospitals met this new challenge to emergency preparedness.

This article discusses how hospitals in Jonesboro, AR, and Denver, CO, met the challenge of dealing with school shooting rampages that resulted in multiple casualties and received widespread media coverage. Hospitals need to be well-prepared to implement their emergency disaster plans and handle the physical and emotional trauma of such incidents which, according to a well-known criminologist, may become more frequent.

Hospital-acquired brevundimonas vesicularis septicaemia following open-heart surgery: case report and literature review.

Brevundimonas vesicularis (B. vesicularis) is a pseudomonad rarely encountered in human infection. A case of nosocomial septicaemia with this organism following open-heart surgery is presented, with a review of the literature.

The ice storm of the century: how hospitals met the challenge.

A huge ice storm in January 1998 affected hospitals and communities in northern New York State and parts of Maine and Canada. This article discusses how some of the region's health facilities and their security departments helped patients, staff, and their communities deal with the unique and prolonged emergency.

Upper posterior mediastinal tumor supplied by an atrial branch of the left circumflex artery.

We report a case of a 39-year-old woman with an upper posterior mediastinal tumor. The tumor was demonstrated by echocardiography and further defined by computerized tomography and magnetic resonance imaging. The tumor was fed by a large atrial branch of the left circumflex artery.

Mammographic appearances of male breast disease.

Various male breast diseases have characteristic mammographic appearances that can be correlated with their pathologic diagnoses. Male breast cancer is usually subareolar and eccentric to the nipple. Margins of the lesions are more frequently well defined, and calcifications are rarer and coarser than those occurring in female breast cancer.

Ketamine attenuates the interleukin-6 response after cardiopulmonary bypass.

Unlabelled: Cardiopulmonary bypass (CPB) has been proposed as a model for studying the inflammatory cascade associated with the systemic inflammatory response syndrome. Serum interleukin-6 (IL-6) concentration seems to be a good indicator of activation of the inflammatory cascade and predictor of subsequent organ dysfunction and death. Prolonged increases of circulating IL-6 are associated with morbidity and mortality after cardiac operations.

Surgical treatment of right ventricular myxoma in infancy.

Myxomas are the most common of all primary cardiac tumors in adults. They are extremely rare in infancy. We report on a 5-month-old infant who was admitted in a state of cardiogenic shock.