32 results match your criteria: "Brooklyn Veterans Administration Medical Center[Affiliation]"

Cytopenias in systemic lupus erythematosus (SLE) require clinical and laboratory workup and bone marrow (BM) examination to determine the cause and for appropriate patient management. Common causes include an increase in SLE activity, immune-mediated hemolysis, iron deficiency, antiphospholipid antibody syndrome, infection, or the effect of medications. We retrospectively evaluated the clinical and laboratory findings of patients with SLE and cytopenias who had undergone BM studies to determine the indicators of malignancy.

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Background: Machine learning algorithms achieve expert-level accuracy in skin lesion classification based on clinical images. However, it is not yet shown whether these algorithms could have high accuracy when embedded in a smartphone app, where image quality is lower and there is high variability in image taking scenarios by users. In the past, these applications were criticized due to lack of accuracy.

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Importance: A recently described noninvasive gene expression test (the pigmented lesion assay [PLA]) with adhesive patch-based sampling has the potential to rule out melanoma and the need for surgical biopsy of pigmented lesions suggestive of melanoma with a negative predictive value of 99% compared with 83% for the histopathologic standard of care. The cost implications of using this molecular test vs visual assessment followed by biopsy and histopathologic assessment (VAH) have not been evaluated.

Objective: To determine potential cost savings of PLA use vs the VAH pathway.

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Introduction: Azimilide dihydrochloride blocks both the rapid (I(Kr)) and slow (I(Ks)) components of the delayed rectified K+ current; dofetilide blocks only I(Kr). Their efficacies were assessed on atrial flutter reentrant circuits in dogs with surgically induced right atrial enlargement.

Methods And Results: Multiple biopsies of the tricuspid valve and banding of the pulmonary artery in male mongrel dogs made them susceptible, about 3 weeks postoperatively, to stimulation-induced sustained (5 min or longer) atrial flutter.

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Elements of the art of practice in mental health.

Am J Occup Ther

October 1998

Brooklyn Veterans Administration Medical Center, Veterans Health Care Center, New York 11201, USA.

Objective: This qualitative study explored elements of artful practice of therapists practicing in mental health treatment settings.

Method: In-depth interviews were conducted with three occupational therapists practicing in mental health who were considered exemplars of artful practice. Themes pertaining to their perspectives and approaches to practice were synthesized from interview data.

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Meningitis is often associated with hyponatremia due to inappropriate secretion of antidiuretic hormone, and diabetes insipidus is associated with bacterial meningitis. This article describes a patient with acquired immunodeficiency syndrome who experienced recurrent episodes of central diabetes insipidus in association with recurrent fungal meningitis. Desmopressin was effective in controlling the polyuria until the episodes of meningitis resolved.

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Most pathways concentrate on reducing the patient's length of stay. One multidisciplinary pathway team aims for a broader approach-promoting wellness as a means to avert hospitalization. Primary treatment teams provide and direct care for a group of patients, resulting in an outpatient system that is accessible and comprehensive.

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Although medication-induced (pill) esophagitis has been recognized for a long time, little data are available on the risk of recently introduced slow-release medications. These formulations may have an obstructive capability (undissolved medication blocking an obstructed lumen) or may cause tissue irritation (continuous leakage from a slowly disintegrating pill). We observed a patient with esophageal carcinoma who developed complete obstruction when three Procardia XL (nifedipine) extended-release tablets blocked the narrowed lumen.

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To determine whether transurethral prostatectomy results in higher long-term mortality rates than open prostatectomy, we reviewed retrospectively 1,125 patients treated by transurethral and 190 treated by nonperineal open prostatectomy for benign disease at 1 institution from 1978 through 1987. Patients in whom prostatic cancer was found were excluded. We identified age, preoperative medical illnesses and urinary retention, American Society of Anesthesiologists category, type of anesthesia, length of followup, health status and cause of death.

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Aluminum catalyzes the oxidation of NADH by vanadate both in the presence and absence of a reducing sugar. The effect of aluminum is concentration dependent and inhibitable with superoxide dismutase but not catalase. The fructose-6-phosphate-free reaction is characterized by an initial lag phase which can be eliminated by preincubating aluminum with NADH, but is not altered by preincubating aluminum with vanadate, suggesting that the effect of aluminum is not directly on vanadate.

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The effectiveness of ciprofloxacin and/or novobiocin therapy was assessed for experimental endocarditis caused by three strains of Enterococcus faecium resistant to ampicillin, vancomycin, and aminoglycosides. Rabbits with endocarditis caused by two of the strains had a significant decrease in bacterial counts in vegetations when treated with both antibiotics. Further studies using combination therapy with ciprofloxacin plus novobiocin for multidrug resistant strains of E.

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Mapping studies of atrial flutter in both the canine sterile pericarditis model and the right atrial enlargement model commonly reveal single loop reentrant circuits in the lower posterior part of the right atrium. Functional bidirectional conduction block and natural anatomical obstacles comprise the central obstacle for reentrant impulse during circus movement atrial flutter. Because the relative roles of anatomical obstacles, in combination with functional barriers, anisotropic conduction, and slow conduction can not be readily assessed with current electrophysiological techniques, an atrial activation model was developed to study the mechanisms of circus movement atrial flutter.

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Objectives: to determine whether ursodeoxycholic acid (UDCA) is effective in improving primary biliary cirrhosis (PBC) or chronic hepatitis (CH).

Methods: Meta-analysis (MA) was performed on nine papers and three abstracts describing PBC and on nine papers and two abstracts with CH that were published between 1985 and 1992 and were identified through MEDLINE. Studies were included if they fulfilled established quality criteria and the patients had at least liver histology at the start and two to three relevant laboratory tests repeated after UDCA.

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Upper gastrointestinal endoscopy revealed a double lumen in the second portion of the duodenum in a 39-year-old man with advanced acquired immunodeficiency syndrome (AIDS). The lesion was not lined with an epithelium and improved with antituberculous therapy. These findings, as well as both an extensive transmural inflammation with foamy macrophages laden with acid-fast microorganisms and the destruction of the bowel wall, were consistent with Mycobacterium avium-intracellulare infection, but not with congenital duplication.

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To study selectively the dilutional aspects of severe blood loss on the serum complement system, we developed an animal model consisting of isovolumic phlebotomy and reinfusion of washed autologous erythrocytes. This model avoided hypoperfusion, ischemia, and transfusion of foreign antigen. We measured total serum protein, C3 antigen, total complement hemolytic activity, and alternative pathway hemolytic activity.

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Nd-YAG laser phototherapy has been demonstrated to be effective for the treatment of airways obstruction caused by tracheal tumors. Pulmonary edema has been reported as a complication following acute relief of an upper airway obstruction. We describe a case where laser photoresection of an endotracheal malignancy resulted in acute pulmonary edema.

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The differentiation between cellulitis and deep vein thrombosis was investigated in a series of patients with acutely swollen, painful, red legs. Oedema-fluid protein concentrations (as mean [SD]) were significantly higher in patients with cellulitis than in those with deep vein thrombosis (19.8 g/l [5.

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The effect of aluminum on intestinal calcium absorption was determined in male Sprague-Dawley rats using an everted intestinal sac technique. Bidirectional calcium flux in the duodena and ilea of normal rats was assessed by means of dual calcium isotopes. Two micromolar aluminum significantly inhibited net calcium absorption (J net) in the duodenum through suppression of mucosato-serosa flux (J m----s).

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Evaluation of certain communication skills in head-injured adults has generally been limited to informal clinical impressions. A rating scale has been developed which addresses several of these communication abilities in a behaviourally based model. Preliminary data based on a sample of four head-injured adults and four trained raters revealed robust inter- and intra-rater reliability.

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To investigate the potential use of cryothermal mapping to localise the sites of the dominant and latent pacemakers of the sinus node, we compared the results of cryothermal and electrical mapping of the sinus node in 16 dogs. In all dogs, cooling (-5 to +5 degrees C) of a localised epicardial area of about 3 X 3 mm2 close to the sulcus terminalis (area 1) resulted in a decrease in heart rate and a change in the P wave configuration. Cooling of an additional area of up to 15 X 3 mm2 (area 2) while cooling of area 1 was maintained resulted in a further decrease in heart rate and a further change in P wave configuration until junctional rhythm occurred.

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To determine the effectiveness of vigorous realimentation with dietary fat, 17 subjects aged 64.0 +/- 2.1 years (mean +/- 1 SEM) were pump-fed via a nasogastric tube for an average of 22 days.

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