Evaluating the Clinical Performance of a Novel, Precision Oral Appliance Therapy Medical Device Made Wholly From a Medical Grade Class VI Material for the Treatment of Obstructive Sleep Apnea.

Objective The objective of this study is to evaluate the clinical performance of a novel, precision, oral appliance therapy (OAT) medical device made entirely from a US Pharmacopeia (USP) medical grade class VI qualified material for the treatment of obstructive sleep apnea (OSA). Methods This was a multi-center, single-arm, chart-based, retrospective study of 91 patients diagnosed with OSA, treated utilizing a novel, precision, OAT medical device. Performance criteria were overall efficacy (reduction of OSA events to less than 10 per hour); efficacy for patients with severe OSA (reduction of OSA events to less than 20 per hour and a 50% improvement); and compliance (the rate of continuation of treatment after at least a one-year follow-up, or, conversely, the rate of discontinuation of treatment due to material-related adverse events or side effects after one year).

Scurvy in the Intensive Care Unit.

Scurvy, caused by vitamin C deficiency, is a forgotten disease in the modern era of medicine. The prevalence of vitamin C deficiency in the United States is reported to be 7.1%.

Embryology of the lower limb demonstrates that congenital absent fibula is a radiologic misnomer.

The congenitally shortened limb (CSL) with fibular deficiency or absence has historically been graded by plain radiography, while associated cartilaginous and arterial soft tissue anomalies have been comparatively neglected. Consistent pathological evidence of remnant cartilaginous bodies in place of the fibula presupposes earlier existence of a preformed cartilaginous template of the fibula. In complete fibular radiographic absences, often associated with midline metatarsal deficiencies, the two usual nutrient arteries to the fibula fail to form, as they normally would have, around the (16-18 mm stage) sixth embryonic week.

The effect of death education on attitudes of hospital nurses toward care of the dying.

Purpose/objectives: To determine the effect of death education on attitudes and behavioral intentions of experienced nurses who care for hospitalized terminally ill adults and their families and to determine the influence of death education on nurses' self-perceptions regarding supervision or peer review of their behavior toward dying patients and their families.

Design: Experimental.

Setting: Adult medical-surgical units in an urban teaching hospital.

Cytoreduction of small intestine metastases using the Cavitron Ultrasonic Surgical Aspirator.

The Cavitron Ultrasonic Surgical Aspirator was used to reduce the volume of the small intestine metastases in 37 patients. Thirty-four patients had epithelial carcinoma of the ovary, and one each had tubal adenocarcinoma, papillary peritoneal tumor, and mesothelioma. Thirty-one patients had stage IIIC disease, and six had stage IV.

Minimizing donor blood exposure in the neonatal intensive care unit. Current trends and future prospects.

Limitations in the knowledge of the pathophysiology of anemia contribute to unfounded and liberal transfusion practices in the preterm infant and to uncertain risk-benefit ratios. Researchers have explored an array of strategies to minimize transfusions. Such strategies include collection and banking of autologous placental blood, administration of recombinant erythropoietin, innovations in blood banking practices, and improved definitions of the markers of anemia with more rigorous transfusion guidelines.

A cohort study comparing laparoscopic-assisted vaginal hysterectomy and extrafascial hysterectomy.

Study Objective: To compare extrafascial hysterectomy (TAH) and laparoscopic-assisted vaginal hysterectomy (LAVH).

Design: Consecutive women scheduled for hysterectomy, who entered one group or the other based on personal preference.

Setting: A university-affiliated women's hospital.

Endometrial squamous metaplasia. An unusual response to progestin therapy of hyperplasia.

Objective: To report the finding of squamous metaplasia within endometrial glands occurring as a result of progestin therapy of hyperplasia.

Design: Case series. Retrospective analysis of two cases from 9235 accessioned endometrial biopsies.

Primary cardiac valve tumors.

Cardiac valve tumors are rare, but may have significant clinical manifestations. We report three cases of mitral valve tumor successfully treated by surgical excision. Two out of three patients presented with neurologic symptoms, and by utilizing echocardiography the valvular lesions were discovered.

Direct spread of subperitoneal disease into solid organs: radiologic diagnosis.

The subperitoneal space is the continuous space interconnecting the peritoneum and retroperitoneum and the abdominal organs. This report expands the concept of direct spread of disease via the subperitoneal space to include direct extension into the solid abdominal viscera (i.e.

Diagnosis of right atrial mass lesions by transesophageal and transthoracic echocardiography.

The echocardiographic findings by transesophageal and transthoracic techniques were compared in 16 patients with right atrial mass lesions diagnosed by transesophageal echocardiography. In only 8 of the 16 patients were the masses imaged by transthoracic echocardiography. Masses in the main body of the right atrium (three of five), as well as those associated with indwelling catheters and pacer wires (three of four) were more likely to be imaged by transthoracic echocardiography than masses in the right atrial appendage (zero of three) or in the superior or inferior vena cava (one of three).

The impact of same-day tests versus traditional overnight testing.

Within the last decade, major technologic advances have been made in clinical microbiology that have resulted in the availability of a wide variety of different methods for the rapid reporting of test results. Included among these technologies are rapid methods for producing antimicrobial susceptibility reports that many regard as the most important information generated by the microbiology laboratory. Ideally, the early availability of this important information should favorably affect patient care by enabling the more judicious use of alternative drug therapies that are equally efficacious yet less toxic and less costly to the patient.

Bidirectional spread of disease via the subperitoneal space: the lower abdomen and left pelvis.

In early fetal life a persistent interconnection between the peritoneum and retroperitoneum of the abdomen and pelvis is formed--the subperitoneal space (SS). This paper serves to complete the description of the specific anatomical nuances of the SS as they relate to the bidirectional direct spread of disease in the left lower abdomen and pelvis. Described are the two avenues of communication (central and lateral pathways) within this portion of the SS.

Spread of disease via the subperitoneal space: the small bowel mesentery.

The designation of the subperitoneal space emphasizes the continuum of the potential space of extraperitoneal and intraperitoneal areolar tissue traversed by blood vessels, lymphatics, and nerves. Across its root, the subserous connective tissue of the small bowel mesentery is anatomically continuous with that deep to the posterior parietal peritoneum. There is thereby provided an avenue of spread from multiple sites to and from the small bowel mesentery and its relationships.

Squamous cell carcinoma of the endometrium presenting as peritonitis with small bowel obstruction.

Squamous carcinoma primary in the endometrium has been rarely reported. Diagnosis of this condition requires adherence to strict histologic criteria. Most patients are postmenopausal at presentation, and long-term survival is poor.

Evaluation of a rapid screening test for detecting group B streptococci in pregnant women.

The QUIDEL Group B Strep Test is an enzyme immunoassay (EIA) that was compared with culture for the rapid detection of moderate to high levels of group B streptococci (GBS) colonization in pregnant women. A total of 331 pregnant women were included in the study protocol, and GBS were cultured from 19 of these patients in moderate or greater amounts (incidence of 5.7%).

Cor triatriatum with isolated pulmonary venous stenosis in an adult: diagnosis with transesophageal two-dimensional echocardiography.

The diagnosis of cor triatriatum in an adult was made from routine two-dimensional transthoracic echocardiography. The findings of aliasing and turbulence in the roof of the left atrium suggested pulmonary venous stenosis. A transesophageal echocardiogram defined both the hemodynamic features of nonobstructing cor triatriatum and the presence of isolated pulmonary venous stenosis.

Use of the Gen-Probe PACE system for the detection of Neisseria gonorrhoeae in urogenital samples.

The Gen-Probe PACE (Probe Assay-Chemiluminescent Enhanced) system for Neisseria gonorrhoeae was compared to Martin-Lewis medium in JEMBEC plates for the direct detection of N. gonorrhoeae in urogenital samples. This 2-hr, nonisotopic chemiluminescent test is based on the use of an acridinium ester-labeled DNA probe that binds with gonococcal target rRNA in a clinical sample.

Quantitative evaluation of the skin and accessory appendages in vulvar carcinoma in situ.

Fifty cases of vulvar carcinoma in situ comprising over 1000 histologic sections were studied. Each case was evaluated to determine the thickness of the neoplastic epidermis and the depth of involved skin appendages. Two precise techniques were used to perform the microscopic measurements.