152 results match your criteria: "Georgetown University Hospital Washington[Affiliation]"

The integration of large language models (LLMs) into clinical diagnostics has the potential to transform doctor-patient interactions. However, the readiness of these models for real-world clinical application remains inadequately tested. This paper introduces the Conversational Reasoning Assessment Framework for Testing in Medicine (CRAFT-MD) approach for evaluating clinical LLMs.

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Venous vascular malformations of the parotid gland are very rare vascular tumors, especially among adults. This case report discusses the presentation and challenges of diagnosing a venous vascular malformation of the parotid gland in a patient with previous oncologic history. Our patient is a 45-year-old female with a history of breast cancer, meningioma, and secreting pituitary adenoma who presented with a malformation on magnetic resonance imaging, incidentally demonstrating a T2 intense mass in the superficial lobe of the right parotid gland.

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Article Synopsis
  • Medication-related osteonecrosis of the temporal bone is uncommon and linked to certain medications, specifically anti-resorptive and tyrosine-kinase inhibitors, with new cases being reported.* -
  • Three case studies highlight patients with osteonecrosis of the external auditory canal (EAC), with treatments ranging from conservative management to surgical reconstruction, showing varying success.* -
  • The findings suggest that these medications can disrupt bone remodeling, and when standard therapies fail, surgical intervention may be necessary for symptom relief.*
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Spontaneous pneumomediastinum: A comprehensive review of diagnosis and management.

Intractable Rare Dis Res

August 2024

Division of Pulmonary, Critical Care and Sleep Medicine, Northwell Health, New Hyde Park, NY, USA.

Pneumomediastinum is a rare condition defined by the presence of air in the mediastinum. In the absence of traumatic injury, iatrogenic injury, or clear etiology, it is called spontaneous pneumomediastinum (SPM). Spontaneous pneumomediastinum most commonly occurs in younger individuals and has a self-limiting course with a good outcome.

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Objective: There is limited data on the impact of clinical-demographic factors on survival outcomes among veterans with head and neck squamous cell carcinoma (HNSCC). This study was undertaken to evaluate the impact of race and other factors on overall survival (OS) in a population of veterans with HNSCC treated with curative intent.

Methods: Demographic and clinical data were collected on veterans with HNSCC treated with curative intent at our institution between 1999 and 2021.

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Objective: To assess the prevalence of health disparities curricula in otolaryngology residency programs and identify implementation barriers.

Study Design: Cross-sectional survey.

Setting: National otolaryngology residency programs.

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Frailty and Metabolic Vulnerability in Heart Failure: A Community Cohort Study.

J Am Heart Assoc

April 2024

Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch National Heart, Lung, and Blood Institute, National Institutes of Health Bethesda MD.

Background: Frailty is common in heart failure (HF) and is associated with death but not routinely captured clinically. Frailty is linked with inflammation and malnutrition, which can be assessed by a novel plasma multimarker score: the metabolic vulnerability index (MVX). We sought to evaluate the associations between frailty and MVX and their prognostic impact.

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Objectives: Our study aims to determine the incidence and potential risk factors for cerebral radiation necrosis (CRN) following treatment of sinonasal malignancies.

Methods: One hundred thirty-two patients diagnosed with sinonasal malignancies over an 18-year period were identified at two institutions. Forty-six patients meeting inclusion criteria and treated with radiation therapy were included for analysis.

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Objective: To provide an analysis of complications following eustachian tube balloon dilation as well as their treatments and outcomes.

Data Sources: PubMed, Ovid Embase, and MAUDE Database.

Review Methods: A systematic approach following PRISMA guidelines was used to identify publications pertaining to balloon dilation of the eustachian tube from PubMed and Ovid Embase databases was used.

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Article Synopsis
  • A 73-year-old woman developed a quickly worsening, ulcerated growth on her eyelid that showed only slight improvement with infection treatment.
  • A biopsy confirmed it was primary cutaneous anaplastic large cell lymphoma (pcALCL), a rare disorder, but no other areas of the body were affected, suggesting a good prognosis.
  • Treatment usually involves surgical removal with clear margins; for more advanced cases, intravenous brentuximab vedotin is recommended.
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Key Clinical Message: Patients with a recent history of peritoneal dialysis catheter removal in the setting of immunosuppression should be monitored for rare bacterial peritonitis. This infection should be managed with ampicillin and gentamicin.

Abstract: There are scattered reports to date of patients with peritonitis caused by .

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Introduction: Both curvilinear and phased array transducers are commonly used to perform lung ultrasound (LUS). This study seeks to compare LUS interpretation accuracy of images obtained using a curvilinear transducer with those obtained using a phased array transducer.

Methods: We invited 166 internists and trainees to interpret 16 LUS images/cineloops of eight patients in an online survey: eight curvilinear and eight phased array, performed on the same lung location.

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Accuracy of 23 Equations for Estimating LDL Cholesterol in a Clinical Laboratory Database of 5,051,467 Patients.

Glob Heart

June 2023

Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: Alternatives to the Friedewald low-density lipoprotein cholesterol (LDL-C) equation have been proposed.

Objective: To compare the accuracy of available LDL-C equations with ultracentrifugation measurement.

Methods: We used the second harvest of the Very Large Database of Lipids (VLDbL), which is a population-representative convenience sample of adult and pediatric patients (N = 5,051,467) with clinical lipid measurements obtained via the vertical auto profile (VAP) ultracentrifugation method between October 1, 2015 and June 30, 2019.

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Objective: To evaluate how pediatric indications for tonsillectomy or adenotonsillectomy relate to gender, race/ethnicity, and age.

Methods: Included consecutive pediatric patients who underwent tonsillectomy or adenotonsillectomy from a single tertiary academic institution between 2012 and 2019. Logistic regression analysis was used to measure association between the indication for tonsillectomy and the demographic variables gender, race/ethnicity, and age.

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A 73-year-old male with a recent finding of pericardial effusion and syncope was evaluated with point of care ultrasound for recurrent effusion. A thickened left ventricle and recurrent pericardial effusion were found. Unexpectedly, on scanning the inferior vena cava (IVC), extensive portal venous gas was identified, a finding previously described as a "meteor shower".

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Post-inflammatory hyperpigmentation is an extremely common disorder of pigmentation in skin of color. It most frequently and severely affects phototypes that are rich in melanin and often has a chronic and unpredictable course. It presents significant treatment challenges and often requires a multi-factorial approach.

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Establishing consensus-based high-acuity low-occurrence skills for EMS physicians: A pilot survey of EMS fellowship faculty.

AEM Educ Train

December 2022

Department of Emergency Medicine Johns Hopkins Medical Institutions Baltimore Maryland USA.

Background: The specialty of emergency medical services (EMS) medicine focuses on providing out-of-hospital patient care, including initial stabilization, treatment, and transport in specially equipped vehicles including ambulances and airframe platforms to hospitals and better-resourced destinations. The Core Content of EMS Medicine outlines the knowledge, procedures, and psychomotor skills relevant to prehospital patient care. However, this document does not specify the high-consequence skills that are infrequently performed and that carry high levels of complexity as well as potential morbidity.

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The stay-suture technique (SST) helps ensure safe replacement of the tracheostomy tube after accidental decannulation. We describe a patient found to have a retained stay suture in the glottis 2 weeks post-decannulation. It is important to appreciate the possible complications associated with SST, including airway compromise, infection, and laryngospasm.

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Objective: To analyze how the COVID-19 pandemic has influenced trends in head and neck squamous cell carcinoma (HNSCC) presentation and diagnosis-including referral patterns, stage at presentation, and time to diagnosis-over a longitudinal time course.

Setting: Multicenter tertiary care academic institution.

Methods: A retrospective review of patients with HNSCC presenting between January 1, 2019 and December 31, 2020 was performed.

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Randomized Trial of Postoperative Venous Thromboembolism Prophylactic Compliance: Aspirin and Mobile Compression Pumps.

J Am Acad Orthop Surg

October 2022

From the Department of Orthopaedics, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown, WV (Dietz, Frye, Lindsey, Murphy, and Klein), and MedStar Georgetown University Hospital/Washington Hospital Center, Washington, DC (Moushmoush).

Background: Aspirin, as a routine venous thromboembolism (VTE) prophylaxis, is approved along with pneumatic compression pumps by the American College of Chest Physicians. We assessed compliance of aspirin and pump use after total joint arthroplasty.

Methods: A randomized trial of aspirin alone or aspirin/mobile compression pumps after total joint arthroplasty was performed.

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Background: Bleeding in people with hemophilia A can be life threatening, and intra-articular bleeds can result in joint damage. Most clinical studies focus on treated bleeds, while bleeds not treated with coagulation factor(s) (untreated bleeds) are underreported.

Objectives: We assessed the incidence of untreated bleeds during a noninterventional study (NIS) wherein people with hemophilia A, with or without factor VIII (FVIII) inhibitors, were managed according to standard practice.

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To present a rare case of Eagle Syndrome in a pediatric patient, reminding the medical community to keep this diagnosis on their differential.

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