37 results match your criteria: "Jefferson Medical College and Thomas Jefferson University[Affiliation]"

A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a number of circumstances and for a variety of reasons. In this article, an attempt is made to delineate the purpose and criteria for blood smear examination in a variety of circumstances that are encountered in everyday laboratory hematology practice. A blood smear scan serves to at least (a) verify the flagged automated hematology results and (b) determine if a manual differential leukocyte count needs to be performed.

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Purpose: The aim of this study was to analyze variability in study withdrawal rates among academic neuroradiologists participating in a utilization management (UM) program.

Methods: The activities of 5 academic neuroradiologists participating in a UM program were assessed. The project period spanned 42 months.

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Context: The key question when managing patients on warfarin therapy who present with life-threatening bleeding is how to use the international normalized ratio (INR) to best direct corrective therapy. The corollary question for the clinical laboratory is at what level will the INR reflect a critical value that requires notifying the clinician.

Objective: To determine the levels of vitamin K-dependent factors over a range of INR values.

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Intubation research on both direct laryngoscopy and alternative intubation devices has focused on laryngeal exposure and not the mechanics of actual endotracheal tube delivery or insertion. Although there are subtleties to tracheal intubation with direct laryngoscopy, the path of tube insertion and the direct line of sight are relatively congruent. With alternative intubation devices, this is not the case.

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Background And Purpose: There has been a steady increase in the utilization of expensive outpatient imaging studies, with a resultant increase in health care costs. To reduce unnecessary and inappropriate studies, the authors' department has participated in a utilization management (UM) program; in this article, the authors report the experience of the division of neuroradiology.

Methods: Using evidence-based guidelines, a commercial UM program provides real-time decision support for physicians ordering expensive outpatient imaging studies.

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Baseline HBV DNA level is the most important factor associated with virologic breakthrough in chronic hepatitis B treated with lamivudine.

World J Gastroenterol

August 2007

Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Aim: To identify the factors associated with virologic breakthrough and to select a subgroup of patients who respond well to lamivudine without developing virologic breakthrough (VBT).

Methods: Of 79 patients who had received lamivudine therapy for 9-57 mo, 34 were HBeAg-positive and 45 were HBeAg-negative, 24 developed virologic breakthrough and 55 did not. Clinical and virologic factors were compared between the two groups.

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Background: Induction with the use of monoclonal antibodies targeting the alpha-chain (CD25) of the high-affinity IL2 receptor may avoid many of the adverse events associated with polyclonal antibodies and significantly impact on rejection-free long-term survival in orthotopic liver transplantation (OLT).

Methods: Forty-two consecutive deceased donor primary OLT were retrospectively analyzed. All patients received two 20-mg doses of basiliximab (days 0 and 4 after OLT) followed by tacrolimus (0.

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MR Imaging of BK virus encephalitis.

AJNR Am J Neuroradiol

May 2006

Department of Radiology, Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

BK virus infection is most often associated with urologic disease in patients who have undergone renal or bone marrow transplantation. We report a rare case of biopsy-confirmed BK virus encephalitis in an immunocompromised patient with hemorrhagic cystitis, in whom dramatic imaging findings were present despite relatively mild clinical symptoms. MR imaging demonstrated widespread increased signal intensity on T2- and fluid-attenuated inversion recovery-weighted images, with restricted diffusion, in the cerebellum, cerebral white matter, and deep gray matter structures.

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Objectives: This study was an analysis of factors associated with stroke in a population of patients paced for sinus node dysfunction in a large prospective clinical trial (Mode Selection Trial [MOST]).

Background: The effects of dual-chamber versus single-chamber ventricular pacing on subsequent stroke in patients with sinus node dysfunction are not known.

Methods: A total of 2,010 patients with sinus node dysfunction were randomized to ventricular or dual-chamber pacing and followed for a median of 33.

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Emerging techniques in the treatment of postoperative pain.

Am J Health Syst Pharm

April 2004

Department of Anesthesiology, Jefferson Medical College and Thomas Jefferson University, Philadelphia, PA 19107-5244, USA.

Purpose: Causes of inadequate postoperative pain control, challenges with currently available analgesic therapies, characteristics of optimal postoperative analgesic therapy, a liposome-encapsulated, sustained-release dosage form of morphine, and other investigational analgesic therapies are described.

Summary: Technical difficulties in analgesic drug administration, inappropriate prescribing, unfounded patient fears or expectations, and the lack of availability of parenteral dosage forms of certain analgesic agents can potentially contribute to inadequate postoperative pain control. The use of epidural catheters for analgesic therapy is limited by the use of prophylactic anticoagulation, the tendency for catheters to migrate and fail, and the need for nursing staff time to monitor the catheter site and infusion pump.

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Rationale: Alteration in serum prolactin (PRL) levels may reflect changes in central dopamine activity, which modulates the behavioral effects of cocaine. Therefore, serum PRL may have a potential role as a biological marker of drug severity and treatment outcome in cocaine dependence.

Objective: We investigated whether serum PRL levels differed between cocaine-dependent (CD) subjects and controls, and whether PRL levels were associated with severity of drug use and treatment outcome in CD subjects.

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Background And Purpose: In this report, the authors assess practice patterns at both academic and nonacademic centers regarding the treatment of aneurysms with Guglielmi detachable coils (GDCs), thrombolysis of the carotid-vertebral arteries, and stent placement with angioplasty of the carotid arteries.

Methods: A neurovascular radiology survey was sent to 102 directors of neuroradiology fellowship programs in the United States and Canada ("academic centers"). The survey was also sent to senior members of the American Society of Neuroradiology (three per state) who were not affiliated with fellowship programs ("nonacademic centers").

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Objective: The approach and credibility of future physicians and nurses as treatment providers for smoking- and tobacco-related diseases may be influenced by their smoking habits. We compared smoking habits among medical and nursing students, and examined whether these habits changed during the course of education for each cohort.

Method: Over 1,100 medical and nursing students from a university were surveyed in year 2000 using a questionnaire that included the Fagerstrom test for nicotine dependence (FTND).

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Background And Purpose: Debate in the neuroradiology community surrounds the amount of formal training in sonography of the carotid arteries that should be provided to fellows. This study was designed to assess current practice patterns at both academic and nonacademic practices regarding the performance of carotid sonography.

Methods: A neurovascular radiology survey was sent to all 102 program directors of neuroradiology fellowships in the United States and Canada (academic practices).

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Despite the widespread use of tobacco and alcohol by illicit drug users, the medical effects of smoking and alcohol use remain understudied among such individuals. We investigated the relationship between smoking and alcohol use, and medical symptoms among 125 cocaine dependent patients. Subjects were assessed for smoking, alcohol use, and medical problems using a standardized self-report instrument (MILCOM).

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Considerable evidence indicates that dopaminergic mechanisms may modulate the central effects of cocaine. We investigated whether basal serum prolactin, a measure of central dopamine activity, differed between cocaine-dependent subjects and controls, and whether prolactin levels among cocaine patients were related to their response to treatment. Eighty-six African-American cocaine-dependent outpatients and 35 African-American controls were studied.

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Quantification of elastic recoil after balloon angioplasty in the iliac arteries.

J Vasc Interv Radiol

December 2001

Department of Radiology, Suite 4200 Gibbon Building, Jefferson Medical College and Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, Pennsylvania 19107, USA.

Purpose: Elastic recoil of the arterial wall has been shown to be responsible for a significant loss of luminal area after balloon angioplasty in the coronary arteries, but it has not been well studied in the peripheral arteries. Because elastic recoil depends on the presence of elastin in the arterial wall, and the amount of elastin varies by artery and proximity to the aorta, the importance of this response to angioplasty may be different in peripheral arteries. The purpose of this study is to document the degree of elastic recoil in the iliac arteries, and analyze variables that might influence the results.

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Objective: To evaluate the effect of acute postoperative alcohol withdrawal on survival of vascularized fibular grafts for mandibular reconstruction.

Design: Retrospective case series of 17 consecutive patients.

Main Outcomes Measure: Relation between flap survival and alcohol withdrawal.

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Fellowship and practice trends in neuroradiology training programs in the United States.

AJNR Am J Neuroradiol

October 2001

Department of Radiology, Jefferson Medical College and Thomas Jefferson University Hospital, 132 South 10th St, Suite 1072 Main Building, Philadelphia, PA 19107, USA.

Background And Purpose: Neuroradiology has become an increasingly diverse and subspecialized discipline. We evaluated the current status and trends affecting fellowship programs and the practice of clinical neuroradiology at academic medical centers, with emphasis on invasive procedures.

Methods: All 85 program directors at Accreditation Council for Graduate Medical Education-approved fellowships in neuroradiology were sent a detailed questionnaire pertaining to various demographic aspects of their program and the performance of certain radiologic examinations of the brain and spine.

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Treatment of deep venous thrombosis and pulmonary embolism with low molecular weight heparin in the geriatric patient population.

Clin Geriatr Med

February 2001

Division of Internal Medicine and Primary Care, Department of Medicine, Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Low-molecular-weight heparins have provided a new approach to treating DVT-PE. These anticoagulants have better bioavailability, a longer half-life, and a more predictable antithrombotic effect than UFH. In the studies reviewed, LMWHs were shown to be safe and effective in preventing recurrent thrombotic events when compared with the more precise UFH dosing schedules.

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A case of locally invasive, long-standing desmoplastic and amelanotic malignant melanoma is described in an 84-year-old man. Histologic examination of the involved periorbital tissue showed neoplastic foci exhibiting a novel pattern reminiscent of microvascular proliferation. These regions were characterized by malignant, S-100-positive tumor cells lining vessel-like spaces in transverse sections and forming tubuler-like structures in longitudinal sections.

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Purpose: In a nonconsecutive series of patients, intravascular ultrasound (IVUS) was investigated for safety and efficacy as an alternative to positive-contrast vena cavography for evaluating the inferior vena cava (IVC) prior to filter placement.

Materials And Methods: In a 6.5-year period, 30 patients (15 women, 15 men) ranging in age from 22 to 98 years old (mean, 56 years) underwent vena cava filter placement without conventional positive-contrast vena cavography, after IVUS evaluation of the IVC with use of a 6.

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