66 results match your criteria: "Los Angeles County + University of Southern California LAC+USC Medical Center.[Affiliation]"

Outcomes from ipsilateral breast tumor recurrence after breast conserving surgery and whole breast irradiation for breast cancer.

Am J Surg

March 2022

Los Angeles County+University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA. Electronic address:

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Introduction: Burn wound depth assessments are an important component of determining patient prognosis and making appropriate management decisions. Clinical appraisal of the burn wound by an experienced burn surgeon is standard of care but has limitations. IR thermography is a technology in burn care that can provide a non-invasive, quantitative method of evaluating burn wound depth.

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  • Kikuchi-Fujimoto's disease (KFD) and adult-onset Still's disease (AOSD) are uncommon inflammatory conditions with unclear causes, and previous reports indicate instances of them occurring together.
  • This study introduces a new case of KFD and AOSD in a middle-aged Hispanic woman, providing fresh insights into demographic and diagnostic characteristics not seen before in overlapping cases.
  • The findings suggest an overlap syndrome due to shared symptoms and treatment responses, pointing to a potentially similar underlying biological mechanism for both diseases.
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Background: Beginning on March 16, 2020, nonurgent scheduled operations at a large, urban, safety net medical center were canceled. The purpose of this study was to determine complications associated with severe acute respiratory syndrome coronavirus 2 infection for all operations done from March 16 to June 30, 2020.

Study Design: This study was a single-institution, retrospective observational analysis of data for all surgical procedures and all severe acute respiratory syndrome coronavirus 2 tests done in the medical center from March 16 to June 30, 2020.

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Challenging issues in rheumatology: thoughts and perspectives.

Clin Rheumatol

May 2021

Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA.

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  • The LA County Department of Health Services created the SAFE @ HOME O2 program to manage COVID-19 patients using ambulatory oxygen support, aiming to enhance patient outcomes during the pandemic.
  • A retrospective study analyzed 621 adult patients with COVID-19 pneumonia who were discharged with home oxygen between March and August 2020, evaluating their health outcomes.
  • Results showed a very low all-cause mortality rate of 1.3% and an 8.5% rate of return hospital admissions within 30 days, indicating effective management of patients at home without significant adverse outcomes.
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  • The text critiques the evidence for using vancomycin AUC24 monitoring in treating serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA), highlighting methodological flaws in current studies.
  • It argues that the data does not convincingly show a benefit over simply lowering trough levels of the drug, suggesting that more effective strategies may involve better antibiotic stewardship and exploring other treatment options.
  • The author warns that focusing on AUC24 monitoring could divert resources from these more advantageous approaches, potentially compromising patient safety and treatment efficacy.
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  • Relying on external labs for HIV confirmation can delay treatment and increase patient anxiety, prompting the need for internal testing.
  • A hospital laboratory successfully verified an HIV antibody differentiation test, which was crucial for speeding up result turnaround times (TATs).
  • Post-implementation, TATs improved significantly, with HIV antibody differentiation results dropping from 40.4 to 17.7 hours and HIV-1 RNA results from 156.5 to 56.5 hours, enhancing overall diagnostic efficiency.
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The clinical significance of high crossing threshold (Ct) detection of SARS-CoV-2 by RT-PCR is inadequately defined. In the course of universal admission screening with the Cepheid Xpert Xpress SARS-CoV-2 assay at our institution, we observed that 3.9 % (44/1123) of SARS-CoV-2 positive results were negative for the envelope (E) gene target but positive for the nucleocapsid (N2) target.

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The administration of cortisone to a bedridden patient with rheumatoid arthritis (RA) 70 years ago was a transformative event in modern medicine. We have since struggled to balance the near-miraculous anti-rheumatic with the yet all-too-frequent devastating side effects of glucocorticoids (GC). With the current availability of newer disease-modifying and biologic anti-rheumatic agents, we were rather surprised to note that 94% of sick hospitalized patients with systemic rheumatic diseases at our medical center were on corticosteroids during a 3-month observation period.

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  • Infectious Disease (ID) is facing challenges in attracting new medical students and trainees despite the constant emergence of new infectious threats and significant public health concerns.
  • The ID Fellowship programs are struggling to fill positions and remain one of the lowest-paid specialties, prompting experts to rethink strategies to improve the field's appeal.
  • Recommended actions include implementing restrictions on ID diagnostics and antibiotic use, establishing pay-for-performance measures for prescribing, and advocating for healthcare reform to shift away from the fee-for-service model, in order to align with current market forces for better outcomes.
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  • The study evaluates the effectiveness of chemical urinalysis (UA) as a screening tool for deciding whether to conduct further tests like microscopic UA and urine culture.
  • The analysis involved over 9,000 UA results, highlighting that chemical UA has high sensitivity (93.0%) but lower specificity (56.9%), indicating it can effectively identify positive cases but may also misclassify some negatives.
  • The findings suggest that relying on chemical UA for reflex testing could streamline workflows and reduce unnecessary testing, as only a small percentage of samples showed discrepancies between chemical UA and microscopic findings.
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Background: Despite widespread recommendations to favor lipase over amylase in the diagnosis and management of acute pancreatitis, many routine hospital laboratories still offer amylase testing. This study sought to evaluate and compare ordering patterns of amylase and lipase in patients with acute pancreatitis.

Methods: We analyzed 438 patients with acute pancreatitis admitted to our hospital.

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Background: This study assessed whether magnetic resonance imaging (MRI) could accurately predict pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) for patients receiving standardized treatment, pre- and post-NAC MRI on the same instrumentation using a consistent imaging protocol, interpreted by a single breast fellowship-trained radiologist.

Methods: A single-institution retrospective analysis was performed including clinical, radiographic, and pathologic parameters for all patients with breast cancer treated with NAC from 2015 to 2018. Radiographic complete response (rCR) was defined as absence of suspicious MRI findings in the ipsilateral breast or lymph nodes.

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  • The patient has a history of hypertension, type 2 diabetes, and chronic hepatitis B with cirrhosis, presenting with shortness of breath, coughing, weight loss, and fatigue over a span of two weeks.
  • A chest imaging revealed enlarged heart (cardiomegaly) and a significant accumulation of fluid around the heart (pericardial effusion), prompting the need for a pericardial drain and fluid analysis.
  • Initial tests indicated a very high level of adenosine deaminase (ADA) in the pericardial fluid, suggesting a possible case of tuberculosis, leading to the start of empirical tuberculosis treatment.
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  • Procalcitonin (PCT) is a key biomarker used to guide decisions in treating systemic bacterial infections, but there's still uncertainty about the consistency across different PCT assays.
  • A study analyzed 37 patient serum samples using four PCT assays and found significant differences in how results were classified at critical decision points for antimicrobial therapy, particularly compared to the BRAHMS KRYPTOR method.
  • The findings suggest that while the assays generally align, many samples could be classified differently among methods, highlighting the urgent need for standardization of PCT testing to ensure reliable clinical interpretations.
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We cared for a woman with sero-positive rheumatoid arthritis (RA), in clinical remission on oral methotrexate (MTX) and hydroxychloroquine, who wished to donate a kidney to a brother with end-stage renal disease (ESRD). We could find scant literature about this unusual clinical circumstance, and therefore review pertinent aspects of renal disease in RA, perioperative medical management, maintenance of disease remission, outcomes for RA patients who have donated kidneys, and relevant ethical issues. Renal complications in RA are not uncommon, with as many as 50% of patients at risk of reduced eGFR.

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