Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

Background & Aims: Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings.

Methods: We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures.

Microlaparoscopy in urogynecology: LSH and sacrocervicopexy.

Study Objective: To determine the feasibility of using only microlaparoscopic (3.5 mm) accessory instruments for performing laparoscopic supracervical hysterectomy (LSH) and sacrocervicopexy with the aid of a transcervically placed cannula for introduction of mesh and needles.

Design: Retrospective evaluation of the first five cases of microlaparoscopic LSH with sacrocervicopexy (Canadian Task Force classification III).

Selective blockade of matrix metalloprotease-14 with a monoclonal antibody abrogates invasion, angiogenesis, and tumor growth in ovarian cancer.

Most patients with ovarian cancer are diagnosed late in progression and often experience tumor recurrence and relapses due to drug resistance. Surface expression of matrix metalloprotease (MMP)-14 on ovarian cancer cells stimulates a tumor-stromal signaling pathway that promotes angiogenesis and tumor growth. In a cohort of 92 patients, we found that MMP-14 was increased in the serum of women with malignant ovarian tumors.

The clinical and economic impact of a sustained program in global plastic surgery: valuing cleft care in resource-poor settings.

Background: The development of surgery in low- and middle-income countries has been limited by a belief that it is too expensive to be sustainable. However, subspecialist surgical care can provide substantial clinical and economic benefits in low-resource settings. The goal of this study is to describe the clinical and economic impact of recurrent short-term plastic surgical trips in low- and middle-income countries.

Social Network Visualization in Epidemiology.

Epidemiological investigations and interventions are increasingly focusing on social networks. Two aspects of social networks are relevant in this regard: the structure of networks and the function of networks. A better understanding of the processes that determine how networks form and how they operate with respect to the spread of behavior holds promise for improving public health.

Teaching approaches that reflect and promote professionalism.

The teaching and cultivation of professionalism have long been part of medical education and have had recent special emphasis because professionalism has been identified as a core competency by the Accreditation Council for Graduate Medical Education. The author focuses on two complementary teaching initiatives that contribute to the development of professionalism in the academic environment: a resident-as-teacher program and an approach to faculty bedside teaching that mirrors and extends the lessons of the resident-as-teacher effort. These have been implemented and refined over the previous 15 years by the author and his colleagues at Mount Auburn Hospital in Cambridge, Massachusetts.

EEG coherence in post-LSD visual hallucinations.

LSD use in certain individuals may result in chronic visual hallucinations, a DSM-IV syndrome known as hallucinogen persisting perception disorder (HPPD). We studied 38 HPPD subjects with a mean of 9.7 years of persistent visual hallucinations and 33 control subjects.

Gongylonema infection of the mouth in a resident of Cambridge, Massachusetts.

We report a case of Gongylonema infection of the mouth, which caused a migrating, serpiginous tract in a resident of Massachusetts. This foodborne infection, which is acquired through accidental ingestion of an infected insect, such as a beetle or a roach, represents the 11th such case reported in the United States.

Fiber manufacturing, membrane classification, and winding technologies associated with membrane oxygenators.

Fiber bundling refers to the process of winding hollow polypropylene fibers onto the central core of a membrane oxygenator. Identifying the various bundling techniques serves to facilitate the clinician's understanding of unique device characteristics and the subsequent manufacturing process. This technical information has been voluntarily provided by the product managers and engineers of current membrane manufacturers.

Bronchiolitis obliterans from exposure to incinerator fly ash.

Inhalation of toxic substances in the workplace can result in a variety of respiratory disorders. One relatively rare sequela of the inhalation of toxic fumes is bronchiolitis obliterans, a condition characterized by fibrosis and narrowing of the small airways. Several substances have been reported to cause bronchiolitis obliterans, including ammonia, chlorine, hydrogen fluoride, hydrogen sulfide, nitrogen dioxide, ozone, phosgene, and other irritant fumes.

Laser prostatectomy with a TURPETTE: evolution with right-angle technique.

Fifty-five patients with symptomatic bladder outlet obstruction were treated with laser ablation of the prostate using right-angle fibers to deliver Nd:YAG laser energy. Dosimetry ranged between 60 and 80 W power in a noncontact mode to achieve both coagulation and vaporization of adenomatous prostate tissue. Most patients were followed for > 1 year.

Expression of vascular permeability factor/vascular endothelial growth factor by human granulosa and theca lutein cells. Role in corpus luteum development.

Vascular permeability factor/vascular endothelial growth factor (VPF/VEGF) is a cytokine that is overexpressed in many tumors, in healing wounds, and in rheumatoid arthritis. VPF/VEGF is thought to induce angiogenesis and accompanying connective tissue stroma in two ways: 1), by increasing microvascular permeability, thereby modifying the extracellular matrix and 2), as an endothelial cell mitogen. VPF/VEGF has been reported in animal corpora lutea and we investigated the possibility that it might be present in human ovaries and have a role in corpus luteum formation.

Laser advances in urology.

This paper reviews the current use of lasers in urology--CO 2, Nd:YAG, KTP/532, Diode, pulsed dye--and describes the most common procedures performed with them. It discusses surgical techniques of lasers that are expected to be useful to urologists in the future and concludes that lasers are important tools for this specialty.

Shame and guilt in eating disorders.

A study of 94 college students supported the hypothesis that women with eating disorders experience more shame and guilt in relation to eating than do either normal or depressed women, and that such shame and guilt differentiate the eating disorders from other psychopathology. Findings revealed an apparent difference in the nature of the depression experienced by eating disordered women and that of depressed women without such disorders. Developmental and clinical implications are discussed.

Flexor tendon ruptures in patients with rheumatoid arthritis.

One hundred fifteen flexor tendon ruptures were reviewed in 43 hands with rheumatoid arthritis, one hand with psoriatic arthritis, and one hand with lupus erythematosis. Ninety-one tendons were ruptured at the wrist, four ruptures occurred at the palm, and 20 ruptures occurred within the digits. At the wrist level, 61 ruptures were caused by attrition on a bone spur and 30 were caused by direct invasion of the tendon by tenosynovium.