Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies.

Objective: Fetal growth is associated with long-term health yet no appropriate standards exist for the early identification of undergrown or overgrown fetuses. We sought to develop contemporary fetal growth standards for 4 self-identified US racial/ethnic groups.

Study Design: We recruited for prospective follow-up 2334 healthy women with low-risk, singleton pregnancies from 12 community and perinatal centers from July 2009 through January 2013.

Impact of transesophageal echocardiography on clinical management of patients over age 50 with cryptogenic stroke and normal transthoracic echocardiogram.

Background: The utility of transesophageal echocardiography (TEE) subsequent to a normal transthoracic echocardiogram (TTE) in older patients with an unexplained stroke is uncertain.

Methods: Two hundred sixty-three consecutive patients over the age of 50 years hospitalized with a clinical stroke confirmed with brain magnetic resonance imaging and a normal TTE were retrospectively analyzed. Patients with atrial fibrillation, atrial flutter, or any other causative reason for stroke were excluded.

Inappropriate mode switching clarified by using a chest radiograph.

An 80-year-old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post-dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead.

Prevalence and correlates of oral human papillomavirus infection among healthy males and females in Lima, Peru.

Purpose: The incidence of human papillomavirus (HPV) associated head and neck cancers (HNCs) have been increasing in Peru. However, the burden of oral HPV infection in Peru has not been assessed. The objective of this cross-sectional study was to estimate the prevalence and correlates of oral HPV infection in a population-based sample from males and females from Lima, Peru.

Systematic review of the efficacy and safety of intradermal versus intramuscular hepatitis B vaccination in end-stage renal disease population unresponsive to primary vaccination series.

Introduction: The response to hepatitis B vaccine in the dialysis population is reduced compared to the general population. The intradermal (ID) hepatitis B vaccine has been studied as a potential alternative to intramuscular (IM) administration. This alternative route of administration may illicit a response via a distinct immunologic pathway that may help achieve higher seroconversion rates and thus, protection against hepatitis B infection in this vulnerable patient population.

Ketamine Abuse Syndrome: Hepatobiliary and Urinary Pathology Among Adolescents in Flushing, NY.

Objectives: Ketamine is a recreational drug widely abused in East Asia and also in certain subpopulations of the United States. Many US clinicians are unaware of abuse symptoms, leading to misdiagnosis and missed opportunities for intervention. We will discuss clinical patterns that should alert a clinician to the possibility of ketamine abuse.

Systemic-to-pulmonary venous shunt in a patient with non-Hodgkin lymphoma: A case report and review of the literature.

We describe a case of a systemic-to-pulmonary venous shunt secondary to superior vena cava obstruction in a patient with newly diagnosed non-Hodgkin lymphoma. This rare condition manifested with symptoms of dyspnea and hypoxemia that were out of proportion to the pleural effusion diagnosed on chest imaging. Standard treatment of such rare collateral plexuses is observation.

Comparison of different stimulation protocols used in in vitro fertilization: a review.

Infertility is one of the major medical problems in the western world caused by genetic or epigenetic factors, or both, which has led to continuous research and advancements in the field of assisted reproductive technology (ART). Many stimulation protocols are available for controlled ovarian hyperstimulation (COH) in in vitro fertilization (IVF). This review compares the agonist long protocol, antagonist protocol and minimal stimulation protocol.

Novel Agents for the Prevention and Management of Hyperkalemia.

Hyperkalemia is defined as serum potassium concentrations elevated above the upper limit of normal (> 5.0 mEq/L). It has become more common in cardiovascular practice due to the growing population of patients with chronic kidney disease and the broad application of drugs that modulate renal elimination of potassium by reducing production of angiotensin II (angiotensin-converting enzyme inhibitors, direct renin inhibitors, β-adrenergic receptor antagonists), blocking angiotensin II receptors (angiotensin receptor blockers), or antagonizing the action of aldosterone on mineralocorticoid receptors (mineralocorticoid receptor antagonists).

Inhaled Technosphere Insulin Compared With Injected Prandial Insulin in Type 1 Diabetes: A Randomized 24-Week Trial.

Objective: To compare the efficacy and safety of Technosphere insulin (TI) and insulin aspart in patients with type 1 diabetes.

Research Design And Methods: This open-label noninferiority trial compared the change in HbA1c from baseline to week 24 of prandial TI (n = 174) with that of subcutaneous aspart (n = 171), both with basal insulin, in patients with type 1 diabetes and HbA1c 7.5-10.

Your postop patient is confused and agitated--next steps?

Your older patient exhibits signs and symptoms that suggest delirium. Here's how to best handle this complication.

Relationship Between Prebiopsy Multiparametric Magnetic Resonance Imaging (MRI), Biopsy Indication, and MRI-ultrasound Fusion-targeted Prostate Biopsy Outcomes.

Background: Increasing evidence supports the use of magnetic resonance imaging (MRI)-ultrasound fusion-targeted prostate biopsy (MRF-TB) to improve the detection of clinically significant prostate cancer (PCa) while limiting detection of indolent disease compared to systematic 12-core biopsy (SB).

Objective: To compare MRF-TB and SB results and investigate the relationship between biopsy outcomes and prebiopsy MRI.

Design, Setting, And Participants: Retrospective analysis of a prospectively acquired cohort of men presenting for prostate biopsy over a 26-mo period.

Magnetic Resonance Imaging-Ultrasound Fusion Targeted Prostate Biopsy in a Consecutive Cohort of Men with No Previous Biopsy: Reduction of Over Detection through Improved Risk Stratification.

Purpose: MRF-TB (magnetic resonance imaging-ultrasound fusion targeted prostate biopsy) may improve the detection of prostate cancer in men presenting for prostate biopsy. We report clinical outcomes of 12-core systematic biopsy and MRF-TB in men who presented for primary biopsy and further describe pathological characteristics of cancers detected by systematic biopsy and not by MRF-TB.

Materials And Methods: Clinical outcomes of 452 consecutive men who underwent prebiopsy multiparametric magnetic resonance imaging followed by MRF-TB and systematic biopsy at our institution between June 2012 and June 2015 were captured in an institutional review board approved database.

Activity of Meropenem Combined with RPX7009, a Novel β-Lactamase Inhibitor, against Gram-Negative Clinical Isolates in New York City.

Multidrug-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are endemic to hospitals in New York City and other regions. RPX7009 is a novel β-lactamase inhibitor with activity against serine carbapenemases. We tested the activity of meropenem plus RPX7009 against 4,500 recent Gram-negative clinical isolates from 11 New York City hospitals.

Activity of Imipenem with Relebactam against Gram-Negative Pathogens from New York City.

Imipenem with relebactam was active against Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp., including K. pneumoniae carbapenemase (KPC)-producing isolates.

Racial differences in opiate administration for pain relief at an academic emergency department.

Introduction: The decision to treat pain in the emergency department (ED) is a complex, idiosyncratic process. Prior studies have shown that EDs undertreat pain. Several studies demonstrate an association between analgesia administration and race.

Equivalent Survival With Mastectomy or Breast-conserving Surgery Plus Radiation in Young Women Aged < 40 Years With Early-Stage Breast Cancer: A National Registry-based Stage-by-Stage Comparison.

Background: Studies have shown that young patients with early-stage breast cancer (BC) are increasingly undergoing mastectomy instead of breast-conserving therapy (BCT) consisting of lumpectomy and radiation. We examined the difference in outcomes in young women (aged < 40 years) who had undergone BCT versus mastectomy.

Materials And Methods: The Surveillance, Epidemiology, and End Results database was queried for women aged < 40 years with stage I or II invasive BC treated with surgery from 1998 to 2003.

The North American Fetal Therapy Network Consensus Statement: prenatal management of uncomplicated monochorionic gestations.

Owing to vascular connections within a single placenta, monochorionic gestations present distinctive prenatal management challenges. Complications that can arise as a result of unbalanced hemodynamic exchange (twin-twin transfusion syndrome and twin anemia polycythemia sequence) and unequal placental sharing (selective fetal growth restriction) should be kept in mind while prenatal management is being planned. Because of unique monochorionic angioarchitecture, what happens to one twin can directly affect the other.

Reduction in the prevalence of carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa in New York City.

We compared susceptibilities of Acinetobacter baumannii and Pseudomonas aeruginosa collected during surveillance studies conducted during 2009 and 2013-2014 involving hospitals in New York City. There were significant decreases in the number of carbapenem-resistant A baumannii and P aeruginosa cases during 2013-2014; it appears the institution of effective infection control measures has contributed to this decline. However the number of isolates of A baumannii with OXA-23-type β-lactamase increased during 2013-2014.

A phase 2 randomized, double-blind, placebo-controlled study of the effect of VIA-2291, a 5-lipoxygenase inhibitor, on vascular inflammation in patients after an acute coronary syndrome.

Objective: Arachidonate 5-lipoxygenase (5-LO) is a key enzyme in the synthesis of leukotrienes. VIA-2291 is a potent 5-LO inhibitor, which has been shown to reduce hsCRP and noncalcified coronary plaque volume following an acute coronary syndrome (ACS). We aim to evaluate the effect of VIA-2291 on vascular inflammation compared to placebo using FDG-PET.

Fine needle aspiration of thyroid nodules in the pediatric population: a 12-year cyto-histological correlation experience at North Shore-Long Island Jewish Health System.

Background: Diagnostic evaluation of thyroid nodules by FNA is used in the clinical management triage based on the knowledge of the rate of malignancy of each diagnostic category. The Bethesda System for Reporting Thyroid Cytopathology was published in 2007 by the National Cancer Institute (NCI). Using this classification, we studied our institution's experience in the pediatric population calculating the rate of malignancy for each diagnostic category, comparing our findings to our general patient population and that of the literature.

Application of stochastic automata networks for creation of continuous time Markov chain models of voltage gating of gap junction channels.

The primary goal of this work was to study advantages of numerical methods used for the creation of continuous time Markov chain models (CTMC) of voltage gating of gap junction (GJ) channels composed of connexin protein. This task was accomplished by describing gating of GJs using the formalism of the stochastic automata networks (SANs), which allowed for very efficient building and storing of infinitesimal generator of the CTMC that allowed to produce matrices of the models containing a distinct block structure. All of that allowed us to develop efficient numerical methods for a steady-state solution of CTMC models.