1,443 results match your criteria: "Penn State Health Milton S. Hershey Medical Center.[Affiliation]"

Early-career surgeons must be exposed to a sufficient number of surgical cases of varying complexity in a mentored environment to allow them to solidify, sustain and build on the skills gained in training. Decreased operative volumes at military treatment facilities and assignments that do not include strong mentoring environments can place military surgeons at a disadvantage relative to their civilian counterparts during this critical time following training. The challenge of lower operative volumes in the current interwar lull has been exacerbated by the decline in beneficiary care conducted within the Military Healthcare System.

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  • The aldosterone renin ratio (ARR) is essential for deciding whether adrenal vein sampling (AVS) is necessary in diagnosing primary hyperaldosteronism.
  • The case emphasizes the importance of interpreting plasma renin and aldosterone levels within context rather than relying solely on imaging.
  • Relying only on imaging without conducting AVS can lead to unnecessary surgeries, such as adrenalectomy on the wrong side or even an unnecessary surgery altogether.
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Background: Despite the increasing use of non-invasive imaging, DSA remains the gold standard for cerebrovascular imaging. However, trends in DSA utilization are poorly understood. The goal of this study was to describe DSA utilization in a large claims database in the US over a 13 year period.

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  • - Current guidelines suggest observing anaphylactic patients for 4-6 hours after receiving epinephrine, but there's conflicting evidence about its effectiveness, especially for children.
  • - This study looked at pediatric patients treated for anaphylaxis in a single ED from 2017-2022 to see how often biphasic reactions occurred and if the observation periods were adequate.
  • - Out of 292 patients observed for an average of about 233 minutes, only 3.4% developed biphasic reactions, with no significant differences found in observation duration or timing of epinephrine administration between those who did and did not experience these reactions.
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Efficacy and Tolerability of Anti-CGRP Monoclonal Antibodies in Patients Aged ≥ 65 Years With Daily or Nondaily Migraine.

Neurol Clin Pract

February 2025

Department of Molecular Medicine (A. Salim), Cleveland Clinic Lerner College of Medicine, Case Western Reserve University; Genomic Medicine Institute (A. Salim, IFM), Lerner Research Institute, Cleveland Clinic; Center for Neurological Restoration (SB, MM, A. Suneja, ZA), Cleveland Clinic Neurological Institute; Quantitative Health Sciences (CS, OH), Lerner Research Institute, Cleveland Clinic, OH; and Neuroscience Institute (EH), Penn State Health Milton S. Hershey Medical Center, Hershey, PA.

Background And Objectives: Despite decreasing prevalence of migraine with advancing age, there remains a significant proportion of individuals aged ≥65 years with migraine. Treatment of this population is difficult and they are often excluded from clinical trials, limiting evidence regarding migraine treatment outcomes. Our objective is to assess the efficacy and tolerability of anti-calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) therapies (erenumab, fremanezumab, and galcanezumab) in patients ≥65 years (O65) compared with patients <65 (U65) with daily or nondaily migraine.

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Introduction: The prevalence of opioid use disorder (OUD) among adolescents has seen an alarming rise, prompting an exploration of the utilization of buprenorphine as a treatment modality. This study aimed to understand the perceptions, experiences, and comfort levels of pediatric emergency medicine (PEM) clinicians in initiating medication-assisted treatment (MAT) for pediatric patients presenting with OUD in emergency departments.

Methods: Utilizing a cross-sectional survey design, data from 110 respondents were collected from a potential participant pool of 3062 for a response rate of 3.

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Background: There is an unmet need for early detection of heart failure decompensation, allowing patients to be managed remotely and avoid hospitalization.

Objectives: The purpose of this study was to compare a strategy utilizing data from a wearable HF sensor for management following a HF hospitalization to usual care.

Methods: Eligible subjects were discharged from the hospital within the previous 10 days and had a HF event in the previous 6 months.

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  • Developmental and epileptic encephalopathies (DEEs) are serious childhood epilepsy syndromes with frequent seizures and significant cognitive impairments, often not responding to standard treatments.
  • Recent advancements in neuromodulation techniques like deep brain stimulation (DBS) and responsive neurostimulation (RNS) show promise in managing these conditions by targeting specific brain networks involved in seizures.
  • Initial findings, particularly with DBS for Lennox-Gastaut syndrome (LGS), indicate some effectiveness, but mixed results across various DEEs highlight the need for a better understanding of brain networks to guide optimal treatment strategies.
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Adult-onset Still's disease masquerading as acute coronary syndrome: a case report and review of the literature.

J Med Case Rep

October 2024

Division of Infectious Diseases and Epidemiology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.

Article Synopsis
  • Adult-onset Still's disease is a rare inflammatory condition that can cause symptoms like fevers and myopericarditis, as seen in a young man who developed these after a respiratory infection.
  • The patient had significant medical issues, including high fever, chest pain, and was eventually diagnosed after thorough testing; he responded well to steroids but experienced side effects before achieving remission with tocilizumab.
  • Early recognition of this disease is essential for effective treatment, as steroids are the primary option despite their risks, while newer biologics like tocilizumab offer benefits but can be expensive.
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Autonomic Neural Blockade in Minimally Invasive Surgery.

JAMA Surg

December 2024

Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.

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  • Bipolar disorder is a serious mental health problem that affects people all over the world and can lead to other health issues, especially heart problems.
  • People with bipolar disorder are more likely to have heart diseases and may face a higher chance of dying from them.
  • It's important to learn how bipolar disorder affects the body so that we can better help those who have it stay healthy and manage their heart health.
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  • The study investigated the rates of coinfections among patients with babesiosis, focusing on the relationship between these coinfections and severe health outcomes, including mortality.
  • Researchers analyzed data from the TriNetX database from 2015 to 2022, identifying a 42% prevalence of coinfections primarily with an organism causing similar tick-borne diseases.
  • Findings showed that 90-day mortality rates were actually lower in patients with coinfections compared to those with only babesiosis, highlighting a complex interplay between these infections and health outcomes.
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Ethical dimensions of clinical data sharing by US healthcare organizations for purposes beyond direct patient care: Interviews with healthcare leaders.

Appl Clin Inform

October 2024

Department of Biostatistics, Epidemiology and Informatics, and the Leonard David Institute of Health Economics, University of Pennsylvania, Philadelphia, United States.

Objectives: Empirically investigate current practices and analyze ethical dimensions of clinical data sharing by healthcare organizations for uses other than treatment, payment, and operations. Make recommendations to inform research and policy for healthcare organizations to protect patients' privacy and autonomy when sharing data with unrelated third parties.

Methods: Semi-structured interviews and surveys involving 24 informatics leaders from 22 US healthcare organizations, accompanied by thematic and ethical analyses.

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  • Justinian II was overthrown in the eighth century, had his nose amputated, and was exiled.
  • After ten years, he returned to power through a violent coup.
  • Researchers have debated whether he underwent ancient rhinoplasty to regain his nose, but it's deemed highly unlikely.
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Introduction: Alleviation of symptom severity for major depressive disorder (MDD) is known to be associated with a lagged improvement of functioning. Pharmacotherapy guidelines support algorithms for MDD treatment. However, it is currently unclear whether concordance with guidelines influences functional recovery.

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Parastomal endometriosis in a patient with inflammatory bowel disease.

J Minim Invasive Gynecol

September 2024

Penn State Health Milton S. Hershey Medical Center, Department of Surgery, Division of Colorectal Surgery, 500 University Drive, Hershey, PA, 17033. Electronic address:

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New Frontiers in Hypertrophic Obstructive Cardiomyopathy.

J Cardiothorac Vasc Anesth

December 2024

Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA. Electronic address:

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Background: Currently, the established approach for addressing stage IV non-small cell lung cancer (NSCLC) involves combining chemotherapy with immunotherapy. However, the necessity for molecular analysis prior to commencing immunotherapy often results in a delay in its initiation following the commencement of chemotherapy. Therefore, this study aimed to study the significance of postponing immunotherapy on pertinent patient outcomes.

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  • The study investigates how infection rates, particularly during the COVID-19 pandemic, may relate to sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS), comparing data from before and during the pandemic.
  • It utilizes mortality data from the CDC between 2018 and 2021, focusing on cases classified under specific codes related to SUID and SIDS, to analyze monthly variations in death rates.
  • Findings reveal a significant increase in SUID risk during the pandemic period, especially beginning July 2020, indicating a notable shift in epidemiological patterns compared to the prepandemic baseline.
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A penile fracture is a rare but urgent urologic emergency that requires immediate surgical correction to preserve erectile function. It results from a rupture of the tunica albuginea of one or both corpora cavernosa. Patients classically will present with a history of recent sexual activity and a sudden "snap," followed by detumescence, pain, and swelling of the phallus.

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  • The ASMBS and IFSO updated the guidelines for Metabolic and Bariatric Surgery in 2022, replacing 30-year-old NIH recommendations.
  • These new guidelines are based on stronger evidence and are designed to support healthcare professionals and patients in making informed decisions about surgery.
  • The study evaluates the quality of evidence and the effectiveness of these updated recommendations compared to the old criteria.
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Heat Stroke Management Updates: A Description of the Development of a Novel In-Emergency Department Cold-Water Immersion Protocol and Guide for Implementation.

Ann Emerg Med

January 2025

Valleywise Health Medical Center, Department of Emergency Medicine, Phoenix, AZ; Creighton University School of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, AZ.

Article Synopsis
  • The increasing incidence of heat stroke due to climate change necessitates urgent strategies to combat weather-related health issues and prevent severe outcomes like organ failure.
  • The text focuses on a new protocol for cold-water immersion in emergency departments, aimed at quickly lowering core body temperatures in patients with heat stroke, particularly those with altered mental states and temperatures over 40 °C.
  • It highlights the implementation of this protocol during the summer of 2023, detailing its effectiveness, challenges faced, and the need for collaboration, education, and infrastructure improvements in emergency care.
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Objective: The medical literature has demonstrated disparities and variability in physician salaries and, specifically, emergency physician (EP) salaries. We sought to investigate individual physician characteristics, including sex and educational background, together with individual preferences of graduating EPs, and their association with the salary of their first job.

Methods: The American College of Emergency Physicians and the George Washington University Mullan Institute surveyed 2019 graduating EPs.

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  • Program signaling (PS) was introduced in the emergency medicine residency application process during the 2022-2023 cycle, allowing applicants to indicate their preferred programs.
  • A study assessing how program directors utilized PS involved a 41% response rate from EM residency programs, indicating most participated and had an average of 60 signals received, influenced by factors like geographic location and program type.
  • Overall, while PS was used primarily in holistic reviews (52.2% of responses), its perceived importance was notably lower compared to traditional application elements like standardized letters of evaluation.
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Introduction: Prior work notes the AUA In-Service Exam (ISE) percentile ranking of chief residents correlates with the American Board of Urology Qualifying Exam (QE) performance. We present a 5-year analysis of resident performance on the ISE and subsequent QE to determine if earlier time points in training may identify those needing additional educational support.

Methods: Participant ISE scores over a 5-year period from 2014 to 2018 and subsequent QE scores in 2019 were recorded.

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