3,308 results match your criteria: "University of Pennsylvania Medical Center.[Affiliation]"

Article Synopsis
  • The study focuses on the use of Left Ventricular Assist Devices (LVAD) in advanced heart failure patients, particularly those with a history of ventricular tachyarrhythmia (VTA), and aims to improve outcomes through a new intra-operative ablation protocol.
  • Researchers designed a randomized clinical trial involving 100 LVAD candidates, comparing those receiving intra-operative VTA ablation against those receiving standard medical management.
  • The trial will track various outcomes for an average of 18 months post-surgery, assessing VTA recurrence, adverse events, right heart function, healthcare utilization, and quality of life.
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  • The third edition of The Bethesda System for Reporting Thyroid Cytopathology standardizes diagnoses into six categories, with each category assigned a single name and updated risk of malignancy (ROM) based on recent data.
  • The "atypia of undetermined significance" category is simplified into two subgroups, and new information on pediatric thyroid disease, including ROMs and management, has been added.
  • The edition also aligns nomenclature with the latest World Health Organization classification and introduces chapters on molecular testing and clinical perspectives in thyroid disease.
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Article Synopsis
  • - The third edition of The Bethesda System for Reporting Thyroid Cytopathology enhances the standardized reporting system for thyroid fine needle aspirations and introduces unified naming for six diagnostic categories with updated risk of malignancy (ROM) data.
  • - The "atypia of undetermined significance" category is simplified into two subgroups based on their ROM and molecular profiles, improving clarity in diagnosis.
  • - New chapters on molecular testing and clinical perspectives on thyroid disease have been added, along with a focus on pediatric thyroid conditions and their management.
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Immunohistochemistry in the pathologic diagnosis and management of thyroid neoplasms.

Front Endocrinol (Lausanne)

June 2023

Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Perelman School of Medicine, Philadelphia, PA, United States.

Article Synopsis
  • Immunohistochemistry is essential in thyroid pathology, advancing from confirming thyroid origin to molecular profiling and predicting clinical behavior.
  • It plays a crucial role in updating the classification of thyroid tumors and emphasizes the importance of using a panel of immunostains while considering cytologic and architectural features.
  • The use of immunohistochemistry can be effectively applied to specimens with limited cellularity, but it requires laboratory validation to ensure accurate diagnoses.
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An emerging technology (ET) for laboratory medicine can be defined as (including biomarkerssoftware, applications, and algorithms) Considering the laboratory medicine-specific definition, this document examines eight key tools, encompassing clinical, analytical, operational, and financial aspects, used throughout the life cycle of ET implementation. The tools provide a systematic approach starting with identifying the unmet need or identifying opportunities for improvement (Tool 1), forecasting (Tool 2), technology readiness assessment (Tool 3), health technology assessment (Tool 4), organizational impact map (Tool 5), change management (Tool 6), total pathway to method evaluation checklist (Tool 7), and green procurement (Tool 8). Whilst there are differences in clinical priorities between different settings, the use of this set of tools will help support the overall quality and sustainability of the emerging technology implementation.

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Non-surgical management and analgesia strategies for older adults with multiple rib fractures: A systematic review, meta-analysis, and joint practice management guideline from the Eastern Association for the Surgery of Trauma and the Chest Wall Injury Society.

J Trauma Acute Care Surg

March 2023

From the Division of Acute Care Surgery, Loma Linda University Medical Center (K.M.), Loma Linda; University of California Irvine Medical Center (S.D.S.), Irvine; Scripps Memorial La Jolla (G.T.), San Diego, California; Division of Trauma and Critical Care Surgery, Department of Surgery (S.C., K.L.H., S.K.A., G.K.), Duke University Medical Center, Durham, North Carolina; The Mayo Clinic (B.K.), Rochester, Minnesota; University of California San Francisco-Fresno (K.L.K.), Fresno, California; Lehigh Valley Health Network (R.B.), Allentown, Pennsylvania; Stanford University Medical Center (K.S., L.M.K.), Palo Alto, California; University of Pennsylvania Medical Center (A.M.S.), Philadelphia, Pennsylvania; University of Nebraska Medical Center (Z.M.B.), Omaha, Nevada; Texas Tech University Health Sciences Center (S.E.B.), Lubbock, Texas; Massachusetts General Hospital (H.K.), Boston, Massachusetts; University of Florida College of Medicine (M.C.), Jacksonville, Florida; University of Utah Medical Center (R.N.), Salt Lake City, Utah; MetroHealth Cleveland Medical Center (J.J.C.), Cleveland, Ohio; Johns Hopkins Medical Center (E.R.H.), Baltimore, Maryland.

Background: Chest wall injury in older adults is a significant cause of morbidity and mortality. Optimal nonsurgical management strategies for these patients have not been fully defined regarding level of care, incentive spirometry (IS), noninvasive positive pressure ventilation (NIPPV), and the use of ketamine, epidural, and other locoregional approaches to analgesia.

Methods: Relevant questions regarding older patients with significant chest wall injury with patient population(s), intervention(s), comparison(s), and appropriate selected outcomes were chosen.

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Orthotopic liver transplantation (OLT) is a viable treatment option for end-stage liver disease. Significant perioperative stress is placed on the cardiovascular system because of hemodynamic changes and the length of the operation. Diagnosis and treatment of cardiovascular disease before OLT are imperative to ensure favorable outcomes.

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Diagnosing ectopic pregnancy using Bayes theorem: a retrospective cohort study.

Fertil Steril

January 2023

Postgraduate Program in Medicine: Surgical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Gynecology and Obstetrics, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Serv. Ginecologia e Obstetrícia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Electronic address:

Objective: To verify the accuracy of an online algorithm using Bayes' theorem for diagnosing ectopic pregnancy (EP) using human chorionic gonadotropin (hCG), ultrasound, and clinical data in a real cohort.

Design: A retrospective cohort study.

Setting: Gynecologic emergency unit in a tertiary teaching hospital.

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The term "emerging technology" (ET) is used extensively, and there are numerous definitions offered, but to our knowledge, none specifically encompass the field of laboratory medicine. An ET definition that incorporates the overarching IFCC aim of "Advancing excellence in laboratory medicine to support healthcare worldwide" would clarify discussions. We discuss key aspects of the term "emerging technology(ies)" as it applies to laboratory medicine with a view to laying the foundations for a practical definition for the profession and propose the definition of an ET as "".

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Importance: The Patent Foramen Ovale (PFO)-Associated Stroke Causal Likelihood classification system combines information regarding noncardiac patient features (vascular risk factors, infarct topography) and PFO features (shunt size and presence of atrial septal aneurysm [ASA]) to classify patients into 3 validated categories of responsiveness to treatment with PFO closure. However, the distinctive associations of shunt size and ASA, alone and in combination, have not been completely delineated.

Objective: To evaluate the association of PFO closure with stroke recurrence according to shunt size and/or the presence of an ASA.

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Background: Urine cytology is commonly used as a screening test for high-grade urothelial carcinoma for patients with risk factors or hematuria and is an essential step in longitudinal monitoring of patients with previous bladder cancer history. However, the semisubjective nature of current reporting systems for urine cytology (e.g.

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Spindle cell proliferations originating in follicular derived thyroid neoplasms are rare and known to cause diagnostic conundrums. We describe a unique case of a spindle cell variant of follicular thyroid carcinoma (FTC) in a 48-year-old female without relevant past medical history, who was being followed for a 1.4 cm left thyroid nodule for the past 15 months.

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Introduction: High-risk human papillomavirus (HR-HPV) status is critical in the diagnosis of oropharyngeal squamous cell carcinoma, informing prognosis and choice of therapy. HR-HPV status additionally plays a key role in the evaluation of squamous cell carcinoma of unknown origin metastatic to cervical lymph nodes. Thus, HR-HPV testing of fine needle aspirate (FNA) specimens from the head and neck is invaluable for accurate diagnosis, prognostication, and treatment planning.

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Article Synopsis
  • Glatiramer acetate (GA) is approved for treating relapsing multiple sclerosis, and this study examined its long-term effectiveness, particularly comparing early versus delayed treatment start.
  • Participants in the trial showed that those who started GA treatment early had better outcomes, with less worsening in disability scores and longer times to disease progression than those who started treatment later.
  • Overall, while GA treatment was beneficial over the long term and showed no new safety concerns, a limitation of the study was that only about 25% of participants completed the follow-up period.
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Atopy as Immune Dysregulation: Offender Genes and Targets.

J Allergy Clin Immunol Pract

July 2022

Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; St Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address:

Allergic diseases are a heterogeneous group of disorders resulting from exaggerated type 2 inflammation. Although typically viewed as polygenic multifactorial disorders caused by the interaction of several genes with the environment, we have come to appreciate that allergic diseases can also be caused by monogenic variants affecting the immune system and the skin epithelial barrier. Through a myriad of genetic association studies and high-throughput sequencing tools, many monogenic and polygenic culprits of allergic diseases have been described.

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A multidisciplinary approach to heart failure care in the hospital: improving the patient journey.

Hosp Pract (1995)

August 2022

Department of Emergency Medicine, Wayne State University, School of Medicine, Detroit, MI, USA.

Background: Despite advancements in care for patients with heart failure (HF), morbidity and mortality remain high. Hospitalizations and readmissions for HF have been the focus of significant attention among health care providers and payers, with an eye toward reducing health care costs. However, considerable variability exists with regard to inpatient workflows and management for patients with HF, which represents a significant opportunity to improve care.

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rECHOmmend: An ECG-Based Machine Learning Approach for Identifying Patients at Increased Risk of Undiagnosed Structural Heart Disease Detectable by Echocardiography.

Circulation

July 2022

Department of Translational Data Science and Informatics (A.E.U-C., L.J., J.M.P., S.R., J.A.R., C.W.G., C.M.H., B.K.F., R.C.); Geisinger, Danville, PA.

Article Synopsis
  • The study focuses on improving the diagnosis of structural heart diseases through a new ECG-based machine learning model that predicts various conditions, potentially increasing patient outcomes.
  • By analyzing 2.2 million ECGs linked to health records, researchers tested their model on seven echocardiography-confirmed diseases, ultimately achieving a high predictive accuracy (0.91 AUC) with a 42% positive predictive value.
  • The composite model outperformed individual disease predictions and showed consistent results across different datasets, emphasizing the effectiveness of incorporating diverse patient data for better heart disease detection.
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Colorectal cancer (CRC) is among the most frequent forms of cancer, and new strategies for its prevention and therapy are urgently needed. Here we identify a metabolite signalling pathway that provides actionable insights towards this goal. We perform a dietary screen in autochthonous animal models of CRC and find that ketogenic diets exhibit a strong tumour-inhibitory effect.

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Kaposiform lymphangiomatosis is an uncommon generalized lymphatic anomaly with distinctive clinical, radiologic, histopathologic, and molecular findings. Herein, we document the pathology in 43 patients evaluated by the Boston Children's Hospital Vascular Anomalies Center from 1999 to 2020. The most frequent presentations were respiratory difficulty, hemostatic abnormalities, and a soft tissue mass.

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The surgical repair of type A aortic dissection often involves prosthetic proximal aortic and arch reconstruction. Hypothermic circulatory arrest is typically used in these complex surgeries given the required prolonged ischaemia and the associated morbidity and mortality. A novel vascular anastomoses device (Device) has been developed to rapidly connect a native vessel to a polyester graft.

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