Impact on in-hospital outcomes with drug-eluting stents versus bare-metal stents (from 665,804 procedures).

Contemporary large-scale data, regarding in-hospital outcomes depending on the types of stent used for percutaneous coronary intervention (PCI) is lacking. We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2006 to 2011 using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code 36.06 (bare-metal coronary artery stent, BMS) or 36.

Discrepant Glucose Results between Capillary and Venous Blood in an 83-Year-Old White Man.

Herein, we present a case of pseudohypoglycemia induced by hypothermia in an 83-year-old white man in whom glucose levels between venous and capillary blood were discrepant. Although pseudohypoglycemia has been reported in the literature, it is under-recognized among health care professionals and laboratorians. Health care professionals may encounter pseudohypoglycemia using glucose meters; the potentially inaccuracy of glucose meter results for critically ill patients has been intensely debated recently.

Results of ventricular septal myectomy and hypertrophic cardiomyopathy (from Nationwide Inpatient Sample [1998-2010]).

Ventricular septal myomectomy (VSM) is the primary modality for left ventricular outflow tract gradient reduction in patients with obstructive hypertrophic cardiomyopathy with refractory symptoms. Comprehensive postprocedural data for VSM from a large multicenter registry are sparse. The primary objective of this study was to evaluate postprocedural mortality, complications, length of stay (LOS), and cost of hospitalization after VSM and to further appraise the multivariate predictors of these outcomes.

Immunohistochemical analysis of expressions of RB1, CDK4, HSP90, cPLA2G4A, and CHMP2B is helpful in distinction between myxofibrosarcoma and myxoid liposarcoma.

The role and diagnostic efficacy of gene and protein products RB1, CDK4, CHMP2B, HSP90, and cPLA2G4A, all previously shown to be involved in tumor genesis and cell proliferation, were examined by immunohistochemical techniques in 32 cases of myxofibrosarcomas and 29 myxoid liposarcomas (all diagnosis had been confirmed by fluorescence in situ hybridization). HSP90 demonstrated strong nuclear and cytoplasmic positivity in all myxoid liposarcoma cases, while only 4 myxofibrosarcomas showed scattered HSP90 positivity. All but 4 cases of myxofibrosarcoma displayed strong positivity for cPLA2G4A, while only 2 myxoid liposarcoma cases were cPLA2G4A positive and both were CHMP2B negative.

Cluster headache.

Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. Headaches often recur at the same time each day during the cluster period, which can last for weeks to months. Some patients have chronic cluster headache without remission periods.

Analysis of comparison of patient preference for two insulin injection pen devices in relation to patient dexterity skills.

Insulin therapy is the cornerstone of medical treatment for many patients with diabetes. Self-administration of this life-saving medication is no longer limited to the traditional vial and syringe. Instead, more and more patients worldwide are using prefilled insulin pen devices.

Tumor-to-tumor metastasis: case report of a pulmonary adenocarcinoma metastatic to a clear cell renal cell carcinoma.

Tumor-to-tumor metastasis is a very rare event. The recipient tumor may be benign or malignant. Renal cell carcinoma is the most common tumor recipient of metastasis while lung carcinoma is the most common donor tumor.

Sustainability and scalability of the hospital elder life program at a community hospital.

The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium in older hospitalized adults, has been successfully replicated in a community teaching hospital as a quality improvement project. This article reports on successfully sustaining the program over 7 years and expanding its scale from one to six inpatient units at the same hospital. The program currently serves more than 7,000 older patients annually and is accepted as the standard of care throughout the hospital.

Nocturia and aging: diagnosis and treatment.

Nocturia is a frequently encountered problem in clinical practice and a reason for nephrology consultation. Many studies have clearly shown the negative effect of nocturia on several aspects of health-related quality of life and morbidity. Age-associated physiological, structural, hormonal, and histological changes play an important role in the increasing incidence of nocturia in elderly individuals.

Diagnostic accuracy and limitations of fine-needle aspiration cytology of bone and soft tissue lesions: a review of 1114 cases with cytological-histological correlation.

Background: Fine-needle aspiration (FNA) cytology is increasingly being used as a diagnostic modality for soft tissue and bone lesions. These diagnoses can be challenging because of a variety of factors, including interpretation and sampling issues. This study investigates the diagnostic utility of FNA biopsy, in addition to the diagnostic pitfalls, in soft tissue and bone cytopathology.

Molecular Pathology of the Genitourinary Tract: Molecular Pathology of Kidney and Testes.

With the advent of newer molecular technologies, our knowledge of cellular mechanisms with tumors of the kidney and testis has grown exponentially. Molecular technologies have led to better understanding of interplay between the von Hippel-Lindau gene and angiogenic cytokines in renal cancer and isochromosome 12p in testicular neoplasms. The result has been development of antiangiogenic-targeted therapy within recent years that has become the mainstay treatment for metastatic renal cell cancer.

Shared leadership: taking flight.

Nursing leaders are continually seeking ways to improve the work environment in their organizations. Instituting a shared leadership model supports a journey to promote a culture of nursing excellence. The author reviews key principles and how these principles were used as catalysts for change.

Molecular Pathology of the Genitourinary Tract: Prostate and Bladder.

The knowledge of cellular mechanisms in tumors of the prostate and bladder has grown exponentially. Molecular technologies have led to the discovery of TMPRSS2 in prostate cancer and the molecular pathways distinguishing low- and high-grade urothelial neoplasms. UroVysion with fluorescence in situ hybridization is already commonplace as an adjunct to cytologic diagnosis of urothelial neoplasms.

Pleomorphic lobular carcinoma in pleural fluid: diagnostic pitfall for atypical mesothelial cells.

Pleomorphic lobular carcinoma (PLC) is a subtype of infiltrating lobular carcinoma because of its dyscohesiveness, linear infiltration pattern, and lack of membranous E-cadherin staining. However, it differs from classic lobular carcinoma because of its high-grade cytology and more aggressive clinical behavior. In breast fine-needle aspiration biopsies, PLC can be confused with invasive ductal carcinoma, particularly the apocrine variant.

Primary cardiac osteosarcoma with recurrent episodes and unusual patterns of metastatic spread.

Primary osteosarcoma of the heart is an extremely rare entity. In this report, we describe a case of primary osteosarcoma of the heart that recurred and metastasized. The patient is a 50-year-old woman who presented with an abrupt onset of dyspnea, dizziness, and palpitations.

Assessment of "best practice" treatment patterns for a "radiation oncology community outreach group" engaged in cancer disparities outcomes.

Objective: Minority patients with cancer have higher recurrence rates than the general population and are more likely to be treated at community centers where the standard of care has been reported to be inferior to that at academic centers. These issues are being explored by Radiation Oncology Community Outreach Group (ROCOG), a consortium of 5 Community Radiation Oncology centers participating in a National Cancer Institute-funded Disparities Grant. As a quality assurance/quality improvement initiative, this study was undertaken to ensure that treatment was at a "best practice" level.

Transition of a bedside clinician to a nurse educator.

Career opportunities exist in nursing education for medical-surgical nurses. However, nurses need to understand the role, responsibilities, and the work requirements of a nursing faculty member. Steps for planning and assuming a career as a nursing faculty are provided.

Transforming care at the bedside: patient-controlled liberalized diet.

A 2003 partnership between the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation created an initiative to redesign medical-surgical inpatient care - Transforming Care at the Bedside (TCAB). TCAB is intended to transform the elements that affect care on medical/surgical units by rapidly creating, testing, and measuring new ideas. TCAB began as a pilot with three hospitals nationwide, including the University of Pittsburgh Medical Center (UPMC) Shadyside in Pittsburgh, Pennsylvania.