Oncologic Outcomes in Patients with Residual Upper Tract Urothelial Carcinoma Following Neoadjuvant Chemotherapy.

Background And Objective: Growing evidence supports the use of neoadjuvant chemotherapy (NAC) for upper tract urothelial carcinoma (UTUC). However, the implications of residual UTUC at radical nephroureterectomy (RNU) after NAC are not well characterized. Our objective was to compare oncologic outcomes for pathologic risk-matched patients who underwent RNU for UTUC who either received NAC or were chemotherapy-naïve.

Characteristics of early pleural effusions after orthotopic heart transplantation: comparison with coronary artery bypass graft surgery.

Objectives: Pleural effusions appearing within the first 30 postoperative days following coronary artery bypass grafting (CABG) are classified as early and believed to be directly related to the surgery. The characteristics of such effusions are well-described. Orthotopic heart transplantation is also known to be complicated by pleural effusions; however, their characteristics have not been systematically reported.

Implementing Daily Leadership Safety Huddles in a Public Hospital: Bridging the Gap.

Background: A Leadership Safety Huddle was instituted in efforts to improve communication and make safety culture a priority at our institution. The Huddle is a transparent, regularly recurring forum of clinical and administrative hospital leaders, in which safety issues and concerns are identified, shared, and swiftly addressed.

Methods: Metrics regarding huddle effectiveness in 3 areas are studied: information technology (IT) services ticket resolution time, bladder catheterization, and one-to-one inpatient monitoring.

Innovative pharmacologic approaches to cardiopulmonary resuscitation.

The survival rate of patients undergoing cardiopulmonary resuscitation is 5 to 15%. New cardiopulmonary resuscitation treatment approaches under investigation include the use of vasopressin as a vasopressor, amiodarone for the treatment of ventricular tachyarrhythmias, and adenosine antagonists (i.e.

HIV-associated (non-thymic) intrathoracic lymphoepithelial cyst in a child.

An unusual case of a juxtabronchial lymphoepithelial cyst in an HIV-positive child with post-obstructive pneumonia is presented. The pathogenesis and similarity with parotid lymphoepithelial cysts is discussed.

Laparoscopy in the management of children with chronic recurrent abdominal pain.

Background And Objectives: The purpose of the present study was to evaluate the results of diagnostic laparoscopy in children with chronic recurrent abdominal pain.

Patients And Methods: Thirteen children with chronic recurrent abdominal pain were subjected to diagnostic laparoscopy. Ages varied from 10 to 17 years.

Specificity of glycosaminoglycan suppression of endothelin-1 production by human umbilical vein endothelial cells.

Endothelin-1 (ET-1) is the most potent vasoconstrictor peptide found in nature. Its production is stimulated by thrombin. By inhibiting thrombin we have previously shown that heparin, a highly negatively-charged glycosaminoglycan (GAG), suppresses the production of ET-1 by cultured human umbilical vein endothelial cells (HUVEC).

Video-assisted thoracoscopy in the management of recurrent spontaneous pneumothorax in the pediatric population.

Background And Objectives: The purpose of the present study was to evaluate the application of video-assisted thoracoscopy in the management of recurrent spontaneous pneumothorax in the pediatric population.

Patients And Methods: Between 1995 and 1997, four patients with recurrent spontaneous pneumothorax were treated. Ages varied from 14 to 17 years.

Symptomatic atrioventricular dual pathway double responses: a role for slow pathway ablation.

Two patients with symptomatic fast/slow pathway double responses were evaluated with electrophysiology studies. Chronic palpitations were resistant or worsened by medical therapy. No reentry tachycardias were induced.

Safety and efficacy of outpatient transseptal radiofrequency ablation of atrioventricular accessory pathways.

A retrospective analysis of 60 consecutive patients who underwent outpatient transseptal radiofrequency ablation of left sided accessory pathways at Westchester County Medical Center/New York Medical College from September 1994 to December 1997 was performed. Patients were followed for a mean duration of 22 months. No complications either local or related to the transseptal method were observed.

Asynchronous and asymmetric burst-suppression in a patient with a corpus callosum lesion.

Introduction: Burst suppression is seen in the electroencephalograms of patients receiving high doses of pentobarbital. In such circumstances, burst suppression is characterized by bilaterally synchronous and symmetric bursts of electrical activity followed by intervals of attenuation.

Methods: We report on a case of asymmetric and asynchronous pentobarbital-induced burst suppression that occurred after a corpus callosum lesion sustained during trauma.

Predicting and preventing pressure ulcers in adults with paralysis.

A questionnaire mailed to all 2,295 members of the Eastern Paralyzed Veterans Association measured 45 potential risk factors for pressure ulcers. Logistic-regression analysis and Cox proportional-hazards analyses were used to identify the variables that were independently associated with pressure ulcers. The survey response rate was 42.

Maternal Lyme disease and congenital heart disease: A case-control study in an endemic area.

Objective: The purpose of this study was to determine whether maternal Lyme disease increases the risk of congenital heart defect.

Study Design: This retrospective case-control study was carried out at a medical center in a suburban area where Lyme disease is endemic. Case patients comprised 796 children with a diagnosis of congenital cardiac anomaly.

Maternal magnesium sulfate and the development of neonatal periventricular leucomalacia and intraventricular hemorrhage.

Objective: Neonatal periventricular leucomalacia and intraventricular hemorrhage are strong correlates of cerebral palsy. Our objective was to evaluate the effect of maternal magnesium sulfate exposure on the incidence and severity of periventricular leucomalacia and intraventricular hemorrhage in preterm neonates.

Methods: Nine hundred eighteen consecutive inborn neonates with birth weights from 500 to 1750 g were divided primarily into two groups on the basis of maternal exposure to magnesium sulfate.

Ontogeny of renal dysplasia in Ivemark syndrome: light and immunohistochemical characterization.

Ivemark syndrome is a rare sporadic or autosomal recessive disorder characterized by pancreatic fibrosis, renal dysplasia and hepatic dysgenesis. There have been no data describing the renal changes during embryologic development in this syndrome. In this report, we document the pathological findings of the kidney in three subjects with Ivemark syndrome: 6 months, 21 weeks and 16 weeks, respectively.

Laparoscopy in pediatric abdominal trauma.

Background: The use and indications for laparoscopy have been increasing. As part of this trend, a new algorithm may emerge for pediatric trauma in which laparoscopic techniques are used in hemodynamically stable patients with suspected hollow viscus perforation.

Case Report: We present a case in which laparoscopy was successfully used in a pediatric trauma patient as a diagnostic and therapeutic modality.

In vitro effects and clinical evaluation of a human chorionic gonadotrophin preparation in acute leukemia.

Commercial human chorionic gonadotrophin (HCG) preparations decrease the tumorigenicity of human tumors in immunodeficient mice and induce apoptotic cell death in animal tumor models. Preliminary studies in humans have demonstrated tumor regression in patients with Kaposi's sarcoma given intralesional injections of HCG. To further evaluate HCG's antitumor activity we conducted in vitro and clinical evaluations of HCG in acute myeloid leukemia (AML).

Colonization and microbiology of the motile enterococci in a patient population.

The motile enterococci with the vanC gene have intrinsic low-level resistance to vancomycin, but have not been implicated in a nosocomial outbreak. We determined the colonization rate of motile enterococci in hospitalized and nonhospitalized patients. Perianal or stool specimens were cultured in Enterococcosel broth supplemented with 6 micrograms of vancomycin per mL.

Intra-amniotic pressure reduction in twin-twin transfusion syndrome.

Objective: Our purpose was to measure intra-amniotic pressure before and after decompression amniocentesis in twin-twin transfusion syndrome.

Study Design: Intra-amniotic pressures were measured during decompression amniocentesis on 18 occasions in 5 pregnancies complicated by twin-twin transfusion syndrome. The intra-amniotic pressure was determined with a water manometer before and after removal of amniotic fluid.

Acute pancreatitis caused by penicillin.

Acute pancreatitis in childhood is a rare condition but should still be considered in all children presenting with abdominal pain. A complete history and physical exam with emphasis on recent trauma, infection, chronic diseases, and current medications should be obtained. Numerous and varied drugs have been implicated in the development of pancreatitis.

Neonatal middle cerebral artery infarction: association with elevated maternal anticardiolipin antibodies.

A full-term neonate was born to a 41-year-old woman via elective primary cesarean section for frank breech presentation after a 41-week pregnancy. Starting at 6 hr of age the infant presented with multiple episodes of apnea and cyanosis, in association with moderate hypotonia, subsequently requiring assisted ventilatory support for 2 days. Computerized axial tomography of the brain revealed infarction in the distribution of the left middle cerebral artery.

Efficacy of an OspA vaccine preparation for prevention of Lyme disease in New York State.

A multicenter, double-blinded, placebo-controlled study was done comparing a 30-microgram dose of a single protein recombinant OspA vaccine preparation with a saline placebo for efficacy in prevention of Lyme disease in humans. The OspA vaccine (30-microgram dose) or saline placebo was given intramuscularly at day 0, 1 month later, and 12 months later. Cases of possible Lyme disease were evaluated clinically and using culture, polymerase chain reaction and immunoblot assays.