Acosta A.M.,University of Illinois at Chicago |
Adley B.P.,Advocate Lutheran General Hospital
Archives of Pathology and Laboratory Medicine | Year: 2017
Perivascular epithelioid cell tumors (PEComas) are rare neoplasms that share phenotypic features with angiomyolipomas, clear cell sugar tumors, and lymphangioleiomyomatosis. They presumably represent the neoplastic counterpart of a yet-unidentified perivascular epithelioid cell that expresses smooth muscle and melanocytic immunomarkers. The uterus is the second most common site of origin for perivascular epithelioid cell tumors, after the retroperitoneum. Although most uterine perivascular epithelioid cell tumors are clinically benign and can be cured by a complete surgical excision, there is a subset characterized by both local and distant dissemination. Unfortunately, no single histopathologic or immunohistochemical parameter can accurately predict the clinical behavior of these tumors, which is why the 2012 World Health Organization classification of tumors of the female reproductive organs suggests the use of several criteria to predict the risk of aggressive clinical behavior. Here we review those perivascular epithelioid cell tumors of the uterine corpus with aggressive clinical behavior reported in the literature, and we discuss their most relevant clinical and histopathologic features.
News Article | May 3, 2017
The American Association for Physician Leadership® announces the election of two new leaders of its board of directors and three accomplished physician leaders to join its board of directors. The new board leaders and members begin their tenure in May and serve four-year terms. New Board Chair: Alan P. Marco, MD, MMM, CPE, FAAPL Marco serves as president and CEO of Wright State Physicians, the faculty practice group at Wright State University Boonshoft School of Medicine in Dayton, Ohio. New Vice Chair: Daniel A. Lace, MD, CPE, FAAPL Lace serves as chief medical officer and principal of Leaders in Medicine, based in Wayne, Illinois. New Board Member: Thomas Higgins, MD, MBA, CPE, FACP, MCCM Higgins serves as chief medical officer at Baystate Franklin Medical Center in Greenfield, Massachusetts, and Baystate Noble Hospital in Westfield, Massachusetts. New Board Member: Lisa Laurent, MD, MBA, CPE Laurent serves as president-elect of the medical staff and chairman of the credentials committee at Advocate Lutheran General Hospital and President of Advanced Radiology Consultants, both in Park Ridge, Illinois. New Board Member: Byron C. Scott, MD, MBA, CPE, FACEP, FAAPL Scott serves as associate chief medical officer for Truven Health Analytics, which is part of the IBM Watson Health business unit, and on staff at Northwestern Medicine’s Immediate Care Center, both in Chicago, Illinois. “This talented group of physicians will enhance the strength of our board,” says Peter Angood, MD, FRCS(C), FACS, MCCM, president and CEO of the association. “The members continue to endorse our goal of having many skills and facets within health care reflected among our board members.” The board of directors is made up of fellows or distinguished fellows of the association or members attaining a master’s degree with an association partner university. Candidates are nominated by their peers. A slate of candidates is brought before the membership in an online election in the first quarter of the year. Honoring Fellows: Dennis K. Wentz, MD, CCHP, FAAPL, was named a distinguished fellow of the association, and David J. Shulkin, MD, ACPL, FAAPL, and Ramanathan Raju, MD, MBA, FACS, FACHE, FAAPL, were named honorary fellows. Shulkin is the U.S. Secretary of Veteran Affairs, appointed to office in February. Other board members: Laura Clapper, MD, MPPA, CPE, FAAPL; Gregory Jolissaint, MD, MS, CPE, FAAPL; and Mark Lester, MD, MBA, CPE, FAANS, FACS, FACPE; Bret Burton, MD, MBA, CPE, FAAPL; Howard Shaw, MD, MBA, CPE, FACOG, FAAPL; Albert Tzeel, MD, MHSA, CPE, FAAPL; past chair Napoleon Knight, MD, MBA, CPE, FACEP, FAAPL. Retiring from the board are William R. Casperson, MD, FACS, CPE, FAAPL; and Anthony D. Slonim, MD, DrPH, CPE, FAAPL. The American Association for Physician Leadership® is the only professional organization dedicated to providing education, career support and advocacy to support physician leaders as they create transformative solutions within the rapidly evolving field of health care. Founded in 1975 as the American College of Physician Executives (ACPE), the nonprofit association has educated thousands of physicians worldwide and has members in 46 countries at varying stages of their careers. The association is known for its award-winning magazine, the Physician Leadership Journal, its continuing medical education (CME) courses, and its Certified Physician Executive (CPE) certification program. Based in Tampa, Florida, the association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education credits, and by the Certifying Commission in Medical Management to award CPE certification. Learn more online at physicianleaders.org, via email at info(at)physicianleaders(dot)org, or call 800-562-8088.
News Article | February 9, 2017
The experience of a mammogram turning out to be a false alarm can have significant impact on a woman's attitude toward breast cancer screening. Findings of a new study published in the journal Cancer Epidemiology, Biomarkers & Prevention on Feb. 9 revealed that the trauma of getting a false-positive result from a mammogram can cause many women to delay or even skip the next screening. A false positive occurs when an aberration on a mammogram appears it is cancer, but additional tests such as biopsy or added imaging would later reveal as benign. The patient, who has gone through distress and various procedures, could opt to delay or skip her next mammogram, which breast cancer experts said could be a potentially deadly mistake since early detection of tumors can help save lives. "Experiencing a false positive (FP) screening mammogram is economically, physically, and emotionally burdensome, which may affect future screening behavior by delaying the next scheduled mammogram or by avoiding screening altogether," researchers wrote in their study. For the new study, Firas Dabbous, from Advocate Lutheran General Hospital, and colleagues looked at the data of more than 741,000 mammograms that were conducted on almost 262,000 women between the years 2001 and 2014. The researchers found that over 12 percent of the X-rays yielded a false-positive result. Fifteen percent of those who received negative results did not come back for a mammogram, but the percentage rose to 22 percent in women who received a false-positive result. Of the women with more than one mammogram, those with a negative result from their first mammogram had up to 36 percent increased likelihood of getting another screening over the next three years compared with the women who had false-positive result on their first mammogram. The researchers, however, were not able to determine whether the women gave up on breast cancer screening or they had it done somewhere else. The researchers also found that women who had a false-positive result on the first mammogram delay their second mammogram screening by an average of 13 months. Dabbous and colleagues warned that delays and skipped mammograms can have dangerous effects on a woman's health since the odds of getting diagnosed with late-stage breast cancer within the next four years was 0.4 percent in women who had a false-positive result, which is higher compared with the 0.3 percent risk in those who had true negative result. Cancer experts said that this difference is statistically significant. "The delays the authors observed were significant," said Robert Smith, from the American Cancer Society. "If these findings can be validated in other studies, then it suggests that extra attention should be dedicated to ensuring that women with false positive findings are reminded to return to annual or biennial screening with sufficient notice and multiple reminders." The women with false positive tend to be younger, premenopausal, and were more likely to be getting their first breast cancer screening. They were also more likely to be black and have denser breasts. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | November 15, 2016
Want more information about Park Ridge Homes for Sale? Feel free to visit the website at www.buypropertyright.com Park Ridge is a prosperous city located in Chicago suburb with a population of 37,480 residents and located about 15 miles Northwest of downtown Chicago, minutes from O’Hare International Airport. Founded in 1873, Park Ridge has made much progress, yet retains its small hometown atmosphere and remains a wonderful place to live and work. The City is committed to providing excellence in City services in order to uphold a high quality of life. Many residents have lived here all their lives and others return because of the sense of community. There are numerous ways to get involved in the activities and organizations available, such as service groups, schools, churches, sports and civic groups, as well as through the volunteer boards, commissions and committees that are appointed by the mayor to assist the City. Business is thriving in Park Ridge, with many new and family-run stores and restaurants available in the Uptown area and in South Park plus the Higgins Corridor. For all service and shopping needs, please consider Park Ridge first. The City has received several prestigious awards for the Uptown development which was recognized for its attractive combination of residences and retail. Public art sculptures accent the area. Selection of artists and specific works were made and commissioned by the City’s Public Art Commission to complement the Uptown redevelopment. Project developers PRC Partners LLC sponsored the two sculptures at the Shops of Uptown to help connect the community and Chicagoland arts. “Prairie Dance,” is a bronze sculpture by John Adduci and “Sky Trail,” was created by Bob Emser. Both are internationally known for their work. “Celebration” by William Jaquet and “Story Teller” by David Unger were purchased by the City for the City Commons area. The City is often referred to as the community of volunteers. The Brickton Art Center and the Park Ridge Civic Orchestra and the Center of Concern have all won Governor’s Home Town First Place awards for excellence and volunteer involvement. Free summer concerts, performed by the Park Ridge Fine Arts Symphony Orchestra, take place in front of City Hall on Friday evenings in the summer. The Farmers Market is another popular offering, open late May through October at Prairie and Garden streets. The Park Ridge Public Library—honored as “Library of the Year” by the North Suburban Library System—feeds the need to read. Park Ridge is also home of Advocate Lutheran General Hospital, consistently recognized as one of the country’s top 100 hospitals. The Park District, a separate taxing body from the City, offers well-rounded recreation and social programming for residents of all ages and schools have received many awards for excellence. Need more information about Park Ridge Homes for Sale? Feel free to visit www.buypropertyright.com OR contact area expert Patrick O’Connell at 708-473-5222 and by email at firstname.lastname@example.org. For more information, please visit http://www.buypropertyright.com
Nabhan C.,Advocate Lutheran General Hospital |
Petrylak D.P.,Columbia University
Clinical Genitourinary Cancer | Year: 2012
Recent insights into mechanisms by which prostate cancer becomes castration resistant have allowed better and more rational therapeutic design. These novel therapies have complemented the modest success that chemotherapy has shown in recent years changing the landscape of this disease and leading to improved outcomes. Angiogenesis and immune deregulation are 2 pathways that have increasingly been shown to lead into castration resistant prostate cancer (CRPC). Thalidmide and lenalidomide are immunomodulatory agents with antiangiogenesis properties that have shown activity in this setting with acceptable safety profile. In this review, we discuss briefly the different mechanisms that render prostate cancer castration resistant and elaborate on thalidomide and lenalidomide data in CRPC after reviewing their theoretic mechanisms of action. This timely review coincides with the identification of newer therapies against CRPC affirming our steady movement toward better disease control. © 2012 Elsevier Inc. All rights reserved.
Nabhan C.,Advocate Lutheran General Hospital |
Kay N.E.,Mayo Medical School
Clinical Medicine Insights: Oncology | Year: 2011
The treatment of chronic lymphocytic leukemia (CLL) has evolved over the past decade. Our better understanding of disease biology and risk stratification has allowed delivering more effective therapies. In fact, front-line chemoimmunotherapy has demonstrated improvement in overall survival when compared to chemotherapy in randomized studies. Yet, treatment of relapsed CLL remains challenging and few agents are effective in that setting. Ofatumumab (Ofa) is a humanized monoclonal antibody targeted against CD20 with demonstrable activity in rituximab-resistant CLL cell lines. This agent was recently approved for the treatment of relapsed/refractory CLL patients who have failed fludarabine and alemtuzumab. In this review, we provide a historical perspective on approaches to CLL as front-line and in the relapsed setting. We further summarize novel anti-CD20 antibodies with specific emphasis on ofa. We review studies that led to ofatumumab's approval including pre-clinical data, trials using ofa in combination therapies, and adverse events/toxicities reported with this agent. © the author(s), publisher and licensee Libertas Academica Ltd.
Klassman L.,Advocate Lutheran General Hospital
Journal of Neuroscience Nursing | Year: 2011
Treatment of acute stroke is difficult due to the complexity of events triggered by ischemic insult. Current reperfusion strategies are time limited and, alone, may not be sufficient to achieve maximal neurologic outcomes. Therapeutic hypothermia (TH) appears to be a promising neuroprotective therapy, as it affects a wide range of destructive mechanisms occurring in ischemic brain tissue. Animal research has substantiated the use of TH in acute stroke. Human studies utilizing TH in acute stroke have shown trends toward positive effects; however, there have been a variety of measurements and methods making comparisons difficult. The ideal protocol for the use of TH in stroke has not yet been developed and requires determination of optimal depth, duration, and methods of temperature measurement and cooling for acute stroke. The purposes of this article were to (1) discuss the effects of ischemia and reperfusion in acute stroke, (2) discuss how TH can potentially limit neurological injury, and (3) review current literature on the use of hypothermia as a treatment for acute stroke. Copyright © 2011 American Association of Neuroscience Nurses.
Sasaki K.J.,Advocate Lutheran General Hospital |
Miller C.E.,Advocate Lutheran General Hospital
Journal of Minimally Invasive Gynecology | Year: 2014
Adnexal torsion is one of a few gynecologic surgical emergencies. Misdiagnosis or delay in treatment can have permanent sequelae including loss of an ovary with effect on future fertility, peritonitis, and even death. A PubMed search was performed between 1985 and 2012 for reviews, comparative studies, and case reports to provide a review of the epidemiology, risk factors, clinical presentation, common laboratory and imaging findings, and treatments of adnexal torsion. Common symptoms of torsion include pain, nausea, and vomiting, with associated abdominal or pelvic tenderness, and may differ in premenarchal and pregnant patients. Laboratory and imaging findings including ultrasound with Doppler analysis, computed tomography, and magnetic resonance imaging can assist in making the diagnosis but should not trump clinical judgment; normal Doppler flow can be observed in up to 60% of adnexal torsion cases. Treatment depends on the individual patient but commonly includes detorsion, even if the adnexae initially seem necrotic, with removal of any associated cysts or salpingo-oophorectomy, because recurrence rates are higher with detorsion alone or detorsion with only cyst aspiration. © 2014 AAGL.
Wieczorkiewicz S.M.,Advocate Lutheran General Hospital |
Kassamali Z.,University of Illinois at Chicago |
Danziger L.H.,University of Illinois at Chicago
Annals of Pharmacotherapy | Year: 2013
Background: More than half of all medications are inappropriately prescribed, dispensed, or sold and only 50% of patients take their medications correctly. Oftentimes, unwanted or expired medications are saved for later use, stored indefinitely, or disposed via the sink, toilet, or garbage. Objective: To determine how residents in Cook County, Illinois, use, store, and dispose of their medications to assess the possible impact of these medications on health care and the environment. Methods: Researchers at the University of Illinois conducted a survey of Cook County residents over a 13-week period. Residents were surveyed regarding their use, storage, and disposal of prescription and nonprescription medications. Results: From 3954 telephone numbers generated through random-digit dialing, 445 telephone interviews were completed. Eighty-one and a half percent of respond ents had prescription medications and 92.4% had nonprescription medications in their homes. On average, respondents possessed 4.4 distinct prescription and 5.5 distinct nonprescription medications. Despite possessing a number of medications, approximately 30% of respondents stated that they took no medication on a regular basis; 59% of respondents reported disposing medications in the household gar bage and 31% flushed them down the toilet or sink. Over 80% of respondents stated that they had never received information about proper medication disposal. Thirty-seven percent reported having leftover unexpired medications from a previous illness. Of these, 63% stopped taking their medications because they believed that they no longer needed them or because they felt better. Thirty-two percent of respond ents expected to have leftover prescription medications within the next 6 months. Conclusions: Almost all respondents had excess and leftover medications in their homes. This may be a result of both overprescribing and poor medication adherence. In addition to the potential human health risk of nonadherence, disposal of excess medication raises concerns about their environmental impact and safety. © 1967-2013 Harvey Whitney Books Co. All rights reserved.
Cholkeri-Singh A.,Advocate Lutheran General Hospital |
Sasaki K.J.,University of Illinois at Chicago
Journal of Minimally Invasive Gynecology | Year: 2015
Hysteroscopy is widely performed in infertile women. A review of peer-reviewed, published literature from the PubMed database on uterine intracavitary pathology, proximal tubal occlusion, failed invitro fertilization procedures, and first trimester miscarriages of infertile women was performed to examine the importance, feasibility, and success rates of diagnostic and operative hysteroscopy when evaluating and treating these conditions. © 2015 AAGL.