Alta Bates Summit Medical Center

Saint Helena, CA, United States

Alta Bates Summit Medical Center

Saint Helena, CA, United States

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News Article | November 3, 2016

OAKLAND, Calif., Nov. 3, 2016 /PRNewswire/ -- Every vote is important. We've heard this sentiment quite often this election year – and the volunteers at Sutter Health's Alta Bates Summit Medical Center are working to ensure that patients who are in the hospital on Election Day are still...

Morgan D.J.,University of Maryland, Baltimore | Morgan D.J.,VA Maryland Healthcare System | Okeke I.N.,Haverford College | Laxminarayan R.,Center for Disease Dynamics | And 4 more authors.
The Lancet Infectious Diseases | Year: 2011

In much of the world antimicrobial drugs are sold without prescription or oversight by health-care professionals. The scale and effect of this practice is unknown. We systematically reviewed published works about non-prescription antimicrobials from 1970-2009, identifying 117 relevant articles. 35 community surveys from five continents showed that non-prescription use occurred worldwide and accounted for 19-100% of antimicrobial use outside of northern Europe and North America. Safety issues associated with non-prescription use included adverse drug reactions and masking of underlying infectious processes. Non-prescription use was common for non-bacterial disease, and antituberculosis drugs were available in many areas. Antimicrobial-resistant bacteria are common in communities with frequent non-prescription use. In a few settings, control efforts that included regulation decreased antimicrobial use and resistance. Non-prescription antimicrobial and antituberculosis use is common outside of North America and northern Europe and must be accounted for in public health efforts to reduce antimicrobial resistance. © 2011 Elsevier Ltd.

Belek K.A.,Alta Bates Summit Medical Center | Gruber R.P.,Stanford University | Gruber R.P.,University of California at San Francisco
Aesthetic Surgery Journal | Year: 2014

Background: Initial patient perceptions of rhinoplasty results are complicated by early postoperative edema, ecchymosis, and distortion. Anecdotal evidence suggests that taping the nose immediately upon splint removal aids with the patient's psychological adjustment to his or her new appearance. Objectives: The authors attempt to assess the overall impact of taping after splint removal on patient well-being while providing statistical validation regarding the utility of this intervention. Methods: The authors evaluated the reaction of 24 postoperative rhinoplasty patients on the day of splint removal by photographing them and noting their verbal responses. Those patients who were obviously happy received no taping and were dismissed from the study. The remainder of the patients received flesh-colored tape (3M, St Paul, Minnesota) and their subsequent reactions were noted and photographed. Results: Of 24 consecutive patients, 16 received tape. Fifteen of those taped initially displayed a flat affect (group A), while 1 was clearly unhappy (group B). The remaining 8 patients were obviously happy (group C) and were excluded from taping. Thirteen (86%) of those in group A displayed immediate subjective improvement after taping (χ2 = 12.8; P < .001). The lone patient in group B continued to be unhappy and required ongoing reassurance. Conclusions: Application of tape immediately upon splint removal after rhinoplasty improves initial patient perceptions. Taping can provide a simple and risk-free intervention for patients who do not express immediate satisfaction. © 2013 The American Society for Aesthetic Plastic Surgery, Inc.

Zaniello B.A.,University of Washington | Kessler D.A.,New York Blood Center | Vine K.M.,New York Blood Center | Grima K.M.,Red Cross | Weisenberg S.A.,Alta Bates Summit Medical Center
PLoS Neglected Tropical Diseases | Year: 2012

We retrospectively calculated the prevalence and epidemiologic characteristics of Chagas infection in the New York blood donor population over three years utilizing the New York Blood Center's database of the New York metropolitan area donor population. Seventy Trypanosoma cruzi positive donors were identified from among 876,614 donors over a 3-year period, giving an adjusted prevalence of 0.0083%, with 0.0080% in 2007, 0.0073% in 2008, and 0.0097% in 2009. When filtered only for self-described "Hispanic/Latino" donors, there were 52 Chagas positive donors in that 3-year period (among 105,122 self-described Hispanic donors) with an adjusted prevalence of 0.052%, with 0.055% in 2007, 0.047% in 2008, and 0.053% in 2009. In conclusion, we found a persistent population of patients with Chagas infection in the New York metropolitan area donor population. There was geographic localization of cases which aligned with Latin American immigration clusters. © 2012 Zaniello et al.

Chung C.S.,Alta Bates Summit Medical Center | Yock T.I.,Massachusetts General Hospital | Nelson K.,Boston University | Xu Y.,Harvard University | And 4 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2013

Purpose: Proton radiation, when compared with photon radiation, allows delivery of increased radiation dose to the tumor while decreasing dose to adjacent critical structures. Given the recent expansion of proton facilities in the United States, the long-term sequelae of proton therapy should be carefully assessed. The objective of this study was to compare the incidence of second cancers in patients treated with proton radiation with a population-based cohort of matched patients treated with photon radiation. Methods and Materials: We performed a retrospective cohort study of 558 patients treated with proton radiation from 1973 to 2001 at the Harvard Cyclotron in Cambridge, MA and 558 matched patients treated with photon therapy in the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Patients were matched by age at radiation treatment, sex, year of treatment, cancer histology, and site. The main outcome measure was the incidence of second malignancies after radiation. Results: We matched 558 proton patients with 558 photon patients from the Surveillance, Epidemiology, and End Results registry. The median duration of follow-up was 6.7 years (interquartile range, 7.4) and 6.0 years (interquartile range, 9.3) in the proton and photon cohorts, respectively. The median age at treatment was 59 years in each cohort. Second malignancies occurred in 29 proton patients (5.2%) and 42 photon patients (7.5%). After we adjusted for sex, age at treatment, primary site, and year of diagnosis, proton therapy was not associated with an increased risk of second malignancy (adjusted hazard ratio, 0.52 [95% confidence interval, 0.32-0.85]; P=.009). Conclusions: The use of proton radiation therapy was not associated with a significantly increased risk of secondary malignancies compared with photon therapy. Longer follow-up of these patients is needed to determine if there is a significant decrease in second malignancies. Given the limitations of the study, these results should be viewed as hypothesis generating. © 2013 Elsevier Inc.

Silkiss R.Z.,California Pacific Medical Center | Reier A.,Alta Bates Summit Medical Center | Coleman M.,New York Presbyterian Hospital | Lauer S.A.,Yeshiva University
Ophthalmic Plastic and Reconstructive Surgery | Year: 2010

Purpose: To assess the efficacy and safety of rituximab-mediated B-lymphocyte depletion as treatment for thyroid eye disease (TED). Methods: Prospective, open-label, interventional clinical trial evaluating 12 patients with TED and Clinical Activity Scores (CAS) (VISA [vision, inflammation, strabismus and appearance/exposure] classification) of 4 or greater followed for 1 year after rituximab (1000 mg) treatment, administered intravenously on days 1 and 15. CAS, peripheral B-lymphocyte levels, thyroid autoantibody levels, and thyroid function tests were recorded at baseline, 4 weeks, 8 weeks, 12 weeks, 24 weeks, 36 weeks, and 52 weeks after the second infusion. The primary endpoint was a change from baseline in CAS. Thyroid-stimulating immunoglobulin and thyroid-stimulating hormone levels were also monitored over the 12-month postinfusion observation period. Results: CAS scores demonstrated a statistically significant decrease from baseline at each of the follow-up visits. Thyroid-stimulating immunoglobulin and thyroid-stimulating hormone levels demonstrated no statistically significant change from baseline. B-cell depletion was observed within 1 month after rituximab treatment, and peripheral B-lymphocyte counts started to increase 36 weeks after the infusion. B-cell depletion was well tolerated, and there were no adverse effects of the rituximab infusions. Conclusions: CAS scores were significantly reduced over time in this group of 12 patients and appeared to be associated with rituximab infusion. The variable natural history of TED makes it difficult to definitively assign efficacy. The results support the continued investigation of rituximab for TED in a larger placebo-controlled trial. © 2010 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Hass L.,Alta Bates Summit Medical Center
Annals of Family Medicine | Year: 2010

Nosocomial infections are increasingly multidrug resistant and at times more virulent. As such, they pose real threats to patients and clinicians. In this essay the author discusses his own methacillin-resistant staphylococcus infection and how it has affected his work in the hospital. In so doing, he reflects on the value of touch in the doctor-patient relationship. In particular, he discusses how gloves serve as a barrier to infection but also create a small distance between the doctors and their patients. The implications of contact precautions must be considered as we reflect on balancing patient-centered care with infection control.

Wang G.Y.,Childrens Hospital Oakland Research Institute | Wang J.,Childrens Hospital Oakland Research Institute | Mancianti M.-L.,Alta Bates Summit Medical Center | Epstein E.H.,Childrens Hospital Oakland Research Institute
Cancer Cell | Year: 2011

Basal cell carcinomas (BCCs) are hedgehog-driven tumors that resemble follicular and interfollicular epidermal basal keratinocytes and hence long have been thought to arise from these cells. However, the actual cell of origin is unknown. Using cell fate tracking of X-ray induced BCCs in Ptch1+/- mice, we found their essentially exclusive origin to be keratin 15-expressing stem cells of the follicular bulge. However, conditional loss of p53 not only enhanced BCC carcinogenesis from the bulge but also produced BCCs from the interfollicular epidermis, at least in part by enhancing Smo expression. This latter finding is consistent with the lack of visible tumors on ears and tail, sites lacking Smo expression, in Ptch1+/- mice. © 2011 Elsevier Inc.

Weisenberg S.A.,Alta Bates Summit Medical Center | Perlada D.E.,Alta Bates Summit Medical Center
American Journal of Tropical Medicine and Hygiene | Year: 2013

Two cases of domestically acquired fascioliasis are reported. Patient One was a 63-year-old male who developed a febrile illness 2 months after eating watercress in Marin County. Patient Two was a 38-year-old male who had eaten watercress with Patient One, and also developed a febrile illness. Both patients had eosinophilia and liver lesions on imaging. Diagnosis was made by serology and treatment was with triclabendazole. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene.

Burke J.S.,Alta Bates Summit Medical Center
Archives of Pathology and Laboratory Medicine | Year: 2011

Context.-The gastrointestinal tract is the most common site of extranodal lymphomas. Although all histologic categories of malignant lymphoma develop in the gastrointestinal tract, large B-cell lymphomas predominate, followed by extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) type; the latter is especially prevalent in stomach. The acceptance of extranodal marginal zone lymphoma of MALT type as a clinicopathologic entity has reduced the number of cases that formerly were interpreted as florid lymphoid hyperplasia ("pseudolymphoma"). Nonetheless, the distinction of lymphoid hyperplasia from a lymphoma of MALT type in small biopsy specimens remains problematic. Objective.-To assess the relevant morphologic, immunologic, molecular, and genetic properties of gastrointestinal lymphomas and to present a feasible tactic for diagnosis, expressly for small biopsy specimens. Data Sources.-Case-derived material and literature review using PubMed (National Library of Medicine). Conclusions.-Most gastrointestinal lymphomas are readily amenable to an unqualified diagnosis, primarily those cases consisting of monomorphic large cells whether of B- or T-cell lineage, including cases associated with enteropathy. Diagnosis for infiltrates dominated by small lymphocytes remains taxing, as the differential diagnosis embraces not only MALT lymphoma and lymphoid hyperplasia but also mantle cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia/small lymphocytic lymphoma. Adherence to strict morphologic criteria is the standard for diagnosis, but these criteria should be augmented by immunologic studies together with judicious use of molecular techniques to determine clonality. In establishing a diagnosis of gastric marginal zone lymphoma of MALT type, determination of t (11 ;18) (q21 ;q21) status may be required since this translocation has clinical ramifications.

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