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...

Saljoughian M.,Alta Bates Summit Medical Center
U.S. Pharmacist | Year: 2016

There is growing evidence that numerous drug-induced allergies are not mediated by the pathogenic role of allergen-specific immunoglobulin E (IgE). The case for such non–IgE-mediated, or pseudoallergic, reactions is proposed on the basis of the mechanism of mast cell and basophil activation. The pseudoallergic symptoms can resemble those of a true allergy but are caused by histamine release from cutaneous mast cells. Oral and injectable opioids are among the drugs that cause these symptoms, but the symptoms may not be due to a true allergy. Therefore, in patients who show these reactions, it is important to choose a safe alternative drug. Remember that most patients who say they are allergic to an opioid have experienced only a side effect that has been misclassified as an allergy. Published data suggest that as many as nine out of 10 patients labeled with an opioid allergy do not have a true allergy.1 On the other hand, patients who are considered allergic to an opioid present a serious challenge to clinicians because pain is not always controlled with nonopioid alternatives such as NSAIDs. This article briefly discusses the true opioid allergy versus pseudoallergy, opioid side effects, and alternative options to control pain. © 2000 - 2016 Jobson Medical Information LLC unless otherwise noted.

Saljoughian M.,Alta Bates Summit Medical Center
U.S. Pharmacist | Year: 2016

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the United States. It is also the number-one cause of death globally. People with CVD, or those who are at high CVD risk, need early detection and management of their condition, through either counseling or medication.1 Vitamin D is a fat-soluble vitamin and has long been known to play a classic hormonal role in skeletal health by regulating calcium and phosphate metabolism. In recent years, vitamin D deficiency has been identified as a potential risk factor for several diseases not traditionally associated with vitamin D, such as CVD and cancer. Many researchers have reported the evidence suggesting an association between low 25-hydroxyvitamin D levels and CVD and the possible mechanisms involved in these conditions.2 Vitamin D deficiency has also been associated with clinical atherosclerosis in coronary calcification as well as with cardiovascular events such as myocardial infarction, stroke, and congestive heart failure. Several clinical studies have generally demonstrated an independent association between vitamin D deficiency and various manifestations of degenerative CVD such as vascular calcification.3 While the deficiency of vitamin D has now been proven to have a connection with CVD, the role of vitamin D supplementation in the management or treatment of this disease remains to be established.3 In this article, we take a closer look at the new findings on vitamin D deficiency and the reported association between its deficiency and CVD. © 2000 - 2016 Jobson Medical Information LLC unless otherwise noted.

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.

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.

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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