Graves B.W.,Chestnut Medical
Journal of Midwifery and Women's Health | Year: 2010
As the obesity epidemic increases, primary care clinicians are encountering obesity and health problems associated with obesity more frequently than ever before. In 2007, 41% of women were classified as obese, with a body mass index (BMI) of 30 or higher. Non-Hispanic blacks and Hispanics are more likely to be obese than white, non-Hispanics. A wide spectrum of health problems has been associated with obesity, including cardiovascular disease, diabetes, metabolic syndrome, osteoarthritis, and polycystic ovary syndrome. Obesity has been shown to be a low-grade inflammatory state, which may be responsible for many of the comorbidities. The general consensus recommends screening for obesity and counseling to promote weight loss. In some cases, pharmacotherapy and or bariatric surgery may be recommended. © 2010 American College of Nurse-Midwives.
Tidswell M.,Chestnut Medical |
LaRosa S.P.,Brown University
Expert Review of Anti-Infective Therapy | Year: 2011
The human innate immune system initiates inflammation in response to bacterial molecules, particularly Gram-negative bacterial endotoxin. The steps by which endotoxin exposure leads to systemic inflammation include binding to Toll-like receptor-4 that specifically recognizes endotoxin and subsequently triggers cellular and molecular inflammatory responses. Severe sepsis is a systemic inflammatory response to infection that induces organ dysfunction and threatens a person's survival. Severe sepsis is frequently associated with increased blood levels of endotoxin. It is a significant medical problem that effects approximately 700,000 patients every year in the USA, resulting in 250,000 deaths. Eritoran tetrasodium is a nonpathogenic analog of bacterial endotoxin that antagonizes inflammatory signaling by the immune receptor Toll-like receptor-4. Eritoran is being evaluated for the treatment of patients with severe sepsis. © 2011 Expert Reviews Ltd.
Mithoefer K.,Chestnut Medical
The journal of knee surgery | Year: 2013
The purpose of this article is to provide an overview and perspective of the available options for clinical outcomes evaluation of articular cartilage repair in the knee. A nonsystematic literature review of reported clinical measures for functional, qualitative, and quantitative structural outcomes evaluation after knee articular cartilage repair was performed. Several outcome scores have been validated for articular cartilage repair in the knee with the International Knee Documentation Committee score, Lysholm score, and Knee injury Osteoarthritis Outcome Score being reported most frequently. Activity measures including Tegner and Marx activity scales and the rate of return to sports have direct practical relevance for athletically active patients. Macroscopic and histological assessment provides important structural information about repair cartilage quality and quantity. In addition, magnetic resonance imaging (MRI) outcome scoring and functional MRI are gaining increasing popularity and promise less invasive systematic assessment. In summary, clinical outcome evaluation after cartilage repair can be performed by various established and validated functional outcome instruments as well as several evolving outcome parameters that provide clinically relevant outcome information for researchers, clinicians, and patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Chestnut Medical | Date: 2011-03-10
A vascular occluding device for modifying blood flow in a vessel, while maintaining blood flow to the surrounding tissue. The occluding device includes a flexible, easily compressible and bendable occluding device that is particularly suited for treating aneurysms in the brain. The neurovascular occluding device can be deployed using a micro-catheter. The occluding device can be formed by braiding wires in a helical fashion and can have varying lattice densities along the length of the occluding device. The occluding device could also have different lattice densities for surfaces on the same radial plane.
Rousou J.A.,Chestnut Medical
Journal of Cardiac Surgery | Year: 2013
Background: Fibrin sealants are used for hemostasis and tissue adherence. Aim of Study This systematic review summarizes published clinical data for fibrin sealant use in cardiovascular surgery. Methods: A literature search for the following terms was conducted using PubMed and EMBASE: (TISSEEL or Tissucol or Beriplast P or Evicel or Quixil or Crosseal or Reliseal or Fibringluraas or Bolheal or Tachosil or Vivostat or Vitagel or Artiss or "fibrin glue" or "fibrin sealant" or "fibrin tissue adhesive") and (cardiac or cardiovascular or vascular or heart or coronary or surgery). Case reports and series were excluded; although reports of controlled trials were preferred, uncontrolled trial data were also considered. Results: Clinical trials and chart review analyses of fibrin sealants were identified and summarized. Although clinical trial data were available for other agents, the majority of published studies examined TISSEEL. Overall, TISSEEL and other fibrin sealants showed improvements over standard of care or control groups for a variety of predefined endpoints. Safety findings are also summarized. Conclusions: Data from these studies showed that fibrin sealants were well tolerated and provided effective hemostasis in a range of cardiac and aortic surgeries. © 2013 Wiley Periodicals, Inc.