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Springfield, PA, United States

Leopold N.A.,Crozer Chester Medical Center | Daniels S.K.,Baylor College of Medicine

Swallowing is an act requiring complex sensorimotor integration. Using a variety of methods first used to study limb physiology, initial efforts to study swallowing have yielded information that multiple cortical and subcortical regions are active participants. Not surprisingly, the regions activated appear to overlap those involved in both oral and nonoral motor behaviors. This review offers a perspective that considers the supranuclear control of swallowing in light of these physiological similarities. © 2009 Springer Science+Business Media, LLC. Source

Evans L.,Crozer Chester Medical Center | Kohl D.,Fitzgerald Mercy Hospital
Journal of Emergency Nursing

As an emergency nurse, finding time to familiarize oneself with arterial-line monitoring or a new piece of equipment is often impossible. A group of staff nurses recognized the need for more "hands-on" learning and pursued a method to make our education more meaningful. A hospital general nursing skills day offered little benefit to ED nursing staff who are tasked with more specialized skills. It was imperative to develop an efficient process to prepare the ED nurses to provide best practice and care to their patients. © 2014 Emergency Nurses Association. Source

Gawchik S.M.,Crozer Chester Medical Center
Mount Sinai Journal of Medicine

Allergy to natural rubber latex is an important clinical condition that occurred after the institution of universal precautions to protect healthcare workers. A rapid increase and production of both examination and surgical gloves resulted in an epidemic of allergy to latex protein. Healthcare workers in both the medical and dental environments, as well as specific groups of individuals including those with spina bifida, myelodysplasia, and food allergies (banana, kiwi, avocado, and others), were at increased risk of sensitization. Clinical symptoms in the latex allergic individual ranged from type I hypersensitivity reaction including rhinoconjunctivitis, asthma, and systemic reaction to type IV hypersensitivity reaction, which occur from the chemicals added during the manufacturing process. Diagnosis of latex allergy is based on a clinical history that correlates the development of symptoms in relationship to exposure. In the United States there are no skin tests approved by the Food and Drug Administration. Therefore a combination of clinical judgment and serologic testing such as ImmunoCAP and Immulite is helpful. The primary treatment of latex allergy is avoidance of exposure to the latex protein. © 2011 Mount Sinai School of Medicine. Source

Propst K.,Crozer Chester Medical Center | Tunitsky-Bitton E.,Cleveland Clinic | Schimpf M.O.,University of Michigan | Ridgeway B.,Cleveland Clinic
International Urogynecology Journal and Pelvic Floor Dysfunction

Pyogenic spondylodiscitis includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. This is a rare complication of sacral colpopexy, but can lead to devastating consequences for the patient. We present two cases of pyogenic spondylodiscitis following sacral colpopexy. In addition, we discuss 26 cases of pyogenic spondylodiscitis reported in the literature from 1957 to 2012. Techniques to decrease rates of infection include proper identification of the S1 vertebra, awareness of the suture placement depth at the level of the sacrum and at the vagina, and early treatment of post-operative urinary tract and vaginal infections. Awareness of symptoms, timely diagnosis and multidisciplinary approach to management is essential in preventing long-term complications. © The International Urogynecological Association 2013. Source

Kekevian A.,Crozer Chester Medical Center | Gershwin M.E.,University of California at Davis | Chang C.,Thomas Jefferson University
Autoimmunity Reviews

Idiopathic pulmonary fibrosis is a difficult disease to diagnose. Idiopathic pulmonary fibrosis is a member of a class of diseases known as idiopathic interstitial pneumonias. Other members include nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, and lymphocytic interstitial pneumonia. Usual interstitial pneumonia (UIP) is the pathological equivalent of idiopathic pulmonary fibrosis. Prior to 2011, the diagnosis was based on major and minor criteria, but because these criteria were not evidence based, the criteria were modified by consensus from the American Thoracic Society, the European Respiratory Society, the Japanese Respiratory Society, and the Latin American Thoracic Association. These new criteria now include satisfying three core requirements, including exclusion of other possible cause of interstitial lung disease, specific findings of usual interstitial pneumonia on high resolution computed tomography, and a combination of "possible UIP" findings on high resolution computed tomography and UIP findings on lung biopsy. Idiopathic pulmonary fibrosis is a severe, progressive disease with limited treatment options, and exacerbations are associated with a high degree of morbidity and mortality. © 2014 Elsevier B.V. Source

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