Good Samaritan Hospital Medical Center

West Islip, NY, United States

Good Samaritan Hospital Medical Center

West Islip, NY, United States

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PubMed | Good Samaritan Hospital Medical Center
Type: | Journal: Obesity surgery | Year: 2017

Portomesenteric vein thrombosis (PMVT) is a rare, but potentially life-threatening, complication following laparoscopic sleeve gastrectomy (LSG).Here, we discuss three cases of LSG complicated by the development of PMVT post-operatively. All patients presented within the first 20days post-operatively with complaint of non-specific abdominal pain. All patients were successfully treated with therapeutic anticoagulation during hospitalization and discharged home with long-term anticoagulation.As the number of LSG performed annually continues to increase, a high index of suspicion should remain for PMVT in patients presenting with abdominal pain post-operatively. We suspect that the development of PMVT in patients undergoing LSG is secondary to manipulation of short gastric vessels, tributaries of the portal venous system, in combination with local inflammation and dehydration.

The International Nurses Association is pleased to welcome Carole Schneider, RN to their prestigious organization with her upcoming publication in the Worldwide Leaders in Healthcare. Carole is a registered nurse and case manager at Good Samaritan Hospital Medical Center in West Islip, New York. She has over 33 years of experience specializing in nursing and case management. Carole was educated at Catholic Medical Center. She is a Certified Case Manager and is additionally certified in CPR and Basic Life Support. Carole stays current in her field through an active membership in the Case Managers Society of Long Island. When not assisting patients, she enjoys spending time with friends and family. Learn more about Carole here: and be sure to read her upcoming publication in the Worldwide Leaders in Healthcare. To find a Doctor by Specialty and Zip Code Please visit and book your appointment online instantly.

Myszewski J.H.,Good Samaritan Hospital Medical Center | Jones V.S.,Good Samaritan Hospital Medical Center
Journal of Pediatric Surgery Case Reports | Year: 2015

The retroperitoneal location of the duodenum and the small volume of the peritoneal cavity in pediatric patients make the laparoscopic repair of congenital duodenal anomalies challenging. As a result, robotic-assisted repair of duodenal atresia in a pediatric patient has been reported only once in the literature. This report describes the robotic-assisted laparoscopic repair of a congenital duodenal diaphragm in a 2-year-old, 8 kg patient who presented with vomiting and failure to thrive. An upper gastrointestinal series revealed partial obstruction at the second part of the duodenum with proximal dilatation. These findings are consistent with a duodenal diaphragm. Traditional laparoscopy was utilized to kocherize the first and second parts of the duodenum and to identify a loop of proximal jejunum for the proposed anastomosis. A duodeno-jejunal anastomosis was then performed using intra-corporeal suturing with a daVinci SI robotic system. The patient had a quick and uneventful post-operative course. At 6 month follow-up, she was asymptomatic and the surgical incisions had healed with excellent cosmetic appearance. A combination of laparoscopic and robotic techniques offers a promising alternative to open or purely laparoscopic repair of congenital duodenal anomalies. © 2015 The Authors. Published by Elsevier Inc.

Sharma A.N.,Good Samaritan Hospital Medical Center | Sharma A.N.,Mount Sinai School of Medicine | Hoffman R.J.,Beth Israel Deaconess Medical Center
Emergency Medicine Clinics of North America | Year: 2011

Toxin-related seizures result from an imbalance in the brain's equilibrium of excitation-inhibition. Fortunately, most toxin-related seizures respond to standard therapy using benzodiazepines. However, a few alterations in the standard approach are recommended to ensure optimal care and expedient termination of seizure activity. If 2 doses of a benzodiazepine do not terminate the seizure activity, a therapeutic dose of pyridoxine (5 g intravenously in an adult and 70 mg/kg intravenously in a child) should be considered. Phenytoin should be avoided because it is ineffective for many toxin-induced seizures and is potentially harmful when used to treat seizures induced by theophylline or cyclic antidepressants. © 2011 Elsevier Inc.

Jones V.S.,Good Samaritan Hospital Medical Center
Journal of Pediatric Surgery | Year: 2015

Background Though single incision laparoscopic cholecystectomy (SILC) is cosmetically appealing, it is technically a difficult operation. The recent introduction of robotic single-site cholecystectomy (RSSC) has made single incision cholecystectomy easier to perform. While a few papers have reported its application in adults, it has not been documented in children. Methods Data on seventeen consecutive children who underwent RSSC by a single surgeon over a ten-month period were retrospectively reviewed. Patient demographics, total operative time, console time, hospital stay, complications and reasons for procedural delay were recorded. Results Sixteen operations were completed robotically using the single incision robotic platform. No major postoperative complications were noted. Median total operative time was 94 minutes with interquartile range (IQR) being 81.5-119.5 minutes. The median console time was 39 minutes (IQR: 30-72 minutes). The median total operative time for the first eight cases was 118 minutes (IQR: 103-127 minutes) and for the next nine cases 90 minutes (IQR: 76-93 minutes). Common causes for procedural delay were slipped clips, bile spillage, bleeding and leaking Single-Site® port. Conclusions This unique series of RSSC documents its feasibility and safety in children. A short learning curve and operative times comparable to RSSC in adults and SILC in children were observed. Being technically easier, RSSC becomes an attractive alternative to SILC to sustain its cosmetic benefit. © 2015 Elsevier Inc. All rights reserved.

Kao J.,Good Samaritan Hospital Medical Center | Chen C.-T.,New York University | Tong C.C.L.,Mount Sinai Medical Center | Packer S.H.,Mount Sinai Medical Center | And 3 more authors.
Targeted Oncology | Year: 2014

Preliminary results demonstrated that concurrent sunitinib and stereotactic body radiation therapy (SBRT) is an active regimen for metastases limited in number and extent. This analysis was conducted to determine the long-term survival and cancer control outcomes for this novel regimen. Forty-six patients with oligometastases, defined as five or fewer clinical detectable metastases from any primary site, were treated on a phase I/II trial from February 2007 to September 2010. The majority of patients were treated with 37.5 mg sunitinib (days 1-28) and SBRT 50 Gy (days 8-12 and 15-19) and maintenance sunitinib was used in 39 % of patients. Median follow up for surviving patients is 3.6 years. The 4-year estimates for local control, distant control, progression-free and overall survival were 75 %, 40 %, 34 % and 29 %, respectively. At last follow-up, 26 % of patients were alive without evidence of disease, 7 % were alive with distant metastases, 48 % died from distant metastases, 2 % died from local progression, 13 % died from comorbid illness, and 4 % died from treatment-related toxicities. Patients with kidney and prostate primary tumors were associated with a significantly improved overall survival (hazard ratio=0.25, p=0.04). Concurrent sunitinib and SBRT is a promising approach for the treatment of oligometastases and further study of this novel combination is warranted. © 2013 Springer-Verlag.

Pusic M.V.,Columbia University | Pusic M.V.,New York University | Andrews J.S.,University of Minnesota | Kessler D.O.,Columbia University | And 6 more authors.
Medical Education | Year: 2012

Objectives Using a large image bank, we systematically examined how the use of different ratios of abnormal to normal cases affects trainee learning. Methods This was a prospective, double-blind, randomised, three-arm education trial conducted in six academic training programmes for emergency medicine and paediatric residents in post-licensure years 2-5. We developed a paediatric ankle trauma radiograph case bank. From this bank, we constructed three different 50-case training sets, which varied in their proportions of abnormal cases (30%, 50%, 70%). Levels of difficulty and diagnoses were similar across sets. We randomly assigned residents to complete one of the training sets. Users classified each case as normal or abnormal, specifying the locations of any abnormalities. They received immediate feedback. All participants completed the same 20-case post-test in which 40% of cases were abnormal. We determined participant sensitivity, specificity, likelihood ratio and signal detection parameters. Results A total of 100 residents completed the study. The groups did not differ in accuracy on the post-test (p=0.20). However, they showed considerable variation in their sensitivity-specificity trade-off. The group that received a training set with a high proportion of abnormal cases achieved the best sensitivity (0.69, standard deviation [SD]=0.24), whereas the groups that received training sets with medium and low proportions of abnormal cases demonstrated sensitivities of 0.63 (SD=0.21) and 0.51 (SD=0.24), respectively (p<0.01). Conversely, the group with a low proportion of abnormal cases demonstrated the best specificity (0.83, SD=0.10) compared with the groups with medium (0.70, SD=0.15) and high (0.66, SD=0.17) proportions of abnormal cases (p<0.001). The group with a low proportion of abnormal cases had the highest false negative rate and missed fractures one-third more often than the groups that trained on higher proportions of abnormal cases. Conclusions Manipulating the ratio of abnormal to normal cases in learning banks can have important educational implications. © Blackwell Publishing Ltd 2012.

French V.A.,Olson Center for Womens Heath | French V.A.,Good Samaritan Hospital Medical Center | Davis J.S.,Olson Center for Womens Heath | Davis J.S.,Good Samaritan Hospital Medical Center | And 4 more authors.
Obstetrics and Gynecology | Year: 2013

OBJECTIVE: To assess the contraception and fertility counseling provided to women with solid organ transplants. METHODS: A telephone survey of 309 women aged 19- 49 years who had received a solid organ transplant at the University of Nebraska Medical Center was performed. Of the 309 eligible women, 183 responded. Patients were asked 19 questions regarding pretransplant and posttransplant fertility awareness and contraception counseling. Data were summarized using descriptive statistics. RESULTS: Patients had undergone a variety of solid organ transplantations: 40% kidney (n573); 32% liver (n559); 6% pancreas (n511); 5% heart (n59); 3% intestine (n55); and 14% multiple organs (n526). Before their transplantations, 79 women (44%) reported they were not aware that a woman could become pregnant after transplantation. Only 66 women aged 13 and older at the time of transplantation reported that a health care provider discussed contraception before transplantation. Approximately half of women surveyed were using a method of contraception. Oral contraceptive pills were the most commonly recommended method. Twenty-two of the 31 pregnancies after organ transplantation were planned, which is higher than that of the general population. CONCLUSION: Few women with transplants are educated regarding the effect of organ transplantation on fertility and are not routinely counseled about contraception or the potential for posttransplant pregnancy. Health care providers should incorporate contraceptive and fertility counseling as part of routine care for women with solid organ transplants. © 2013 by The American College of Obstetricians and Gynecologists.

Pergolotti A.,Good Samaritan Hospital Medical Center
Nephrology nursing journal : journal of the American Nephrology Nurses' Association | Year: 2011

The purpose of this study was to compare the effect of the buttonhole method to the traditional method of cannulation on time to hemostasis, needle stick pain, pre-needle stick anxiety, and aneurysm size. Forty-five participants from two naturally occurring groups were accessed at four monthly intervals from a chronic dialysis unit yielding 170 units of data. Results supported the buttonhole method of cannulation as advantageous as opposed to the traditional method of AV fistula cannulation.

Parikh F.,Mount Sinai School of Medicine | Duluc D.,Baylor Institute of Immunology | Imai N.,Mount Sinai School of Medicine | Clark A.,Mount Sinai School of Medicine | And 13 more authors.
Cancer Research | Year: 2014

While viral antigens in human papillomavirus (HPV)-related oropharyngeal cancer (HPVOPC) are attractive targets for immunotherapy, the effects of existing standard-of-care therapies on immune responses to HPV are poorly understood. We serially sampled blood from patients with stage III-IV oropharyngeal cancer undergoing concomitant chemoradiotherapy with or without induction chemotherapy. Circulating immunocytes including CD4+ and CD8+ T cells, regulatory T cells (Treg), and myeloid-derived suppressor cells (MDSC) were profiled by flow cytometry. Antigen-speci fi c T-cell responses were measured in response to HPV16 E6 and E7 peptide pools. The role of PD-1 signaling in treatment-related immunosuppression was functionally de fi ned by performing HPV-specific T-cell assays in the presence of blocking antibody. While HPV-specific T-cell responses were present in 13 of 18 patients before treatment, 10 of 13 patients lost these responses within 3 months after chemoradiotherapy. Chemoradiotherapy decreased circulating T cells and markedly elevated MDSCs. PD-1 expression on CD4+ T cells increased by nearly 2.5-fold after chemoradiotherapy, and ex vivo culture with PD-1-blocking antibody enhanced HPV-specific T-cell responses in 8 of 18 samples tested. Chemoradiotherapy suppresses circulating immune responses in patients with HPVOPC by unfavorably altering effector:suppressor immunocyte ratios and upregulating PD-1 expression on CD4+ T cells. These data strongly support testing of PD-1-blocking agents in combination with standard-of-care chemoradiotherapy for HPVOPC. ©2014 AACR.

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