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Morristown, NJ, United States

Luttenberger K.,Morristown Memorial Hospital
The Nurse practitioner | Year: 2011

The presentation of endocarditis varies from patient to patient, making it a difficult infection to diagnose correctly. While some patients will develop symptoms acutely over days, it may take weeks or months for symptoms to develop as in the case of subacute bacterial endocarditis. Source

Jaromahum J.,Morristown Memorial Hospital
Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses | Year: 2010

BACKGROUND: Esophagectomy is the most common treatment for esophageal cancer (Pierie, Goedegebuure, Schuerman, & Leguit, 2000). Dysphagia is the most common symptom, after esophagectomy (Easterling et al., 2000; Ludwig, Thirlby, & Low, 2001; Pierie et al., 2000; Verschuur et al., 2006). The aim of this study was to describe patients' experiences of eating after esophagectomy. METHOD: A phenomenology approach was used to describe and understand eating experiences after esophagectomy. FINDINGS: Three major categories of experiences were extrapolated from informant verbal reports: physical, psychosocial, and psychological. Within these categories main themes were identified and included gastrointestinal feelings, fear of going home, and positive feelings toward eating. CONCLUSION: Most patients may not be able to eat exactly as they did prior to their operation (Ludwig et al., 2001). Findings from this study illustrate patients should be provided with a diet they perceive as socially acceptable with minimal eating discomforts. Source

Joffe R.T.,Staten Island University Hospital | Joffe R.T.,Boston University | Pearce E.N.,Boston University | Hennessey J.V.,Harvard University | And 2 more authors.
International Journal of Geriatric Psychiatry | Year: 2013

Objectives To perform a critical review of the literature on the mood and cognitive changes associated with subclinical hypothyroidism (SCH), with an emphasis on older adults. To evaluate these data against the Consensus Statement on the management of SCH from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. Method A comprehensive literature review. Results Subclinical hypothyroidism may be associated with an increased risk of mood and cognitive dysfunction, although the strength of this association and the efficacy of replacement hormone therapy require further investigation. Conclusion It remains unclear whether SCH leads to significant mood and cognitive impairments in most older patients. More research is required to determine the nature and extent of this association and whether thyroid hormone replacement therapy is appropriate and effective in treating SCH-associated neurobehavioral impairments. Copyright © 2012 John Wiley & Sons, Ltd. Source

Frey M.K.,Cornell University | Ward N.M.,New York Medical College | Caputo T.A.,Cornell University | Taylor J.,Cornell University | And 2 more authors.
Gynecologic Oncology | Year: 2012

Objective: Lymphatic ascites is an unusual complication in patients with cancer. In the gynecologic oncology patient population, the most common etiology is operative lymph node dissection. The purpose of this study was to explore the incidence, presenting symptoms, methods of diagnosis and treatment modalities utilized for lymphatic ascites in patients undergoing lymph node dissection for gynecologic cancers. Methods: This observational study retrospectively reviewed the charts of patients who underwent lymphadenectomy as part of the surgical management for a gynecologic cancer. Patients that developed postoperative lymphatic ascites between January 2000 and December 2010 were included for analysis. Data extracted from the medical records included tumor pathology, number of harvested lymph nodes, postoperative course, method of diagnosis and treatment. Results: From a total of 300 surgical staging procedures, 12 patients with lymphatic ascites were identified (4%). The most common reported symptom was leakage of clear fluid per vagina (7, 58%), followed by abdominal distension (4, 33%). The median interval from surgery to development of symptoms was 12.5 days (range 0-22 days). 5 patients had complete resolution of symptoms with dietary modifications alone while 7 patients required paracentesis. The median time from surgery to resolution of symptoms was 44 days (range 9-99). Conclusion: Lymphatic ascites is an under recognized and infrequently reported postoperative complication. Although it usually resolves spontaneously or with conservative management without sequelae, this condition can significantly prolong postoperative recovery and cause patient discomfort. To our knowledge this is the largest group of patients undergoing gynecologic surgical staging procedures to be reviewed for the occurrence of lymphatic ascites. © 2012 Elsevier Inc. All rights reserved. Source

Musanti R.,Morristown Memorial Hospital | Musanti R.,The New School
Medicine and Science in Sports and Exercise | Year: 2012

Purpose: This study, theoretically based on the Exercise Self-Esteem Model, EXSEM, examined effects of exercise modality on physical and global self-esteem (PSE, GSE) in breast cancer survivors. The EXSEM posits GSE at the apex with PSE feeding into GSE. PSE has three subdomains: physical condition (PC), attractive body (AB), and physical strength (PS). The goals were to compare the effect of combination modality versus single-modality exercise on PSE and GSE and to explore the relationship between exercise modality and the subdomains of PSE. Methods: Survivors were randomly allocated to flexibility (F), aerobic (A), resistance (R), or aerobic plus resistance (AR), 12-wk, individualized, home-based exercise program. Pre/posttesting included submaximal treadmill test, six-repetition maximum chest press and leg press, YMCA bench press, shoulder/hip flexibility, and bioelectric impedance analysis body composition. Esteem measures were the Physical Self-Perception Profile and the Rosenberg Self-Esteem Scale. Results: Forty-two women completed the study (F = 12, A = 10, R = 9, and AR = 11). Fitness improvements congruent with exercise modality were seen in all groups. PSE and GSE outcomes did not reveal a greater effect from the combination modality program, AR, compared with the single-modality programs A and R. The relationships between the single-modality groups and the subdomains of PC, PS, and AB were supported in the R group (PS and AB increased) and were partially supported in the A group (PC, not AB, increased). Conclusions: A single-modality R program significantly improved all domains of PSE, and participation in the A program improved the PC subdomain. The combination exercise program did not enhance PSE greater than the single-modality programs. EXSEM was a useful framework for exploring esteem in breast cancer survivors. Copyright © 2012 by the American College of Sports Medicine. Source

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