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Atlanta, GA, United States

Bohluli B.,University of Tehran | Varedi P.,Tehran University of Medical Sciences | Nazari S.,University of Tehran | Bagheri S.C.,Northside Hospital | And 2 more authors.
Journal of Oral and Maxillofacial Surgery | Year: 2013

The proper nasolabial angle is a determinant factor in achieving a pleasant result in esthetic rhinoplasty surgery. Nasal tip position depends on various interrelated elements. Its rotation should be analyzed by assessing the nasolabial angle. An increase in this angle results in an upward tilt of the base of the nose with a concomitant decrease in nasal length. Several methods have been advocated to improve this angle; unfortunately, these techniques have considerable limitations in modifying and stabilizing nasal tip rotation. The general principles for rotating the nasal tip include removing the factors that resist the rotation of the lower lateral cartilages, creating space to accommodate them, rotating the lower lateral cartilages into the desired position, and stabilizing the cartilages in the desired position. Resection of the cephalic margin of the lateral crura fulfills these goals. This report describes a straightforward and stable method that uses cephalic portions of the lower lateral crural cartilages as 2 flaps to suspend the nasal tip to the septum to modify and stabilize the nasolabial angle. © 2013 American Association of Oral and Maxillofacial Surgeons. Source

Gomez E.,Mayo Medical School | Gustafson D.R.,Mayo Medical School | Colgrove R.,Harvard University | Ly T.,Fauquier Hospital | And 3 more authors.
Journal of Clinical Microbiology | Year: 2011

Robinsoniella peoriensis is a recently described anaerobic, spore-forming, Gram-positive bacillus originally recovered from swine manure. We report four human cases in which R. peoriensis was isolated from clinical samples. Copyright © 2011, American Society for Microbiology. All Rights Reserved. Source

Gudeman J.,Ther Rx Corporation | Jozwiakowski M.,Ther Rx Corporation | Chollet J.,Ther Rx Corporation | Randell M.,Northside Hospital
Drugs in R and D | Year: 2013

Pharmacy compounding involves the preparation of customized medications that are not commercially available for individual patients with specialized medical needs. Traditional pharmacy compounding is appropriate when done on a small scale by pharmacists who prepare the medication based on an individual prescription. However, the regulatory oversight of pharmacy compounding is significantly less rigorous than that required for Food and Drug Administration (FDA)-approved drugs; as such, compounded drugs may pose additional risks to patients. FDA-approved drugs are made and tested in accordance with good manufacturing practice regulations (GMPs), which are federal statutes that govern the production and testing of pharmaceutical products. In contrast, compounded drugs are exempt from GMPs, and testing to assess product quality is inconsistent. Unlike FDA-approved drugs, pharmacy-compounded products are not clinically evaluated for safety or efficacy. In addition, compounded preparations do not have standard product labeling or prescribing information with instructions for safe use. Compounding pharmacies are not required to report adverse events to the FDA, which is mandatory for manufacturers of FDA-regulated medications. Some pharmacies engage in activities that extend beyond the boundaries of traditional pharmacy compounding, such as large-scale production of compounded medications without individual patient prescriptions, compounding drugs that have not been approved for use in the US, and creating copies of FDA-approved drugs. Compounding drugs in the absence of GMPs increases the potential for preparation errors. When compounding is performed on a large scale, such errors may adversely affect many patients. Published reports of independent testing by the FDA, state agencies, and others consistently show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved drugs. Compounded sterile preparations pose the additional risk of microbial contamination to patients. In the last 11 years, three separate meningitis outbreaks have been traced to purportedly 'sterile' steroid injections contaminated with fungus or bacteria, which were made by compounding pharmacies. The most recent 2012 outbreak has resulted in intense scrutiny of pharmacy compounding practices and increased recognition of the need to ensure that compounding is limited to appropriate circumstances. Patients and healthcare practitioners need to be aware that compounded drugs are not the same as generic drugs, which are approved by the FDA. The risk-benefit ratio of using traditionally compounded medicines is favorable for patients who require specialized medications that are not commercially available, as they would otherwise not have access to suitable treatment. However, if an FDA-approved drug is commercially available, the use of an unapproved compounded drug confers additional risk with no commensurate benefit. © 2013 The Author(s). Source

Nezhat C.H.,Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine | Dun E.C.,Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine | Wieser F.,Emory University | Zapata M.,Northside Hospital
American Journal of Obstetrics and Gynecology | Year: 2013

Extranodal marginal zone B-cell lymphomas are uncommon. Most occur in the gastrointestinal tract. Marginal zone B-cell lymphomas of the female genital tract are rare, and few cases exist of marginal zone B-cell lymphomas of the uterus, cervix, and fallopian tubes. We report the first marginal zone B-cell lymphoma of the ovary, fallopian tube, and appendix arising in endometriosis. © 2013 Mosby, Inc. Source

Brister K.J.,Beth Israel Deaconess Medical Center | Singh R.S.,Northside Hospital | Wang H.H.,Beth Israel Deaconess Medical Center
Diagnostic Cytopathology | Year: 2015

Background: The Bethesda System for Reporting Thyroid Cytopathology was published in 2008 and was implemented at Beth Israel Deaconess Medical Center (BIDMC) in June, 2010. Prior to this date, our diagnostic scheme was similar to the Bethesda System, except for the category of "Atypia/Follicular Lesion of Undetermined Significance" (AUS). This study evaluates the impact of the Bethesda System on the rate and the positive predictive value (PPV) of the diagnostic categories at BIDMC. Methods: We performed a retrospective review of all thyroid fine-needle aspirations (FNAs) during the time periods January, 2006 to November, 2008 and June, 2010 to July, 2011 and the subsequent thyroidectomy specimens. Results: Post-Bethesda System, diagnoses that are equivocal for diverse reasons and which have wide-ranging PPVs are now all grouped into the AUS category, and the proportion of cases that are in the atypical/AUS category rose from 3.7% in the pre-Bethesda period to 12% in the post-Bethesda period. Conclusion: The AUS category has a PPV approaching 50% in our lab. This creates uncertainty regarding the appropriate management for this category and may cause unnecessary overuse of molecular testing for cases in the AUS category. © 2014 WILEY PERIODICALS, INC. Source

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