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Chicago, IL, United States

Rush University is a private university on the West Side of Chicago, Illinois. The university, founded in 1972, is the academic arm of Rush University Medical Center. Rush University comprises: Rush Medical College Rush University College of Nursing Rush University College of Health science The Graduate College of Rush UniversityRush encompasses a 613-bed hospital serving adults and children, the 61-bed Johnston R. Bowman Health Center and Rush University. The campus occupies an 8-acre site on Chicago's Near West Side, in the Illinois Medical District, which also includes its teaching hospital, Rush University Medical Center. Wikipedia.

Mulshine J.L.,Rush University
CA: a cancer journal for clinicians | Year: 2014

After a comprehensive review of the evidence, the United States Preventive Services Task Force recently endorsed screening with low-dose computed tomography as an early detection approach that has the potential to significantly reduce deaths due to lung cancer. Prudent implementation of lung cancer screening as a high-quality preventive health service is a complex challenge. The clinical evaluation and management of high-risk cohorts in the absence of symptoms mandates an approach that differs significantly from that of symptom-detected lung cancer. As with other cancer screenings, it is essential to provide to informed at-risk individuals a safe, high-quality, cost-effective, and accessible service. In this review, the components of a successful screening program are discussed as we begin to disseminate lung cancer screening as a national resource to improve outcomes with this lethal cancer. This information about lung cancer screening will assist clinicians with communications about the potential benefits and harms of this service for high-risk individuals considering participation in the screening process. © 2014 American Cancer Society.

Systematic review. The primary objectives of this review were to compare the effectiveness and safety of various anterior cervical decompressive and reconstructive procedures for diffuse or multifocal cervical spondylotic myelopathy (CSM). An additional objective was to describe the most common ancillary stabilization techniques used with the different anterior decompressive procedures. Surgical management of CSM provides for neurological recovery and disease stabilization in a cost-effective way. Although both retrospective and prospective data support management of CSM by anterior cervical decompression and fusion, the choice decision between various anterior surgical options remains unclear. We conducted a systematic search in MEDLINE and the Cochrane Collaboration Library for human studies in the English-language literature published through September 2012. We included studies comparing multiple discectomies with single or multiple corpectomy, multiple discectomies with discectomy-corpectomy hybrid, and multiple corpectomies with discectomy-corpectomy hybrid, comparing effectiveness and safety outcomes of each procedure, and defining the ancillary stabilization techniques used. Exclusion criteria included patients with degenerative disc disease or degenerative joint disease without CSM, single-level CSM, ossified posterior longitudinal ligament (OPLL), spinal tumor, concomitant infection, and ankylozing spondylitis. Case series, case reports, data not reported separately for each comparison group, or studies that consisted of an N less than 10 for either comparison group were excluded. The evidence strength was rated using the GRADE (Grades of Recommendation Assessment, Development, and Evaluation) criteria. Of the 49 citations identified from our search, 10 studies were initially found suitable for inclusion. Patients undergoing any of the 3 procedures generally experienced improvements in clinical outcomes (neck disability index, Japanese Orthopaedic Association score, and Visual Analogue Scale score for pain) as well as overall sagittal alignment, with minimal perioperative morbidity. There is moderate evidence supporting selection of multiple discectomies compared with corpectomy or discectomy-corpectomy hybrid procedures with regard to superior clinical outcomes and postoperative sagittal alignment. Furthermore, if more extensive operation is needed, there is evidence to support the selection of discectomy-corpectomy hybrid procedures compared with multiple corpectomies if it is technically feasible to accomplish the requisite decompression. The multiple discectomies approach also may have a lower incidence of C5 palsy than corpectomy or discectomy-corpectomy hybrid approaches. All 3 operative approaches are effective strategies for the anterior surgical management of CSM. When the patient pathoanatomy permits, selection of multiple discectomies is favored compared with corpectomy or discectomy-corpectomy hybrid approaches. EVIDENCE-BASED CLINICAL RECOMMENDATIONS: When pathoanatomically appropriate with minimal retrovertebral disease, we recommend the selection of multiple discectomy over corpectomy or discectomy-corpectomy hybrid procedures. OVERALL STRENGTH OF EVIDENCE: Low. Strong. RECOMMENDATION 2: When retrovertebral disease is significant, we recommend, when possible, that discectomy-corpectomy hybrid procedures be performed instead of multiple corpectomies. OVERALL STRENGTH OF EVIDENCE: Moderate. Strong. SUMMARY STATEMENTS: There is no evidence to guide choice of ancillary external immobilization techniques following multilevel anterior decompression and fusion procedures for CSM.

Background: Essential hypertension is frequently associated with hyperuricemia in both adult and pediatric patients. Lowering serum uric acid level may provide greater benefit than simply treating hypertension. Patients and methods: Forty-four adolescents, aged 12-19 years, newly diagnosed as essential hypertension (secondary hypertension was excluded) and previously untreated were randomized (open label trial) to receive either enalapril or enalapril plus allopurinol in combination. All participants had baseline serum uric acid level ≥5.5 mg/dl. Results: Baseline mean blood pressure (BP), age and body mass index were similar between the two groups. After 8 weeks' treatment, BP reduction was greater, percent of treatment group achieving target BP level was greater, and serum uric acid level was lower in the combination treatment group. There were no adverse effects during the course of therapy. Conclusion: Results suggest that uric acid reduction may be used as adjunctive antihypertensive therapy in hypertensive adolescents with hyperuricemia while closely monitoring for any adverse effect. © Italian Society of Nephrology 2013.

Hall D.,Rush University
Movement disorders : official journal of the Movement Disorder Society | Year: 2012

Carriers of fragile X mental retardation 1 (FMR1) repeat expansions in the premutation range (55-200 CGG repeats) often develop a syndrome of kinetic tremor, cerebellar ataxia, and parkinsonism; designated the fragile X-associated tremor ataxia syndrome (FXTAS). Neurological signs have not been reported in carriers of gray zone (45-54 CGG repeats) expansions. We describe 3 patients with FMR1 gray zone alleles who meet diagnostic criteria for FXTAS. Our cases suggest that the definition of the FXTAS may need to be broadened to include individuals with FMR1 repeat expansions in the gray zone. These neurological signs may be due to elevated levels of expanded CGG repeat FMR1 mRNA in the gray zone carriers, similar to the changes seen in premutation carriers with FXTAS. Copyright © 2011 Movement Disorder Society.

People with epilepsy have a high risk of developing depressive disorders, and people with primary depressive disorders have a high risk of developing epilepsy. Furthermore, a lifetime history of depressive disorders has been associated with a poor response of the seizure disorder to pharmacotherapy and epilepsy surgery. The aim of this Review is to identify the principal neurobiological pathogenic mechanisms of depressive disorders with the potential to facilitate the epileptogenic process or cortical hyperexcitability in experimental animal studies or those that can aggravate known pathogenic mechanisms of epilepsy in human beings. These mechanisms include (1) a hyperactive hypothalamic-pituitary-adrenal axis; (2) structural and functional abnormalities of cortical structures; (3) increased glutamatergic and decreased GABAergic and serotonergic activity; and (4) immunological abnormalities. The data presented in this Review provide experimental evidence that might begin to explain the bidirectional relation between depressive disorders and epilepsy and that can be regarded as a source for future research. © 2012 Elsevier Ltd.

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