St Francis Medical Center
St Francis Medical Center
News Article | July 21, 2017
New Jersey provides another significant boost for the growing, nationwide movement to increase the tobacco age to 21. Tobacco 21 laws have also been enacted by California, Hawaii and at least 255 cities and counties, including New York City, Chicago, Boston, Cleveland, St. Louis and both Kansas Cities. The Oregon Legislature approved a similar bill earlier this month, and Gov. Kate Brown has indicated she will sign the measure into law. A tobacco 21 bill also awaits the governor's signature in Maine, and statewide measures remain under consideration in Massachusetts and elsewhere. We applaud Gov. Christie and the New Jersey Legislature for their leadership in enacting this new law. In signing the bill, Gov. Christie rightly noted that raising the tobacco age gives young people a "better understanding of how dangerous smoking can be and that it is better to not start smoking in the first place." He added, "My mother died from the effects of smoking, and no one should lose their life due to any addictive substance." Well said, Governor. Increasing the tobacco age to 21 will reduce tobacco use among youth and young adults – age groups when nearly all tobacco use begins and that are heavily targeted by the tobacco industry. We know that about 95 percent of adult smokers began smoking before they turned 21. Increasing the tobacco age will help counter the industry's efforts to target young people at a critical time when many move from experimenting with tobacco to regular smoking. In New Jersey alone, tobacco companies spend over $175 million a year to market their deadly and addictive products. This legislation will also help keep tobacco out of high schools, where younger teens often obtain tobacco products from older students. A 2015 report by the prestigious Institute of Medicine (now called the National Academy of Medicine) concluded that increasing the tobacco age to 21 will significantly reduce the number of adolescents and young adults who start smoking, with immediate and long-term benefits for the nation's health. Tobacco use is the No. 1 cause of preventable death in the United States, killing over 480,000 Americans and costing the nation about $170 billion in health care bills each year. In New Jersey, tobacco kills 11,800 people and costs over $4 billion in health care expenses each year. Without additional action to reduce tobacco use, 143,000 kids alive today in New Jersey will die prematurely from smoking. Increasing the tobacco age to 21 is a critical step in reducing and eventually eliminating tobacco's terrible toll. About Tobacco-Free Kids The Campaign for Tobacco-Free Kids is a leading force in the fight to reduce tobacco use and its deadly toll in the United States and around the world. Our vision: A future free of the death and disease caused by tobacco. We work to save lives by advocating for public policies that prevent kids from smoking, help smokers quit and protect everyone from secondhand smoke. About Lourdes Health System The Lourdes Health System is one of the region's leading healthcare providers, recognized nationally for excellence in clinical care and service to the community. The system has two general acute care hospitals, located in Camden and Willingboro, New Jersey, and a growing network of ambulatory care facilities and physician practices located throughout southern New Jersey. A major teaching affiliate of the Rowan University School of Osteopathic Medicine, Lourdes provides a full range of medical, surgical, obstetrical, behavioral health, rehabilitation and long-term acute care services. The Lourdes Cardiovascular Institute is recognized nationally for excellence in heart care. Lourdes Health System has an Accountable Care Organization (ACO), Nursing School; comprehensive Wellness Services; and LIFE program for All-Inclusive Care of the Elderly. Lourdes is well-known for its outreach services, providing care to those most in need. Lourdes is a member of Trinity Health, a health system serving residents in 21 states. About St. Francis Medical Center St. Francis Medical Center was founded in 1874 by the Sisters of St. Francis of Philadelphia as Trenton's first hospital. Today, it is an acute care teaching hospital with more than 300 medical staff physicians representing all specialties and a member of the Trinity Health System. Known as the Heart Hospital, St. Francis is Mercer County's only comprehensive cardiac surgery program. Our advanced and comprehensive cardiovascular services include the new hybrid lab which combines the imaging capabilities of a cardiac catheterization lab with the sterile environment of a conventional operating room (OR). Other programs include the Regional Cancer Center; Compassionate Care Hospice; Behavioral Health; an accredited Sleep Disorders Center; and a designated primary stroke center. LIFE St. Francis, A Program of All Inclusive Care for the Elderly (PACE), was the first program in the State of New Jersey. Additionally, the Wound Care Center, features a hyperbaric oxygen therapy chamber and the hospital has a newly renovated walk in clinic, an Imaging Center featuring a 64-Slice CT Scanner and offers digital mammography. St. Francis is also home to the School of Nursing and School of Radiological Technology in addition to several primary care and specialty practices known as LIFE Care Physicians.
Dake M.D.,Stanford University |
Ansel G.M.,MidWest Cardiology Research Foundation |
Jaff M.R.,Massachusetts General Hospital |
Ohki T.,Jikei University School of Medicine |
And 10 more authors.
Circulation: Cardiovascular Interventions | Year: 2011
Background-Sustained benefits of drug-eluting stents in femoropopliteal arteries have not been demonstrated. This prospective, multinational, randomized study was designed to compare the 12-month safety and effectiveness of a polymer-free, paclitaxel-coated nitinol drug-eluting stent (DES) with percutaneous transluminal angioplasty (PTA) and provisional bare metal stent (BMS) placement in patients with femoropopliteal peripheral artery disease. Methods and Results-Patients were randomly assigned to primary DES implantation (n=236) or PTA (n=238). Demographics and lesion characteristics were similar between groups (eg, average lesion length, approximately 65±40 mm). One hundred twenty patients had acute PTA failure and underwent secondary random assignment to provisional DES (n=61) or BMS (n=59). Primary end points were the 12-month rates of event-free survival and patency in the primary DES and PTA groups. Compared with the PTA group, the primary DES group exhibited superior 12-month event-free survival (90.4% versus 82.6%; P=0.004) and primary patency (83.1% versus 32.8%; P<0.001), satisfying the primary hypotheses. In the secondary evaluations, (1) the primary DES group exhibited superior clinical benefit compared with the PTA group (88.3% versus 75.8%; P<0.001), (2) the provisional DES group exhibited superior primary patency (89.9% versus 73.0%; P=0.01) and superior clinical benefit (90.5% and 72.3%, P=0.009) compared with the provisional BMS group, and (3) the stent fracture rate (both DES and BMS) was 0.9% (4/457). Conclusions-Femoropopliteal peripheral artery disease treatment with the paclitaxel-eluting stent was associated with superior 12-month outcomes compared with PTA and provisional BMS placement. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00120406. © 2011 American Heart Association, Inc.
Farrell J.J.,University of Illinois at Urbana - Champaign |
Larson J.A.,St Francis Medical Center |
Akeson J.W.,University of Illinois at Urbana - Champaign |
Lowery K.S.,Ibis Biosciences |
And 5 more authors.
Journal of Clinical Microbiology | Year: 2014
We describe the first reported case of Ureaplasma parvum prosthetic joint infection (PJI) detected by PCR. Ureaplasma species do not possess a cell wall and are usually associated with colonization and infection of mucosal surfaces (not prosthetic material). U. parvum is a relatively new species name for certain serovars of Ureaplasma urealyticum, and PCR is useful for species determination. Our patient presented with late infection of his right total knee arthroplasty. Intraoperative fluid and tissue cultures and pre- and postoperative synovial fluid cultures were all negative. To discern the pathogen, we employed PCR coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Our patient's failure to respond to empirical antimicrobial treatment and our previous experience with PCR/ESI-MS in culture-negative cases of infection prompted us to use this approach over other diagnostic modalities. PCR/ESI-MS detected U. parvum in all samples. U. parvum-specific PCR testing was performed on all synovial fluid samples to confirm the U. parvum detection. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
Jegatheesan P.,Santa Clara Valley Medical Center |
Song D.,Santa Clara Valley Medical Center |
Angell C.,Santa Clara Valley Medical Center |
Angell C.,OConnor Hospital |
And 2 more authors.
Pediatrics | Year: 2013
OBJECTIVE: To establish simultaneous pre- and postductal oxygen saturation nomograms in asymptomatic newborns when screening for critical congenital heart disease (CCHD) at ∼24 hours after birth. METHODS: Asymptomatic term and late preterm newborns admitted to the newborn nursery were screened with simultaneous pre- and postductal oxygen saturation measurements at ∼24 hours after birth. The screening program was implemented in a stepwise fashion in 3 different affiliated institutions. Data were collected prospectively from July 2009 to March 2012 in all 3 centers. RESULTS: We screened 13 714 healthy newborns at a median age of 25 hours. The mean preductal saturation was 98.29% (95% confidence interval [CI]: 98.27-98.31), median 98%, and mean postductal saturation was 98.57% (95% CI: 98.55-98.60), median 99%. The mean difference between the pre- and postductal saturation was -0.29% (95% CI: -0.31 to -0.27) with P < .00005. Its clinical relevance to CCHD screening remains to be determined. The postductal saturation was equal to preductal saturation in 38% and greater than preductal saturation in 40% of the screens. CONCLUSIONS: We have established simultaneous pre- and postductal oxygen saturation nomograms at ∼24 hours after birth based on >13 000 asymptomatic newborns. Such nomograms are important to optimize screening thresholds and methodology for detecting CCHD.
Cleri D.J.,St Francis Medical Center |
Cleri D.J.,Seton Hall University |
Ricketti A.J.,St Francis Medical Center |
Ricketti A.J.,Seton Hall University |
Vernaleo J.R.,Wyckoff Heights Medical Center
Infectious Disease Clinics of North America | Year: 2010
This article reviews the virology, history, pathology, epidemiology, clinical presentations, complications, radiology, laboratory testing, diagnosis, treatment, and prevention of severe respiratory distress syndrome, with reference to documented outbreaks of the disease. © 2010 Elsevier Inc. All rights reserved.
Bailey L.D.,St Francis Medical Center
Advances in Neonatal Care | Year: 2013
Nurse-to-nurse, or horizontal, hostility creates a multitude of problems. There are a number of specific and direct problems, including impact on the culture of nursing, stress, healthcare economics, and patient outcomes, that are illustrated in the literature. Horizontal hostility is a pervasive and destructive force that must be addressed in every venue in which nursing is involved. This study discusses the problem of horizontal hostility and the impact it has on nursing and healthcare. Nursing theory is applied to practice and provides concepts and frameworks that are utilized to underscore the critical nature of the problem and provide a map for solutions. Copyright © 2013 by The National Association of Neonatal Nurses.
Pressman G.S.,Albert Einstein Medical Center |
Agarwal A.,Albert Einstein Medical Center |
Braitman L.E.,Albert Einstein Medical Center |
Muddassir S.M.,St Francis Medical Center
American Journal of Cardiology | Year: 2010
Mitral annular calcium (MAC) is a common finding at echocardiography, although it is an unusual cause of severe mitral stenosis. Although MAC is known to be associated with atherosclerosis and chronic kidney disease, little is known about its natural history as affects mitral valve function. This report describes a cohort of 37 outpatients with severe MAC (>5 mm) of whom 32 were followed longitudinally with echocardiography (mean follow-up 2.6 ± 1.6 years). Progression of the mitral valve gradient occurred in 16 of 32 (50%). There was wide variation in rate of progression with a few subjects demonstrating a rapid increase in gradient, up to 9 mm Hg/year. Progression of mitral valve gradient correlated with baseline gradient at rest and with severity of overall cardiac calcification as measured by a semiquantitative echocardiographic score. Age at index echocardiogram was inversely related to mitral valve gradient after baseline, suggesting that calcification may proceed at a greater rate in younger patients. In conclusion, although severe mitral stenosis is uncommon in patients with MAC, those with a pre-existing gradient at rest and severe overall cardiac calcification appear to be at greater risk for development of this disease state. © 2010 Elsevier Inc. All rights reserved.
Kansal R.,Cedars Sinai Medical Center |
Quintanilla-Martinez L.,University of Tübingen |
Datta V.,Cedars Sinai Medical Center |
Lopategui J.,Cedars Sinai Medical Center |
And 2 more authors.
Genes Chromosomes and Cancer | Year: 2013
Langerhans cell histiocytosis (LCH) is a well-known but rare disease that may occur at any age with markedly variable clinical features: self-regressive, localized, multiorgan, aggressive, or fatal outcome. Congenital LCH is rare and often clinically benign. While LCH is characterized by a clonal proliferation of Langerhans cells, its etiology is unknown. Although BRAF V600E mutations were recently identified as a recurrent genetic alteration in LCH cases, the clinical significance of this mutation within the heterogeneous spectrum of LCH is also currently unknown. We studied a cutaneous, benign form of congenital LCH that occurred in a newborn male, without recurrence for 8 years. Histopathologically, the skin lesion excised after birth showed the typical cytologic and immunophenotypic features of LCH. Sequencing analysis of Exon 15 of the BRAF gene revealed the V600D mutation, with an allelic abundance of 25-30%, corresponding to the LCH cells being hemizygous for the mutant allele. BRAF V600E-specific polymerase chain reaction was negative. Our report is the first to identify the rare, variant BRAF V600D mutation in LCH, and provides support for constitutively activated BRAF oncogene-induced cell senescence as a mechanism of regression in congenital, benign LCH. Further, our clinicopathologic findings provide proof for the first time that the V600D mutation can also occur in the absence of ultraviolet light, and can occur in a clinically benign proliferation, similar to the V600E mutation. Additional clinicopathologic studies in larger numbers of LCH patients may be valuable to ascertain the pathophysiologic role of BRAF mutations in LCH. © 2012 Wiley Periodicals, Inc.
Barnette A.R.,St Francis Medical Center |
Barnette A.R.,University of Washington |
Horbar J.D.,University of Vermont |
Soll R.F.,University of Vermont |
And 7 more authors.
Pediatrics | Year: 2014
BACKGROUND AND OBJECTIVE: Computed tomography (CT) is still used for neuroimaging of infants with known or suspected neurologic disorders. Alternative neuroimaging options that do not expose the immature brain to radiation include MRI and cranial ultrasound. We aim to characterize and compare the use and findings of neuroimaging modalities, especially CT, in infants with neonatal encephalopathy. METHODS: The Vermont Oxford Network Neonatal Encephalopathy Registry enrolled 4171 infants (≥36 weeks' gestation or treated with therapeutic hypothermia) between 2006 and 2010 who were diagnosed with encephalopathy in the first 3 days of life. Demographic, perinatal, and medical conditions were recorded, along with treatments, comorbidities, and outcomes. The modality, timing, and results of neuroimaging were also collected. RESULTS: CT scans were performed on 933 of 4107 (22.7%) infants, and 100 of 921 (10.9%) of those received multiple CT scans. Compared with MRI, CT provided less detailed evaluation of cerebral injury in areas of prognostic significance, but was more sensitive than cranial ultrasound for hemorrhage and deep brain structural abnormalities. CONCLUSIONS: CT is commonly used for neuroimaging in newborn infants with neonatal encephalopathy despite concerns over potential harm from radiation exposure. The diagnostic performance of CT is inferior to MRI in identifying neonatal brain injury. Our data suggest that using cranial ultrasound for screening, followed by MRI would be more appropriate than CTat any stage to evaluate infants with neonatal encephalopathy. Copyright © 2014 by the American Academy of Pediatrics.
Stone R.H.,St Francis Medical Center |
Bricknell S.S.,St Francis Medical Center
Respiratory Care | Year: 2011
Partial or total obstruction of an endotracheal tube (ETT) by mucus can cause severe respiratory distress, hypoxemia, or death. Signs of an obstructed ETT include increased ventilation pressure, changes in the ventilator graphics, SpO2 decrease, and cardiovascular changes. We present 3 patients whose ETTs were partially obstructed by mucus. In each case the patient displayed adverse effects from the obstruction, but once the obstruction was removed they showed dramatic improvement. In each case we used a new device (Rescue Cath, Omneotech, Tavernier, Florida) designed to remove mucus from the ETT lumen. The 3 cases demonstrate that the device is effective and capable of relieving the adverse effects of ETT mucus obstruction. © 2011 Daedalus Enterprises.