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Crick B.C.,St Vincents Medical Center
Journal of surgical orthopaedic advances | Year: 2011

Litigation involving Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS), because of its complexities, is often difficult to prove or defend. In our review of 56 verdicts and settlements in the state of Florida, in cases involving a diagnosis or misdiagnosis of RSD or CRPS, over half resulted in a substantial verdict or settlement for the plaintiff. Source


Li Z.,St Vincents Medical Center | Vaziri H.,University of Connecticut Health Center
Best Practice and Research: Clinical Gastroenterology | Year: 2012

The treatment of chronic diarrhoea can be challenging. While Oral Rehydration Solution is an important step in treating diarrhoeal illnesses, various medications can be used to alleviate the symptoms while the patient is undergoing diagnostic work up or to target the underlying mechanism responsible for their diarrhoea. Medications are also being prescribed in cases when there is a strong suspicious about a diagnosis or when there is no specific treatment for an underlying aetiology. This chapter discusses the treatment options for diarrhoeal disorders.© 2012 Elsevier Ltd. All rights reserved. Source


Heekin R.D.,St Vincents Medical Center | Fokin A.A.,Heekin Institute for Orthopedic Research
The journal of knee surgery | Year: 2014

We sought to determine the incidence of bicompartmental osteoarthritis among knee replacement patients for possible bone-sparing procedures. In 259 consecutive Knee Registry subjects undergoing total or unicondylar knee arthroplasty, all three compartments of the knee joint were evaluated. Radiographic images and preoperative cruciate ligaments assessment combined with intraoperative cartilage grading using Outerbridge classification was implemented for patients' evaluations. Among the candidates for knee replacement arthroplasty, 59% had osteoarthritis in all three compartments, 28% had bicompartmental disease, and 4% had unicompartmental disease. Nine percent of patients exhibited inconclusive osteoarthritis pattern. Only 5% of the patients were found to have cruciate ligaments impairment. Older patients ( > 65 years) were significantly more likely to have bi- and tricompartmental disease. We had found that 28% of our registry population had bicompartmental disease and infrequent impairment of cruciate ligaments, indicating that between one-fourth and one-third of patients undergoing total knee arthroplasty could be considered for bone preserving bicompartmental knee arthroplasty. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. Source


Guddati A.K.,St Vincents Medical Center
Medical Oncology | Year: 2012

Ovarian cancer is one of the major causes of death in women with gynecologic malignancy. Most patients respond favorably to platinum therapy, but relapses are common. There is emerging evidence that a special subset of cells that is highly tumorigenic is responsible for recurrence of the disease. This subset of cells has been characterized by several groups and has been found to have the properties of cancer stem cells. They have been isolated from tumor samples obtained during surgical cytoreduction and also from the ascitic fluid of ovarian cancer patients. Currently, there are no known unique markers to define these cells, but several groups have used different approaches to purify them. Although some heterogeneity has been observed in these cells, most of them satisfy the functional definition of a stem cell. Advances in characterization of ovarian cancer stem cells are instrumental in developing therapies that specifically target them. This review describes the advances made in characterization of these cells, basis of their resistance to conventional chemotherapeutic agents and the prognostic implications of utilizing mechanisms specific to ovarian cancer stem cell for therapeutic interventions. Eliminating ovarian cancer stem cells could possibly lead to a prolongation of the disease-free survival period and hopefully a definitive cure. © 2012 Springer Science+Business Media, LLC. Source


Leder S.B.,Yale University | Ross D.A.,St Vincents Medical Center
Dysphagia | Year: 2010

Debate continues regarding an association between tracheotomy and aspiration status. The aim of this research was to perform a direct replication study to investigate further the causal relationship, if any, between tracheotomy and aspiration. Twenty-five consecutive adult hospitalized patients participated. Inclusion criteria were a pretracheotomy dysphagia evaluation, subsequent tracheotomy and tracheotomy tube placement, then a post-tracheotomy dysphagia reevaluation prior to decannulation. Twenty-two (88%) participants exhibited the same aspiration status or resolved aspiration pre- versus post-tracheotomy. Three participants exhibited new aspiration posttracheotomy due to worsening medical conditions. Conversely, four participants exhibited resolved aspiration post-tracheotomy due to improved medical conditions. Excluding these seven participants, all nine participants who aspirated pretracheotomy also aspirated post-tracheotomy and all nine participants who did not aspirate pretracheotomy also did not aspirate post-tracheotomy (P>0.05). No statistically significant differences were found between aspiration status and days since tracheotomy x2 = 0.08, P<0.05) or between age and aspiration status (P>0.05). The absence of a causal relationship between tracheotomy and aspiration status was confirmed. © Springer Science+Business Media, LLC 2009. Source

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