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Singer A.J.,State University of New York at Stony Brook | Talan D.A.,View Medical | Talan D.A.,University of California at Los Angeles
New England Journal of Medicine | Year: 2014

Abscesses are a common form of skin and soft-tissue infection and are increasing in incidence. Although the diagnosis of an abscess can be straightforward, ultrasonography may be helpful in cases in which the abscess is deep, complex, or obscured by extensive cellulitis. A standard approach to incision and drainage remains the mainstay of abscess management, whereas routine packing may be unnecessary. The use of smaller incisions with loop drains and the use of primary closure may be considered in appropriate cases. Adjunctive antibiotic treatment and wound cultures should be limited to patients with severe cases, immunocompromised patients, and those in whom initial therapy is failing. Because of the relatively high failure rates even with optimal treatment, patient education and follow-up are recommended. Copyright © 2014 Massachusetts Medical Society.


The idea of a Global Health Section within the American Academy of Neurology (AAN) came from a group of neurologists with active work in sub-Saharan Africa, who believed that the AAN could provide a greater leadership role in supporting the advancement of quality neurologic training, research, and patient care in low and middle-income countries (LMICs). Initially a Special Interest Group, the Global Health Section was approved for full section status in September 2011 and endorsed by the AAN Board of Directors in October 2011. The Global Health Section currently consists of over 200 members. In a 2-part series, we present a summary of the Global Health Section strategic plan and vision for future activities.


Beavis A.,View Medical
Obstetrics and gynecology | Year: 2012

Approximately 24% of American adults have tattoos. Studies of humans and mice demonstrate that tattoo pigment migrates to lymph nodes and can cause lymphadenopathy. A 32-year-old woman presented with a 6-cm vulvar mass and extensive bilateral inguinofemoral lymphadenopathy. Bilateral small tattoos were noted in the groins. Vulvar biopsy confirmed squamous cell carcinoma, and fine needle aspiration of the lymph nodes showed no evidence of malignancy. The patient underwent a radical hemivulvectomy and bilateral inguinofemoral lymphadenectomy. Both inguinal and femoral nodes were enlarged because of extracellular tattoo pigment and reactive follicular hyperplasia without any evidence of metastasis. This case emphasizes the need to consider tattoo pigment as a cause of lymphadenopathy in any patient with a regional tattoo.


Mikhail N.,View Medical
Current Drug Safety | Year: 2014

Canagliflozin is a newly approved drug for the treatment of type 2 diabetes. This agent lowers blood glucose mainly by increasing urinary glucose excretion through inhibition of sodium glucose co-transporter 2 (SGLT2) in the kidneys. Data derived from randomized clinical trials lasting up to 52 weeks suggest that canagliflozin is generally well tolerated. The most common adverse effects are genital mycotic infections occurring in 11-15% of women exposed to canagliflozin versus 2-4% of those randomized to glimepiride or sitagliptin. In men, corresponding proportions are 8-9% versus 0.5-1%. Urinary tract infections (UTI) are slightly increased (5-7%) with the use of canagliflozin compared with placebo (4%). The risk of hypoglycemia associated with canagliflozin is marginally higher than placebo, but markedly increases when the drug is used in conjunction of insulin or sulfonylureas (SU), in patients with chronic kidney disease (CKD), and in the elderly. Worsening renal function and hyperkalemia may occur in patients using canagliflozin, particularly in patients with underlying CKD. Mild weight loss (mean 2-4 kg) and lowering of blood pressure represent 2 advantages of canagliflozin owing to its osmotic diuretic effect. However, the latter action may lead to postural hypotension and dizziness in susceptible subjects. Another concerning adverse effect of canagliflozin is an average 8% increase in plasma levels of low-density lipoprotein cholesterol (LDL-C) compared with placebo. Overall, canagliflozin is a useful addition for treatment of type 2 diabetes, but its safety needs to be established in long-term clinical trials. © 2014 Bentham Science Publishers.


Studies designed to evaluate the short-term effects of incretin-related drugs in subjects with cardiac disease are still preliminary. In patients with heart failure, two of five studies showed that glucagon-like peptide-1 (GLP-1) infusion was associated with an absolute increase in left ventricular ejection fraction (LVEF) by 6-10 %, whereas no significant benefit was observed in the remaining three studies. In patients with coronary artery disease, single infusion of the GLP-1 receptor analog, exenatide, did not increase LVEF, but this drug may decrease infarct size in patients with myocardial infarction presenting with short duration of ischemic symptoms. Single dose of GLP-1 and the dipeptidyl-peptidase-IV (DPP-IV) inhibitor, sitagliptin, may improve left ventricular function, predominantly in ischemic segments, and attenuate post-ischemic stunning. Nausea, vomiting and hypoglycemia were the most common adverse effects associated with GLP-1 and exenatide administration. Increased heart rate was also observed with exenatide in patients with heart failure. Large randomized trials including diabetic patients with preexisting heart failure and myocardial infarction showed that chronic therapy with the DPP-IV inhibitors saxagliptin and alogliptin did not reduce cardiovascular events or mortality. Moreover, saxagliptin use was associated with significant increase in frequency of heart failure requiring hospitalization, hypoglycemia and angioedema. Overall, short-term preliminary data suggest potential cardioprotective effects of exenatide and sitagliptin in patients with heart failure and myocardial infarction. Meanwhile, long-term randomized trials suggest no benefit of alogliptin, and increased harm associated with the use of saxagliptin. © 2014 Springer Science+Business Media.


Yu P.P.,View Medical
Cancer Journal | Year: 2011

Health information technology will transform health care delivery over the coming years. The central element of this will be the electronic health record, maintained by health professionals and linked to other health care providers, patients, and research and population health databases. Support of oncology functionality will necessitate special attention to how electronic health records are constructed, cancer-related data represented within, and clinical decision support tools designed to best support the objectives of quality care and cost-effectiveness. Standardization of functions and software will permit data exchange, leading to enhanced interoperability of systems. The present efforts at establishing oncology-related standards for electronic health records are reviewed. Copyright © 2011 by Lippincott Williams & Wilkins.


Patent
View Medical | Date: 2015-08-14

A traction bed includes (a) a frame upon which an individual is supportable, (b) a first single-sided lever arm pivotably coupled to the frame at a location proximate both a first end of the frame and a first side of the frame, wherein the first single-sided lever arm is configured to be coupled to an arm of an individual, (c) a second single-sided lever arm pivotably coupled to the frame at a location proximate both a second end of the frame and the first side of the frame, wherein the second single-sided lever arm is configured to be coupled to a leg of an individual, and (d) a control system operable to direct a force onto each of the single-sided lever arms to pivot the single-sided lever arms relative to the frame, wherein the force directed to the first single-sided lever arm is separately variable from the force directed to the second single-sided lever arm.


Patent
View Medical | Date: 2015-06-04

Example traction devices, systems and methods for use thereof are provided. An example traction device may include (a) a frame comprising a top support having first and second ends, where the first end of the top support is coupled to a first vertical support and the second end of the top support is coupled to a second vertical support and (b) a balance bar moveably coupled to the top support via a wire, where opposing ends of the balance bar are each coupled to an attachment ring or define a receptacle.


A method of analyzing a spinal region of a subject. The method includes steps of obtaining a first sagittal image of the spinal region of the subject using an upright magnetic resonance imaging unit; identifying a first vertebral edge on a first side of a first disc in the first sagittal image; identifying a second vertebral edge on a second side of the first disc in the first sagittal image; and determining a first angle between the first vertebral edge and the second vertebral edge for the first disc.


Patent
View Medical | Date: 2014-12-10

Example traction devices, systems and methods for use thereof are provided. An example traction device may include (a) a frame comprising a top support having first and second ends, where the first end of the top support is coupled to a first vertical support and the second end of the top support is coupled to a second vertical support and (b) a balance bar moveably coupled to the top support via a wire, where opposing ends of the balance bar are each coupled to an attachment ring or define a receptacle.

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