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1.
Eloise R. Galligan Lindsey Fix Sameera Husain Philip Zachariah Darrell J. Yamashiro Christine T. Lauren 《Journal of cutaneous pathology》2019,46(2):159-161
We report a case of disseminated Trichosporon asahii in a patient on systemic antifungal therapy who presented with multiple cutaneous nodules suggestive of fungal infection. Histologic features resembled neutrophilic eccrine hidradenitis but staining with periodic acid‐Schiff and Gomori methenamine silver confirmed the clinical diagnosis. This case highlights the importance of maintaining suspicion for trichosporonosis and contextualizing histologic findings within the underlying clinical picture. 相似文献
2.
3.
Rebecca P. Ang Robert M. Klassen Wan Har Chong Vivien S. Huan Isabella Y.F. Wong Lay See Yeo Lindsey L. Krawchuk 《Journal of adolescence》2009,32(5):1225-1237
We provide further evidence for the two-factor structure of the 9-item Academic Expectations Stress Inventory (AESI) using confirmatory factor analysis on a sample of 289 Canadian adolescents and 310 Singaporean adolescents. Examination of measurement invariance tests the assumption that the model underlying a set of scores is directly comparable across groups. This study also examined the cross-cultural validity of the AESI using multigroup confirmatory factor analysis across both the Canadian and Singaporean adolescent samples. The results suggested cross-cultural invariance of form, factor loadings, and factor variances and covariances of the AESI across both samples. Evidence of AESI's convergent and discriminant validity was also reported. Findings from t-tests revealed that Singaporean adolescents reported a significantly higher level of academic stress arising from self expectations, other expectations, and overall academic stress, compared to Canadian adolescents. Also, a larger cross-cultural effect was associated with academic stress arising from other expectations compared with academic stress arising from self expectations. 相似文献
4.
John P Elliott Hugh S Miller Suzanne Coleman Debbie Rhea Diana Abril Karen Hallbauer Niki B Istwan Gary J Stanziano 《Journal of perinatology》2005,25(10):626-630
OBJECTIVE: To assess the impact of activity restriction (AR) on the incidence of preterm birth in women treated for preterm labor testing negative for fetal fibronectin (fFN). STUDY DESIGN: Women who were diagnosed with preterm labor and tocolyzed with magnesium sulfate were concurrently screened with fFN for the purpose of subsequent management. Included were consenting patients with negative fFN, gestational age 23 0/7-33 6/7 weeks, cervical dilation < or =3 cm, and minimal vaginal bleeding. Patients were randomized to AR or no AR. Primary study outcome was incidence of preterm delivery and interval from randomization to delivery. RESULTS: A total of 73 women with negative fFN were randomized (36 with AR, 37 without AR). The overall preterm birth rate was 40%, with 44.4% of patients with AR and 35.1% of patients without AR delivering preterm, p=0.478. CONCLUSION: Maternal AR did not impact pregnancy outcome. The incidence of preterm birth in symptomatic women testing fFN negative was higher than previously reported. 相似文献
5.
Mark A. Trimble Salvador Borges-Neto Stuart Smallhelser Ji Chen Emily F. Honeycutt Linda K. Shaw Jaekyeong Heo Robert A. Pagnanelli E. Lindsey Tauxe Ernest V. Garcia Fabio Esteves Frank Seghatol-Eslami G. Neal Kay Ami E. Iskandrian 《Journal of nuclear cardiology》2007,14(3):298-307
Background Cardiac resynchronization therapy (CRT) is approved for the treatment of patients with advanced systolic heart failure and
evidence of dyssynchrony on electrocardiograms. However, a significant percentage of patients do not demonstrate improvement
with CRT. Echocardiographic techniques have been used for more accurate determination of dyssynchrony. Single photon emission
computed tomography (SPECT) myocardial perfusion imaging has not previously been used to evaluate cardiac dyssynchrony. The
objective of this study is to evaluate mechanical dyssynchrony as described by phase analysis of gated SPECT images in patients
with left ventricular dysfunction, conduction delays, and ventricular paced rhythms.
Methods and Results A novel count-based method is used to extract regional systolic wall thickening amplitude and phase from gated SPECT images.
Five indices describing the phase dispersion of the onset of mechanical contraction are determined: peak phase, phase SD,
bandwidth, skewness, and kurtosis. These indices were determined in consecutive patients with left ventricular dysfunction
(n=120), left bundle branch block (n=33), right bundle branch block (n=19), and ventricular paced rhythms (n=23) and were
compared with normal control subjects (n=157). Phase SD, bandwidth, skewness, and kurtosis were significantly different between
patients with left ventricular dysfunction, left bundle branch block, right bundle branch block, and ventricular paced rhythms
and normal control subjects (all P<.001) Peak phase was significantly different between patients with right ventricular paced rhythms and normal control subjects
(P=.001).
Conclusions A novel SPECT technique for describing left ventricular mechanical dyssyn-chrony has been developed and may prove useful in
the evaluation of patients for CRT.
This study was funded in part by a research grant from the Medtronic-Duke Strategic Alliance, of which Dr Borges-Neto is the
primary investigator. 相似文献
6.
John P Elliott Niki B Istwan Ann Collins Debbie Rhea Gary Stanziano 《Journal of perinatology》2005,25(1):4-7
OBJECTIVE: To identify the etiology and impact of preterm delivery in twin gestations. STUDY DESIGN: Twin gestations delivered at 33.0 to 36.9 weeks were identified in a perinatal database, and categorized by indication for delivery. Deliveries were identified as indicated, or non-indicated (discretionary). Neonatal outcomes were measured by birth weight, length of stay, NICU admission, and ventilator utilization. Data were divided and analyzed by indicated or discretionary delivery, and gestational age at delivery. RESULTS: Analyzed were 3252 twin gestations (6504 infants), with 78% having indicated delivery. Of the 22% with discretionary delivery, nearly 40% required NICU admission. With each advancing week of gestation, there was a significant decrease in incidence of NICU admission and nursery days. CONCLUSION: The majority of preterm deliveries were indicated, though 22% were discretionary. It is vital to consider neonatal morbidity and costs related to gestational age when choosing discretionary delivery. 相似文献
7.
Richard Sacknoff M.D. Robert A. Novelline M.D. James T. Rhea M.D. J. Nash Lawrason M.D. Patrick M. Rao M.D. 《Emergency radiology》1997,4(2):109-111
A 36-year-old man was brought to the emergency department after being assaulted. A mandible series showed a nondisplaced fracture through the angle of the mandible extending through the left third molar tooth. Axial slices from a nonhelical computed tomographic (CT) examination of the head as well as a helical CT examination of the mandible failed to demonstrate the fracture. The fracture was well shown, however, on sagittal CT reformations. Although CT is generally regarded as more sensitive than plain radiography for the detection of fractures, fractures may be overlooked by CT if examination in only one plane is performed. 相似文献
8.
Patrick M. Rao M.D. James T. Rhea M.D. Robert A. Novelline M.D. 《Emergency radiology》1997,4(5):268-275
This article reviews a focused helical appendiceal computed tomographic technique and discusses an approach to appendiceal computed tomographic interpretation. 相似文献
9.
This study describes a method for determining the number of radiographic rooms devoted to emergency radiology that would be
required to keep mean patient waiting time at a desired level.
A desired mean waiting time for patients must be determined. In our setting, a mean waiting time of 8 minutes resulted in
few complaints. The waiting time then sets the required utilization rate of available capacity. Daily and hourly volume and
variability in volume of examinations were measured over a 3-month period. This represents the demand. The needed number of
rooms is determined by comparing demand with effective available capacity for different numbers of rooms.
To maintain an 8-minute mean waiting time, 50% utilization of capacity is required. Mean demand on Sundays is 176 examinations.
Five rooms are required, since this gives a 180-examination effective capacity.
Using waiting time as the primary decision criterion for making capacity decisions in emergency radiology has several advantages:
the method is easy to use, volume variability is taken into account, and the focus is on service to patients. 相似文献
10.
Cleveland Clinic Lerner College of Medicine (CCLCM) is an innovative, five-year medical education track within Case Western Reserve University School of Medicine (Case) with a focused mission to attract and educate a limited number of highly qualified persons who seek to become physician investigators. CCLCM curriculum governance, faculty appointments and promotions, and admissions committees are integrated with respective Case committees. The CCLCM curriculum is based on faculty-defined professional attributes that graduates are expected to develop. These attributes were used to create curricular and assessment principles that guided the development of an integrated basic science, clinical science, and research curriculum, conducted in an active learning environment. An organ-system approach is used to solidify an understanding of basic science discipline threads in the context of relevant clinical problems presented in PBL and case-based discussion formats. Clinical skills are introduced in the first year as part of the two-year longitudinal experience with a family practice or internal medicine physician. The research program provides all students with opportunities to learn and experience basic and translational research and clinical research before selecting a research topic for their 12- to 15-month master-level thesis project. All Case students participate in required and elective clinical curriculum after the second year, but CCLCM students return to the Cleveland Clinic on selected Friday afternoons for program-specific research and professionalism-learning activities. A unique portfolio-based assessment system is used to assess student achievements in nine competency areas, seven of which reflect the Accreditation Council for Graduate Medical Education competencies. 相似文献