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Pseudo-Atrial Flutter Secondary to a Chest Wall Percussion Device. 假性心房扑动继发于胸壁打击器。
Connecticut Medicine Pub Date : 2017-04-01
Gregory R Madden, John J Chang
{"title":"Pseudo-Atrial Flutter Secondary to a Chest Wall Percussion Device.","authors":"Gregory R Madden,&nbsp;John J Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pseudo-atrial flutter is an EKG artifact that mimics a true atrial flutter. We report a case of pseudo-atrial flutter in a 67-year-old male with quadriplegia and ventilator dependence due to amyotrophic lateral sclerosis (ALS) who was hospitalized for respite care. Ihe pseudo-atrial flutterwas found to be due to percussions from a built-in chest wall percussion device in a hospital mattress used for chest physiotherapy.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 4","pages":"231-233"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36058347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pectus Carinatum: Factors That Contribute to Success and Failure of Nonoperative Treatment. 胸突:影响非手术治疗成败的因素。
Connecticut Medicine Pub Date : 2017-04-01
Shefali Thaker, Matthew Anderson, James Fezio, Christine Rader, Meghna V Misra
{"title":"Pectus Carinatum: Factors That Contribute to Success and Failure of Nonoperative Treatment.","authors":"Shefali Thaker,&nbsp;Matthew Anderson,&nbsp;James Fezio,&nbsp;Christine Rader,&nbsp;Meghna V Misra","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pectus carinatum is a congenital chest wall deformity characterized by protrusion ofthe sternum and ribs. External bracing has been the gold standard treatment for this condition for the past 20 years.</p><p><strong>Purpose: </strong>The primary purpose of the study was to identify factors that contribute to treatment success of bracing for patients with pectus carinatum. The secondary aim was to identify the optimal age to recommend bracing for pectus carinatum.</p><p><strong>Methods: </strong>176 patients who were evaluated for a brace for pectus carinatum were contacted to participate in an online survey about their experience. A retrospective chart review was conducted on patients who participated in the survey.</p><p><strong>Results: </strong>Subjects rated themselves as more confident afterbracing(P=.002). Patients who hadfamily sup- port, and no documented complaints (P = .024) and (P = .009) respectively, were more likely to say they had made the right choice to wear the brace.</p><p><strong>Conclusions: </strong>This study demonstrated that family support and fewer complaints are predictors of success for the brace.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 4","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36058342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tragus Piercing Presenting as a Novel Risk Factor with Magnetic Resonance Imaging. 磁共振成像显示耳屏穿孔是一种新的危险因素。
Connecticut Medicine Pub Date : 2017-04-01
Shuo Li, Neeraj Bhatt, Nishant Gupta, Yogesh Kumar, Mark A Rosovsky
{"title":"Tragus Piercing Presenting as a Novel Risk Factor with Magnetic Resonance Imaging.","authors":"Shuo Li,&nbsp;Neeraj Bhatt,&nbsp;Nishant Gupta,&nbsp;Yogesh Kumar,&nbsp;Mark A Rosovsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although magnetic resonance imaging (MRI) excels in a number of medical imaging utilities, one of its particular attraction is the lack of ionizing radiation. However, MRI scans are associated with their own unique safety concerns. We encountered two cases of lost tragus piercings presenting as a novel risk factor in MRI safety. The lost tragus piercings caused temporary discomfort and pain but were able to be removed without complication. Heightened awareness for this potential source of patient harm, particularly with more individuals obtaining body piercings, is necessary for appropriate patient screening.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 4","pages":"227-229"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36058346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bilateral Giant Cell Arteritis Presenting as Bilateral Sudden Vision Loss. 双侧巨细胞动脉炎表现为双侧突发性视力丧失。
Connecticut Medicine Pub Date : 2017-04-01
Dhruv K Modi, Khusbboo Sheth, Stefanie Wade, Rochelle Castillo, Sukrut Nanavaty, Syed Salman Ali
{"title":"Bilateral Giant Cell Arteritis Presenting as Bilateral Sudden Vision Loss.","authors":"Dhruv K Modi,&nbsp;Khusbboo Sheth,&nbsp;Stefanie Wade,&nbsp;Rochelle Castillo,&nbsp;Sukrut Nanavaty,&nbsp;Syed Salman Ali","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) is the most common form of primary vasculitis and it mainly involves large to medium sized vessels. It is also referred to as temporal arteritis as it primarily affects the temporal artery. Ocular involvement frequently occurs in GCA; if not promptly diagnosed, it can cause devastating ocular complications including complete vision loss and permanent blindness. In the majority of cases, it is unilateral; however, there are rare instances where bilateral ocular involvement is reported. In our report, we present the case of a patient presenting with bilateral sudden vision loss associated with GCA.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 4","pages":"235-236"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36058348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Titer of Circulating Antiglutamic Acid Decarboxylase Antibodies in a Patient with Cerebellar Ataxia and Type 1 Diabetes. 1例小脑性共济失调合并1型糖尿病患者循环抗谷氨酸脱羧酶抗体的高滴度检测。
Connecticut Medicine Pub Date : 2017-03-01
Rachna Kataria, Sushmitha Fernandes, Jasmin Lebastchi, Claudio A Bravo, Kanaga N Sena
{"title":"High Titer of Circulating Antiglutamic Acid Decarboxylase Antibodies in a Patient with Cerebellar Ataxia and Type 1 Diabetes.","authors":"Rachna Kataria,&nbsp;Sushmitha Fernandes,&nbsp;Jasmin Lebastchi,&nbsp;Claudio A Bravo,&nbsp;Kanaga N Sena","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 24-year-old female who was recently diagnosed with Type 1 diabetes mellitus (TiD) presented with a five-year history of visible gait disturbance and slurred speech. Her neurologic examination was remarkable for dysarthria, bilateral nystagmus, dysdiadochokinesia, finger-nose incoordination, heel-knee incoordination, and ataxic gait. A brain MRI disclosed diffuse cerebellar atrophy. Her serum antiglutamic acid decarboxylase (GAD) antibody titer was elevated. Antinuclear antibody (ANA) test was positive with atiterofl:2560 and a speckledpattern. Genetictests for inherited ataxia, including Friedreich ataxia, were negative for mutations. Her cerebrospinal fluid (CSF) analysis revealed oligoclonal bands and she had a positive CSF GAD65 antibody. A diag- nosis of GAD antibody-induced cerebellar ataxia was considered. She developed GAD autoimmune antibody positive TiD during the course ofher dis- ease. GAD antibody-associated cerebellar ataxia is a rare entity, however it should be considered as a possibility in patients with associated autoimmune disease and positive anti-GAD antibody.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"161-164"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent Vulvar Carcinoma in a Skin Graft: A Case Reiort and Review of the Literature. 皮肤移植后外阴癌复发一例报告及文献复习。
Connecticut Medicine Pub Date : 2017-03-01
James M Clark, Michael P Hopkins, Emilia Krol, Daniel Chase, Dorothy Sparks
{"title":"Recurrent Vulvar Carcinoma in a Skin Graft: A Case Reiort and Review of the Literature.","authors":"James M Clark,&nbsp;Michael P Hopkins,&nbsp;Emilia Krol,&nbsp;Daniel Chase,&nbsp;Dorothy Sparks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recentyears, theincidence ofvul- var carcinoma has increased over 400%, specifically in the population of young women. We present a patient with an extensive history of recurrent vulvar carcinoma in situ who underwent multiple surgi- cal procedures and subsequent reconstruction with a skin graft, who then returned with a rare recur- rence in the graft. Multiple hypotheses have been proposedto explain the recurrence ofthis type ofcar- cinoma; however, none provides a solid explanation. It has been noted that the increase in the incidence of vulvar cancer correlates with the increased incidence of HPV infection; the relationship between the two has been well-established. In conclusion, we recommend close and long-term follow-up for high-risk patients with this type of neoplasm.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"165-167"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemodilution Then Hemoconcentration after Resuscitation of Patients with Severe Sepsis or Septic Shock. 严重脓毒症或感染性休克患者复苏后血液稀释和血液浓缩。
Connecticut Medicine Pub Date : 2017-03-01
Olurotimi Adekolu, Constantine A Manthous
{"title":"Hemodilution Then Hemoconcentration after Resuscitation of Patients with Severe Sepsis or Septic Shock.","authors":"Olurotimi Adekolu,&nbsp;Constantine A Manthous","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The impact of fluid ri suscitation on hematologic parameters and function has been well studied in hemorrhagic shock. Similar research has not been conducted in resuscitation of septic shock.</p><p><strong>Hypothesis: </strong>In the absence of accompanying hemorrhage, resuscitation of patients with sepsis should be marked by hemodilution, followed by hemoconcentration during recovery.</p><p><strong>Methods: </strong>Records of patients with primary diagnoses of severe sepsis or septic shock treated in a community hospital intensive care unit (ICU) between 2009 and 2012 were extracted from an electronic d tabase for analysis. Demographic, physiologic, an laboratory values were recorded at daily intervals.</p><p><strong>Results: </strong>132 patients with an average age of 70. (SD 15.1) years and Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 15. (6.0) were studied. Patients spent an average of 10. (9.9) days in the ICU and 18.9 (12.0) days in hospita 19 (14.4%) did not survive hospitalization. Mean admission hematocrit was 34.8 (6.5%), and lo\"m est hematocrit, adjusted for (average 0.2 U PRBC) transfusions, 25.3 (5.1)% (P < .001), occurred after an average of four days of treatment, and 7.2 (5.4 L of cumulative positive fluid balance. By day 10 adjusted hematocritincreased to 26.9(8.1) (P =.006' 'Ihere was a significant (P < .001) albeit loose correlation (R = .35) of cumulative positive fluid balance associated with lowest hematocrit.</p><p><strong>Conclusion: </strong>Fluid resuscitation of patients with severe sepsis or septic shock is marked by initial reductions of hematocrit followed by increases during recovery, as fluid is mobilized.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"169-171"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Remembering the Basics. 记住基本知识。
Connecticut Medicine Pub Date : 2017-03-01
Jeffrey A Gordon
{"title":"Remembering the Basics.","authors":"Jeffrey A Gordon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Partial Denervation and Anterior Release of the Hip Joint Capsule to Relieve Pain and Improve Function at Five Years Follow-up. 5年随访:部分去神经和髋关节囊前松解缓解疼痛和改善功能。
Connecticut Medicine Pub Date : 2017-03-01
Izuchukwu Ibe, Matthew L Webb, Andrea Halim, Stephen Nelson, Kristaps Keggi
{"title":"Partial Denervation and Anterior Release of the Hip Joint Capsule to Relieve Pain and Improve Function at Five Years Follow-up.","authors":"Izuchukwu Ibe,&nbsp;Matthew L Webb,&nbsp;Andrea Halim,&nbsp;Stephen Nelson,&nbsp;Kristaps Keggi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traditionally, patients with significant hip pain due to degenerative hip disease, who are not surgical candidates for a total hip arthroplasty (THA), or are wary of the procedure, have been managed with various modalities with variable effectiveness.</p><p><strong>Objectives: </strong>We have recently developed an anterior release of the contracted hip capsule along with par- tial denervation ofthe hip joint performed on an out- patient basis to relieve pain and improve function.</p><p><strong>Study design: </strong>A case series of 24 patients.</p><p><strong>Methods: </strong>From November 2007 to April 2009, 24 partial,denervation procedures through an anterior approach were performed by a single surgeon. A clinical survey was conducted five years following the intervention.</p><p><strong>Results: </strong>Eighteen ofthe 24 patients were alive at the time of follow-up. Four of the six patients who were deceased at the time of follow-up had not undergone aTHA while two had. Fifteen ofthe 18 patients who were still living received a THA while three did not. Ihe interval time to arthroplasty was 19 months.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"145-151"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Quality-Industrial Complex: Paying the Piper. 质量-工业综合体:承担责任。
Connecticut Medicine Pub Date : 2017-03-01
Michael M Deren
{"title":"The Quality-Industrial Complex: Paying the Piper.","authors":"Michael M Deren","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"181-183"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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