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Overview of Various Birth Control Options. 各种避孕方法概述。
Connecticut Medicine Pub Date : 2017-03-01
Alyssa Boutin, Corinne Ewing
{"title":"Overview of Various Birth Control Options.","authors":"Alyssa Boutin, Corinne Ewing","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"173-179"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107840","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
Widespread Systemic and Peripheral Embolization of Left Atrial Myxoma Following Blunt Chest Trauma. 钝性胸外伤后左心房黏液瘤的广泛全身和外周栓塞。
Connecticut Medicine Pub Date : 2017-03-01
Woo Cheal Cho, Anshu Trivedi
{"title":"Widespread Systemic and Peripheral Embolization of Left Atrial Myxoma Following Blunt Chest Trauma.","authors":"Woo Cheal Cho,&nbsp;Anshu Trivedi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiacmyxomas arethemostcom- mon benign primary cardiac neoplasms, typically arising from the interatrial septum at the border of the fossa ovalis.'Ihey are generally divided into two anatomic types - ovoid and papillary myxomas -the latter ofwhich are less common but more frequently associated with embolic events. Despite their high embolic potential, however, widespread systemic and peripheral embolization, particularly to the lower extremities, is still uncommon. Furthermore, systemic tumor embolization secondary to trauma is only rarely reported and predominantly associ- ated with major blunt force trauma, such as motor vehicle accidents. Herein, we report a case of a 24-year-old male with widespread systemic and peripheral embolization of a left atrial myxoma, resulting in bilateral lower extremity ischemia, as well as multiple infarcts in major solid organs, in- cluding the heart, triggered by blunt chest trauma incurred during a basketball game.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"153-156"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108392","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
First, Do No Legislative Harm. 第一，不要立法伤害。
Connecticut Medicine Pub Date : 2017-03-01
Matthew C Katz
{"title":"First, Do No Legislative Harm.","authors":"Matthew C Katz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"187-189"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107837","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
Otologic Pathology and Hearing Loss in Children with Down Syndrome, 6 - 18 Years Old. 6 - 18岁唐氏综合症儿童的耳科病理和听力损失。
Connecticut Medicine Pub Date : 2017-03-01
Scott R Schoem
{"title":"Otologic Pathology and Hearing Loss in Children with Down Syndrome, 6 - 18 Years Old.","authors":"Scott R Schoem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ihis article is a retrospective, sin- gle-center, single-surgeon review of all patients with Down syndrome (Trisomy 21) seen at a free- standing children's hospital between January 2000 and December 2011. The aim was to assess for un- recognized otologic pathology and hearing impair- ment in all new patients between six and 18 years old. Two-hundred-nine patients were seen during the study time frame. Fifty-one patients underwent ear tube surgery with eight patients undergoing surgery for at least three sets of ear tubes. Four patients underwent more advanced ear surgeries for perforation, severe retraction with conductive hearing loss, or acquired cholesteatoma.'Ihere were no cervical subluxations or dislocations periopera- tively. 'Ihirty-six of 47 patients between six and 18 years old had some degree of hearing impairment. 'he success rate of otologic surgery is similar to the non-Down syndrome population. A more compre- hensive database should be developed to ascertain the incidence ofhearingimpairmentin school-aged children with Down syndrome.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"141-143"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108390","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
Paraneoplastic Erythema Nodosum as a Prelude to Hodgkin Lymphoma. 副肿瘤结节性红斑是霍奇金淋巴瘤的前奏。
Connecticut Medicine Pub Date : 2017-03-01
Yazeed Samara, Justin Thomas, Constantin A Dasanu
{"title":"Paraneoplastic Erythema Nodosum as a Prelude to Hodgkin Lymphoma.","authors":"Yazeed Samara,&nbsp;Justin Thomas,&nbsp;Constantin A Dasanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Erythema nodosum is currently thought to represent a delayed hypersensitivity reac- tion to deposition of circulating immune complexes, followed by neutrophilic infiltration of the septa in the subcutaneous tissue. We describe a patient with advanced Hodgkin lymphoma with B symptoms, preceded by erythema nodosum of the left shin by 12 weeks. This dermatologic entity cleared after the treatment for Hodgkin lymphoma, suggesting a true paraneoplastic reaction. Given its known temporal association with Hodgkin lymphoma, we believe that this link deserves more exploration in both re- search laboratories and clinical practice.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"157-160"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108393","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
Uncertainty Among Acute Care Surgery Providers Does Not Change with Experience. 急性护理手术提供者的不确定性不会随着经验而改变。
Connecticut Medicine Pub Date : 2017-03-01
Bishwajit Bhattacharya, Adrian Maung, Kevin Schuster, Kimberly A Davis
{"title":"Uncertainty Among Acute Care Surgery Providers Does Not Change with Experience.","authors":"Bishwajit Bhattacharya,&nbsp;Adrian Maung,&nbsp;Kevin Schuster,&nbsp;Kimberly A Davis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute care surgery (ACS) is a demanding profession that is by its na- ture unpredictable and requires practitioners to routinely deal with uncertainty and stress. We hy- pothesized that the field attracts people who are comfortable working in such an environment and that their comfort with uncertainty increases with experience. A surgeon's stress with uncertainty can be assessed usingthe previouslyvalidated Physician Reaction to Uncertainty Scale (PRU scale).</p><p><strong>Methods: </strong>After approval from our IRB and the Eastern Association for the Surgery of Trauma (EAST) Research and Scholarship Committee, an online-survey was sent to EAST members. The survey included demographic questions and the PRU scale. 'The PRU scale requires answering 15 questions on a scale of one to six (strongly disagree to strongly agree) with four subsections measuring anxiety to uncertainty, concern about outcomes, reluctance to disclose uncertainty to patients, and reluctance to disclose mistakes to physicians. A higher score represents greater discomfort. Survey requests were sent to 1707 members; 424 surveys were complete and used for analysis.</p><p><strong>Results: </strong>Most respondents were surgeons (92.4%) and male (77.1%). Average total score was 40.4/90. Overall discomfort with uncertainty on the PRU scale did not vary with gender (p = .88), experience (P=.11), age (P=.21), or practice location (P=.26). With increased experience, there was decreased re- luctance to disclose uncertaintyto patients (P = .03) and a trend to decreased anxiety about outcomes (P=.09).</p><p><strong>Conclusion: </strong>Overall discomfort with uncertainty among ACS providers appears to be inherent in their personality and does not change over a career span.'Ihis factor may play a role in the development of occupational stress since discomfort with uncer- tainty appears to persist over time. Future studies looking at other surgical specialties for comparison and atlongitudinal studies may provide insight into the personality of the community.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36108389","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 DOI: 10.1097/00152193-198911000-00034
J. A. Gordon
{"title":"Remembering the Basics.","authors":"J. A. Gordon","doi":"10.1097/00152193-198911000-00034","DOIUrl":"https://doi.org/10.1097/00152193-198911000-00034","url":null,"abstract":"","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3 1","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00152193-198911000-00034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44013597","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
Acute Disseminated Encephalomyelitis Following Meningococcal Vaccination: Case Report and Review of the Literature. 脑膜炎球菌接种后急性播散性脑脊髓炎:病例报告及文献回顾。
Connecticut Medicine Pub Date : 2017-02-01
Rosana Gnanajothy, Lauren Frederic Visserman, Kanaga N Sena
{"title":"Acute Disseminated Encephalomyelitis Following Meningococcal Vaccination: Case Report and Review of the Literature.","authors":"Rosana Gnanajothy,&nbsp;Lauren Frederic Visserman,&nbsp;Kanaga N Sena","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 17-year-old female presentedwith acute disseminated encephalomyelitis (ADEM), a demyelinating disease ofthe central nervous system, fourweeks after receiving a meningococcalvaccination. The report highlights a rare but known presen- tation following routine vaccination that requires a high degree ofsuspicion in recognition and management. Early initiation of steroid therapy, followed by a steroid taper over one month resulted in a favorable outcome of complete neurological recovery.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 2","pages":"103-106"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36078194","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
Levamisole-Adulterated Cocaine-Induced Skin Lesions: A Case Report and Literature Review. 左旋咪唑掺假可卡因致皮肤病变1例报告及文献复习。
Connecticut Medicine Pub Date : 2017-02-01
Dipen B Khanapara, Amruta Panwala, Bhavtosh Dedania, Edgar R Naut
{"title":"Levamisole-Adulterated Cocaine-Induced Skin Lesions: A Case Report and Literature Review.","authors":"Dipen B Khanapara,&nbsp;Amruta Panwala,&nbsp;Bhavtosh Dedania,&nbsp;Edgar R Naut","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Levamisole is used as an agent to increase the total weight of street cocaine. We report the case of a 28-year-old female who presented with multiple painful, ulcerating lesions. She tested positive for cocaine and levamisole. Her skin lesions improved with abstinence from cocaine. Patients with levamisole-induced toxicity most often present with skin manifestations or joint pain. Leukopenia, neutropenia, and agranulocytosis are common lab abnormalities seen in these patients. Complete resolution of the skin lesions are observed approximatelythree weeks after abstinence. Patients known to use street drugs, who present with unexplained skin rash, neutropenia, and multiple immunological abnormalities, should be tested for both cocaine and levamisole. Urine toxicology screen is positive for cocaine approximately 72 hours after ingestion. Levamisole requires specialized testing that is not readily available commercially andis positive forless than 48 hours after exposure.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 2","pages":"95-98"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36078192","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
Anticoagulation in Cardiobacterium hominis Prosthetic Valve Endocarditis in a Patient with Hypercoagulability: A Clinical Dilemma. 高凝患者的人心杆菌人工瓣膜心内膜炎的抗凝治疗:一个临床困境。
Connecticut Medicine Pub Date : 2017-02-01
Natasha Mamdani, Jatan Shah, Michael Simms
{"title":"Anticoagulation in Cardiobacterium hominis Prosthetic Valve Endocarditis in a Patient with Hypercoagulability: A Clinical Dilemma.","authors":"Natasha Mamdani,&nbsp;Jatan Shah,&nbsp;Michael Simms","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiobacterium hominis is an uncommon cause of prosthetic valve endocarditis (PVE) and often presents insidiously. In comparison, prosthetic valve thrombosis (PVT) is a rare, but life-threatening condition that commonly occurs due to inadequate anticoagulation. Anticoagulation is relatively contraindicated in patients with endocarditis as it may prove to be lethal due to increased risk of cerebral hemorrhage. However, anticoagulation is required in patients with PVT, or for its prevention. We present a case of a 35-year-old male with a history of hypercoagulability and St. Jude's aortic valve on warfarin, who presented with chest pain andwas found to have a mass on the aorticvalve, with blood cultures revealing C. hominis.The patient was treated with appropriate antibiotics and anticoagulation was continued. No neurological complications were noted during the treatment period. This case demonstrates that carefully weighing the risks and benefits of continuing anticoagulation is essential in preventing poor outcomes.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 2","pages":"99-101"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36078193","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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