Jewish Hospital

About: Jewish Hospital is a healthcare organization based out in Cincinnati, Ohio, United States. It is known for research contribution in the topics: Antigen & Population. The organization has 3881 authors who have published 3414 publications receiving 123044 citations.

Clinical Outcomes of Postmastectomy Radiation Therapy After Immediate Breast Reconstruction

Abstract: Purpose To determine the long-term complication rates and cosmetic results for patients undergoing postmastectomy radiation therapy (PMRT) after immediate reconstruction (IR). Methods and Materials Between January 1998 and December 2005, 92 patients underwent modified radical mastectomy, IR, and PMRT in our practice. A total of 69 patients underwent tissue expander and implant reconstruction (TE/I), and 23 underwent autologous tissue reconstruction (ATR). Follow-up regarding complications and cosmesis was obtained for all 92 patients. Complications were scored as follows: Grade 1, no discomfort; Grade 2, discomfort affecting activities of daily living; Grade 3, surgical intervention or intravenous antibiotics required; and Grade 4, removal or replacement of the reconstruction. Cosmesis was rated as either acceptable or unacceptable to the patient. Both complications and cosmesis were correlated with treatment- and patient-related factors. Results Median follow-up for all patients was 38 months. The overall rate of severe complications (Grade 3–4) was 25%. The overall rate of poor functional results (Grade 2–4) was 43.4%. When analyzed as a function of type of reconstruction, the rate of Grade 3 to 4 complications was 33.3% for TE/I vs. 0% for ATR ( p = 0.001). The rate of Grade 2 to 4 complications was 55% for TE/I vs. 8.7% for ATR ( p p = 0.007). No other treatment or patient-related factors had a significant impact on either complications or cosmesis. Conclusion In patients undergoing PMRT after IR, ATR is associated with fewer long-term complications and better cosmetic results than TE/I.

Metformin, pre-eclampsia, and pregnancy outcomes in women with polycystic ovary syndrome.

Abstract: Aims Was metformin during pregnancy in women with polycystic ovary syndrome (PCOS) associated with pre-eclampsia, and was it safe for mother and neonate? Methods In the current study, pre-eclampsia and other pregnancy outcomes were prospectively studied in 90 women with PCOS who conceived on metformin 1.5–2.55 g/day, and had ≥ 1 live birth (97 pregnancies, 100 live births) compared with 252 healthy women (not known to have PCOS) with ≥ 1 live birth, consecutively delivered in a community obstetrics practice. Results Women with PCOS were older than controls (33 ± 5 vs. 29 ± 6 years, P 35 years old at conception (23 vs. 13%, P = 0.028), much heavier (93 ± 23 vs. 72 ± 18 kg, P < 0.0001, BMI 33.8 ± 7.8 kg/m2 vs. 25.6 ± 5.9, P < 0.0001), and more likely to be Caucasian (97 vs. 90%, P = 0.05), but there were similar numbers with preconception Type 2 diabetes mellitus [2/90 (2.2%) vs. 1/252 (0.4%), P = 0.17]. Pre-eclampsia in PCOS (5/97 pregnancies, 5.2%), did not differ (P = 0.5) from controls (9/252, 3.6%), nor did it differ (P = 1.0) in PCOS vs. control primigravidas [2/45 (4.4%) vs. 4/91 (4.4%)]. Development of gestational diabetes in PCOS did not differ from controls [9/95 pregnancies (9.5%) vs. 40/251 (15.9%), P = 0.12]. Of the 100 live births to 90 women with PCOS, there were no major birth defects. Mean ± sd birth weight of the 80 live births ≥ 37 weeks gestation in women with PCOS (3414 ± 486 g) did not differ from controls’ 206 live births ≥ 37 weeks (3481 ± 555 g), P = 0.34, nor did the percentage of ≥ 37 week gestation neonates ≥ 4000 g (12.5 vs. 17.5%, P = 0.3) or ≥ 4500 g (1.3 vs. 2.9%, P = 0.7). Conclusions Metformin is not associated with pre-eclampsia in pregnancy in women with PCOS, and appears to be safe for mother and fetus.

MR diagnosis of rotator cuff tears of the shoulder: value of using T2-weighted fat-saturated images.

Abstract: The purpose of this study was to compare the use of fat-saturated T2-weighted spin-echo MR imaging with that of conventional T2-weighted spin-echo MR imaging to detect full- and partial-thickness tears of the rotator cuff of the shoulder, using arthroscopy as the standard for the diagnosis.Forty-nine consecutive patients with shoulder pain who had both MR imaging and arthroscopy of their affected shoulders were studied. The study group consisted of 10 patients with full-thickness tears of the rotator cuff, 20 with partial-thickness tears of the rotator cuff, and 19 with intact rotator cuff tendons proved arthroscopically. All patients had T1-weighted, conventional T2-weighted, and fat-saturated T2-weighted MR images obtained in a plane slightly oblique to the coronal plane along the long axis of the supraspinous tendon. The images were divided into two sets, one including both T1-weighted and conventional T2-weighted images, the other including T1-weighted and fat-saturated T2-weighted images. Two musculo...