LAC+USC Medical Center

About: LAC+USC Medical Center is a healthcare organization based out in Los Angeles, California, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 1348 authors who have published 886 publications receiving 21927 citations. The organization is also known as: County/USC & Los Angeles County General.

Ground-Level Falls at Skilled Nursing Facilities Are Associated With More Serious Lower Extremity Injuries Compared With Home

Abstract: Ground-level falls (GLFs) are the number one cause of injury and death in the older adult population. We compared injury profiles of GLFs at SNFs to those at homes, hypothesizing that GLFs at SNFs would lead to higher risks for serious (AIS ≥ 3) traumatic brain injury (TBI) and lower extremity (LE) injuries compared to GLFs at home. The 2015-2016 Trauma Quality Improvement Program was used to compare patients sustaining GLFs at home and SNFs. From 15,873 patients sustaining GLFs, 14,306 (90.1%) occurred at home while 1,567 (9.9%) at SNFs. More patients with GLFs at SNFs were female, older, and had greater incidence of congestive heart failure, end-stage renal disease, and dementia (p < 0.001) compared to those at home. Although, GLF SNF patients had lower injury severity scores (9 vs. 10, p < 0.001) and incidence for TBI (28.0% vs 33.4%, p < 0.001), they had a higher rate of femur fractures (55.1% vs. 38.9%, p < 0.001). After controlling for female, end stage renal disease, smoking, dementia, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and stroke, patients falling at SNFs had an increased risk of sustaining serious LE injury AIS (OR 1.64, p < 0.001), but not serious TBI AIS (OR 0.89, p = 0.073). In conclusion, compared to GLFs at home, those at SNFs have a higher risk for serious LE injury, with femur fractures being the most common. However, GLFs at SNFs and homes had no significant difference in risk for serious TBI. Future studies are warranted to evaluate preventative measures to reduce LE injuries at SNFs.

Sarcomatoid Renal Cell Carcinoma Five Cases With lmmuno- and Lectin Histochemistry Supporting Proximal Tubular Origin

Abstract: Histologically, the sarcomatoid variant of renal cell carcinoma (SRCC) is a pleomorphic spindle or giant cell malignancy resembling a sarcoma. Clinically, SRCC is associated with a worse prognosis than common renal cell carcinoma (CRCC) of clear or granular cell types. The authors reviewed the clinical and pathologic findings in five cases of SRCC and performed avidin-biotin peroxidase staining with Leu-M1 and biotinylated lotus tetragonolobus lectin, which react with proximal tubules, biotinylated soybean and dolichos biflorus agglutinins, which react with distal tubules, cytokeratin AE 1, epithelial membrane antigen, and vimentin. Five of five SRCCs reacted with at least one marker of proximal tubular differentiation. No case reacted with distal tubular differentiation markers. Three of five cases were cytokeratin positive, one of five was epithelial membrane antigen positive, and zero of five were vimentin positive. Since most cases of CRCC react with proximal tubular markers, these findings suggest th...