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.

Computed Tomography and Magnetic Resonance Imaging in Abscess and Anal Fistula

Abstract: Cryptoglandular infection represents one of the oldest known surgically treated conditions and to this day continues to bewilder even the most experienced colorectal surgeons. Computed tomography (CT) and magnetic resonance imaging (MRI) are both valuable modalities with which to evaluate acute anorectal infections; however, they both have advantages and disadvantages in this setting. For example, CT scanning is readily available 24 hours a day in most major hospitals, and whereas it is perhaps most valuable when excluding ongoing concomitant infections, it has a very limited role in evaluating anal fistula. MRI is more effective than CT in evaluating softtissue structures, and the different MRI techniques now available, such as body-coil MRI, phased-array MRI, high-resolution MR fistulography, and subtraction fistulography, increases MRI utility for evaluating recurrent and complex anal fistulas. In fact, the current state of the art suggests that MRI is the gold standard for imaging such condition in most centers throughout the world.

Spindle cell carcinoma of the breast managed with neoadjuvant AIM: A case report.

Abstract: Spindle cell carcinoma (SpC), also known as metaplastic carcinoma-spindle cell type, is a subtype of metaplastic carcinoma. Metaplastic carcinomas of the breast are rare but are thought to be more aggressive than invasive ductal carcinomas. Due to their rarity, there are few randomized trials that can inform any standardized approaches to treatment. Treatment is instead extrapolated from other types of breast cancer or metaplastic carcinomas of different locations. Here we present the first known case report of a patient with spindle cell carcinoma of the breast successfully treated with a standard sarcoma neoadjuvant regimen of doxorubicin, ifosfamide, and mesna (AIM) that resulted in >99% necrosis of the tumor and negative margins at the time of resection.

Factors Associated with Longer Transportation Time to North American Style Emergency Department in Japan

Abstract: Japanese emergency departments have traditionally been separated into tertiary and secondary centers. Ter‐ tiary emergency centers focus on the care of trauma and critically ill patients, while secondary emergency cen‐ ters operate with limited resources and only accept patients of a limited acuity from emergency medical services (EMS). In contrast, North American-style Emergency Departments (NAED) have been developed, with the aim of accepting both critical and non-critical patients. We conducted a retrospective, observational study using mu‐ nicipal EMS records from 2012 in a Japanese city. Our aim was to identify patient characteristics associated with long EMS transportation times to NAED in an urban city where both traditional and NAED centers are available. The primary endpoint was long transportation time, defined as >35 minutes. Other items included the distance of transportation from the scene (km), age, sex, reason for transportation (medical or surgical), relevant specialty determined by EMS, condition severity, number of EMS negotiations until acceptance, and the reason for diversion by other hospitals. Multivariate logistic regression was used to find characteristics associated with long transportation time. A total of 2934 patients were included in the analysis. Median transportation time was 29 minutes (IQR 21–38). Characteristics that were associated with long transportation time included age (years) (OR, 1.02; 95%CI, 1.02–1.03; P<0.01), patients with orthopedic (OR, 1.69; 95%CI, 1.08–2.66; P=0.02) or neu‐ rosurgical (OR, 1.72; 95%CI, 1.21–2.47; P<0.01) conditions, and the number of EMS negotiations until accept‐ ance (OR, 4.08; 95%CI, 3.12–5.33; P<0.01). Long transportation times were negatively associated with patients with medical (OR, 0.66; 95%CI, 0.46–0.96; P=0.03) and ear nose and throat (ENT) (OR, 0.13; 95%CI, 0.04– 0.44; P<0.01) conditions. This is likely because the NAEDs fill an unmet need for patients that require certain types of care, such as surgical or neurosurgical treatment, or because they accept patients that have been refused by other centers.