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.

Craniosynostosis and Congenital Craniofacial Disorders

Abstract: Craniosynostosis refers to the premature fusion of cranial sutures and is often associated with ophthalmologic comorbidities. These associations include, but are not limited to, significant refractive errors, strabismus, ocular adnexal and orbital malformations, and structural abnormalities of the globe. Diagnosis and treatment of the various craniosynostoses and related syndromes can be difficult and is often managed by utilizing a team of physicians who specialize in craniofacial disorders. The role of the ophthalmologist in monitoring the visual development of these patients is extremely important. He or she must be knowledgeable of the common and potentially sight-threatening ocular findings in craniosynostosis.

Cochlear Nerve Canal Stenosis: Association With MYH14 and MYH9 Genes.

Abstract: The bony cochlear nerve canal transmits the cochlear nerve as it passes from the fundus of the internal auditory canal to the cochlea. Stenosis of the cochlear nerve canal, defined as a diameter less than 1.0 mm in transverse diameter, is associated with inner ear anomalies and severe to profound congenital hearing loss. We describe an 11-month-old infant with nonsyndromic congenital sensorineural hearing loss with cochlear nerve canal stenosis. Next-generation sequencing revealed heterozygous mutations in MYH9 and MYH14, encoding for the inner ear proteins myosin heavy chain IIA and IIC. The patient's hearing was rehabilitated with bilateral cochlear implantation.

Chronic Asthma Therapy

Abstract: 1. Kenny Y.C. Kwong, MD* 2. Craig A. Jones, MD† 1. 2. *Assistant Clinical Professor of Pediatrics, Division of Allergy-Immunology. 3. 4. †Assistant Professor of Pediatrics, Chief, Division of Allergy-Immunology, LAC+USC Medical Center, Los Angeles, CA. Dr Jones has received grants from and has served as a speaker and consultant for the following companies: Glaxo-Wellcome, Merck, Schering, Pfizer, and Hoechst Marion Roussel. Upon completing the article, the reader should be able to: 1. Describe the symptoms of persistent asthma with chronic airway inflammation. 2. List the types of medications required by patients who have persistent asthma. 3. Delineate the coexisting conditions that can exacerbate asthma. 4. Describe the benefits and risks of inhaled steroids for the treatment of persistent asthma. 5. List the benefits of an asthma action plan for a patient. During the past 20 years, asthma-related morbidity and mortality have increased in industrialized countries worldwide. This has led to expanded research on the pathophysiology of the disease and the development of more effective therapeutic agents for its control. In addition, national and international organizations have established and disseminated guidelines for the evaluation and treatment of asthma. Despite these efforts, asthma remains a leading cause of pediatric emergency department visits and hospitalizations. However, these trends in outcomes can be reversed through early recognition of disease severity and initiation of appropriate preventive therapy. Current emphasis in asthma therapy is directed toward accurate assessment of asthma severity, avoidance of environmental risk factors, and appropriate use of agents to control inflammation in the airways. This strategy is based on an improved understanding of the pathogenesis of asthma and an appreciation of the link between airway inflammation, airway hyper-responsiveness, and asthma severity. The pathophysiology of this disease is a complex interplay between inflammation, structural airway changes, and airway responsiveness. Persistent airway inflammation, characterized by the presence of CD4+ lymphocyte subsets (TH2), eosinophils, and mast cells, is considered central to the disease process (Fig. 1⇓) . This inflammation has been associated with an increase in airway responsiveness to various stimuli and pathologic airway changes, including epithelial cell damage, airway edema, airway smooth muscle hypertrophy, mucous gland hypertrophy, and abnormal collagen matrix deposition with thickening of the basement membrane. Long-term …

Initiating a Standard Venous Thromboembolism Prophylaxis Order Set Designed to Improve Patient Outcomes at Los Angeles County+University of Southern California.

Abstract: Improving patient safety is vital for all hospitals due to increasing public reporting and pay-for-performance reimbursement Venous thromboembolism (VTE) remains a leading cause of preventable mortality accounting for 5 per cent of inpatient deaths The purpose of this study was to outline the process of implementing standard VTE prophylactic order sets in a 600-bed academic safety net hospital and assess the resulting change in patient outcomes Outcomes were assessed by comparing the rate that eligible inpatients receive VTE prophylaxis and the rate of preventable VTE's compared with total VTE's From 2011 to 2015, random samples of 60 Los Angeles County+University of Southern California inpatients were generated monthly to examine compliance rates by comparing ICD-9 diagnostic codes to ordered VTE prophylaxis All inpatient VTE's are retrospectively analyzed Baseline-ordered VTE prophylaxis was 37 per cent in 2010 The target of 85 per cent was exceeded by the second quarter of 2012 to 2013 when compliance reached 88 per cent, a 51 per cent increase from baseline (P < 001) These results suggest VTE protocols are effective though standardization across service lines is often difficult Despite these challenges, after implementing standard order sets, we saw compliance increase significantly Ongoing analysis to determine whether VTE rates have significantly decreased is presently underway

A novel approach for US-guided central venous cannulation in phantom models: the oblique technique

Abstract: reduction in the rate of PVWP with the oblique technique. We detected a higher likelihood of PVWP with SA (22%, 95% CI 11-32%) versus LA (5%, 95% CI -1-11%), or oblique (10%, 95% CI 2-18%) (Pearson chi2 8.2; df=2; p=0.02). Conclusion The three techniques for US-guided central vessel cannulation are equivalent with respect to time to cannulation and rates of successful cannulation. The SA technique for US-guided central access is associated with a significant increase in PVWP when compared with LA or oblique approaches. This deserves further investigation, as it is the most frequently employed technique.