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.

Medical management of appendicitis in early-term pregnancy.

Abstract: A 19-year-old G1 at 37 weeks presented with acute non-ruptured appendicitis. Her advanced gestational age and surgical anatomy presented a complex surgical scenario. She was treated with intravenous antibiotics and induction of labour, which resulted in resolution of the appendicitis and an uncomplicated vaginal delivery at early term. This case is an example that appendicitis occurring in early-term pregnancy can be successfully managed with intravenous antibiotics, but this is a complex clinical scenario with a limited evidence base to make management decisions. Future studies of medical management of appendicitis in pregnancy, specifically in later gestation, are needed to provide additional information to guide clinicians.

The Elderly Patient

Abstract: The geriatric population is the fastest growing age group today, and geriatric trauma accounts for a significant proportion of admissions to trauma centers. Due to functional changes with age, preexisting diseases, and pre-injury medications, geriatric trauma patients have limited physiological reserves and, therefore, require much more aggressive evaluation and treatment than their younger counterparts. A low threshold for field triage directly to a trauma center is warranted in elderly trauma patients. The primary and secondary survey follows ATLS guidelines; however, age-related conditions impact patient evaluation. The treatment algorithms for penetrating trauma in the elderly are no different. In any bleeding elderly patient, consider damage control interventions early. Selective nonoperative management of penetrating solid organ injuries, applied in many young trauma victims, is more likely to fail in older patients and, in general, should be reserved for low-grade injuries. When managed successfully, a significant number of elderly patients sustaining penetrating trauma will be able to return to levels of reasonable function and thus justify aggressive management.

Myomatous Erythrocytosis Syndrome: A Case Report

Abstract: We report the case of a 36-year-old woman with erythrocytosis due to ectopic erythropoietin production by a very large uterine leiomyoma. Awareness of this uncommon condition is important so that the correct diagnosis can be suggested prior to surgery and radical resection can be avoided.

Utilizing Optical Coherence Tomography in Glaucoma Management

Abstract: The diagnosis of glaucoma relies on identifying characteristic structural damage of the optic nerve head and corresponding loss of visual function. Historically, the assessment of structural damage was limited to clinical examination and optic disc stereoscopic photographs and was oftentimes subjective. With the advent of spectral-domain optical coherence tomography (SD-OCT), which allows for faster scan speeds and improved spatial resolution, the clinical use of OCT for the diagnosis of glaucoma and detection of glaucomatous progression has become widespread. SD-OCT allows for objective assessment of the circumpapillary retinal nerve fiber layer and optic nerve head, and research studies have demonstrated high sensitivity and specificity for the detection of glaucoma. Progression may be detected through event-based analysis, which compares current and baseline scans, or trend-based analysis, which employs change analysis software to detect the presence and rate of progression. Several factors, including scan quality, artifact, segmentation errors, refractive error, ethnicity, and glaucoma severity may affect scan results, and examiners should be aware of these factors to avoid incorrect scan interpretation. Examiners should also be aware of limitations of reference databases, which vary between devices. Ongoing research is being conducted to examine the structure-function relationship between retinal ganglion cell loss, estimated by SD-OCT or newer swept-source OCT technology, as well as combining various OCT measurements to improve the accuracy of detecting glaucoma and its progression.