New York Methodist Hospital

About: New York Methodist Hospital is a healthcare organization based out in Brooklyn, New York, United States. It is known for research contribution in the topics: Myocardial infarction & Percutaneous coronary intervention. The organization has 948 authors who have published 936 publications receiving 29954 citations.

Appropriate Use of Prophylactic Antibiotic Agents in Gynecologic Surgeries at a Midwestern Teaching Hospital.

Abstract: Background: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. Patients and Methods: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included. Based on published guidelines for prophylactic antibiotic agents for gynecologic surgery by ACOG, procedures were classified as antibiotic-indicated or antibiotic-not-indicated. Chi-square and Fisher exact test analysis were used to identify factors associated with antibiotic use. Results: Of the 1,735 cases eligible for inclusion, 1,045 (60.2%) had antibiotic agents recommended per guidelines, and appropriate antibiotic agents were given in 1,031 (98.7%) of those cases. In 690 (3...

Severe high-grade dysplasia and in-situ carcinoma of the common bile duct and pancreatic duct

Abstract: Tumours of the head of the pancreas and common bile duct present a serious surgical problem because they necessitate a complicated and extensive resection Pancreaticoduodenectomy (the Whipple procedure) is arguably the most difficult procedure in general surgery, but should only be considered if the tumour is locally contained when identified Because carcinomas of the pancreatic and common bile ducts tend to present late in the disease course, many of these lesions are unresectable However, due to advances in techniques of diagnosis and early detection, tumours that would have previously gone unrecognised are now being identified These small lesions, often discovered when they are at the stage of carcinoma in situ or high-grade dysplasia, present a new set of management dilemmas Commonly discussed examples include lobular neoplasia of the breast and the dysplasia associated with Barrett’s oesophagus 1,2 With more attention being paid to earlier detection and more careful pathological assessment, these previously overlooked histological features are attracting more interest We present a case of ampullary carcinoma with associated high-grade severe dysplasia throughout the common bile duct and pancreatic duct seen in the resected tissue This extent of dysplasia involving both ducts has only recently been reported and constitutes a difficult management dilemma A 73-year-old woman was admitted to hospital with a complaint of pruritis that had been getting persistently worse during the previous 2 months She had no other associated complaints including no pain, weight loss, or change in dietary habits She had a history of diabetes mellitus, hypertension, congestive heart failure, and asthma, and was being treated with losartan, amlodipine besylate, clonidine, furosemide, and insulin She had no allergies, had not previously had surgery, and there was no family history of cancer She had a 20 pack-year smoking history and drank alcohol occasionally On physical examination, she was alert and in no acute distress with no jaundice Abdominal examination revealed no palpable mass or tenderness The stool was normal colour and there was no occult blood on rectal examination She was found to have a high concentration of bilirubin of 14 mg/L, direct bilirubin 13 mg/L, alkaline phosphatase 833 u/L Her hepatitis serology tests were positive for hepatitis C Ultrasound of the upper abdomen showed a common bile duct of 10 mm, a pancreatic duct of 8 mm, and dilated intrahepatic ducts and a dilated gallbladder A computed tomography scan showed similar findings but no evidence of a pancreatic mass An endoscopic retrograde cholangiopancreatography (ERCP) was done and cytological analysis revealed adenocarcinoma The patient subsequently underwent the Whipple procedure During the operation it was established that there was no asceitis and no evidence of metastases or lymphadenopathy The antrum, duodenum, common bile duct, gallbladder, and head and uncinate process of the pancreas were all removed After initial postoperative care in

Endovascular treatment of a thrombosed intracardiac vena cava filter

Abstract: Intracardiac migration of a vena cava filter (VCF) is a rare but potentially fatal complication. We describe a unique case of intracardiac migration of a permanent VCF with extensive thrombus propagating into the inferior vena cava and right atrium. Percutaneous thrombectomy with the AngioVac (AngioDynamics, Latham, NY) device was performed, and the permanent VCF was percutaneously removed.

Perceived value of the american board of surgery certificate : A survey of 2,000 fellows of the american college of surgeons

Abstract: Background: This study was undertaken to identify perceptions of surgeons of the value of the American Board of Surgery (ABS) certificate. Study Design: Two-thousand Fellows of the American College of Surgeons received a 30-item survey designed to identify their demographics and their assessments of the functional and financial value of the certificate. Functional value was assessed using a 5-point scale in the areas of professional recognition, personal satisfaction, court proceedings, job security, mobility, and advancement, whether the certificate was necessary to obtain an academic or a clinical position, and whether it served as an indicator of depth or breadth of surgical knowledge or of clinical competence. Perceived professional lifetime financial value of the certificate was also assessed. Results: Return response rate was 37.2%. The ABS certificate was perceived to be most valuable in obtaining an academic or a clinical position and playing a significant role in court proceedings. It was perceived as least valuable in indicating breadth of knowledge and clinical competence. Sixty-seven percent responded that certified surgeons should earn more, and 49% estimated the certificate's lifetime financial value as more than $500,000. Sixty-two percent of surgeons approved of continuing the recertification process every 10 years. Conclusions: The ABS certificate is perceived as an objective credentialing instrument that affords diplomates power, status, an opportunity to obtain an academic or clinical position, job mobility, protection in court proceedings, and greater income. Although it is perceived as an instrument that could aid a career, it is not viewed as an indicator of a person's clinical competence.