Phoebe Putney Memorial Hospital

About: Phoebe Putney Memorial Hospital is a healthcare organization based out in Albany, Georgia, United States. It is known for research contribution in the topics: Population & PET-CT. The organization has 83 authors who have published 108 publications receiving 2275 citations.

Severe Male Breast Enlargement.

Abstract: An 11-year-old boy presents with grade 3 gynecomastia, with sagging breasts and darkened areolas

Primary Management of Squamous Cell Carcinoma of the Anal Canal: A 30-year Community Hospital Experience.

Abstract: We reviewed outcomes of 41 patients treated with curative-intent radiotherapy for anal canal carcinoma at a community hospital between 1985 and 2015. Twenty-six (63%) presented with stage I or II disease while 15 (37%) had stage III. Thirty-seven received definitive chemoradiation and 4 radiotherapy alone. Thirteen (31.7%) received ≤59.4Gy. Thirty-two (78%) were treated with 3-dimensional conformal radiotherapy while 9 (22%) received intensity-modulated radiotherapy. At 5 years, local control, regional control, freedom from distant metastasis, cause-specific survival, and overall survival were 80%, 98%, 88%, 77%, and 51%. Of those who received >59.4Gy, local control and overall survival were not improved.

Aerobic actinomycetes that masquerade as pulmonary tuberculosis

Abstract: Background: There is an increasing recognition of organisms in the order Actinomycetales including Nocardia sp. causing lung infections that mimic pulmonary tuberculosis or fungal pneumonias. Methods: We retrospectively evaluated a cohort of patients in the southeastern United States in whom a presumptive diagnosis of pulmonary tuberculosis was initially entertained but who eventually were found to have infection caused by Rhodococcus sp. or Tsukamurella sp. Results: Among a cohort of 52 individuals diagnosed as case suspects for pulmonary tuberculosis, we identifi ed six patients who were infected with either Rhodococcus sp. or Tsukamurella sp. Of these six patients, two had co-infection with Mycobacterium tuberculosis. Conclusions: Infection with aerobic actinomycetes may mimic pulmonary tuberculosis or may cause concomitant disease in patients with pulmonary tuberculosis.

False positive PET/CT and sodium fluoride scans in assessing bone lesions

Abstract: 1622 Objectives The introduction of high-sensitivity high-resolution PET/CT scanners has created a renewed interest in utilizing 18F-sodium fluoride (18F-NaF) as imaging agent to evaluate primary and metastatic bone tumors. In this research project, we estimated the rate of false positive PET/CT and 18F-NaF scans when performed to assess bone lesions. Methods Thirty-five consecutive PET/CT and 18F-NaF scans were acquired on 31 patients (25 males, 6 females; mean age 73.4 y; age range, 49-91 y) who were referred to our institution for further evaluation because of biopsy proven cancer, clinical symptoms suggestive of cancer or other abnormal scans. This research was based on scans of patients suffering from: lung cancer (n = 2), prostate cancer (n = 19), myeloma (n = 4), breast cancer (n = 7), renal cell carcinoma (n = 1), unknown primary (n = 1) and bone pain (n = 1). Every patient received an 18F-NaF dose proportional to his/her body weight of 4.1 MBq/kg and scanned in 3D mode at 40-60 min. post-injection. All 18F-NaF images were reviewed by a senior nuclear medicine physician for the presence of bone malignancies using the distinctive features of malignant lesions observed on CT. Results A total of 618 areas of increased 18F-NaF uptake in the skeleton were analyzed for cancer: skull (38), spine (203), ribs (50), long/short bones and joints (258) and pelvis (69). The positive predictive values (PPV) of abnormal PET/CT and 18F-NaF in the skull, spine, ribs, long/short bones and joints, and pelvis were 28.9%, 21.2%, 74.0%, 14.3% and 24.6%, respectively. Conclusions False positive 18F-NaF scans, to our surprise, occurred more frequently than expected with an average PPV of 32.6%. Most false positive 18F-NaF uptakes were observed in the joints and areas of degenerative changes particularly in long/short bones and spine. One explanation for the relatively high PPV of 74.0% in ribs was the inclusion of a stage IV breast cancer patient, scanned 2 times, who had dissemination of malignant tumors.

A Practical Guide for Managing Antibiotic Allergies in the Emergency Department.

Abstract: Up to 30% of patients report at least one antibiotic allergy, but oftentimes these antibiotic allergies are misdiagnosed. In fact, of the 10% of patients reporting penicillin allergies, 90%-98% are not truly allergic. In an era of increasing antibiotic resistance coupled with a limited number of new antibiotics, evaluating antibiotic allergies is critical in providing optimal patient care. Differentiating adverse drug reactions from antibiotic allergies may seem like a daunting task for clinicians and providers, especially in the emergency department, where decisions are made quickly. However, a systemic approach, including medical record review coupled with patient and/or family interview, is vital in managing patients with antibiotic allergies. Inappropriate, alternative antibiotics are frequently chosen due to patient allergies, and data suggest higher rates of broad-spectrum antibiotic use, antibiotic resistance, and poor outcomes as a result. Herein, we review antibiotic selection in patients reporting antibiotic allergies in the emergency department.