Texas Medical Center

About: Texas Medical Center is a healthcare organization based out in Houston, Texas, United States. It is known for research contribution in the topics: Population & Cancer. The organization has 2845 authors who have published 2394 publications receiving 79426 citations.

Diagnosis and Treatment of Neuropsychiatric Disorders

Abstract: Neuropsychiatry is the subspecialty of psychiatry that deals with disorders at the intersection of neurology and psychiatry. Neuropsychiatric disorders are complex and incompletely understood. Neuroscience research is beginning to elucidate the biological underpinnings of many of these disorders. These advances have the potential to improve diagnosis, inform treatment selection, and facilitate development of new and better interventions.

Extranodal small lymphocytic proliferation: a clinicopathologic and immunocytochemical study.

Abstract: Twelve patients who presented with extranodal small lymphocytic proliferations were studied. The patients ranged in age from 33 to 67 years; six were male and six female. Locations of the initial lesion included the conjunctiva and orbit, lung, stomach, small bowel, skin, and subcutis. The histopathologic picture in all cases was that of a dense infiltrate of small lymphocytes with rounded nuclei; there were usually admixed plasma cells and sometimes germinal centers. Immunoperoxidase staining for immunoglobulin light chains demonstrated monoclonality in four cases and polyclonality in four; results were inconclusive or blocks were unavailable in the remainder. Follow-up ranged from 53 to 216 months with a median of 92 months. In three cases, there was no recurrence or recurrence only at the site of initial involvement; in three, there was a sequential involvement of different extranodal sites without significant morbidity; and in six, there was progressive disease. One of the latter patients developed nodular sclerosing Hodgkin's disease 48 months after diagnosis of the small lymphocytic process. There was no correlation between histopathologic findings and clinical source. All of the four patients with monoclonal immunoperoxidase staining and two of those with polyclonal staining had a progressive course; in the two with polyclonal staining, monoclonality was demonstrated later. It is concluded that the behavior of extranodal small lymphocytic proliferations cannot be reliably predicted by histopathologic criteria and that immunoperoxidase findings may be helpful as an indicator of an adverse course when monoclonality is demonstrated. Additional studies concerning this latter point are desirable.

Drug eluting stents for below the knee lesions in patients with critical limb ischemia : long-term follow-up.

Abstract: Objectives The purpose of this study was to assess the long-term limb preservation and/or healing of ulcers in patients with critical limb ischemia (CLI) and severe infrapopliteal atherosclerotic disease treated with drug eluting stents (DES). Background Percutaneous revascularization has become an effective treatment for CLI in patients with infrapopliteal atherosclerotic disease. Recent reports using DES in patients with CLI have documented excellent short-term infrapopliteal vessel patency. Higher primary patency rates in infrapopliteal vessels treated with DES could translate into better long-term clinical outcomes and improved limb salvage rates. Methods Twenty-four consecutive patients with CLI (defined as rest pain, nonhealing ulcers, or gangrene) because of severe infrapopliteal disease were treated with DES from August 2004 to June 2006. Results Procedural success was achieved in 96% (27/28) of targeted lesions. There were no procedure-related deaths, acute vessel thrombosis events, or need for urgent surgical intervention. There was one case of distal embolization. Clinical follow up, ranging 8-34 months, is available for 100% of patients of which 83% (20/24) achieved limb preservation and healing. Angiographic and/or sonographic follow up, ranging 6-34 months, is available in 79% (19/24) of patients of which 95% (18/19) had patent target vessels. Conclusions DES is a safe and effective long-term option for CLI due to severe infrapopliteal arterial disease. Long-term vascular patency led to a high rate of limb preservation and low amputation rate. A multicenter trial should further elucidate the role of DES in the treatment of CLI.