Thomas Jefferson University Hospital

About: Thomas Jefferson University Hospital is a healthcare organization based out in Philadelphia, Pennsylvania, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 6173 authors who have published 7631 publications receiving 197620 citations.

Adenomyosis: current concepts and imaging considerations.

Abstract: A denomyosis is a cause of menorrhagia and dysmenorrhea, and symptoms correlate with its histologic severity [1]. Formerly, women with dysfunctional uterine bleeding caused by adenomyosis would be diagnosed and cured by hysterectomy. A growing interest in its nonoperative diagnosis is driven by concerns about the inappropriate use of hysterectomy, by innovations of less invasive alternatives to surgery, and by the development of imaging techniques capable of reliably diagnosing the disorder. The alternatives to surgery for dysfunctional uterine bleeding-for example, endometrial resection or ablation-have a lower success rate if uterine bleeding is caused by deep adenomyosis [2]. This report examines the spectrum of adenomyosis on sonography and MR imaging as related to the pathologic aspects of the disease.

The modified use of a proximal humeral locking plate for tibiotalocalcaneal arthrodesis.

Abstract: Background: Different types of fixation have been used to achieve a tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to retrospectively examine the modified use of a 3.5-mm proxi...

Dosimetry of iodine-131 ethiodol in the treatment of hepatoma.

Abstract: The in vivo distribution and kinetics of (/sup 131/I)Ethiodol injected through the hepatic artery have been measured on a group of four patients with hepatocellular carcinoma. The (/sup 131/I)Ethiodol was distributed predominantly in the liver (70-90%) and lungs (10-20%) and was selectively concentrated and retained in the patients with massive and multinodular hepatomas with approximately 10% of the administered activity localizing in tumor. The radioactivity in the blood 2 hr postinjection was less than 0.1% and was never higher than 0.9% of the administered activity. The radioactivity cleared from normal liver tissue with an effective half-life of approximately 4 days while the clearance time from the tumor was 20-25% longer. Activity in the lungs initially increased and then cleared with a 5-day effective half-life. Based on these measurements, the estimated dose per mCi of (/sup 131/I)Ethiodol administered is 31 rad to the liver, 22 rad to the lungs, 1.9 rad to the total body and 239 rad to a 4-cm diameter tumor. These results suggest that (/sup 131/I)Ethiodol has the potential to deliver curative radiation doses to hepatomas with acceptable radiation burdens to normal tissues.

Impact of a standardized protocol and antibiotic-impregnated catheters on ventriculostomy infection rates in cerebrovascular patients.

Abstract: Background Ventriculostomy infections create significant morbidity. To reduce infection rates, a standardized evidence-based catheter insertion protocol was implemented. A prospective observational study analyzed the effects of this protocol alone and with antibiotic-impregnated ventriculostomy catheters. Objective To compare infection rates after implementing a standardized protocol for ventriculostomy catheter insertion with and without the use of antibiotic-impregnated catheters. Methods Between 2003 and 2008, 1961 ventriculostomies and infections were documented. A ventriculostomy infection was defined as 2 positive CSF cultures from ventriculostomy catheters with a concurrent increase in cerebrospinal fluid white blood cell count. A baseline (preprotocol) infection rate was established (period 1). Infection rates were monitored after adoption of the standardized protocol (period 2), institution of antibiotic-impregnated catheter A (period 3), discontinuation of antibiotic-impregnated catheter A (period 4), and institution of antibiotic-impregnated catheter B (period 5). Results The baseline infection rate (period 1) was 6.7% (22/327 devices). Standardized protocol (period 2) implementation did not change the infection rate (8.2%; 23/281 devices). Introduction of catheter A (period 3) reduced infections to 1.0% (2/195 devices, P=.0005). Because of technical difficulties, this catheter was discontinued (period 4), resulting in an increase in infection rate (7.6%; 12/157 devices). Catheter B (period 5) significantly decreased infections to 0.9% (9 of 1001 devices, P=.0001). The Staphylococcus infection rate for periods 1, 2, and 4 was 6.1% (47/765) compared with 0.2% (1/577) during use of antibiotic-impregnated catheters (periods 3 and 5). Conclusion The use of antibiotic-impregnated catheters resulted in a significant reduction of ventriculostomy infections and is recommended in the adult neurosurgical population.