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  • 1
    Language: English
    In: Science (New York, N.Y.), 02 December 2016, Vol.354(6316), pp.1103-1104
    Description: Hematopoietic stem cells (HSCs) are at the helm of the hierarchically organized hematopoietic system that ensures the lifelong production of all blood cells. HSCs depend on metabolic cues to secure their protective quiescent status and to enable rapid activation and replenishment of the blood system in response to stressful situations such as infections, excessive bleeding, or chemotherapy-induced myeloablation (-). On pages 1156 and 1152 of this issue, Ito et al. and Taya et al. , respectively, uncover important roles for the degradation of defective mitochondria (mitophagy) and the amino acid valine in HSC maintenance and function.
    Keywords: Cues ; Hematopoietic Stem Cells -- Metabolism
    ISSN: 00368075
    E-ISSN: 1095-9203
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  • 2
    Language: English
    In: European Urology, 1986, Vol.12(4), pp.265-269
    Description: Pelvic lymphadenectomy and interstitial radiotherapy of the prostate for early carcinoma is a procedure with a significant postoperative morbidity, depending on the extent of dissection, type of drainage, and use of heparin. Hematoma and lymphocele formation seem to be promoted by heparin. Limited lymph node dissection, appropriate, drainage, and the abandonment of heparin for prophylaxis of thromboembolism can reduce the complications associated with pelvic lymphadenectomy.
    Keywords: Clinical Papers ; Brachytherapy ; Prostatic Carcinoma ; Pelvic Lymphadenectomy ; Complications ; Medicine
    ISSN: 0302-2838
    E-ISSN: 1873-7560
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  • 3
    Language: English
    In: Operative Techniques in Sports Medicine, 2010, Vol.18(3), pp.146-154
    Description: The unstable scaphoid fracture can be treated by a variety of different methods including open reduction and internal fixation (ORIF), percutaneous fixation with either K-wires or cannulated screws, and arthroscopic-assisted reduction and internal fixation (AARIF) with various cannulated screw systems. The drawbacks of ORIF include extensive soft-tissue dissection, disruption of the nondominant volar blood supply, division of the radioscaphocapitate and or radiolunate ligaments and volar capsule, and prolonged rehabilitation. Percutaneous fixation avoids the aforementioned drawbacks yet relies on fluoroscopic guidance alone to ensure accurate reduction of the scaphoid fracture fragments and optimal positioning of the implant in the central third axis of the scaphoid. The frank technical limitations of plain radiography as well as fluoroscopy in detailed visualization of the oddly oriented scaphoid finitely limit the accuracy of the percutaneous technique. AARIF avoids all the limitations of ORIF yet allows direct visualization of the scaphoid fracture site and ensures accurate reduction of the fragments before and during definitive arthroscopically assisted internal fixation. AARIF also assists in accurate targeting of the proximal pole apex or “sweet spot” assuring central third scaphoid axis placement in addition to allowing detection of concurrent pathology in the radiocarpal or midcarpal joints. Scaphoid AARIF is a convenient therapeutic alternative that avoids many of the inherent pitfalls of ORIF and percutaneous fixation.
    Keywords: Scaphoid Fracture ; Arthroscopic Fixation ; Medicine
    ISSN: 1060-1872
    E-ISSN: 1557-9794
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  • 4
    In: Western Journal of Emergency Medicine, 2016, Vol.17(4), p.471-472
    Description: A sexually active 35-year old woman presented to the emergency department with intermittent vaginal spotting and pelvic cramping over the preceding four weeks. She had an intrauterine device (IUD) placed three months prior and has never been pregnant. The threads of the IUD and a small amount of blood coming from the cervix were seen on pelvic exam. Laboratory testing revealed a β-human chorionic gonadotropin level of 70,000 mIU/mL. Pelvic ultrasound imaging showed the IUD (Figure 1) and a viable intrauterine pregnancy (IUP, Figure 2).
    Keywords: Diagnostic Acumen
    ISSN: 1936-900X
    E-ISSN: 1936-9018
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  • 5
    Language: English
    In: SMU Law Review, 2014, Vol.67(4), pp.729-744
    Keywords: Probable Cause – Laws, Regulations and Rules ; Racial Profiling – Laws, Regulations and Rules ; Searches and Seizures – Laws, Regulations and Rules ; Rule of Law – Evaluation
    ISSN: 1066-1271
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  • 6
    Language: English
    In: Journal of Hand Surgery, 2010, Vol.35(4), pp.604-610
    Description: This study was designed to morphometrically assess the base of the little and ring finger metacarpals as potential osteochondral donors to resurface distal condylar defects of the proximal phalanx. The proximal phalanges were dissected from all 4 fingers in 10 cadaveric hands and the following measurements were obtained from the distal condylar surface: anteroposterior height, radial-ulnar width, and radius of curvature. Measurements were obtained from posteroanterior and lateral radiographic views, which were digitized and analyzed using digital imaging software. Comparable measurements were obtained from the base of the small and ring metacarpals. The anteroposterior dimension of both potential donor metacarpals was large enough to resurface the distal condyles of each of the proximal phalanges; however, this was not true for the radial-ulnar dimensions. The distal ulnar condyle of the long finger proximal phalanx was largest, measuring 4.9 (± 0.) mm dorsally and 6.2 (± 0.5) mm volarly in the radial-ulnar dimension. Only the small metacarpal base had sufficient stock in the radial-ulnar dimension (9.4 [± 1.7]) mm dorsally and 10.6 [± 2.0] mm volarly) to resurface this condyle. With respect to radius of curvature (ROC), the donor-to-recipient ROC ratio was 1.43 for the small metacarpal base versus 2.12 for the ring metacarpal base. Linear regression analysis revealed a stronger relationship in ROC between donor and recipient condyle when the small metacarpal base served as the donor (R = 0.96 vs R = 0.60). As determined from morphometric measurements of the 2 potential donor sites tested, the base of the small metacarpal provides the best match for resurfacing distal condylar defects of the proximal phalanges.
    Keywords: Osteochondral Arthroplasty ; Proximal Phalanx Unicondyle Fracture ; Proximal Interphalangeal Joint Injury
    ISSN: 0363-5023
    E-ISSN: 1531-6564
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  • 7
    Language: English
    In: American Journal of Emergency Medicine, March 2013, Vol.31(3), pp.478-481
    Description: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. Emergency medicine physicians at an inner-city academic medical center were asked to cannulate the axillary vein in a torso phantom model. They were randomized to start with either the longitudinal or transverse approach and completed both sequentially. Participants answered questionnaires before and after the cannulation attempts. Measurements were taken regarding time to completion, success, skin punctures, needle redirections, and complications. Fifty-seven operators with a median experience of 85 ultrasound procedures (interquartile range, 26-120) participated. The frequency of first-attempt success was 39 (0.69) of 57 for the longitudinal method and 21 (0.37) of 57 for the transverse method (difference, 0.32; 95% confidence interval [CI], 0.12-0.51 [ = .001]); this difference was similar regardless of operator experience. The longitudinal method was associated with fewer redirections (difference, 1.8; 95% CI, 0.8-2.7 [ = .0002]) and skin punctures (difference, 0.3; 95% CI, − 2 to + 0.7 [ = .07]). Arterial puncture occurred in 2 of 57 longitudinal and 7 of 57 transverse attempts; no pleural punctures occurred. For successful attempts, the time spent was 24 seconds less for the longitudinal method (95% CI, 3-45 [ = .02]). The longitudinal method of visualizing the axillary vein during ultrasound-guided venous access is associated with greater first-attempt success, fewer needle redirections, and a trend of fewer arterial punctures compared with the transverse orientation.
    Keywords: Medicine
    ISSN: 0735-6757
    E-ISSN: 1532-8171
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  • 8
    Language: English
    In: Emergency Medicine Clinics of North America, November 2012, Vol.30(4), pp.949-959
    Description: Cardiovascular emergencies in pregnancy are rare but often catastrophic. This article reviews the diagnosis and management of venous thromboembolism, aortic dissection, acquired heart disease and cardiomyopathy, acute myocardial infarction, and cardiac dysrhythmias in the setting of pregnancy. It also reviews updated resuscitation guidelines for cardiac arrest and perimortem cesarean section.
    Keywords: Pregnancy ; Pulmonary Embolus ; Aortic Dissection ; Cardiomyopathy ; Acute Myocardial Infarction ; Arrhythmia ; Cardiac Arrest ; Perimortem Cesarean Section ; Medicine
    ISSN: 0733-8627
    E-ISSN: 1558-0539
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  • 9
    Article
    Article
    Language: English
    In: Emergency Medicine Clinics of North America, November 2012, Vol.30(4), pp.xv-xvi
    Keywords: Medicine
    ISSN: 0733-8627
    E-ISSN: 1558-0539
    Source: ScienceDirect Journals (Elsevier)
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  • 10
    Language: English
    In: Journal of Hand Surgery, April 2014, Vol.39(4), pp.792-802
    Description: Fracture dislocations of the hand are difficult and often unforgiving injuries. Keys to treatment include early recognition, stable concentric reduction, and protected early active range of motion maintaining joint stability. The balance between stability and mobility is difficult to manage; therefore, surgeons need a wide array of treatments to tailor management to the specific fracture pattern. With appropriate treatment, residual stiffness and pain can be minimized. This Current Concepts review aims to provide up-to-date management for proximal interphalangeal, distal interphalangeal, and metacarpophalangeal joint fracture dislocations.
    Keywords: Finger ; Joint ; Fracture ; Dislocation ; Subluxation
    ISSN: 0363-5023
    E-ISSN: 1531-6564
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