Medicine And Health, Rhode Island[JOURNAL]

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Ascending colon ganglioneuroma.

Bagdasaryan R

Med Health R I · 2012 Jan · PMID 22439457

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Case of malignant priapism and review of the literature.

Ahmed H, Elsamra S, Sigman M

Med Health R I · 2012 Jan · PMID 22439456

Malignant priapism, or priapism secondary to locally invasive or metastatic cancer, is a rarely reported phenomenon with a very poor prognosis. We report on a case of malignant priapism secondary to metastasis of urothel... Malignant priapism, or priapism secondary to locally invasive or metastatic cancer, is a rarely reported phenomenon with a very poor prognosis. We report on a case of malignant priapism secondary to metastasis of urothelial carcinoma of the bladder in a 73 year old gentleman who underwent a radical cystectomy with negative margins but positive nodal disease three months prior to presentation. The rapid progression of disease and resultant demise of this patient is unusual even when compared to the limited available literature. Rapid progression to muscle invasion despite intravesical immunotherapy, histologic involvement of the prostate and seminal vesicles with extensive lymphovascular invasion, and the rapid development of metastasis are all consistent with the aggressive nature of a cancer that has metastasized to the penis. Further, while conservative penile sparing therapy may be a goal in patients with limited life expectancy, ongoing pain and infectious concerns may force the physician to resort to a penectomy.

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State-wide support for physician-mothers who are breastfeeding.

MacNamara MM, Moren K, Taylor LE … +1 more , Taylor JS

Med Health R I · 2012 Jan · PMID 22439455

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Evaluation of possible inflammatory bowel disease: a survey of Rhode Island physicians.

Saha S, Lam M, Roberson E … +7 more , Shah S, LeLeiko NS, Lidofsky S, Bright R, Flowers N, Merrick M, Sands BE

Med Health R I · 2012 Jan · PMID 22439454

BACKGROUND: Patients with undiagnosed inflammatory bowel disease (IBD) are often evaluated initially by primary care physicians (PCPs). Despite the frequency with which PCPs evaluate chronic abdominal pain and chronic di... BACKGROUND: Patients with undiagnosed inflammatory bowel disease (IBD) are often evaluated initially by primary care physicians (PCPs). Despite the frequency with which PCPs evaluate chronic abdominal pain and chronic diarrhea, little is known about how they approach these symptoms. OBJECTIVES: To determine the diagnostic practices and referral patterns of PCPs when confronting a patient with potential IBD. METHODS: We conducted a mail survey of PCPs practicing in Rhode Island. Clinical vignettes describing patients with chronic abdominal pain and chronic diarrhea were presented. Respondents were asked to indicate how they would evaluate these scenarios and when they would refer to a specialist. RESULTS: 432 PCPs were surveyed; 35.6% responded. Wide variation in PCPs' definitions of chronic abdominal pain and chronic diarrhea was found, with only 26% and 51% of physicians, respectively, defining these symptoms to be chronic per standard definitions. Laboratory testing was found to vary significantly with practice type (p < 0.01 for 2 patient groups). Patient age influenced the ordering of diagnostic imaging (p < 0.0001), while patient gender did not. CONCLUSIONS: There is significant variability among PCPs in the threshold after which common gastrointestinal symptoms become chronic as well as in their diagnostic evaluation of these symptoms. This variability may lead to a lag in the diagnosis of IBD and influence patient outcomes.

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Contagion as a fiscal problem.

Aronson SM

Med Health R I · 2012 Jan · PMID 22439453

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Number needed to treat (NNT); number needed to harm (NNH).

Friedman JH

Med Health R I · 2012 Jan · PMID 22439452

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The harsh vocabulary of intemperance.

Aronson SM

Med Health R I · 2011 Dec · PMID 22409134

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Sexual orientation and health risk behaviors among Rhode Island public high school students, 2009.

Cryan B, Perry D

Med Health R I · 2011 Dec · PMID 22409133

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The 'golden hour' treatment of acute ischemic stroke.

Iqbal A

Med Health R I · 2011 Dec · PMID 22409132

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The importance of stroke units.

Meisel K, Silver B

Med Health R I · 2011 Dec · PMID 22409131

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Secondary stroke prevention in 2011: an update on available options.

Ozark S, Silver B

Med Health R I · 2011 Dec · PMID 22409130

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Primary stroke prevention and community education.

Vecchione M

Med Health R I · 2011 Dec · PMID 22409129

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Novel stroke rehabilitation interventions.

Mernoff ST, Lo AC

Med Health R I · 2011 Dec · PMID 22409128

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Intra-arterial therapy for acute stroke: trials and tribulations.

Jayaraman MV, Haas RA, Ahn SH

Med Health R I · 2011 Dec · PMID 22409127

Intra-arterial therapy (IAT) for acute ischemic stroke has undergone great evolution during the past decade. While intra-venous therapy remains the standard of care for eligible patients, there are those patients in whom... Intra-arterial therapy (IAT) for acute ischemic stroke has undergone great evolution during the past decade. While intra-venous therapy remains the standard of care for eligible patients, there are those patients in whom IV tPA is contraindicated, or those who fail to improve following IV tPA. In those cases, patients with accessible arterial occlusions may benefit from IAT, especially when recanalization can occur within six hours from symptom onset. Future advancements in device development and patient selection may further improve outcomes.

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