Yimei Miao - Academia.edu (original) (raw)
Papers by Yimei Miao
Blood, Dec 2, 2016
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the gen... more Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with non-valvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. Use of rivaroxaban in cancer patients at Memorial Sloan Kettering Cancer Center (MSKCC) is monitored in the setting of a Quality Assessment Initiative. Patients with active cancer and AF, treated with rivaroxaban from 1/1/2014 through 3/31/2016 are included in this analysis. Clinical endpoints were defined a priori and assessed through text searches of medical records. A total of 163 evaluable patients were identified. After adjusting for competing risks, the estimated 1 year cumulative incidence of ischemic stroke was 1.4% (95% CI=0-3.4%) and major bleeding was 1.2% (95% CI=0-2.9%). The risk of clinically-relevant non-major bleeding leading to discontinuation of anticoagulation at 1 year was 14.0% (95% CI=4.2-22.7%). The cumulative incidence of mortality was 22.6% (95% CI=12.2-31.7%) at one year, reflecting an active cancer population. One patient died after developing an acute ischemic cerebrovascular insult. In
Blood, Dec 3, 2015
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Blood, Nov 29, 2018
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Blood, Dec 3, 2015
com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major b... more com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major bleeding episodes. Lastly, 10 patients died of cancer-related causes during an episode of thrombocytopenia. This Quality Assessment Initiative supports the safety and efficacy of our guidelines for therapeutic enoxaparin dose modification.
Blood, 2017
Background: CIT is a common complication of chemotherapy, resulting in delay or dose reduction of... more Background: CIT is a common complication of chemotherapy, resulting in delay or dose reduction of treatment. There is no approved or validated treatment. We report the first prospective trial showing correction and prevention of recurrence of CIT. Methods: A phase II, open label trial of romiplostim, a thrombopoietin receptor agonist, versus observation control. Solid tumor patients with at least 4 weeks of thrombocytopenia ( 100,000/mcL within 3 weeks. Secondary endpoints included safety and resumption of chemotherapy without recurrence of CIT. Observation patients who failed to correct their platelet counts, were eligible to cross-over to receive romiplostim (not shown). Analysis was by Intention-To-Treat, and statistics were by two-tailed Fisher9s exact test. Results: 40 patients were enrolled. Mean age was 58 years (range 28-77). All patients had either metastatic disease (35), or locally advanced disease (5). The majority had GI cancer (22). When 8 observation patients were enr...
Blood, 2018
Introduction: Cancer associated thrombosis (CAT) is a common complication of cancer, associated w... more Introduction: Cancer associated thrombosis (CAT) is a common complication of cancer, associated with significant morbidity and mortality. While incidence varies with cancer type, stage, chemotherapy, and other factors, estimates are that up to 20% of cancer patients will experience at least one venous thromboembolic (VTE) episode. VTE consist of deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and there is a spectrum of vascular involvement. DVTs are classified as proximal (popliteal vein or above) and PE may be subsegmental, segmental, lobar, main, or saddle embolism. Our standard approach has been to treat all DVTs and all PEs in cancer patients, regardless of the size of the involved vessel. However, it is not clear if the risk of recurrent VTE in a patient with a "small" subsegmental PE, or a calf vein DVT, is comparable to that of an individual with a larger vascular involvement. In this study, we characterized the largest vessel involved in the initial VTE ...
Journal of Clinical Oncology, 2016
10134Background: Chemotherapy-induced thrombocytopenia (CIT) is a common toxicity of cancer thera... more 10134Background: Chemotherapy-induced thrombocytopenia (CIT) is a common toxicity of cancer therapy, often leading to delay or reduction in chemotherapy. We conducted a randomized open-label phase ...
Journal of Thrombosis and Thrombolysis, 2017
com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major b... more com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major bleeding episodes. Lastly, 10 patients died of cancer-related causes during an episode of thrombocytopenia. This Quality Assessment Initiative supports the safety and efficacy of our guidelines for therapeutic enoxaparin dose modification.
Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2017
Conclusions: Compression therapy use after great saphenous vein (GSV) ablation performed in patie... more Conclusions: Compression therapy use after great saphenous vein (GSV) ablation performed in patients without ulceration had no significant benefit over no compression as determined by patient-reported or clinician-reported outcomes. It may be an unnecessary adjunct following GSV ablation. Summary: Whether or not compression improves the results of GSV ablation has been a question for some time since clinician impression was that it did not. This randomized controlled trial spanned a 4-year study period ending in 2013. Those with C6 disease were excluded since it was likely that these patients would benefit by compression therapy regardless. Patients were randomized on a 1:1 basis, but the method of randomization was not stated. If both limbs required intervention, then the procedures were completed on separate occasions and assigned to the opposite group. Thigh-high compression (30-40 mm Hg) stockings applied for 7 days was compared to no compression following endovenous ablation (91% RFA) of the GSV. The stockings were applied for 24 hours and only during waking hours thereafter. The Venous Clinical Severity Score (VCSS), a clinician outcome tool, and the Chronic Venous Insufficiency Questionaire (CIVIQ-2), a patient determined outcome tool, were determined at days 1, 7, 14, 30, and at 90 days. These two Quality of Life scales were the primary end points for the study. Secondary end points were postprocedural pain (Visual Analog Pain Scale), which was obtained daily for 1 week, and an analog bruising score (photography evaluated by a blinded clinical research staff not involved in direct patient care) obtained 1 week after the procedure. Procedural success was a closed vein on duplex imaging, but the precise timing of the evaluation was unclear. Forty-six were randomized to compression and 39 to no compression for a total of 85 limbs (70 patients). Patient demographics were similar between groups. We are only provided two comparisons of VCSS scores (pre-and postprocedure and compression vs no compression, respectively, 5.7 vs 5.6 [P ¼ .89] and 3.3 vs 4.4 [P ¼ .49]). The CIVIQ-2 scores were provided at each time point and demonstrated no statistical difference (compression vs no compression at 1 week [36.9 vs 35.1; P ¼ .59]), and 90 days (29.1 vs 22.5; P ¼ .37), with a general improvement in both groups over time. Pain and bruising score demonstrated no significant difference in treatment vs no treatment (pain scores day 1: 3.0 vs 3.1; P ¼ .95; day 7: 2.1 vs 2.8; P ¼ .15) and bruising score (1.2 vs 1.4; P ¼ .56). All veins were successfully ablated as assessed by duplex imaging. Comment: This study should be commended for evaluating patients with validated quality-of-life scoring tools as the primary end point. This has been lacking in prior studies and was a major deficiency in each. There are some caveats which make the study results less convincing. The method of randomization should be stated since when clarified and followed eliminates one potential for bias. In the discussion, the authors note that only 20% of the patients returned for the 90-day evaluation, which makes the number likely too small to be used as a statistically valid end point. Since the data do not lend itself to a life-table format, some estimation of the patients returning for each evaluation should be provided. The comment regarding a trend to better pain control with compression does support some other studies but is not supported statistically by the findings in this study. In the final analysis, this study suggests that compression therapy may not be beneficial after endovenous ablation of the GSV vein but statistical inconsistencies do not allow a firm recommendation.
The American Journal of Cardiology, 2017
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the gen... more Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with non-valvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. Use of rivaroxaban in cancer patients at Memorial Sloan Kettering Cancer Center (MSKCC) is monitored in the setting of a Quality Assessment Initiative. Patients with active cancer and AF, treated with rivaroxaban from 1/1/2014 through 3/31/2016 are included in this analysis. Clinical endpoints were defined a priori and assessed through text searches of medical records. A total of 163 evaluable patients were identified. After adjusting for competing risks, the estimated 1 year cumulative incidence of ischemic stroke was 1.4% (95% CI=0-3.4%) and major bleeding was 1.2% (95% CI=0-2.9%). The risk of clinically-relevant non-major bleeding leading to discontinuation of anticoagulation at 1 year was 14.0% (95% CI=4.2-22.7%). The cumulative incidence of mortality was 22.6% (95% CI=12.2-31.7%) at one year, reflecting an active cancer population. One patient died after developing an acute ischemic cerebrovascular insult. In
Journal of Thrombosis and Thrombolysis, 2016
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Current Urology, 2015
The Bartholin's glands are located symmetrically at the posterior region of the vaginal opening a... more The Bartholin's glands are located symmetrically at the posterior region of the vaginal opening and play an important role in the female reproductive system. These two peasized glands are involved in mucus secretion and vaginal lubrication. Cyst formation in the glands is common and results from mucus build-up in gland ducts. It is important to monitor such cysts because they may occur in the form of carcinomas. Larger cysts and abscesses are found in the lower vestibular region and typically present with erythema and edema. Biopsy is an effective method for distinguishing between Bartholin's gland cysts and differential diagnosis. While smaller cysts may be asymptomatic and may be left untreated, larger cysts require medical attention. Several treatment options are available, including marsupialization and CO 2 laser. Healing and recovery depend on the severity of infection and course of treatment.
Open Journal of Obstetrics and Gynecology, 2013
SOJ Anesthesiology & Pain Management, 2014
International Journal of Urological Nursing, 2014
We present a patient who experienced urinary retention with a comorbid phimosis and redundant pre... more We present a patient who experienced urinary retention with a comorbid phimosis and redundant prepuce, most likely complications of diabetes mellitus. Additionally, we report a rare complication of difficult catheterization, where the prepuce intussuscepted into the urethral meatus. Attempts to change the catheter with poor visualization of the external meatus secondary to diabetic phimosis resulted in telescoping of the prepuce into the urethra. Circumcision and meatotomy of the external meatus alleviated the acute issue and prevented potential problems with future catheterizations.
Journal of Applied Life Sciences International, 2015
Pelvic Congestion Syndrome (PCS) is a common concern for premenopausal, multiparous women with ch... more Pelvic Congestion Syndrome (PCS) is a common concern for premenopausal, multiparous women with chronic pelvic pain persisting greater than 6 months. It is defined as observable congestion of pelvic veins due to pelvic varicosities that cause reflux and dilation of ovarian veins, resulting in venostasis [1,2]. Although the etiology is unknown, PCS is associated with anterior, posterior or circumaortic location of left renal vein (vascular compression of the left renal vein between the aorta and the superior mesenteric artery) and Nutcracker syndrome. Another marker of PCS includes the absence of functional ovarian venous valves at the junction of left ovarian vein and left renal vein that increase venous pressure in left ovarian vein causing vulvar varicosities [2-4]. It is important to investigate the pathology, as well as the various diagnostic and therapeutic methods available to effectively manage patients with PCS.
Fetal and Pediatric Pathology, 2015
Shaken Baby Syndrome occurs in infants as a result of the brain pushing against the skull due to ... more Shaken Baby Syndrome occurs in infants as a result of the brain pushing against the skull due to severe acceleration-deceleration forces. Symptoms of Shaken Baby Syndrome include subdural, subarachnoid, and retinal hemorrhages. MRI and ocular examinations are used to determine the extent of mental and visual damage and β-amyloid precursor protein immunohistochemical staining is used to detect axonal injuries. Surgeries such as Subdural hemorrhage (SDH) evacuation surgery and the Burr hole craniotomy are used to treat Shaken Baby Syndrome; however, the prognosis is poor in many cases. Because of the severity of Shaken Baby Syndrome and its traumatic and sometimes fatal effects, it is important to educate new parents, nurses, and doctors on the syndrome in order to prevent incidents.
Blood, Dec 2, 2016
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the gen... more Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with non-valvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. Use of rivaroxaban in cancer patients at Memorial Sloan Kettering Cancer Center (MSKCC) is monitored in the setting of a Quality Assessment Initiative. Patients with active cancer and AF, treated with rivaroxaban from 1/1/2014 through 3/31/2016 are included in this analysis. Clinical endpoints were defined a priori and assessed through text searches of medical records. A total of 163 evaluable patients were identified. After adjusting for competing risks, the estimated 1 year cumulative incidence of ischemic stroke was 1.4% (95% CI=0-3.4%) and major bleeding was 1.2% (95% CI=0-2.9%). The risk of clinically-relevant non-major bleeding leading to discontinuation of anticoagulation at 1 year was 14.0% (95% CI=4.2-22.7%). The cumulative incidence of mortality was 22.6% (95% CI=12.2-31.7%) at one year, reflecting an active cancer population. One patient died after developing an acute ischemic cerebrovascular insult. In
Blood, Dec 3, 2015
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Blood, Nov 29, 2018
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Blood, Dec 3, 2015
com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major b... more com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major bleeding episodes. Lastly, 10 patients died of cancer-related causes during an episode of thrombocytopenia. This Quality Assessment Initiative supports the safety and efficacy of our guidelines for therapeutic enoxaparin dose modification.
Blood, 2017
Background: CIT is a common complication of chemotherapy, resulting in delay or dose reduction of... more Background: CIT is a common complication of chemotherapy, resulting in delay or dose reduction of treatment. There is no approved or validated treatment. We report the first prospective trial showing correction and prevention of recurrence of CIT. Methods: A phase II, open label trial of romiplostim, a thrombopoietin receptor agonist, versus observation control. Solid tumor patients with at least 4 weeks of thrombocytopenia ( 100,000/mcL within 3 weeks. Secondary endpoints included safety and resumption of chemotherapy without recurrence of CIT. Observation patients who failed to correct their platelet counts, were eligible to cross-over to receive romiplostim (not shown). Analysis was by Intention-To-Treat, and statistics were by two-tailed Fisher9s exact test. Results: 40 patients were enrolled. Mean age was 58 years (range 28-77). All patients had either metastatic disease (35), or locally advanced disease (5). The majority had GI cancer (22). When 8 observation patients were enr...
Blood, 2018
Introduction: Cancer associated thrombosis (CAT) is a common complication of cancer, associated w... more Introduction: Cancer associated thrombosis (CAT) is a common complication of cancer, associated with significant morbidity and mortality. While incidence varies with cancer type, stage, chemotherapy, and other factors, estimates are that up to 20% of cancer patients will experience at least one venous thromboembolic (VTE) episode. VTE consist of deep vein thrombosis (DVT) and/or pulmonary embolism (PE), and there is a spectrum of vascular involvement. DVTs are classified as proximal (popliteal vein or above) and PE may be subsegmental, segmental, lobar, main, or saddle embolism. Our standard approach has been to treat all DVTs and all PEs in cancer patients, regardless of the size of the involved vessel. However, it is not clear if the risk of recurrent VTE in a patient with a "small" subsegmental PE, or a calf vein DVT, is comparable to that of an individual with a larger vascular involvement. In this study, we characterized the largest vessel involved in the initial VTE ...
Journal of Clinical Oncology, 2016
10134Background: Chemotherapy-induced thrombocytopenia (CIT) is a common toxicity of cancer thera... more 10134Background: Chemotherapy-induced thrombocytopenia (CIT) is a common toxicity of cancer therapy, often leading to delay or reduction in chemotherapy. We conducted a randomized open-label phase ...
Journal of Thrombosis and Thrombolysis, 2017
com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major b... more com episode, prior to enoxaparin dose modification. There were 13 clinically relevant non-major bleeding episodes. Lastly, 10 patients died of cancer-related causes during an episode of thrombocytopenia. This Quality Assessment Initiative supports the safety and efficacy of our guidelines for therapeutic enoxaparin dose modification.
Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2017
Conclusions: Compression therapy use after great saphenous vein (GSV) ablation performed in patie... more Conclusions: Compression therapy use after great saphenous vein (GSV) ablation performed in patients without ulceration had no significant benefit over no compression as determined by patient-reported or clinician-reported outcomes. It may be an unnecessary adjunct following GSV ablation. Summary: Whether or not compression improves the results of GSV ablation has been a question for some time since clinician impression was that it did not. This randomized controlled trial spanned a 4-year study period ending in 2013. Those with C6 disease were excluded since it was likely that these patients would benefit by compression therapy regardless. Patients were randomized on a 1:1 basis, but the method of randomization was not stated. If both limbs required intervention, then the procedures were completed on separate occasions and assigned to the opposite group. Thigh-high compression (30-40 mm Hg) stockings applied for 7 days was compared to no compression following endovenous ablation (91% RFA) of the GSV. The stockings were applied for 24 hours and only during waking hours thereafter. The Venous Clinical Severity Score (VCSS), a clinician outcome tool, and the Chronic Venous Insufficiency Questionaire (CIVIQ-2), a patient determined outcome tool, were determined at days 1, 7, 14, 30, and at 90 days. These two Quality of Life scales were the primary end points for the study. Secondary end points were postprocedural pain (Visual Analog Pain Scale), which was obtained daily for 1 week, and an analog bruising score (photography evaluated by a blinded clinical research staff not involved in direct patient care) obtained 1 week after the procedure. Procedural success was a closed vein on duplex imaging, but the precise timing of the evaluation was unclear. Forty-six were randomized to compression and 39 to no compression for a total of 85 limbs (70 patients). Patient demographics were similar between groups. We are only provided two comparisons of VCSS scores (pre-and postprocedure and compression vs no compression, respectively, 5.7 vs 5.6 [P ¼ .89] and 3.3 vs 4.4 [P ¼ .49]). The CIVIQ-2 scores were provided at each time point and demonstrated no statistical difference (compression vs no compression at 1 week [36.9 vs 35.1; P ¼ .59]), and 90 days (29.1 vs 22.5; P ¼ .37), with a general improvement in both groups over time. Pain and bruising score demonstrated no significant difference in treatment vs no treatment (pain scores day 1: 3.0 vs 3.1; P ¼ .95; day 7: 2.1 vs 2.8; P ¼ .15) and bruising score (1.2 vs 1.4; P ¼ .56). All veins were successfully ablated as assessed by duplex imaging. Comment: This study should be commended for evaluating patients with validated quality-of-life scoring tools as the primary end point. This has been lacking in prior studies and was a major deficiency in each. There are some caveats which make the study results less convincing. The method of randomization should be stated since when clarified and followed eliminates one potential for bias. In the discussion, the authors note that only 20% of the patients returned for the 90-day evaluation, which makes the number likely too small to be used as a statistically valid end point. Since the data do not lend itself to a life-table format, some estimation of the patients returning for each evaluation should be provided. The comment regarding a trend to better pain control with compression does support some other studies but is not supported statistically by the findings in this study. In the final analysis, this study suggests that compression therapy may not be beneficial after endovenous ablation of the GSV vein but statistical inconsistencies do not allow a firm recommendation.
The American Journal of Cardiology, 2017
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the gen... more Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with non-valvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. Use of rivaroxaban in cancer patients at Memorial Sloan Kettering Cancer Center (MSKCC) is monitored in the setting of a Quality Assessment Initiative. Patients with active cancer and AF, treated with rivaroxaban from 1/1/2014 through 3/31/2016 are included in this analysis. Clinical endpoints were defined a priori and assessed through text searches of medical records. A total of 163 evaluable patients were identified. After adjusting for competing risks, the estimated 1 year cumulative incidence of ischemic stroke was 1.4% (95% CI=0-3.4%) and major bleeding was 1.2% (95% CI=0-2.9%). The risk of clinically-relevant non-major bleeding leading to discontinuation of anticoagulation at 1 year was 14.0% (95% CI=4.2-22.7%). The cumulative incidence of mortality was 22.6% (95% CI=12.2-31.7%) at one year, reflecting an active cancer population. One patient died after developing an acute ischemic cerebrovascular insult. In
Journal of Thrombosis and Thrombolysis, 2016
of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from t... more of new or recurrent VTE and major bleeding were comparable to the cancer subgroup analysis from the EINSTEIN studies. The results of our Clinical Pathway provide guidance on Rivaroxaban use for treatment of CAT, and suggest that safety and efficacy is preserved, compared with pastpublished experience with LMWH.
Current Urology, 2015
The Bartholin's glands are located symmetrically at the posterior region of the vaginal opening a... more The Bartholin's glands are located symmetrically at the posterior region of the vaginal opening and play an important role in the female reproductive system. These two peasized glands are involved in mucus secretion and vaginal lubrication. Cyst formation in the glands is common and results from mucus build-up in gland ducts. It is important to monitor such cysts because they may occur in the form of carcinomas. Larger cysts and abscesses are found in the lower vestibular region and typically present with erythema and edema. Biopsy is an effective method for distinguishing between Bartholin's gland cysts and differential diagnosis. While smaller cysts may be asymptomatic and may be left untreated, larger cysts require medical attention. Several treatment options are available, including marsupialization and CO 2 laser. Healing and recovery depend on the severity of infection and course of treatment.
Open Journal of Obstetrics and Gynecology, 2013
SOJ Anesthesiology & Pain Management, 2014
International Journal of Urological Nursing, 2014
We present a patient who experienced urinary retention with a comorbid phimosis and redundant pre... more We present a patient who experienced urinary retention with a comorbid phimosis and redundant prepuce, most likely complications of diabetes mellitus. Additionally, we report a rare complication of difficult catheterization, where the prepuce intussuscepted into the urethral meatus. Attempts to change the catheter with poor visualization of the external meatus secondary to diabetic phimosis resulted in telescoping of the prepuce into the urethra. Circumcision and meatotomy of the external meatus alleviated the acute issue and prevented potential problems with future catheterizations.
Journal of Applied Life Sciences International, 2015
Pelvic Congestion Syndrome (PCS) is a common concern for premenopausal, multiparous women with ch... more Pelvic Congestion Syndrome (PCS) is a common concern for premenopausal, multiparous women with chronic pelvic pain persisting greater than 6 months. It is defined as observable congestion of pelvic veins due to pelvic varicosities that cause reflux and dilation of ovarian veins, resulting in venostasis [1,2]. Although the etiology is unknown, PCS is associated with anterior, posterior or circumaortic location of left renal vein (vascular compression of the left renal vein between the aorta and the superior mesenteric artery) and Nutcracker syndrome. Another marker of PCS includes the absence of functional ovarian venous valves at the junction of left ovarian vein and left renal vein that increase venous pressure in left ovarian vein causing vulvar varicosities [2-4]. It is important to investigate the pathology, as well as the various diagnostic and therapeutic methods available to effectively manage patients with PCS.
Fetal and Pediatric Pathology, 2015
Shaken Baby Syndrome occurs in infants as a result of the brain pushing against the skull due to ... more Shaken Baby Syndrome occurs in infants as a result of the brain pushing against the skull due to severe acceleration-deceleration forces. Symptoms of Shaken Baby Syndrome include subdural, subarachnoid, and retinal hemorrhages. MRI and ocular examinations are used to determine the extent of mental and visual damage and β-amyloid precursor protein immunohistochemical staining is used to detect axonal injuries. Surgeries such as Subdural hemorrhage (SDH) evacuation surgery and the Burr hole craniotomy are used to treat Shaken Baby Syndrome; however, the prognosis is poor in many cases. Because of the severity of Shaken Baby Syndrome and its traumatic and sometimes fatal effects, it is important to educate new parents, nurses, and doctors on the syndrome in order to prevent incidents.