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Biomedical subjects

D Grande

Publications and source records attributed to D Grande.

16 recordsLinked to original sources
PubMed2004

[Intracranial artifact un magnetic resonance caused by embolization of microscopic metallic fragment].

Magnetic resonance imaging (MRI) artifacts have been described in many articles published in the literature. We present the case of a 72 year old man who was admitted due to left inferior limb weakness. MRI imaging demonstrated an acute right infarction of the right posterior cerebral artery. In the right frontal lobe a metallic artifact was demonstrated as well. The artifact showed a central signal void and it was surrounded by a high signal intensity rim. His aortic valve had been replaced 12 years earlier. This indicates that the artifact is in fact due to a small metallic fragment embolization during cardiac surgery.

Aged↗
PubMed2001

Student leadership and activism for social change in the US.

As the US health-care system continues on a path toward greater patient and provider dissatisfaction and decreasing access to primary health services, there is a growing need for leadership among tomorrow's health professionals. Students of today must acquire the skills to lead the United States toward solutions that will offer universal access and eliminate disparities. As examined in the US, there are two main modes for students to learn these meaningful skills; curriculum- and institution-based leadership development and organization-based leadership development. In this paper we review these two methods from an American perspective and discuss ways that educational institutions can support student leadership development. In addition, we address ways in which non-governmental organizations can provide opportunities to foster student leadership. Lastly, we offer recommendations for US policy change at institutional, local, state, and national levels to help achieve the goals stated above.

Journal Article↗
PubMed2001

Use of dermal grafts in reconstructing deep nasal defects and shaping the ala nasi.

BACKGROUND: Deep postsurgical defects on the nose and alar rim pose a challenge to repair. Several techniques are available to reestablish normal contour. If a depressed area is anticipated, dermal grafts can be used to fill the defect and soften contour irregularities. The technique is simple and can prevent the need for a more complicated repair. OBJECTIVE: To reestablish normal contour over nasal defects by using dermal grafts as a tissue filler in conjunction with graft and flap reconstruction. METHODS: Fifteen patients had contour deformities that could be improved with dermal graft insertion under their full-thickness skin grafts or flaps. Fourteen of these patients had nasal defects and one had a vermilion border defect that resulted from tumor removal by Mohs surgery. Patient selection, dermal graft harvesting, and surgical technique are described. RESULTS: All patients showed cosmetic benefit from dermal grafting. Contour was improved in each case. Fourteen patients had no significant complications. One flap showed tip necrosis in a patient who was a smoker. No resorption of the dermal grafts occurred over the 1- to 9-month follow-up period. No cyst formation occurred. CONCLUSION: Dermal grafts can be used during the initial repair of postsurgical nasal defects. These dermis grafts effectively fill the defect and restore contour. The technique is simple, easily mastered, and can obviate the need for more complicated repair.

Aged↗
PubMed2000

Thyroid follicular carcinoma: a case report.

We present an 8-year-old boy with thyroid follicular carcinoma. Differentiated thyroid follicular carcinoma is very uncommon in childhood and is not usually suspected as the explanation of a thyroid nodule during infancy. The purpose of our paper is to demonstrate the imaging findings in a child and to emphasise the importance of including this tumour in the differential diagnosis of thyroid nodules in children.

Adenocarcinoma, Follicular↗
PubMed2000

Teaching prevention through electives.

The Liaison Committee on Medical Education (LCME) accreditation standards affirm that the medical school curriculum should include elective courses to supplement the required courses and provide opportunities for students to pursue individual academic interests. The breadth of opportunities in preventive medicine and population health is extensive as students seek rotations at health departments, rural and urban community health centers, community agencies, occupational health sites, schools, and abroad. A growing number of students choose to participate in MD/MPH dual-degree programs. This article describes four prototypes that foster student learning in preventive medicine: population health, international health, American Medical Student Association opportunities, and public health degree programs. These four types of electives enable students to participate in the front lines of preventive services through experiential learning in: community and population health both at home and abroad, continuous quality improvement, organization and behavioral change, interprofessional teamwork, and health care policy. For those with particular interests in population health and preventive medicine, an increasing number of medical schools offer dual MD/MPH programs, either in conjunction with schools of public health or in graduate programs in public health.

Community Health Centers↗
PubMed1997

The American Stop Smoking Intervention Study for cancer prevention: an overview.

The American Stop Smoking Intervention Study (ASSIST) is a programme to implement proven interventions in 17 states across the United States. ASSIST applies all that we have learned in 10 years of research on tobacco use prevention and control. The goal of this seven-year project is to reduce the prevalence of smoking and cigarette consumption in the ASSIST states. The scientific basis for ASSIST is described, followed by a general description of the project and its current status in the 17 targeted states.

Advertising↗
PubMed1995

Postoperative wound infection rates in dermatologic surgery.

BACKGROUND: Multiple factors related to the nature of the surgical procedure can influence the risk of wound infection in dermatologic surgery. Despite that, wound infection rates in dermatologic surgical procedures are believed to be low. OBJECTIVE: This study was conducted: 1) to determine wound infection rates in Mohs and excisional surgery; and 2) to investigate if factors such as lesion type, anatomic location, postoperative defect size, number of Mohs stages required to achieve a tumor-free plane, and the type of reconstructive procedure influence the rate of surgical wound infections. RESULTS: Wound infection rate for 530 Mohs procedures and 517 excisions combined was 2.29%, falling within the predicted range for "clean" surgical procedures. In addition, Mohs procedures performed on the ear as well as large postoperative defects were found to have a higher rate of wound infections. CONCLUSION: Dermatologic surgery can be safely performed in an outpatient setting without a significant risk of infection. Certain anatomic sites, such as the ear, as well as size of postoperative defect, are important factors in predicting the risk of postoperative wound infection.

Boston↗
PubMed1993

Temporal matrix synthesis and histologic features of a chondrocyte-laden porous collagen cartilage analogue.

Cartilage resurfacing by chondrocyte transplantation, using porous collagen matrices as a vehicle to secure the cells in cartilage defects, has been used experimentally in animals. This in vitro study evaluated the temporal morphologic features and proteoglycan synthesis of chondrocyte-laden collagen matrices. Forty-two porous collagen disks were implanted with a minimum of 6 x 10(6) viable chondrocytes, covered by a polymerized collagen gel layer, and 6 disks were harvested after 0, 3, 7, 10, 14, 18, or 22 days of incubation in supplemented Ham's F12 medium at 37 C and 5% CO2. Histologic and histochemical evaluation of formalin-fixed segments of the cultured disks indicated that the chondrocytes proliferated in the implant, producing small groups and linear segments of cells by day 14. The collagen framework remained intact over the course of the study with thick areas attributable to depositions of matrix material after day 10. Alcian blue-stained matrix was evident in the pericellular region of chondrocytes in sections of disks harvested on days 14, 18, and 22. Glycosaminoglycan (GAG) assay by dimethylmethylene blue dye binding after papain digestion of the disk segments revealed negligible amounts of GAG at day 0. Significant (P < or = 0.0001) increase in total GAG content was observed by day 3 (0.329 micrograms/mg of disk) and further increases were observed until a plateau in GAG quantity was seen on day 14. Mean peak GAG content was 0.553 +/- 0.062 micrograms/mg. Secondary treatment of the papain-digested implants with keratanase and chondroitinase ABC yielded similar trends in chondroitin sulfate (CS) and keratan sulfate (KS) concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Development of an in vitro temporomandibular joint cartilage analog.

A method of producing an in vitro cartilage tissue analog by traditional organ culture methods in an animal model is presented. The resultant tissue analog had the clinical appearance and characteristics of the temporomandibular joint disc. Development of such an analog for in vivo autografting could provide an alternative to present methods for disc repair.

Animals↗
PubMedDate not supplied

Treatment of occluded distal splenorenal shunts with endovascular stents: a report of two cases.

Surgical treatment of an occluded or stenotic portosystemic shunt is difficult and carries a high risk of mortality. We report two cases of early thrombosis of distal splenorenal shunt (DSRS) successfully treated by transcatheter recanalization and stent placement. At 18-month follow-up, the patients remained asymptomatic and control venograms showed continued patency of the shunt with no evidence of stenosis or collaterals.

Aged↗
PubMedDate not supplied

[Diagnosis of thoracic outlet syndrome by angio-MRI].

OBJECTIVE: To evaluate the sequences and maneuvers recommended for the study of the thoracic outlet syndrome (TOS) and the usefulness of magnetic resonance imaging (MRI) in demonstrating its etiology. MATERIAL AND METHODS: We present a study of eight patients with clinical presentation suggestive of TOS. All underwent MRI, gadolinium-enhanced angio-MRI with the arms extended along the body and with postural maneuvers of abduction and elevation of the arms, plain-film chest x-rays, and digital angiography. The anatomic characteristics of the superior aperture of the thorax were analyzed on both sides before and during postural maneuvering. Likewise, the permeability of the vessels and integrity of the brachial plexus was studied. RESULTS: In two cases, angio-MRI demonstrated thrombosis, of the subclavian artery in one case and of the subclavian vein in the other, caused by a cervical rib, which was confirmed at plain-film chest x-ray. In one case, angio-MRI demonstrated stenosis of the subclavian artery on abduction, secondary to hypertrophy of the anterior scalene muscle, and digital angiography showed the same findings. In two cases, angio-MRI showed vascular thrombosis, arterial in one case and venous in the other, without evidence of anatomic anomalies; these findings were confirmed at digital angiography. In two cases, no pathological findings were observed at MRI, angio-MRI, or digital angiography. In one case, MRI showed the presence of a cervical rib without vascular repercussions. CONCLUSION: Gadolinium-enhanced angio-MRI is useful in the evaluation of TOS. It is important to examine patients at rest and during different postural maneuvers. In many cases it is possible to determine the cause of vascular compression.

Female↗