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J Goldberg

Publications and source records attributed to J Goldberg.

435 records · Page 25Linked to original sources

The revised estimated survival probability index of trauma severity.

The construction of a revised version of the Estimated Survival Probability Index (or ESP index) is described. The original index had been proposed as a tool that would be useful in grading from hospital medical records the severity of injuries sustained by patients hospitalized with trauma conditions. The revised index (RESP) is based on a data set of 61,419 records. Unlike the ESP, the RESP index is based upon parameters that are age specific and specific to decimal ICDA codes. The RESP is validated by correlating RESP scores with observed mortality by using an independent set of multiple-trauma patients. Overall, a strong monotonic relationship between the RESP index and increasing mortality was demonstrated. Also, the RESP index correlated with mortality in selected subsets of multiple trauma patients with extremely severe injuries. Some uses and limitations of this index are discussed.

Adult↗

Radiographic alterations in the foot following toe-to-thumb free transfer.

Bone radiographs of 15 males who underwent a toe-hand transplant were studied to characterize alterations in the biomechanics of the foot after the procedure. Anteroposterior, lateral, and sesamoid radiographic views were used. Previous research has assessed this surgery clinically; however, this is one of the first investigations of this technique using conventional radiographs. Definite trends were observed on the operative foot, including stress reaction, disuse osteopenia, arch angle changes, and alignment alterations. Eleven patients exhibited both a stress reaction and some degree of disuse osteopenia. Seven of the subjects demonstrated a decreased arch angle on the operated foot as compared with the contralateral foot. Eight subjects exhibited a varus drift of the second ray. Although these donor defects can be anticipated following this surgery, the long-term benefits of a functional thumb outweigh them.

Adult↗

Expression of beta-human chorionic gonadotropin (beta-hCG) in non-trophoblastic elements of transitional cell carcinoma of the bladder: possible relationship with the prognosis.

Transitional cell carcinoma (TCC) of the bladder is a neoplasm with variability in its clinical behavior. Although there are several studies correlating stage and ABO isoantigen expression with invasiveness, there is no single predictor factor to assess the potential invasiveness, especially in the low grade, non-invasive TCC. In the present study we evaluated the correlation of histological grade plus stage and the expression of beta human chorionic gonadotropin (beta-hCG), in 100 cases of TCC, with the clinical behavior. These features were correlated with tumor progression in patients with at least two years of follow up. We observed more aggressiveness in G4 group (high grade and invasive) (93% had tumor progression) when compared to G1 group (low grade and superficial) (11% had tumor progression). However in 25.5% of the TCC cases (groups G2: low grade and invasive and G3: high grade and superficial) the clinical behavior was intermediate, showing some limitation in using grading and staging only, as a predictive factor. There was an expression of beta-hCG in 21.4% of the cases in up to 25% of the tumor cells without any trophoblastic morphology. These beta-hCG producing TCC had a strong correlation with aggressiveness: 39.1% and 12.8% of the TCC expressed beta-hCG with and without tumor progression, respectively.

Adult↗