A 68-year-old woman with a history of follicular lymphoma had pathological findings of grade 3B follicular lymphoma, mantle cell lymphoma (MCL), and diffuse large B-cell lymphoma (DLBCL) identified in 1 lymph node. The DLBCL appeared to be a transformation of the follicular lymphoma. The nodules were diffusely and strongly positive for CD20, BCL6, and BCL2. CD43 highlighted smaller lymphocytes in a fraction of the nodules. BCL1 staining was variable with a mixture of nodular and mantle zone patterns. The diffuse areas showed weaker positivity for CD10, BCL2, and BCL6. CD3 and CD5 highlighted intermixed T cells. The Ki-67 proliferative index was overall estimated to be 60%. Fluorescent in situ hybridization performed on the lymph node was positive for CCND1/IGH. The patterns of BCL1 and BCL6 staining demonstrated 2 separate populations of neoplastic B lymphocytes.

01 Jan 2013·Southern Medical JournalQ4 · MEDICINE

Disaster Management and Physician Preparedness

Q4 · MEDICINE

Article

Author: Weibley, Eilene ; Kumar, Ajoy

There are an increasing amount and variety of disasters occurring throughout the United States. Many of these disasters require physicians to provide medical assistance. This article provides a brief introduction to disaster preparedness and its recent history and physicians' obligations, role, education, preparation, and response. It is the intent of this article to increase awareness and provide pathways for physician education and involvement.

01 Oct 2011·AANA journal

Intrathecal hydromorphone for cesarean delivery: in search of improved postoperative pain management: a case report.

Article

Author: Rauch, Erik

Currently, morphine and fentanyl are the most commonly used intrathecal opioids for the postoperative pain management of patients who underwent cesarean delivery. Unfortunately, the analgesic benefits of these 2 drugs tend to fall into different extremes based on lipid solubility. Intrathecal hydromorphone may provide more consistent analgesia because its lipid solubility falls between that of the other 2 opioids. A 22-year-old woman with a 39-week intrauterine pregnancy, gravida 2, para 1, came in for a scheduled second-time cesarean delivery. Her preoperative history included a morphine allergy discovered when administered intrathecally during her first cesarean delivery. Thus, in this case, preservative-free hydromorphone, 100 microg, was administered intrathecally as the opioid replacement for the spinal anesthetic. Intrathecal hydromorphone was found to have provided superior pain relief with fewer side effects in this patient, who received intrathecal morphine for the same surgery 2 years earlier. This case report supports an emerging hypothesis that intrathecal hydromorphone is not only safe but possibly more effective than other intrathecal opioids for pain management after cesarean delivery. The purpose of this case report is to encourage the development of more research regarding this use of intrathecal hydromorphone.

News (Medical) associated with Foundation for a Healthy St. Petersburg

16 Feb 2021

·www.beckershospitalreview.com

Bayfront Health St. Petersburg names new CMO, CNO

Trina Espinola, MD, was named chief medical officer of Bayfront Health St. Petersburg (Fla.), and Lorraine Parker, MSN, RN, was named CNO and assistant vice president, the hospital said Feb. 15. Dr. Espinola has been serving as interim CMO of the organization, which is part of Orlando (Fla.) Health. She also previously served as chief of staff and chief of surgery during her time at Bayfront, and is board certified in otolaryngology. Ms. Parker has been serving as interim CNO of Bayfront. She began her career as a nursing assistant and previously worked in leadership roles at Orlando Health Winnie Palmer Hospital for Women & Babies.

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