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  1. Article: Hydrogel Sealant for Closure of Clear Corneal Incisions in Combined Glaucoma Procedures.

    Machiele, Ryan D / Guduru, Abhilash / Herndon, Leon W

    Clinical ophthalmology (Auckland, N.Z.)

    2022  Volume 16, Page(s) 861–865

    Abstract: Purpose: The purpose of this study is to determine whether ReSure hydrogel sealant is superior to standard suture for closure of clear corneal incisions in the setting of combined glaucoma procedures.: Setting: Glaucoma Department, Duke University ... ...

    Abstract Purpose: The purpose of this study is to determine whether ReSure hydrogel sealant is superior to standard suture for closure of clear corneal incisions in the setting of combined glaucoma procedures.
    Setting: Glaucoma Department, Duke University Eye Center.
    Design: This is a retrospective case series. Subjects studied were patients in a 6-year period undergoing combined phacoemulsification and glaucoma surgery. All cases were performed by the same surgeon. Wound closure methods correlated with discrete timeframes, as ReSure replaced suture midway through the study period, thereby establishing sutured closure as an analogous control group.
    Methods: All cases included a phacoemulsification procedure requiring a 2.4 mm clear corneal incision. Upon completion of the phacoemulsification portion of the case, the wound was closed with either ReSure hydrogel or standard 10-0 suture closure. The researchers assessed the rate of Seidel-positive corneal wound leak on postoperative day one.
    Results: In all cases employing ReSure, no wound leak was observed at postoperative day one. Within the suture group, 3 cases showed Seidel positivity of the corneal incision. This equates to a statistically significant difference in wound leak frequency of 2.04% (P = 0.012); confidence interval, 0.21 to 5.82.
    Conclusion: ReSure was able to maintain closure 100% of the time over hundreds of combined cases. Suture, though the standard of practice, did not perform to this level, presenting with 3 cases of spontaneous wound leak. We conclude that ReSure is highly effective and superior to suture in closure of clear corneal incisions in combined glaucoma procedures.
    Language English
    Publishing date 2022-03-19
    Publishing country New Zealand
    Document type Journal Article
    ISSN 1177-5467
    ISSN 1177-5467
    DOI 10.2147/OPTH.S354531
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Severe Vaginal Bleeding in a Case of Renal Cell Carcinoma.

    Machiele, Ryan / Renbarger, Taylor / Guidry, Bret

    Case reports in obstetrics and gynecology

    2019  Volume 2019, Page(s) 2174051

    Abstract: Renal Cell Carcinoma (RCC) accounts for approximately 2-3% of all adult cancers and carries the highest mortality of the genitourinary cancers. Metastatic disease is seen in approximately 16% of cases and when present represents an advanced status. ... ...

    Abstract Renal Cell Carcinoma (RCC) accounts for approximately 2-3% of all adult cancers and carries the highest mortality of the genitourinary cancers. Metastatic disease is seen in approximately 16% of cases and when present represents an advanced status. Metastasis of RCC to the vagina has rarely been cited in literature and when present can mimic primary vaginal cancer in clinical presentation and symptoms. Biopsy is performed to delineate the etiology and, in the presence of clear cells and certain immunohistochemistry markers, RCC needs to be included in the differential diagnosis. Treatment protocols are limited due to the rarity of the condition, with retrospective and comparative studies alongside cervical cancer treatment protocols serving as the basis. Herein, we describe a unique case of profuse vaginal bleeding secondary to vaginal metastases of RCC and discuss the relevant aspects of diagnosis and treatment.
    Language English
    Publishing date 2019-05-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627654-9
    ISSN 2090-6692 ; 2090-6684
    ISSN (online) 2090-6692
    ISSN 2090-6684
    DOI 10.1155/2019/2174051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Analysis of Sexually Transmitted Diseases Within the Patient Population at a Student-Run Free Clinic.

    Elshazzly, Mohamed / Mnatsakanian, Ani / Machiele, Ryan / Aghili, Roxana / Kuo, Yen-Ping / Hinkelman, Amy

    The Journal of the American Osteopathic Association

    2017  Volume 118, Issue 10, Page(s) e86–e91

    Abstract: Context: Uninsured patients living in rural areas of North Carolina have been inordinately affected by the increasing prevalence of sexually transmitted diseases (STDs) in the midst of severe budget cuts to treatment programs and a shortage of rural ... ...

    Abstract Context: Uninsured patients living in rural areas of North Carolina have been inordinately affected by the increasing prevalence of sexually transmitted diseases (STDs) in the midst of severe budget cuts to treatment programs and a shortage of rural primary care physicians. The Campbell University Community Care Clinic, a self-funded, student-run clinic, provides free health care to uninsured residents of rural Harnett County. As a relatively new clinic serving a unique population, epidemiologic research is paramount to the clinic's continued efficacy.
    Objective: To determine which STDs are present in this patient population and to identify demographic groups at higher risk of contracting STDs.
    Methods: This study was a retrospective analysis of patient medical records from March 1, 2015, to March 6, 2018. Records were evaluated to identify STD cases based on diagnostic information, such as primary diagnoses, positive laboratory results, and clinical indicators.
    Results: A total of 449 patient records were analyzed, revealing an STD incidence rate of 5.3%, which represents a higher STD frequency than the national average of 2%. Our results identified human papillomavirus infection and gonorrhea as the most frequent STDs (n=7 [29.2%] and n=6 [25%], respectively), followed by chlamydia (n=4 [16.7%]), herpes simplex virus (n=4 [16.7%]), syphilis (n=2 [8.3%]), hepatitis C virus (n=2 [4.2%]), trichomoniasis (n=1 [4.2%]), and HIV (n=1 [4.2%]) infections. Among racial/ethnic groups, Hispanics had a slightly higher relative risk (RR) for STDs by a factor of 1.3 when normalized to the average frequency. Patients aged 26 to 29 and 30 to 39 years had a significantly higher RR for STDs: 2.1 and 2.0, respectively. Furthermore, female patients had an STD frequency 3 times that of male patients.
    Conclusion: This study reveals noteworthy health risks in a rural uninsured population, including a higher rate of gonorrhea compared with national rates and a higher RR for STDs in certain demographic groups. These findings form a foundation for improvements in care through earlier STD diagnoses, effective treatment, and enhanced patient education.
    MeSH term(s) Adolescent ; Adult ; Ambulatory Care Facilities ; Female ; Humans ; Male ; Medically Uninsured/statistics & numerical data ; Middle Aged ; North Carolina ; Retrospective Studies ; Rural Health Services ; Sexually Transmitted Diseases/epidemiology ; Socioeconomic Factors ; Student Run Clinic ; Young Adult
    Language English
    Publishing date 2017-11-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 410350-6
    ISSN 1945-1997 ; 0003-0287 ; 0098-6151
    ISSN (online) 1945-1997
    ISSN 0003-0287 ; 0098-6151
    DOI 10.7556/jaoa.2018.150
    Database MEDical Literature Analysis and Retrieval System OnLINE

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