Sarafem

Larry T. Khoo, MD

• Director of Neurological and Spine Surgery
• The Spine Clinic of Los Angeles
• Los Angeles, California

These disorders may be otherwise asymptomatic women's health big book of exercises itunes purchase sarafem line, there may be potential to develop other manifestations of these diseases including in the other hand menstruation kop buy cheapest sarafem and sarafem, and it may be possible to slow the rate of progression of this condition through active clinical management women's health clinic jeffersonville indiana buy cheap sarafem 10mg line. Evidence for the Use of Screening There are no quality studies incorporated into this analysis pregnancy 9 weeks 4 days buy sarafem with a mastercard. Initial Care Initial care of patients with Kienbock disease involves identification and elimination or control of potential systemic contributing factors. Recommendation: Self-application of Ice for Acute, Subacute, or Chronic Kienbock Disease Self-application of ice is recommended for treatment of acute, subacute, or chronic Kienbock disease. Recommendation: Self-application of Heat for Acute, Subacute, or Chronic Kienbock Disease Self-application of heat is recommended for treatment of acute, subacute, or chronic Kienbock disease. Recommendation: Splints for Acute, Subacute, or Chronic Kienbock Disease Splints are recommended for treatment of select patients with acute, subacute, or chronic Kienbock disease. These interventions are not invasive, have no adverse effects, and are not costly, thus they are recommended. Splints are not invasive and have few adverse effects over the short term although over the long term there are concerns regarding the potential for accelerated debility disuse and weaknesss of the wrist. Follow-up Visits Patients with Kienbock disease generally require periodic appointments to follow the clinical course. Frequencies of appointments may be greater where workplace limitations are required. Post-operative rehabilitation can be considerable, with a requirement for occupational or physical therapy on a prolonged basis in order for the patient to recover as much function as possible. Medications Over-the-counter medications are generally helpful for pain associated with Kienbock disease. Patients with Kienbock disease often develop chronic pain (see Chronic Pain Guideline for a comprehensive approach to managing chronic pain). They are not invasive, have few adverse effects in employed populations, and are low cost, thus they are recommended. Caution is warranted if there is use of anesthetic agents over large areas of the body, as adverse effects from systemic absorption have been reported. Evidence for the Use of Topical Medications There are no quality studies incorporated into this analysis. However, exercise is nearly always necessary for post-operative patients and is frequently used for patients in the subacute and chronic phases. Zero articles met the inclusion criteria Surgery Recommendation: Surgical Repair for Chronic Kienbock Disease Surgical treatment is recommended as an option for patients with moderate to marked impairment if not improved 8 weeks post-injury or after 6 weeks of non-operative treatment due to Kienbock disease. There are many different surgical procedures and no quality comparative studies that have been reported. Surgical procedures utilized have included: lunate excision with silicone implants(1028-1030) (no longer recommended), excision with autogenous soft tissue implants including coiled palmaris longus tendon,(1028, 1031-1036) external fixation,(1035, 1037) arthrodesis,(1038, 1039) radial shortening,(1040, 1041) scaphoid trapezium-trapezoid fusion,(1036, 1042, 1043) in advanced cases, proximal row carpectomy,(1044 1046), lunate core decompression,(1047, 1048) (Mehrpour 11, Rodrigues-Pinto 12) and vascularized bone transfers. Of the 8 articles considered for inclusion, zero randomized trials and 8 systematic studies met the inclusion criteria. Diagnostic Criteria A history of an acute traumatic event with forceful loading of the wrist, combined with a negative examination other than ligamentous tenderness and negative x-rays. Of the 57 articles considered for inclusion 0 diagnostic studies met the inclusion criteria. Of the 445 articles considered for inclusion 0 diagnostic studies met the inclusion criteria. Rationale for Recommendations There are no quality studies evaluating x-rays for wrist sprains. There is no evidence other studies are helpful in the acute setting (see discussion of scaphoid fractures for other studies in the presence of ongoing, non-resolving pain. Of the 248 articles considered for inclusion 0 diagnostic studies met the inclusion criteria. Recommendation: Relative Rest for Acute Wrist Sprains Relative rest is recommended for treatment of acute wrist sprains. Recommendation: Splinting for Moderate or Severe Acute or Subacute Wrist Sprains Splinting is recommended for treatment of moderate or severe acute or subacute wrist sprains. Recommendation: Self-application of Ice for Acute Wrist Sprain Self-application of ice is recommended for treatment of acute wrist sprain. Recommendation: Self-application of Heat for Acute Wrist Sprain Self-application of heat is recommended for treatment of acute wrist sprain. Splints are recommended particularly for patients with moderate to severe sprains. Of the 2 articles considered for inclusion, zero randomized trials and 2 systematic studies met the inclusion criteria. Of the one article considered for inclusion, 1 randomized trial and zero systematic studies met the inclusion criteria. Grip study, increased wrap not Oral placebo Sciences tendinosis, strength improved pain relief, functional reported. Severe wrist sprains may require occupational or physical therapy mostly for teaching mobilization exercises. Wrist sprains that do not resolve or trends towards resolution by 6 weeks should have either further diagnostic evaluation or referral for consideration of other diagnostic testing and treatment options. Medications Over-the-counter medications are generally helpful for pain associated with wrist sprain. They are not invasive, have few adverse effects in employed populations, and are low cost, thus they are recommended for pain associated with acute or subacute wrist sprain. Patients with deficits may require a home exercise program during recovery phases. Surgery Recommendation: Surgery for Treatment of Acute or Subacute Wrist Sprain Surgery is not recommended for treatment of acute or subacute wrist sprain in the absence of a remediable defect. Other than among patients with other trauma necessitating surgery, wrist sprains are not believed to respond to surgery. Mallet Finger Diagnostic Criteria Mallet finger is a clinical diagnosis with a characteristic presentation of inability to extend the distal segment when the extensor tendon is damaged. X-rays may assist in identifying fractures and the magnitude of the involvement of the joint surface, which if large enough, alters management to surgery. While ultrasound has been used for imaging,(1040) there is no evidence it alters treatment or prognosis and x-ray studies appear sufficient for diagnostic purposes. Recommendation: Splints for Acute or Subacute Mallet Finger Extension splinting with the joint in a neutral or hyperextended position is moderately recommended for treatment of acute or subacute mallet finger. Splints must hold the finger in continuous, full extension for a minimum duration of 6 weeks. Of the 12 articles considered for inclusion, 1 randomized trials and 3 systematic studies met the inclusion criteria.

Abstracting for class of case 00 through 14 is to be completed within six months of diagnosis biggest women's health issues cheap sarafem 10 mg on line. This allows for treatment 69 Texas Cancer Registry 2018/2019 Cancer Reporting Handbook Version 1 pregnancy jokes humor cheap sarafem 20 mg on-line. Abstracting for class of case 20 through 22 is to be completed within six months of first contact with the reporting facility menstrual water weight gain purchase 10 mg sarafem. These cases are analyzed because the facility was involved in the diagnostic and therapeutic decision making women's health clinic liverpool 10mg sarafem visa. Note: A facility network clinic or outpatient center belonging to the facility is part of the facility. Abstracting for non-analytical cases should be completed within six months of first contact with reporting facility. Note: Non-analytical class of case codes 49 and 99, are to be used solely by the central registry. A staff physician (codes 10-12, 41) is a physician who is employed by the reporting facility, under contract with it, or a physician who has routine practice privileges there. If the practice is not legally part of the hospital, it will be necessary to determine whether the physicians involved have routine admitting privileges or not, as with any other physician. Note: Code 00 applies only when it is known the patient went elsewhere for treatment. If it is not known that the patient actually went somewhere else, code Class of Case 10. Class 38* Initial diagnosis established by autopsy at the reporting facility, cancer not suspected prior to death. Class 41 Diagnosis and all first course treatment given in two or more different staff physician offices with admitting privileges. Class 42 Non-staff physician or non-CoC approved clinic or other facility, not part of reporting facility, accessioned by reporting facility for diagnosis and/or treatment by that entity (for example, hospital abstracts cases from an independent radiation facility). When applied to these types of facilities, the non-hospital source is the reporting facility. Using Class of Case in conjunction with Type of Reporting Source (500) which identifies the source documents used to abstract the cancer being reported, the central cancer registry has two distinct types of information to use in making consolidation decisions. The patient is discharged to another hospital for treatment for lung cancer with brain metastasis. Reporting facility found cancer in a biopsy, but was unable to discover whether the homeless patient actually received any treatment elsewhere. He has a wide excision at the reporting facility, and then is treated with interferon at another facility. Patient was diagnosed by staff physician, received neoadjuvant radiation at another facility, and then underwent surgical resection at the reporting facility. The patient receives radiation therapy at the reporting facility, and no other treatment is given. The patient undergoes surgery followed by radiation therapy at the reporting facility. She underwent a mastectomy at the reporting facility and did not receive any further treatment. After treatment failure, the patient was admitted to the facility for supported care. Explanation this data item is used to differentiate between patients with the same last name. Blanks, spaces, hyphens and apostrophes are allowed; do not use other punctuation. Explanation this data item is used to differentiate between patients with identical first and last names. If the patient does not have a middle name or initial, or it is unknown, leave blank. Enter the maiden name of female patients who are or have been married if the information is available. Record the alias last name followed by a blank space and then the alias first name. If a patient has multiple primary tumors the address may be different if diagnosed at different times. If the address contains more than 60 characters, omit the least important element, such as the apartment or space number. Do not omit elements needed to locate the address in a census tract, such as house number, street, direction or quadrant, and street type (street, drive, lane, road, etc. Punctuation marks are limited to periods, slashes, hyphens and pound signs in this field. Only use the post office box or the rural mailing address when the physical address is not available. Post office box addresses do not provide accurate geographical information for analyzing cancer incidence. These cases should be rare and every effort should be made to obtain a valid address. Note: Document in Text Remarks Other Pertinent Information: Patient address is unknown. Code the residence where the patient spends the majority of time (usual residence). If the usual residence is not known or the information is not available, code the residence the patient specifies at the time of diagnosis. Note: these include snowbirds who live in the south for the winter months, sunbirds who live in the north during the summer months. This also includes persons with vacation residences which they occupy for a portion of the year. Persons who are incarcerated 78 Texas Cancer Registry 2018/2019 Cancer Reporting Handbook Version 1. Persons who are physically or mentally handicapped or mentally ill who are residents of homes, schools, hospitals, or wards c. Armed Forces-For military personnel and their family members, code the address of the military installation or surrounding community as stated by the patient. Deceased Persons Use residency information from a death certificate only when the residency from other sources is coded as unknown. If the person was a resident of a nursing home at diagnosis, use the nursing home address as the place of residence. Explanation A registry may receive the name of a facility instead of a proper street address containing the street number, name, direction, or other elements necessary to locate an address on a street file for the purpose of geocoding. Explanation Allows for the analysis of cancer clusters, environmental studies, or health services research and is useful for epidemiology purposes.

The diagnosis of aplastic anemia is made from the combination of low hematocrit and white cell count or platelet count and markedly reduced cellularity on bone marrow exam women's health clinic harbor ucla purchase sarafem 10 mg with visa. As in other hypoproliferative anemias breast cancer lump size discount 10 mg sarafem otc, the reticulocyte count is low for the degree of anemia women's health issues list 20 mg sarafem mastercard. The serum iron is elevated because of the marked decrease or absence of erythroid precursors to take up iron from transferrin menstruation large blood clots order sarafem 10 mg amex. If body iron stores accumulate to the 15-20 gram range (normal is 1 gram) for any of the reasons discussed below, tissue damage occurs. When the stores exceed the sequestration capacity of the protective storage protein ferritin, iron exists in a reactive form causing tissue injury, probably by generating free radicals. The most commonly affected organs are the liver (cirrhosis and liver cancer), the pancreas (diabetes), and the heart (congestive heart failure). Arthritis, a variety of endocrine disorders including gonadal failure with impotence, and a peculiar bronze skin color complete the clinical picture. Early recognition and removal of iron prophylactically will prevent all the life-threatening complications. This mutation appeared in a Celtic or Viking ancestor about 2,000 years ago somewhere in Northwest Europe. As its ill effects are manifest only after the reproductive period, and it might have had some survival advantage by preventing iron deficiency anemia after blood loss, the mutation spread with the migrating population. This particular mutation is uncommon or nonexistent in non-Caucasians and women are relatively spared, likely due to iron losses through menstruation or pregnancy. Recent evidence suggests that the failure of these proteins to associate leads to a failure of hepcidin secretion by the liver. Thus ferroportin continues to release iron to the plasma from duodenal enterocytes and macrophages despite very high plasma iron and ferritin levels. Starting at birth, the small increase in iron absorption from a normal value of 1 mg to 2-5 mg daily may result in accumulations of 25-50 grams by about age 50. If hemochromatosis is detected when ferritin levels are less than 1,000 ng/ml, tissue damage is unlikely. Treatment is weekly phlebotomy of 500 cc of whole blood, thus removing about 250 mg of iron each time. It may take up to two years to deplete iron stores, after which 3 to 6 phlebotomies per year will prevent iron reaccumulation. Once tissue damage occurs, it is usually irreversible, though progression is slowed by treatment. All first degree relatives of the patient should have genetic counseling and testing so phlebotomy can be undertaken early and complications prevented. Life-table survival curves after diagnosis in phlebotomy treated and untreated groups of patients with idiopathic hemochromatosis. Increased iron absorption occurs in chronic anemias that are due to ineffective erythropoiesis (thalassemia) or hemolysis. This is because anemia per se and increased marrow erythroid activity for any reason decrease hepcidin release from the liver. Iron overload is a very serious clinical problem in thalassemia major where repeated transfusions add to the iron burden. Many patients with marrow disorders that cause a chronic hypoproliferative anemia (myelodysplasia, aplastic anemia) may need repeated red cell transfusions. As the recycled iron from the senescent transfused red cells cannot be excreted, symptomatic iron overload occurs after about 100 units of blood (250 mg iron/unit x 100 = 25 grams). Iron tablets may resemble candy (M&Ms), and as few as three tablets could cause major toxicity. The gastrointestinal mucosa undergoes necrosis, leading to nausea, vomiting, and bloody diarrhea. Summary Iron is essential to life but paradoxically cannot be free in the body because of its toxicity. Elegant methods are employed by the body to conserve iron and to shield it within transport and storage proteins. It is common in young children and in women in the child-bearing years as a result of an imbalance between supply and demand, whereas in older women and men it is commonly a result of gastrointestinal losses, of which cancer is the greatest concern. Describe, and be able to recognize under the microscope, the morphologic findings in the blood and bone marrow in megaloblastic anemia. Describe the pathophysiology and the clinical and laboratory features of vitamin B12 and folate deficiency, including the important similarities and differences between them. Red cell precursors with this abnormality are called megaloblasts rather than normoblasts. Circulating red cells in megaloblastic anemia are typically larger than normal and are therefore called macrocytes. Definitions Macrocytic anemia is a subset of anemia in which the non-nucleated erythrocytes are larger than 100 femtoliters (fl). It is found in association with liver disease, alcoholism, hypothyroidism, and several forms of marrow damage as well as in B12 and folic acid deficiency. Macrocytes are red cells released before they have divided enough times to be normal-sized. For example, because reticulocytes are considerably larger than mature red cells (some young ones may be 150 fl), hemolytic anemia with a high reticulocyte count may be macrocytic on that basis alone. Megaloblastosis is the visible change in nucleated cells that results from a lag in nuclear maturation relative to cytoplasmic maturation. Folic acid deficiency is probably the most common cause of megaloblastic anemia in the general population, but cobalamin deficiency may be a more common cause in parts of the world where intake of animal protein, the dietary source of vitamin B12, is low. Megaloblastic anemia due to vitamin deficiency is a manifestation of advanced deficiency. In a referral hospital with a large proportion of cancer patients, however, the most common cause of megaloblastic change is cancer chemotherapy. Marked macrocytosis and hypersegmentation of neutrophils occur in patients treated with hydroxyurea. In normal people, most neutrophils will have two, three or four lobes, and fewer than five percent will have five lobes. The peripheral blood expressions of megaloblastosis (macrocytosis and neutrophil hypersegmentation) may occur with minimal anemia. Deficiency of Folate or Vitamin B12 Vitamin deficiency is almost invariably the result of one or more of the following five processes: Inadequate intake of folic acid is common among alcoholics and institutionalized patients. Strict vegetarians ingest very little vitamin B12 and should take a vitamin pill containing B12. Other highly restricted diets lacking in meat and fresh vegetables may produce folic acid deficiency. Drugs may prevent removal of glutamic acid residues on folic acid and thereby impair its absorption. Pregnancy and hemolysis increase the need for folate by accelerating its rate of use and are also extremely rare causes of vitamin B12 deficiency. Nitrous oxide inactivates some of the cobalamin, and may be hazardous in subjects with marginal stores. Two centuries ago, a Scottish naval surgeon, James Lind, proved that fresh lemons and limes cured and prevented scurvy among sailors, but the next clear proof of a specific disease due to a specific nutritional deficiency was not recognized until the early 20th century, when thiamine deficiency was shown to cause beriberi among rice-eating peoples of Southeast Asia. Pernicious anemia was well described morphologically and clinically for at least half a century before it was shown to be caused by a nutritional deficiency, although the distinguished American physician, Austin Flint, wrote in 1860 that the disorder was probably due to a failure to assimilate some necessary nutrient from the diet. Flint also proposed to accept the credit for his idea as soon as someone could do the work necessary to prove its validity! Unfortunately, he did not live long enough to see the proof offered by Minot and Murphy in 1926. Their work was intended to determine the most efficacious diet for the regeneration of blood, and they found, of course, that refeeding the blood to the dog was most efficacious.

Syndromes

• Inhalers (bronchodilators) to open the airways, such as ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil), or albuterol
• Systemic lupus erythematosus
• Barium swallow x-ray
• Weakness
• Tube through the mouth into the stomach to empty the stomach (gastric lavage)
• No signs of nerve damage
• Vomiting
• Gums that are tender when touched but are painless otherwise

A6662 the information contained in this program is up to date as of April 16 menopause 55 years purchase sarafem 10mg without prescription, 2018 pregnancy over 45 buy sarafem 10mg visa. A6681 P682 Getting It off Your Chest: A Case of Actinomyces Israelii Causing Empyema Necessitans/A breast cancer charms generic sarafem 10 mg line. Espinal P704 Malignant Pleural Effusion as the First Presentation of Thyroid Monzon menopause quotes and jokes buy 10mg sarafem fast delivery, E. A6669 P705 Catamenial Pneumothorax A Rare Case of Thoracic P688 Extramedullary Hematopoesis of the Pleura: A Rare Cause of Endometriosis/A. A6670 P706 Spontaneous Chylothorax in an Adult with Noonan P689 Pancreatico-Pleural Fistula Presenting with Large Right-Sided Syndrome/R. A6671 P707 Pleural Effusion as Initial Manifestation of Ovarian P690 Exudative Pleural Effusion as an Initial Presentation of Malignancy/E. A6674 P710 Another Case of Pleural Based Malignancy or Perhaps Not: An P693 A Case of Pleuropulmonary Nodular Lymphoid Hyperplasia Unusual Presentation of Gunshot Injury/J. A6695 P697 Deadly Imposter: A Rare Pleural Tumor Masquerading as P714 Catamenial Hemothorax An Unusual Cause of Elevated Pulmonary Abscess/E. A6696 the information contained in this program is up to date as of April 16, 2018. A6708 P716 A Case of Cryptogenic Bilateral Fibrosing Pleuritis, an P730 Congenital Bronchial Atresia/S. A6698 P731 Obliterative Bronchitis and Bronchiolitis After Toxic Epidermal P717 A Pleural Effusion May Be Your Only Clue: A Rare Necrolysis/J. P732 Long Term Sequale of Refrigerant Exposure, All Obstruction Is Abdelfattah, R. A6711 P718 A Case of Epithelioid Malignant Pleural Mesothelioma that P733 3D Printing and the Cystic Fibrosis Lung/A. A6713 P719 Lung Entrapment Due to Pleural Involvement of Lymphoplasmacytic Lymphoma in Waldenstrom P735 Cystic Fibrosis and Twin Pregnancy, the Challenge of Macroglobulinemia/P. A6714 P720 Doege Potter Syndrome: Solitary Fibrous Tumor of the Pleura Facilitator: S. Ramirez, San Martin Transmembrane Regulator Gene Mutation Causing Recurrent de Porres, Peru, p. Discussion: 11:15-12:00: authors will be present for individual discussion Langfelder-Schwind, L. A6722 P727 A Large Airway Problem: A Case of an Elderly Female with P744 A Rare Cause of Overwhelming Sepsis in an Asplenic Mounier-Kuhn Syndrome/A. A6725 the information contained in this program is up to date as of April 16, 2018. P750 Symptoms of Posterior Glottic Stenosis Presenting Three Discussion: 11:15-12:00: authors will be present for individual discussion Decades After Initial Endotracheal Trauma/A. A6741 P752 Tracheobronchopatia Osteochondroplastica; a Rare Cause of Persistent Cough/R. A6745 P756 Chronic Cough in a Woman from Cameroon: A Case of Tropical Pulmonary Eosinophilia/A. A6733 P774 A Curious Case of Hypoxia: Hepatopulmonary Syndrome in P758 Pulmonary Botryomycosis/J. A6751 Spontaneous Rectus Sheath Hematomas in an Unlikely P779 Pentoxifylline Reduces Intrapulmonary Shunt in a Patient with Scenario/B. A6753 the information contained in this program is up to date as of April 16, 2018. P784 A Case of Intermittent Upper Airway Obstruction: Sudden Recurrent Choking Sensation/S. A6757 12:00-1:00: authors will be present for discussion with assigned facilitators P785 Inexplicable Dyspnea in a Soldier: Constrictive Bronchiolitis/K. A6758 P1325 A Protruding Chest Wall Mass: An Unusual Case of Intercostal Facilitator: D. A6771 P786 Bilateral Vocal Cord Paralysis from Type 1 Chiari Malformation Masquerading as Chronic Obstructive Pulmonary Disease/A. A6772 P787 Special Delivery: Opening the Enigma of Dyspnea in the P1327 Quantitative Computed Tomography in Diagnosing Pregnant Patient/J. A6779 P795 Isolated Congenital Sternal Defect/Absence in a Patient of 58 P1334 the Cocktail Effect of Cigarettes and Marijuana in Giant Bullous Year Old/Y. A6768 P1335 A Rare Case of Spontaneous Pulmonary Bleeding into an P796 Breathless with Dapsone/A. A6781 P797 Mitochondrial Myopathy Presenting in Late Adulthood: A Rare P1336 Recurrent Acute Pancreatitis Secondary to Alpha-1-Antitrypsin Occurrence/H. A6783 the information contained in this program is up to date as of April 16, 2018. Mohr, London, United Simulations for Training Critical Care Fellows in Kingdom, p. A6786 P1141 A Ten-Minute Lecture Impacted the Interpretation of Do-Not-Attempt-Resuscitation Order in Resident Physicians in Japan/Y. A6799 Area K (Hall A-B2, Ground Level) Viewing: Posters will be on display for entire session. P1144 Cardiothoracic Surgical Intensive Care Unit Boot Camp Can Improve Cardiovascular Critical Care Knowledge Among Discussion: 11:15-12:00: authors will be present for individual discussion Trainees/M. P1133 A Novel Clinician-Performed Ultrasound Curriculum for Discussion: 11:15-12:00: authors will be present for individual discussion Internal Medicine Residents/C. A6801 P1135 Rapid Mortality Review as a Tool for Resident Debriefing in the P1147 Formalized Ultrasound Education/C. A6791 P1148 Effectiveness of a Self-Directed Critical Care Ultrasound P1136 High Fidelity Simulation-Based Education to Improve Medical Course/Z. A6793 Ultrasonography Performed by Medical Residents Did Not P1138 Implementation of a Formal Medical Intensive Care Unit Lead to Less Fluid Administration/C. A6794 the information contained in this program is up to date as of April 16, 2018. A6815 Medicine Residents Using Carotid Doppler After a Single P1162 the Central Line Mental Model: A Novel Quality Improvement Training Session/J. A6818 in Neonates and Children Based on Radiographic P1165 Extended-Dwell Peripheral Intravenous Catheters: A Novel Location/D. A6813 P1169 A Clinical Decision Support System to Enable Precision Delivery of Evidence-Based Care to Mechanically-Ventilated P1159 A Retrospective Study of the Effect of Emergency Medicine Patients/S. A6814 Association Between the Daily Spontaneous Awakening Trial and Unplanned Extubations/M. A6827 the information contained in this program is up to date as of April 16, 2018. Norena, Vancouver, P1184 Rapid Response Checklists A Pilot Study for a Novel Canada, p. A6837 P1175 Reducing Routine Blood Testing in the Medical-Surgical P1185 Predictors and Outcome of Diagnostic Error in Patients at Risk Intensive Care Unit: a Single Center Quality Improvement for Critical Illness/J. A6830 P1187 Review of Outcomes of Patients Transferred to Medical P1177 Inappropriate Continuation of Stress Ulcer Prophylaxis Intensive Care Units: A Meta-Analysis/A. A6831 P1188 Risk Factors for Unplanned Intensive Care Unit Transfer After Inter-Hospital Transfer of Medical Patients/M. A6843 P1180 Changing Practice of Stress Ulcer Prophylaxis in Medical Intensive Care Unit at Tertiary Care Center/K. A6851 the information contained in this program is up to date as of April 16, 2018. A6863 P1200 Development of an Intensivist Led, Multidisciplinary, and Integrated Service for Vascular Access/S. A6866 P1203 Comparison of Moral Distress and Burnout Among Residents P1215 Cefepime-Induced Non-Convulsive Status Epilepticus: A Rare in Specialty Programs/P. A6868 P1204 Quality Improvement Project Assessing Multidisciplinary Team P1217 Overcoming Mount Fuji A Sign of Pneumocephalus/B. A6873 Area K (Hall A-B2, Ground Level) P1222 Moyamoya Disguised as Multiple Sclerosis Exacerbation/S.

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