Hahnemann University Hospital was a tertiary care center in Center City, Philadelphia, and the Center City Philadelphia teaching hospital of Drexel University College of Medicine. Established in 1885, it was for most of its history the main teaching hospital associated with its namesake medical school, Hahnemann Medical College and Hospital, founded in 1848 and named for Samuel Hahnemann, the founder of homeopathy. Hahnemann University Hospital was fully accredited by the Joint Commission on Accreditation of Healthcare Organizations.Hahnemann University Hospital, located at the southwest corner of Broad and Vine streets, was also affiliated with St. Christopher's Hospital for Children in North Philadelphia.The hospital was owned by American Academic Health System, an affiliate of Paladin Healthcare. The sale of Dallas-based for-profit Tenet Healthcare's remaining Philadelphia assets was completed on January 12, 2018.Under American Academic Health System, Hahnemann's financial condition worsened, with the hospital losing roughly $3 million a month. Joel Freedman, CEO of American Academic Health System, publicly stated that Hahnemann was on the brink of closure unless it found financial support from Pennsylvania or Drexel University College of Medicine. As a way to stem ongoing losses, American Academic Health System laid off hundreds of employees throughout 2018 and 2019, closed outpatient offices and eliminated clinical services. In addition to the hospital's financial turmoil, there was constant turnover in hospital leadership with the hospital going through five CEOs in the course of a year.On June 26, 2019, American Academic Health announced that because of unsustainable financial losses, Hahnemann Hospital would close in September 2019. The union representing 800 registered nurses who worked at Hahnemann appealed to Philadelphia Mayor Jim Kenney, the Philadelphia City Council, the Pennsylvania Legislature and Pennsylvania Governor Tom Wolf to keep the hospital open, but to no avail.[needs update] On June 27, 2019, Governor Wolf and the Pennsylvania Department of Health issued a cease and desist and ordered Hahnemann to not take any action toward the hospital's closure until regulators approved a closure plan. On June 29, 2019, Hahnemann withdrew its Level 1 trauma designation. The closure of the hospital resulted in the ACGME displacing 574 physicians who were in training as residents and fellows, the largest such displacement in U.S. history.In March 2020, public health authorities attempted to reopen the hospital to provide additional beds during the COVID-19 pandemic.In March 2020, public health authorities attempted to reopen the hospital to provide additional beds during the COVID-19 pandemic.
Total hip arthroplasty (THA) is one of the most cost-effective and consistently successful surgeries performed in orthopedics . THA provides reliable outcomes for patients suffering from end-stage degenerative hip osteoarthritis (OA), specifically pain relief, functional restoration, and overall improved quality of life. OA affects millions of Americans, and with an incidence of 88 symptomatic cases per 100,000 patients per year, translating to hip OA claiming the top underlying diagnosis leading to THA. Other underlying diagnoses include hip osteonecrosis (ON), congenital hip disorders, and inflammatory arthritis.The underlying diagnosis that leads to a degenerative hip is an important consideration as this has been shown to impact overall outcome. Overall, THA provides consistent short-term and long-term pain relief and positive patient-reported clinical and functional outcomes. In general, THA provides even more reliable and consistent positive results compared to its counterpart procedure, the total knee arthroplasty (TKA).
Neuraxial anesthesia is a standard of care during parturition. Since bleeding diathesis is a contraindication to neuraxial techniques, data about its safe administration in a thrombocytopenic milieu is limited and evolving. Thrombocytopenia associated with preeclampsia or eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome leads to significant maternal and neonatal morbidity. We present a case of uneventful spinal anesthesia for urgent cesarean section in an eclamptic patient with a precipitous drop in platelet count from 124,000 to 97,000 per cubic millimeter under thromboelastography (TEG) guidance.
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma is a distinct, recently described neoplasm of salivary gland nature that has an unusual microscopic appearance exhibiting multidirectional differentiation. Originally described by Bishop et al. in 2012, this distinct form of head and neck cancer is a very rare entity that few pathologists have encountered in practice, and only 50 cases have been reported in the literature. It usually presents as a large, destructive mass confined to the nasal cavity or paranasal sinuses, and is always associated with high-risk HPV infection. Although histologically it often resembles adenoid cystic carcinoma, this neoplasm also consistently exhibits features of myoepithelial, ductal and squamous differentiation. Newly recognized characteristics have recently been described that include bizarre pleomorphism, sarcomatoid transformation, and heterologous cartilaginous differentiation. These unique features have continued to expand the morphologic spectrum of this neoplasm and justify the recent change in its nomenclature from "HPV-related carcinoma with adenoid cystic-like features" to "HPV-related multiphenotypic sinonasal carcinoma (HMSC)". In 2017, "HPV-related carcinoma with adenoid cystic like features" was included as a provisional tumor type by the World Health Organization Classification of Head and Neck Tumors. Despite the presence of high-grade histologic characteristics such as necrosis and brisk mitotic activity, and a tendency for recurrence, HMSC demonstrates indolent clinical behavior and carries a good prognosis.
