Meghan M O'Brien

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Cutaneous metastases occur in 0.7% to 9% of all malignancies. In women, cutaneous metastases occur most often in breast cancer, followed in order by colorectal carcinoma, melanoma and ovarian carcinoma. Of the squamous cell carcinomas (SCC) that do metastasize, many are exceedingly difficult to differentiate from primary SCC of the skin and are often found(More)
We report an asystolic event in an 8-year-old girl under general anesthesia that occurred after bupivicaine was injected into the eyelid during routine chalazion incision and drainage surgery. Because the bupivacaine was injected directly into the subcuticular space and not intravascularly, we concluded that the patient's asystolic event was induced by an(More)
One predawnmorning during mymedical school surgery rotation, I noticed threatening shadows in my groin—lymph nodes decorating my normally smooth inguinal creases. I had lost a little weight too, despite deliberate attempts to bulk up, symptoms that stuck in the refining sieve of my developing medical intuition. I thoughtofmy family’s cancerhistoryand recent(More)
Existing state surrogate decision-maker laws are fragmented and inconsistent and fail to ensure that all eligible decision makers of the same surrogate priority class are included in the healthcare decisions made for an incapacitated loved one. In this article, we explore three categories of harm that result from failing to include all surrogates of equal(More)
STUDY OBJECTIVE To determine if health care providers at one district hospital in Nairobi, Kenya, possess the training and confidence necessary to attend to basic needs for patient resuscitation. DESIGN Prospective cohort study. SETTING Mbagathi District Hospital, Nairobi, Kenya, a 300-bed, government district-level health care facility serving over one(More)
STUDY OBJECTIVE Reasons for recurrent emergency department (ED) visits have been examined primarily through administrative data review. Inclusion of patients' perspectives of reasons for ED return may help inform future initiatives aimed at reducing recurrent utilization. The objective of this study is to describe the personal experiences and challenges(More)