Melanie Ledbetter

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OBJECTIVE The relationship of hiatal hernia to gastroesophageal reflux disease remains controversial. Previous endoscopic and radiologic studies of hiatal hernia and reflux esophagitis have shown that hiatal hernia is a poor predictor of the presence of endoscopic esophagitis, especially for smaller hernias. Similar correlations with 24-hr pH monitoring(More)
Fetuses heal significantly differently than adults; amniotic fluid and the fetal environment have profound effects on the fetus' response to excisional wounding. The Brazilian gray short-tailed opossum (Monodelphis domesticus) is presented as a new model for early developmental wound healing. This is a small, docile, pouchless marsupial whose young, at(More)
The development of an cellular inflammatory response secondary to mechanical wounding has not been observed previously in the fetus. The effect of amniotic fluid exclusion on the inflammatory response in fetal rabbits subjected to full-thickness dorsal excisional wounds on day 25 of gestation (term = 31-32) was examined. The fetuses were either returned(More)
OBJECTIVES Study relationship of gastroesophageal reflux disease to findings on radiographic examination of the esophagus. METHODS We correlated heartburn (HB) in 360 patients (174 women; 186 men; mean age, 53 yr) to results of pH monitoring (pHM) and radiographic examination of the esophagus. Radiographic findings were categorized as normal (n = 129),(More)
OBJECTIVE The purpose of this study was to evaluate the effect of reduction in radiation dose on CT detection of pulmonary embolism. SUBJECTS AND METHODS Emergency department patients were evaluated for pulmonary embolism with standard and simulated reduced-dose CT angiography. Simulated lower-dose CT angiograms obtained at 90, 45, 22, and 10 mAs(eff)(More)
Uncovered fetal rabbit excisional wounds do not exhibit any classic signs of healing; wounds covered with an impermeable cover do contract, reepithelialize, and exhibit inflammation. Prostaglandin E2 (PGE2) is elevated in amniotic fluid, acting as an immunosuppressant at the maternal-fetal interface. Full-thickness excisional wounds were made on 25-day(More)
OBJECTIVE The purpose of our study was to quantify the factors that contribute to the lack of use of a dedicated CT scanner in the emergency department of our institution and to identify possible changes to reduce scanner idle time. MATERIALS AND METHODS We designed a data collection form to record consecutive periods of patient scanning and periods(More)
BACKGROUND The purpose of this preliminary study was to compare acetaminophen to ketorolac for treating patients with fever in the emergency department (ED). METHODS In this prospective, randomized, double-blind pilot study, patients were enrolled as a convenience sample during a 6-month study period. All subjects 18 years or older with a temperature of(More)
We report a case showing the classic features of a Hangman's cervical spine fracture following a motor vehicle collision. Because this injury was not diagnosed at ED presentation, this case also illustrates the select subset of trauma patients for whom the almost obsolete lateral cervical spine radiograph remains an important part of the radiographic trauma(More)
A candidate for the degree of Doctor of Philosophy And hereby certify that in their opinion it is worthy of acceptance. DEDICATION This document is lovingly dedicated to my husband, Marty, who gave me emotional support, technological advice, and educational wisdom throughout this process. ii ACKNOWLEDGEMENTS I would like to thank my advisor, Dr. Wendy Sims,(More)