Publications by authors named "Thomas Stahl"

12 Publications

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Can lifestyle preferences help explain the persistent gender gap in academia? The "mothers work less" hypothesis supported for German but not for U.S. early career researchers.

PLoS One 2018 28;13(8):e0202728. Epub 2018 Aug 28.

Department of Psychology, Heidelberg University, Heidelberg, Germany.

Do lifestyle preferences contribute to the remaining gender gap in higher positions in academia with highly qualified women-especially those with children-deliberately working fewer hours than men do? We tested the "mothers work less" hypothesis in two samples of early career researchers employed at universities in Germany (N = 202) and in the US (N = 197). Early career researchers in the US worked on average 6.3 hours more per week than researchers in Germany. In Germany, female early career researchers with children had drastically reduced work hours (around 8 hours per week) compared to male researchers with children and compared to female researchers without children, whereas we found no such effect for U.S. researchers. In addition, we asked how long respondents would ideally want to work (ideal work hours), and results revealed similar effects for ideal work hours. Results support the "mothers work less" hypothesis for German but not for U.S. early career researchers.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202728PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112653PMC
February 2019

Tunable Semiconducting Polymer Nanoparticles with INDT-Based Conjugated Polymers for Photoacoustic Molecular Imaging.

Bioconjug Chem 2017 06 31;28(6):1734-1740. Epub 2017 May 31.

Department of Chemistry, University College London , 20, Gordon Street, London WC1H 0AJ, United Kingdom.

Photoacoustic imaging combines both excellent spatial resolution with high contrast and specificity, without the need for patients to be exposed to ionizing radiation. This makes it ideal for the study of physiological changes occurring during tumorigenesis and cardiovascular disease. In order to fully exploit the potential of this technique, new exogenous contrast agents with strong absorbance in the near-infrared range, good stability and biocompatibility, are required. In this paper, we report the formulation and characterization of a novel series of endogenous contrast agents for photoacoustic imaging in vivo. These contrast agents are based on a recently reported series of indigoid π-conjugated organic semiconductors, coformulated with 1,2-dipalmitoyl-sn-glycero-3-phosphocholine, to give semiconducting polymer nanoparticles of about 150 nm diameter. These nanoparticles exhibited excellent absorption in the near-infrared region, with good photoacoustic signal generation efficiencies, high photostability, and extinction coefficients of up to three times higher than those previously reported. The absorption maximum is conveniently located in the spectral region of low absorption of chromophores within human tissue. Using the most promising semiconducting polymer nanoparticle, we have demonstrated wavelength-dependent differential contrast between vasculature and the nanoparticles, which can be used to unambiguously discriminate the presence of the contrast agent in vivo.
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http://dx.doi.org/10.1021/acs.bioconjchem.7b00185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481815PMC
June 2017

Persistent and Recurrent Clostridium difficile Colitis.

Clin Colon Rectal Surg 2015 Jun;28(2):65-9

Interim Chair, Department of Surgery, MedStar Washington Hospital Center; Regional Director, MedStar Colorectal Surgery Program, Washington, District of Columbia.

Clostridium difficile infection (CDI) is the most frequent cause of nosocomial diarrhea. It has become a significant dilemma in the treatment of patients, and causes increasing morbidity that, in extreme cases, may result in death. Persistent and recurrent disease hamper attempts at eradication of this infection. Escalating levels of treatment and novel therapeutics are being utilized and developed to treat CDI. Further trials are warranted to definitively determine what protocols can be used to treat persistent and recurrent disease.
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http://dx.doi.org/10.1055/s-0035-1547333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442717PMC
June 2015

A colorectal surgeon's perspective on the current surgical options for rectal cancer after chemoradiation.

Authors:
Thomas J Stahl

Oncology (Williston Park) 2013 Oct;27(10):968, 970-1

Colorectal Surgical Services, Washington Hospital Center, Washington, DC, USA.

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October 2013

Surgical repair of rectovaginal fistulas in patients with Crohn's disease.

Eur J Obstet Gynecol Reprod Biol 2013 Nov 12;171(1):166-70. Epub 2013 Aug 12.

Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center, Georgetown University School of Medicine, 106 Irving Street, NW Suite 405 South, Washington, DC 20010, United States. Electronic address:

Objectives: To report surgical outcomes of patients who underwent rectovaginal fistula (RVF) repair with a history of Crohn's disease utilizing several reconstructive techniques.

Study Design: Retrospective case series of women (n=6) with Crohn's disease surgically treated with either vaginal or rectal advancement flaps. Demographic information and data specific to Crohn's disease at the time of surgery were collected. In addition, operative reports and postoperative follow-up visits were reviewed.

Results: During the study period, six women with the diagnosis of Crohn's disease and RVF underwent surgical management. Five patients had a vaginal advancement flap (VAF) by Female Pelvic Medicine and Reconstructive Surgery and one patient was treated by the rectal advancement flap by Colorectal Surgery. The failure rate in our study population was 33% (2/6). Of note, two of the patients who had a successful VAF had a previous failure after RAF. In addition, four patients who had a repair via the transvaginal approach had a concomitant pedicled flap procedure (i.e. Martius or gracilis flap). The average follow-up for all our patients was 5 months (+/- 6.5 months). No patients failed if they received a VAF with a concomitant flap procedure.

Conclusions: This case series illustrates several techniques utilized for the repair of RVF in patients with Crohn's disease. The use of a bulbocavernosus flap during the primary repair of RVF in this patient population may be considered to bolster the rectovaginal septum.
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http://dx.doi.org/10.1016/j.ejogrb.2013.08.011DOI Listing
November 2013

Transanal endoscopic microsurgery: safe for midrectal lesions in morbidly obese patients.

Am J Surg 2012 Sep 11;204(3):402-5. Epub 2012 May 11.

Section of Colon and Rectal Surgery, Washington Hospital Center, 106 Irving St. NW, Suite 2100N, Washington, DC 20020-2975, USA.

Background: Transanal endoscopic microsurgery is a safe option for proximal rectal tumors in morbidly obese patients for whom transabdominal pelvic dissection often is fraught with morbidity.

Methods: From a database of 318 patients who underwent transanal endoscopic microsurgery, we report a retrospective case-control study of 9 patients with a body mass index range of 35 to 66 with sessile rectal lesions 6 to 15 cm from the anal verge who underwent transanal endoscopic microsurgery. Case subjects were compared with 15 controls and matched for age, tumor type, and level of tumor. The average body mass index of controls was 30 (P < .001). By using t test analysis, perioperative outcomes (surgical time, blood loss, and hospital length of stay) and postoperative complications were compared.

Results: Sessile tumors were located 7 to 11 cm from the anal verge with a diameter of 1 to 4 cm. Patient and tumor factors such as age, distal tumor margin from anal verge, and tumor diameter were not significantly different between case subjects and controls. Surgical blood loss, surgical time, and hospital length of stay were not significantly different between the 2 groups. One complication occurred among the cases. No complications occurred in the control group. All patients had complete surgical resections with negative margins.

Conclusions: Transanal endoscopic microsurgery in morbidly obese patients is a safe, feasible, and a viable alternative to low anterior resection.
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http://dx.doi.org/10.1016/j.amjsurg.2011.11.011DOI Listing
September 2012

Practice parameters for the surgical treatment of ulcerative colitis.

Dis Colon Rectum 2005 Nov;48(11):1997-2009

Fletcher Allen Health Care, 111 Colchester Avenue, Fletcher 301, Burlington, Vermont 05401, USA.

The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.
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http://dx.doi.org/10.1007/s10350-005-0180-zDOI Listing
November 2005

Vacuum-assisted closure of complex perineal wounds.

Dis Colon Rectum 2004 Oct;47(10):1745-8

Section of Colon and Rectal Surgery, Washington Hospital Center, Washington, DC, USA.

The Vacuum-assisted Closure device decreases the time to wound healing, thus increasing the deposition of granulation tissue, and decreasing the use of wound care specialists. Perineal wounds present a special challenge. We present four cases of complex perineal wounds in which the Vacuum-assisted Closure device was used. In each case, wound care was simplified and healing accelerated. The Vacuum-assisted Closure device allows earlier wound closure, early skin grafting (with improved graft adherence), earlier hospital discharge, and earlier return to baseline functional status. Its use in the perineum presents a challenge, but with proper application, even the most complex perineal wounds can be healed.
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http://dx.doi.org/10.1007/s10350-004-0633-9DOI Listing
October 2004

Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature.

Am Surg 2003 Feb;69(2):166-9

Division of Colon and Rectal Surgery, Washington Hospital Center, Washington, DC, USA.

Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process. Case One is a 52-year-old man with a chronic history of perianal abscesses who presented to the emergency room with a large bowel obstruction. He required diversion and wide local excision with lateral internal sphincterotomy for relief of the obstruction. Pathology from the excised material revealed the unexpected diagnosis of invasive mucinous adenocarcinoma of the anus. Case Two is a 59-year-old man with a chronic history of complex fistulas and abscesses who presented to our office with a horseshoe fistula and deep postanal space abscess. Because of the nonhealing nature of the wound, biopsies from the abscess crater, fistulous tract, and the perianal skin opening were taken. The pathology department identified the specimens as invasive mucinous adenocarcinoma of the anal canal. This is an aggressive cancer often misdiagnosed clinically as benign pathology. A high index of suspicion and biopsy of fistulous tracts and abscesses are the keys to early diagnosis and treatment. With combination chemotherapy and radiation therapy in conjunction with aggressive surgical resection long-term survival might be obtained.
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February 2003

Acute lower gastroenteric bleeding retrospective analysis (the ALGEBRA study): an analysis of the triage, management and outcomes of patients with acute lower gastrointestinal bleeding.

Am Surg 2003 Feb;69(2):145-9

Department of Surgery, Division of Colorectal Surgery, Washington Hospital Center, Medlantic Research Institute, Washington, DC 20010, USA.

Many algorithms have been developed for patients with acute lower gastrointestinal hemorrhage (ALGIH). Their clinical usefulness is not readily apparent. It is important first to observe patterns in admission, triage, and management to formulate hypotheses as to how outcomes might be affected. We reviewed patient charts with the diagnosis of gastrointestinal hemorrhage from June 1998 to January 2001. Patients with ALGIH were entered into a database. We defined patients as having ALGIH if presentation included melena or hematochezia. Patients with hematemesis, bloody nasogastric aspirate, or occult fecal blood were excluded. Observations were made on 420 patients. Seventy-six per cent of patients were admitted to the medical service. Lower endoscopy was the first diagnostic method in 33 per cent. Medical management comprised 52 per cent of first management strategies. Surgeons used angiography (3% vs 1%) or surgery (25% vs 5%) more than other services. Fourteen per cent of patients managed with endoscopy, 16 per cent medically, 17 per cent with surgery, and 67 per cent with interventional radiology required two or more subsequent packed red blood cell transfusions. Mean admission Acute Physiology and Chronic Health Evaluation II score was 9.2 whereas that for those with mortality was 13.5. We conclude that the construction of a database will allow for formation and testing of hypotheses in managing ALGIH.
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February 2003