Medicine and Health Sciences Commons^™

Endo-Sponge In Management Of Anastomotic Colorectal Leaks: A Systematic Review And Meta-Analysis, Banreet S. Dhindsa, Yassin Naga, Syed M. Saghir, Sarav Gunjit Singh Daid, Saurabh Chandan, Harmeet Mashiana, Amaninder Dhaliwal, Abhitej Sidhu, Harlan Sayles, Daryl Ramai, Ishfaq Bhat, Shailender Singh, Stephanie Mcdonough, Douglas G. Adler

School of Medicine Faculty Publications

Background and study aims Following colorectal surgery, anastomotic dehiscence and leak formation has an incidence of 2 % to 7 %. Endo-SPONGE has been applied in the management of anastomatic leaks (ALs) after colorectal surgery. This is the first systematic review and meta analysis to evaluate the efficacy and safety of Endo-SPONGE in the management of colorectal ALs. Patients and methods: The primary outcomes assessed were the technical and clinical success of Endo-SPONGE placement in colorectal ALs. The secondary outcomes assessed were the overall adverse events (AEs) and the AE subtypes. Pooled estimates were calculated using random-effects models with 95 …

Robotic Bronchoscopy For Peripheral Pulmonary Lesion Biopsy: Evidence-Based Review Of The Two Platforms, Abhishek Kumar, Jose D. Caceres, Siddharthan Vaithilingham, Gurshan Sandhu, Nikhil K. Meena

School of Medicine Faculty Publications

Despite many advancements in recent years for the sampling of peripheral pulmonary lesions, the diagnostic yield remains low. Initial excitement about the current electromagnetic navigation platforms has subsided as the real-world data shows a significantly lower diagnostic sensitivity of ~70%. “CT-to-body divergence” has been identified as a major limitation of this modality. In-tandem use of the ultrathin bronchoscope and radial endobronchial ultrasound probe has yielded only comparable results, attributable to the limited peripheral reach, device maneuverability, stability, and distractors like atelectasis. As such, experts have identified three key steps in peripheral nodule sampling—navigation (to the lesion), confirmation (of the correct …

Developing Methods To Detect And Diagnose Chronic Traumatic Encephalopathy During Life: Rationale, Design, And Methodology For The Diagnose Cte Research Project, Jeffrey Cummings, Numerous Authors, See Full List Below

School of Medicine Faculty Publications

Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that has been neuropathologically diagnosed in brain donors exposed to repetitive head impacts, including boxers and American football, soccer, ice hockey, and rugby players. CTE cannot yet be diagnosed during life. In December 2015, the National Institute of Neurological Disorders and Stroke awarded a seven-year grant (U01NS093334) to fund the “Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project.” The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine …

Photonic Designs To Reduce Morbidity And Mortality For Icu Patients On Ventilators, Jacob C. Lomonaco, Noah R. Baker, C. David Melville, Catherine A. Olivo, Matthew D. Carson, Eric J. Seibel

School of Medicine Faculty Publications

Ventilator-associated pneumonia (VAP) is pneumonia that occurs >48hrs after initiation of mechanical ventilation and is a significant cause of morbidity and mortality in patients that are hospitalized in intensive care units (ICU). The risk of developing VAP increases during use, and a diagnosis of VAP has been associated with a substantial cost. There are up to hundreds of thousands of cases in the US per year, costing the healthcare system billions annually. Patients who suffer from VAP frequently require longer ICU stays, higher exposure to antibiotics, and more hospital care at the risk of increased mortality. The SARS-CoV-2 pandemic has …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Publications

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Rethinking Intravenous Catheter Size And Location For Computed Tomography Pulmonary Angiography, Travis Marshall, Nae Meng Chen, Eric Nguyen, David E. Slattery, Tony Zitek

School of Medicine Faculty Publications

Introduction: Computed tomography pulmonary angiography (CTPA) is the test of choice for diagnosis of pulmonary embolism (PE) in the emergency department (ED), but this test may be indeterminate for technical reasons such as inadequate contrast filling of the pulmonary arteries. Many hospitals have requirements for intravenous (IV) catheter size or location for CTPAs to reduce the chances of inadequate filling, but there is a lack of clinical data to support these requirements. The objective of this study was to determine if a certain size or location of IV catheter used for contrast for CTPA is associated with an increased chance …

Ultrasound Guided Placement Of Single-Lumen Peripheral Intravenous Catheters In The Internal Jugular Vein, Tony Zitek, Elizabeth Busby, Heather Hudson, John D. Mccourt, Jamie Baydoun, David E. Slattery

School of Medicine Faculty Publications

Introduction: The peripheral internal jugular (IJ), also called the “easy IJ,” is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods: This was a …

Selective Use Of Pericardial Window And Drainage As Sole Treatment For Hemopericardium From Penetrating Chest Trauma, Paul J. Chestovich Md, Christopher F. Mcnicoll, Douglas R. Fraser, Purvi P. Patel, Deborah A. Kuhls, Esmeralda Clark, John J. Fildes

School of Medicine Faculty Publications

Background

Penetrating cardiac injuries (PCIs) are highly lethal, and a sternotomy is considered mandatory for suspected PCI. Recent literature suggests pericardial window (PCW) may be sufficient for superficial cardiac injuries to drain hemopericardium and assess for continued bleeding and instability. This study objective is to review patients with PCI managed with sternotomy and PCW and compare outcomes.

Methods

All patients with penetrating chest trauma from 2000 to 2016 requiring PCW or sternotomy were reviewed. Data were collected for patients who had PCW for hemopericardium managed with only pericardial drain, or underwent sternotomy for cardiac injuries grade 1–3 according to the …