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Full-Text Articles in Medicine and Health Sciences

Mechanical Properties Of Canine Patella-Ligament-Tibia Segment., Jeffery Biskup, Andy Freeman, W Camisa, J Innes, Michael Conzemius Jan 2104

Mechanical Properties Of Canine Patella-Ligament-Tibia Segment., Jeffery Biskup, Andy Freeman, W Camisa, J Innes, Michael Conzemius

Jeffery Biskup, DVM, DACVS

OBJECTIVE: To test the ex vivo mechanical properties of canine patella-ligament-tibia (PLT) segment and establish the relationship between donor size and PLT dimensions to the mechanical properties of PLT grafts.STUDY DESIGN: Ex vivo mechanical testing study. SAMPLE POPULATION: Canine PLT segments (n = 21 dogs; 42 PLT). METHODS:Morphometric measurements of PLT segments were taken from computed tomography (CT) images and compared with results obtained using calipers. PLT were tested to failure at a rate of 100% length/s. Mechanical properties and failure mode were recorded. RESULTS: PLT width and thickness (P < .001 for both) measured by calipers were significantly lower than those taken from CT images. Thirty-five (83%) specimens failed by avulsion fracture from the patella, 1 failed mid-ligament, and 6 failed by tibial fracture. Dog weight and PLT length had the strongest Pearson's r value when correlated with load at failure (r = 0.73, 0.81, respectively). CONCLUSION:Dog weight and PLT length were the best predictors of load at failure. PLT failure load of dogs weighing >25 kg were similar to those reported for ...


Breakfast With The Experts, Tbd Nov 2018

Breakfast With The Experts, Tbd

Pancreatic Cancer & Related Diseases Symposium

Continental Breakfast, Informational Tables & Scientific Poster Presentations


Download Entire Issue: Gibbon Surgical Review, Volume 1, Issue 2, 2018 Nov 2018

Download Entire Issue: Gibbon Surgical Review, Volume 1, Issue 2, 2018

Gibbon Surgical Review

Download Entire Issue: Gibbon Surgical Review, Volume 1, Number 2, 2018


The Impact Of Depression On Patient Outcomes In Hip Arthroscopic Surgery., Robroy L. Martin, John J. Christoforetti, Ryan Mcgovern, Benjamin R. Kivlan, Andrew B. Wolff, Shane J. Nho, John P. Salvo, Thomas J. Ellis, Geoff Van Thiel, Dean Matsuda, Dominic S. Carreira Nov 2018

The Impact Of Depression On Patient Outcomes In Hip Arthroscopic Surgery., Robroy L. Martin, John J. Christoforetti, Ryan Mcgovern, Benjamin R. Kivlan, Andrew B. Wolff, Shane J. Nho, John P. Salvo, Thomas J. Ellis, Geoff Van Thiel, Dean Matsuda, Dominic S. Carreira

Department of Medicine Faculty Papers

Background: Mental health impairments have been shown to negatively affect preoperative self-reported function in patients with various musculoskeletal disorders, including those with femoroacetabular impingement.

Hypothesis: Those with symptoms of depression will have lower self-reported function, more pain, and less satisfaction on initial assessment and at 2-year follow-up than those without symptoms of depression.

Study Design: Cohort study; Level of evidence, 3.

Methods: Patients who were enrolled in a multicenter hip arthroscopic surgery registry and had 2-year outcome data available were included in the study. Patients completed the 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and ...


Potential Role Of Csf Cytokine Profiles In Discriminating Infectious From Non-Infectious Cns Disorders., Danielle Fortuna, D. Craig Hooper, Amity L. Roberts, Larry A. Harshyne, Michelle Nagurney, Mark T. Curtis Oct 2018

Potential Role Of Csf Cytokine Profiles In Discriminating Infectious From Non-Infectious Cns Disorders., Danielle Fortuna, D. Craig Hooper, Amity L. Roberts, Larry A. Harshyne, Michelle Nagurney, Mark T. Curtis

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Current laboratory testing of cerebrospinal fluid (CSF) does not consistently discriminate between different central nervous system (CNS) disease states. Rapidly distinguishing CNS infections from other brain and spinal cord disorders that share a similar clinical presentation is critical. New approaches focusing on aspects of disease biology, such as immune response profiles that can have stimulus-specific attributes, may be helpful. We undertook this preliminary proof-of-concept study using multiplex ELISA to measure CSF cytokine levels in various CNS disorders (infections, autoimmune/demyelinating diseases, lymphomas, and gliomas) to determine the potential utility of cytokine patterns in differentiating CNS infections from other CNS diseases ...


Metformin Clinical Trial In Hpv+ And Hpv- Head And Neck Squamous Cell Carcinoma: Impact On Cancer Cell Apoptosis And Immune Infiltrate., Joseph M. Curry, Jennifer Johnson, Mehri Mollaee, Patrick Tassone, Dev Amin, Alexander Knops, Diana Whitaker Menezes, My Mahoney, Andrew P. South, Ulrich Rodeck, Tingting Zhan, Larry A. Harshyne, Nancy Philp, Adam J. Luginbuhl, David Cognetti, Madalina Tuluc, Ubaldo E. Martinez-Outshoorn, Md Oct 2018

Metformin Clinical Trial In Hpv+ And Hpv- Head And Neck Squamous Cell Carcinoma: Impact On Cancer Cell Apoptosis And Immune Infiltrate., Joseph M. Curry, Jennifer Johnson, Mehri Mollaee, Patrick Tassone, Dev Amin, Alexander Knops, Diana Whitaker Menezes, My Mahoney, Andrew P. South, Ulrich Rodeck, Tingting Zhan, Larry A. Harshyne, Nancy Philp, Adam J. Luginbuhl, David Cognetti, Madalina Tuluc, Ubaldo E. Martinez-Outshoorn, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Metformin, an oral anti-hyperglycemic drug which inhibits mitochondrial complex I and oxidative phosphorylation has been reported to correlate with improved outcomes in head and neck squamous cell carcinoma (HNSCC) and other cancers. This effect is postulated to occur through disruption of tumor-driven metabolic and immune dysregulation in the tumor microenvironment (TME). We report new findings on the impact of metformin on the tumor and immune elements of the TME from a clinical trial of metformin in HNSCC. Methods: Human papilloma virus-(HPV-) tobacco+ mucosal HNSCC samples (n = 12) were compared to HPV+ oropharyngeal squamous cell carcinoma (OPSCC) samples (n ...


Functional Radical Cervical Dissection For Differentiated Thyroid Cancer: The Experience Of A Single Center, Tulin Adrian, Lucian Alecu, Catalina Poiana, Luminita Tomescu, Iulian Slavu, Raluca Tulin, Silviu Pituru, Cristina Orlov, Radu Jecan, Balalau Cristian, Anca Pantea Stoian, Razvan Hainarosie, Cornelia Nitipir Oct 2018

Functional Radical Cervical Dissection For Differentiated Thyroid Cancer: The Experience Of A Single Center, Tulin Adrian, Lucian Alecu, Catalina Poiana, Luminita Tomescu, Iulian Slavu, Raluca Tulin, Silviu Pituru, Cristina Orlov, Radu Jecan, Balalau Cristian, Anca Pantea Stoian, Razvan Hainarosie, Cornelia Nitipir

Journal of Mind and Medical Sciences

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and ...


A Proposed Therapeutic Algorithm For Colorectal Cancer Prevention, Based On Endoscopic Polypectomies In Patients With Multiple Colonic Polyps, Septimiu Alexandru, Florin D. Ungureanu, Reka Incze Kutasi, Cosmin Alec Moldovan Oct 2018

A Proposed Therapeutic Algorithm For Colorectal Cancer Prevention, Based On Endoscopic Polypectomies In Patients With Multiple Colonic Polyps, Septimiu Alexandru, Florin D. Ungureanu, Reka Incze Kutasi, Cosmin Alec Moldovan

Journal of Mind and Medical Sciences

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare.

Material and method. The present study is based on 2,000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy for various reasons in the Department for Upper and Lower Endoscopy of Witting Clinical Hospital, Bucharest, Romania.

Results. Of the 2,000 patients examined during 2009 - 2017, 594 tumor formations were detected; 148 (24.9%) patients had colorectal malignancies, and 446 (75%) polypoid formations in 313 patients who had one or more colon polyps were found ...


Can Non-Small Cell Lung Cancer Histologic Subtypes Predict Survival? A Single Institution Experience, Cornelia Nitipir, Cristina Orlov, Ana-Maria Popa, Mihaela Olaru, Iulian Slavu, Iaciu Cristian, Razvan Hainarosie, Anca Pantea Stoian, Balalau Cristian Oct 2018

Can Non-Small Cell Lung Cancer Histologic Subtypes Predict Survival? A Single Institution Experience, Cornelia Nitipir, Cristina Orlov, Ana-Maria Popa, Mihaela Olaru, Iulian Slavu, Iaciu Cristian, Razvan Hainarosie, Anca Pantea Stoian, Balalau Cristian

Journal of Mind and Medical Sciences

Introduction. The latest histological classification of lung adenocarcinoma includes lepidic, acinar, papillary, micropapillary, and solid as subtypes. Testing these subtypes for their prognostic and predictive value is an ongoing scientific challenge. The present research article aims to describe the influence this classification has on patient survival.

Materials and Methods. Thirty-three patients were included in the trial. The most important enrollment criterion was the clear specification of the adenocarcinoma subtype in the pathology report. Patients were stratified into three groups which included the adenocarcinoma pathological subtypes as follows: lepidic (LEP), acinar and papillary (ACN/PAP), and micropapillary/solid (MIP/SOL). The ...


Reconstruction Of Heel Soft Tissue Defects Using Sensate Medial Plantar Flap, Mihaela Pertea, Natalia Velenciuc, Oxana Grosu, Bogdan Veliceasa, Vladimir Poroch, Sorinel Lunca Oct 2018

Reconstruction Of Heel Soft Tissue Defects Using Sensate Medial Plantar Flap, Mihaela Pertea, Natalia Velenciuc, Oxana Grosu, Bogdan Veliceasa, Vladimir Poroch, Sorinel Lunca

Journal of Mind and Medical Sciences

Introduction. Reconstruction of heel soft tissue defects represents a true challenge for any surgeon due to the particularities of this anatomical region. The tissue used to reconstruct the heel area must be resistant, innervated, and adapted to take over the body weight. Innervated medial plantar fasciocutaneous flap is one of the best solutions to cover defects at the heel level.

Materials and Methods. We studied 5 patients, 4 males and one female, aged 42 to 67 years, who presented heel soft tissue defects of various etiologies. In all cases, the used reconstructive method was an insular innervated medial plantar fasciocutaneous ...


Sentinel Lymph Node In Early Stage Ovarian Cancer; A Literature Review, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu, Iulian Brezean Oct 2018

Sentinel Lymph Node In Early Stage Ovarian Cancer; A Literature Review, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu, Iulian Brezean

Journal of Mind and Medical Sciences

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a literature review regarding the effectiveness, safety and benefits of this method.

Sentinel lymph node detection in early stage ovarian cancer seems to be a safe and effective method, able to minimize the rate of patients submitted to unnecessary lymph node dissection. The second goal of the procedure, to minimize the risk of missing involved lymph nodes, seems ...


Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda Diphilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks Oct 2018

Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda Diphilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks

Operational Excellence

SAFE TRANSITIONS AND PATIENT HANDOFFS IN A LARGE ACUTE CARE HOSPITAL

It is well documented in the literature that ineffective patient handoffs and transitions continues to be an area that can lead to adverse patient safety events so it is an urgent opportunity for a performance improvement plan. At an academic tertiary care medical center, the lowest scoring domain from the FY2017 AHRQ Patient Safety Culture Survey was patient handoffs and transitions.

A team was established consisting of staff from the Emergency Department and a medical/surgical unit to develop a plan for implementing improvement interventions. Their goal was to ...


The Development And Implementation Of A Reliable Method For Educating Provider Groups On Stroke Discharge Order Sets, Deborah Gregoire, Shawn Taylor, Suneela Nayak, Mark Parker, Kathryn Cope, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley Oct 2018

The Development And Implementation Of A Reliable Method For Educating Provider Groups On Stroke Discharge Order Sets, Deborah Gregoire, Shawn Taylor, Suneela Nayak, Mark Parker, Kathryn Cope, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley

Operational Excellence

THE DEVELOPMENT AND IMPLEMENTATION OF A RELIABLE METHOD FOR EDUCATING PROVIDERS ON STROKE DISCHARGE ORDER SETS

After receiving a comprehensive stroke certification from the Joint Commission, an academic tertiary care medical center created and revised 15 stroke order sets to ensure providers could easily place the correct orders for every stroke patient. Following certification, it was noted that there was inconsistent use of these order sets. This raised concerns that the process to treat a stroke patient may be delayed, creating serious potential risk for the patient.

A goal of this performance improvement plan was to develop and implement a ...


Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, Mmc Asu, Mmc Pacu, Ssu, Endoscopy, Advanced Endoscopy, One Call Center Oct 2018

Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, Mmc Asu, Mmc Pacu, Ssu, Endoscopy, Advanced Endoscopy, One Call Center

Operational Excellence

STRATEGIES TO IMPROVE SAFE PATIENT HANDOFFS AND POST PROCEDURAL FLOW

During patient transfers from one care unit to another, it is imperative for patient safety and satisfaction that timely and complete communication between staff occurs. In an academic tertiary care medical center, a team consisting of representatives from 6 patient care units used improvement methods of operational excellence to improve patient centered movement.

The goal of this project was to improve the percentages of two questions related to information sharing on the FY2018 AHRQ Culture of Patient Safety Survey. Using baseline metrics to reflect the current state of patient wait ...


Strategies To Increase Early Discharges To Decrease Hospital Length Of Stay And Avoidable Patient Days For Neuro-Spine Patients, Corey Fravert, R6, Trauma Team, Rehab Medicine, Neurosurgery, Joy Moody, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks Oct 2018

Strategies To Increase Early Discharges To Decrease Hospital Length Of Stay And Avoidable Patient Days For Neuro-Spine Patients, Corey Fravert, R6, Trauma Team, Rehab Medicine, Neurosurgery, Joy Moody, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operational Excellence

STRATEGIES TO INCREASE MORNING DISCHARGES IN AN ACADEMIC TERTIARY HOSPITAL

Delays in patient discharge result in numerous negative impacts on the health care system. Amongst those are a reduced patient flow and satisfaction, long wait times, and physician/ staff frustration.

An inpatient neurotrauma unit initiated a performance improvement project that utilized a multidisciplinary approach to identify barriers to discharge and coordinate a discharge plan focused on neurospine patients.

A root cause analysis was conducted to collect reasons that these patients were not discharged by 11:00am. As a result of the findings, 4 performance improvement plans were created. Subsequent data ...


The Impact Of Joint Commission International Accreditation On Time Periods In The Operating Room: A Retrospective Observational Study, Takenori Inomata, Ju Mizuno, Masao Iwagami, Shiori Kawasaki, Akie Shimada, Eiichi Inada, Tina Shiang, Atsushi Amano Sep 2018

The Impact Of Joint Commission International Accreditation On Time Periods In The Operating Room: A Retrospective Observational Study, Takenori Inomata, Ju Mizuno, Masao Iwagami, Shiori Kawasaki, Akie Shimada, Eiichi Inada, Tina Shiang, Atsushi Amano

Open Access Articles

The Joint Commission International (JCI) is responsible for upholding standards in healthcare and organizations in compliance receive accreditation. JCI requires quality improvement on patient safety goals, but requirements may prolong the total procedure/surgery time and reduce efficiency. Here, we evaluate the impact of JCI requirements on time periods in the operating room. We included patients who received elective and emergency surgeries under general anesthesia at Juntendo University Hospital between December 2014 and June 2016. Patients were classified as before and after JCI accreditation on December 12, 2015. The primary outcome was total procedure/surgery time. Secondary outcomes include five ...


Comparison Of Survival Indicators Between Myocardial Infarction Patients And Septic Patients Who Received Veno-Arterial Extracorporeal Membrane Oxygenation, Niharika Boinpally, Kennedy Gallagher, Allison Eisenhauer Pa-C, Michael Healy, Kristina Postko Pa-C, James K. Wu Md Sep 2018

Comparison Of Survival Indicators Between Myocardial Infarction Patients And Septic Patients Who Received Veno-Arterial Extracorporeal Membrane Oxygenation, Niharika Boinpally, Kennedy Gallagher, Allison Eisenhauer Pa-C, Michael Healy, Kristina Postko Pa-C, James K. Wu Md

Department of Surgery

No abstract provided.


Successful Renal Transplantation After Presumed Cyanide Toxicity Treated With Hydroxocobalamin And Review Of The Literature, Ryan J. Hendrix, Paulo N.A. Martins, Jeffrey S. Stoff, Aaron Ahearn, Adel Bozorgzadeh, Babak Movahedi Sep 2018

Successful Renal Transplantation After Presumed Cyanide Toxicity Treated With Hydroxocobalamin And Review Of The Literature, Ryan J. Hendrix, Paulo N.A. Martins, Jeffrey S. Stoff, Aaron Ahearn, Adel Bozorgzadeh, Babak Movahedi

Open Access Articles

We report two cases of successful renal transplantation with allografts from donors who suffered anoxic brain injury as the primary cause of death from house fires. Each was treated prophylactically with hydroxocobalamin (Cyanokit) for suspected cyanide toxicity. During organ procurement, gross examination was notable for deep discoloration of the parenchymal tissues. Approximately 6 and 18 months after transplantation, both recipients have excellent renal graft function and remain independent from hemodialysis (HD). Hydroxocobalamin is the antidote for suspected acute cyanide toxicity. While largely tolerated by the recipient, there is concern over the potential functional implications of the associated side effects of ...


Editorial: Fundamentals Of Missed Care – Implications For The Perioperative Environment, Nicholas Ralph Sep 2018

Editorial: Fundamentals Of Missed Care – Implications For The Perioperative Environment, Nicholas Ralph

Journal of Perioperative Nursing

No abstract provided.


Pressure Injury Prevention For Surgery: Results From A Prospective, Observational Study In A Tertiary Hospital, Isabel Wang, Rachel Walker, Brigid M. Gillespie Sep 2018

Pressure Injury Prevention For Surgery: Results From A Prospective, Observational Study In A Tertiary Hospital, Isabel Wang, Rachel Walker, Brigid M. Gillespie

Journal of Perioperative Nursing

No abstract provided.


Private Pain – Identifying Gaps In The Management Of Chronic Pain Patients In Private Hospitals: A Case Study, Johanna Gale Sep 2018

Private Pain – Identifying Gaps In The Management Of Chronic Pain Patients In Private Hospitals: A Case Study, Johanna Gale

Journal of Perioperative Nursing

This is a case study of a patient who experiences chronic pain and was admitted for an acute surgical procedure in a private hospital. It illustrates how communication and teamwork can be overlooked within the multidisciplinary focus when jointly caring for this group of patients within the public and private sectors. This case study offers a nurse-led approach to improving individualised health care for chronic pain patients while preventing gaps in health care.


Establishing A New Cardiac Surgery Service In An Australian University Hospital: Pitfalls And Lessons Learned, Claudia Ciobanu, Sharon Latimer, Brigid M. Gillespie Sep 2018

Establishing A New Cardiac Surgery Service In An Australian University Hospital: Pitfalls And Lessons Learned, Claudia Ciobanu, Sharon Latimer, Brigid M. Gillespie

Journal of Perioperative Nursing

Cardiovascular disease is the leading cause of death among Australians. Creating and delivering a world-class cardiac surgery service in a cost-effective way is the principle goal of health care organisations and managers. Establishing a new health care service is a unique opportunity and requires detailed planning and implementation. Managing change is pivotal to establishing a new patient-focused health care service, and should be coupled with effective communication and teamwork among all stakeholders. There are foreseen and unforeseen challenges associated with any project so sharing the lessons learned is an important way for others in a similar situation to avoid potential ...


Intestinal Bacterial Contamination Of Surgical Instruments Used For Wound Closure During Intestinal Surgery, Norihiro Kameda, Junko Nishio, Toshiko Ogawa, Shinobu Okada Sep 2018

Intestinal Bacterial Contamination Of Surgical Instruments Used For Wound Closure During Intestinal Surgery, Norihiro Kameda, Junko Nishio, Toshiko Ogawa, Shinobu Okada

Journal of Perioperative Nursing

No abstract provided.


Prevalence And Risk Factors Of Low Back Pain And Disability Index Among Operating Room Nurses, Anita Kiruba Jeyakumar, Florence Segaran Sep 2018

Prevalence And Risk Factors Of Low Back Pain And Disability Index Among Operating Room Nurses, Anita Kiruba Jeyakumar, Florence Segaran

Journal of Perioperative Nursing

Introduction

Work related low back pain (LBP) has a clear impact on productivity at work. The aim of the study was to assess the prevalence and risk factors of LBP among operating room (OR) nurses. It also aimed to identify the disability index among those OR nurses diagnosed with LBP.

Method

This cross-sectional survey was conducted among the OR nurses working at a 2500-bed tertiary care centre with 37 operating rooms. OR nurses with a minimum of one year experience were included. A validated self- structured questionnaire was administered to them. Statistical analysis was done using Chi square test, and ...


Plasma Soluble Human Elastin Fragments As An Intra-Aneurysmal Localized Biomarker For Ruptured Intracranial Aneurysm, Daichi Nakagawa, Mario Zanaty, Joseph Hudson, Nahom Teferi, Daizo Ishii, Lauren Allan, Pascal Jabbour, Santiago Ortega-Gutierrez, Edgar A. Samaniego, David M. Hasan Sep 2018

Plasma Soluble Human Elastin Fragments As An Intra-Aneurysmal Localized Biomarker For Ruptured Intracranial Aneurysm, Daichi Nakagawa, Mario Zanaty, Joseph Hudson, Nahom Teferi, Daizo Ishii, Lauren Allan, Pascal Jabbour, Santiago Ortega-Gutierrez, Edgar A. Samaniego, David M. Hasan

Department of Neurosurgery Faculty Papers

Background—Fragmentation of the tunica media is a hallmark of intracranial aneurysm formation, often leading to aneurysmal progression and subsequent rupture. The objective of this study is to determine the plasma level of elastin fragments in the lumen of ruptured versus unruptured human intracranial aneurysms. Methods and Results—One hundred consecutive patients with/without ruptured saccular intracranial aneurysms undergoing endovascular coiling or stent-assisted coiling were recruited. Blood samples were collected from the lumen of intracranial aneurysm using a microcatheter. The tip of the microcatheter was placed inside the aneurysm’s sac in close proximity to the inner wall of the ...


Heparin Bridging Therapy Is Not Necessary For Patients With Atrial Fibrillation Undergoing Temporary Interruption Of Warfarin Therapy For Elective Invasive Procedures Or Surgery, Shannon Paquette Aug 2018

Heparin Bridging Therapy Is Not Necessary For Patients With Atrial Fibrillation Undergoing Temporary Interruption Of Warfarin Therapy For Elective Invasive Procedures Or Surgery, Shannon Paquette

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Douketis JD, Spyropoulos AC, Kaatz S, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. New Engl J Med. Aug 2015;373(9):823-833. doi: 10.1056/NEJMoa1501035


Heat Stroke As A Cause Of Liver Failure And Evaluation Of Liver Transplant, Paulo N.A. Martins, Isabel M. A. Bruggenwirth, James Mcdaid, Martin Hertl, Tatsuo Kawai, Nahel Elias, Raymond T. Chung, James F. Markmann Aug 2018

Heat Stroke As A Cause Of Liver Failure And Evaluation Of Liver Transplant, Paulo N.A. Martins, Isabel M. A. Bruggenwirth, James Mcdaid, Martin Hertl, Tatsuo Kawai, Nahel Elias, Raymond T. Chung, James F. Markmann

Open Access Articles

Heat stroke is a multiple organ dysfunction syndrome of poorly understood pathogenesis. Exertional heat stroke with acute liver failure is a rarely reported condition. Liver transplant has been recommended as treatment in cases of severe liver dysfunction; however, there are only 5 described cases of long-term survival after this procedure in patients with heat stroke. Here, we present 2 cases of young athletes who developed heat stroke. Both patients developed acute liver failure and were listed for liver transplant. Liver function tests of one patient improved, and he was discharged on postoperative day 13. The other patient showed no signs ...


Single-Center Experience With Liver Transplant Using Donors With Very High Transaminase Levels, Paulo N.A. Martins, Amanda Rawson, Babak Movahedi, Isabel M. A. Bruggenwirth, Natasha H. Dolgin, Ann-Britt Martins, Paria Mahboub, Adel Bozorgzadeh Aug 2018

Single-Center Experience With Liver Transplant Using Donors With Very High Transaminase Levels, Paulo N.A. Martins, Amanda Rawson, Babak Movahedi, Isabel M. A. Bruggenwirth, Natasha H. Dolgin, Ann-Britt Martins, Paria Mahboub, Adel Bozorgzadeh

Open Access Articles

OBJECTIVES: Elevation of transaminases has been used as a marker of hepatic ischemic injury and as a crucial parameter for liver graft assessment. However, analysis of serum transaminases has limitations regarding the quantitative assessment of liver necrosis and is not a reliable predictor of outcomes.

MATERIALS AND METHODS: We retrospectively reviewed the medical records of all liver transplants (N = 238) performed at the UMass Memorial Medical Center from 2009 to 2013.

RESULTS: Fourteen liver grafts showed high peak aminotransferases alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at > 1000 U/L. This high aminotransferase group was compared with 224 donors with ...


Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung Aug 2018

Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung

Master's Projects and Capstones

Surgical site infections (SSI) cause negative health care effects to patients and hospitals. SSI is one of the most common types of healthcare-associated infections (HAI) accounting for 31% among hospitalized patients (Centers for Disease Control and Prevention [CDC], 2012). It is associated with prolonged length of stays (LOS), higher morbidity and mortality, and increased healthcare costs. The purpose of this quality improvement project is to decrease SSI rates by enhancing patient education and engagement in preoperative care and hygiene before surgery. In a metropolitan pediatric hospital, a microsystem analysis of the preoperative unit was conducted before generating the SSI Prevention ...


Impact Of Race And Insurance On Door-To-Appendectomy Time Among Pediatric Patients, Carla M. Lopez, Emily R. Christison-Lagay, Daniel Solomon Aug 2018

Impact Of Race And Insurance On Door-To-Appendectomy Time Among Pediatric Patients, Carla M. Lopez, Emily R. Christison-Lagay, Daniel Solomon

Journal of Health Disparities Research and Practice

Racial and ethnic disparities in the rate of appendiceal rupture have been widely reported among the pediatric population. The main reasons for this remain largely unknown given that previous explanations pointing to signs of poor health care access have recently been shown to account for only a small percentage of the difference in perforation rates between white and minority children. Because the risk of perforation increases with time, racial disparities in time delay from emergency department presentation to OR appendectomy may help account for the higher appendiceal perforation rates observed among minority children. This is the first study dedicated to ...