Medicine and Health Sciences Commons^™

Gunshot Wound To The Chest With Retained Epicardial Bullet., Toba Bolaji, Abuoma C Ekpendu, Frederick Giberson

Transitional Year

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance. We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was …

The Philadelphia Surgery Conference: A Value Analysis Of A Hands-On Surgical Skill-Building Event., Luke Dipasquale, Robert Libera, Chi Chi Do-Nguyen, Elizabeth Brehman, Vishwant Tatagari, Heather Waring, Denah Appelt, Arthur Sesso

PCOM Scholarly Papers

Context: Limited opportunities exist to practice technical skills and to be exposed to various surgical specialties during preclinical medical education.

Objectives: To assess the value of workshop-based educational opportunities to medical students during preclinical training.

Methods: One hundred and 75 medical and physician assistant students from 10 medical schools attended the 2019 Philadelphia Surgery Conference. All students received STOP THE BLEED® bleeding control training and participated in four workshops, chosen from a list of 23, that demonstrated a variety of surgical skills. Data collection was accomplished using both a pre- and postconference survey to assess changes in confidence of personal …

Venous Thromboembolism After Penetrating Femoral And Popliteal Artery Injuries: An Opportunity For Increased Prevention, Asanthi Ratnasekera, Odessa Pulido, Sandra Durgin, Sharon Nichols, Alicia Lozano, Danielle Sienko, Alexandra Hanlon, Niels D Martin

General Surgery Resident Research

Background: Trauma patients with penetrating vascular injuries have a higher rate of venous thromboembolism (VTE). The objective of this study was to determine the risk of VTE formation in penetrating femoral and popliteal vascular injuries and the effects of endovascular management of these injuries.

Methods: A retrospective study of Pennsylvania Trauma Outcome Study registry was conducted during a 5-year period (2013-2017). All adult patients with a penetrating mechanism with femoral/popliteal vascular injuries were studied. Primary outcome was incidence of VTE in patients with isolated arterial injuries versus combined arterial/venous injuries. Secondary endpoints were intensive care unit (ICU) length of stay …

Does The Ligasure Vessel Sealing System Provide Benefit In Mortality In Regards To Hepatic Resections?, Samantha M. Kleiber

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not using the LigaSure device provides any benefit in morality in patients undergoing hepatic resection surgery.

STUDY DESIGN: Review of three English language randomized control trials published in 2007, 2009 and 2012.

DATA SOURCES: Data sources obtained for this review primary studies published in peerreviewed journals, found using PubMed.

OUTCOMES MEASURED: Patient mortality, defined as death within 30 days of the surgical procedure.

RESULTS: The study done by Doklestic and et al had 3 patient mortalities occur. The deaths occurred on post op days three, four and …

Is The Use Of A Fresh-Frozen Allograft More Effective Than A Hamstring Autograft In Preserving Functional Knee Ability Post-Surgery In Acl Reconstruction?, Carly E. Black

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of the selective EBM review is to determine whether or not, “Is the use of fresh-frozen allograft more effective than a hamstring autograft in preserving functional knee ability post-surgery in ACL reconstruction?”

STUDY DESIGN: Review of two randomized control trials (RCTs) and one prospective randomized study published between 2011 and 2016, all in English language. The articles compared allograft tendon versus autograft tendon when undergoing ACL reconstructive surgery.

DATA SOURCES: Two randomized control trials (RCTs) and one prospective randomized study were found using PubMed, NCBI, and Cochrane databases. All articles were published in reviewed journals and selected …

Do Adults Undergoing Minimally Invasive Quadriceps-Sparing Total Knee Arthroplasty Have Less Of A Risk Of Developing A Postoperative Deep Venous Thrombosis As Compared To Patients Undergoing A Standard Medial Parapatellar Total Knee Arthroplasty?, Jessica Cataldo-Ramirez

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Do adults undergoing minimally invasive quadriceps-sparing total knee arthroplasty have less of a risk of developing a postoperative deep venous thrombosis as compared to patients undergoing a standard medial parapatellar total knee arthroplasty?”

STUDY DESIGN: A review of one case series published in 2007 and two randomized controlled trials published in 2014.

DATA SOURCES: Primary literature found in PubMed that compared the surgical outcomes of minimally invasive quadriceps-sparing total knee arthroplasty to standard medial parapatellar total knee arthroplasty.

OUTCOME MEASURED: Postoperative deep venous thrombosis development.

RESULTS: …

Is Aromatherapy Effective In Treating Emotional Instability In Women Undergoing Surgical Breast Procedures?, Stephanie Deem

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is aromatherapy effective in treating emotional instability in women undergoing surgical breast procedures?”

Study Design: Systematic review of one single-site, randomized study, one randomized control trial, and one randomized, placebo-controlled study, all English language, one published in 2016 and two published in 2017.

Data Sources: Studies were published in peer-reviewed journals and researched via the PubMed Database.

Outcomes Measured: All of the articles analyzed the effectiveness of aromatherapy in treating emotional instability in women undergoing surgical breast procedures. Improved emotional instability was …

Is Intranasal Ketorolac Both Safe And Effective In Reducing Acute Postoperative Pain For Patients Over 18 Years Of Age That Require Inpatient Hospitalization?, Courtney Koukal

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intranasal ketorolac is both safe and effective in reducing acute postoperative pain for patients over 18 years of age that require inpatient hospitalization.

STUDY DESIGN: Review of three double-blind randomized controlled trials (RCTs) were used, all are from 2008 to present and all are in the English language.

DATA SOURCES: Data sources include articles that were published on both PubMed and Cochrane databases and were selected based on their relevance to the research question as well as patient measured outcomes.

OUTCOMES MEASURED: Outcomes measured include efficacy …

Is Postoperative Consumption Of Coffee Effective In Reducing Postoperative Ileus?, Samantha L. Moran

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is postoperative consumption of coffee effective in reducing postoperative ileus?”

STUDY DESIGN: Review of three randomized controlled trials written in the English language and were published in 2017, 2015, and 2012.

DATA SOURCES: Three randomized control trials were found via PubMed.

OUTCOMES MEASURED: Time in days from the end of surgery until the first passage of stool recorded by patient, or time measured in hours reported by nursing staff.

RESULTS: Dulkskas, et al. (2015) found that the time until the first bowel movement (measured in days) …

Is Therapeutic Play Effective At Reducing Preoperative Anxiety In Children Age 4 Through 12?, Samantha L. Mclaughlin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not therapeutic play is effective at reducing preoperative anxiety in children age 4 through 12.

STUDY DESIGN: Three single blind, randomized controlled trials that were published between 2008 and 2010 and published in the English language.

DATA SOURCES: Each of the three studies that evaluate the effectiveness of therapeutic play in pediatric populations were found using the PubMed database based on their relevance to the clinical question and their inclusion of patient oriented outcomes.

OUTCOMES MEASURED: These three articles compared anxiety and stress levels in preoperative therapeutic …

Kyphotic Progression After Thoracolumbar Burst Fractures Treated Conservatively, With Mis, Or Via Open Approach, Mark Rivkin, Howard Eisenbrock

Research Day

Management of thoracolumbar burst fractures (AO A3) without neurological deficit is subject to debate in the literature. While TLICS provides guidance for injuries necessitating intervention, it makes little mention of best surgical approaches. Furthermore, intact patients with suspected posterior ligamentous complex injury (TLICS 4) compose an additional level of management uncertainty. Present study examined outcomes for TL burst fractures in neurologically intact patients with suspected disruption of the PLC treated with bracing, MIS, or open fixation and fusion.

Is Intravenous Ramosetron 0.3 Mg Effective In The Prevention Of Postoperative Nausea And Vomiting In Women Undergoing Gynecologic Surgery?, Keith S. Elsner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intravenous ramosetron 0.3 mg is effective in the prevention of postoperative nausea and vomiting (PONV) in women undergoing gynecologic surgery.

STUDY DESIGN: Review of three English language primary research articles published later than 1995.

DATA SOURCES: Randomized, double-blinded, controlled clinical trials comparing intravenous ramosetron to placebo or other control groups were identified using Ovid MEDLINE and Cochrane Library databases.

OUTCOMES MEASURED: Measured outcomes include a complete response to the intervention within the first 24-48 hours, the incidence of postoperative nausea and vomiting, need for rescue antiemetic, …

Is The Use Of Apixaban Or Enoxaparin, More Effective In The Prophylaxis Of Venous Thromboembolism Post-Orthopedic Surgery?, Jolene Bohensky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of Apixaban or Enoxaparin is more effective in the prophylaxis of venous thromboembolism post-orthopedic surgery.

STUDY DESIGN: Review of three English language randomized, double-blind, placebo-controlled clinical trials from 2009-2010.

DATA SOURCES: Randomized, double-blind placebo controlled, clinical trials comparing the effectiveness of Apixaban and Enoxaparin in the prophylaxis of Venous Thromboembolism (VTE) post-orthopedic surgery were found using PubMed, the Cochrane Database of Randomized Controlled Trials, and the Cochrane Databases of Systematic Reviews.

OUTCOMES MEASURED: Development of venous thromboembolism (VTE) post-orthopedic surgery including Total …