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Articles 1 - 30 of 196

Full-Text Articles in Surgical Procedures, Operative

Effects Of Psychiatric Comorbidities On The Perioperative Outcomes Following A Primary Total Arthroplasty, Taylor Smith Apr 2018

Effects Of Psychiatric Comorbidities On The Perioperative Outcomes Following A Primary Total Arthroplasty, Taylor Smith

Carroll College Student Undergraduate Research Festival

This review was conducted to compare the perioperative outcomes following a total primary arthroplasty among patients with a psychiatric comorbidity versus those without a psychiatric comorbidity. Literature was reviewed from the database Pubmed. Seven cohort and case-control studies were reviewed, with the largest sample size of 8.4 million patients. Psychiatric comorbidities resulted in increased negative perioperative outcomes compared to patients without psychiatric comorbidities in six articles. These studies observed higher rates of revision, blood transfusion, mortality, non-traditional discharge, and increased length and cost of stay for patients with a diagnosed psychiatric condition. Therefore, it was concluded from most studies ...


Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown Phd, Alexei Gonzalez-Estrada Md Apr 2018

Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown Phd, Alexei Gonzalez-Estrada Md

Appalachian Student Research Forum

Rationale: The purpose of this study is to investigate the stored stability of dilutions of neuromuscular blocking agents (NMBAs), namely cisatracurium, rocuronium, and vecuronium, for skin prick/intradermal testing.

Methods: Concentrations of NMBAs were monitored by liquid chromatography-mass spectrometry (LC-MS/MS) for a period of 14 days. Dilutions of NMBAs were prepared in saline by factors of 10x, 100x, 1,000x, 10,000x, and 100,000x as sensitivity of the assay allowed. Diluted drug products were stored in a laboratory refrigerator until sampling. On sampling days, aliquots of each dilution were removed and compared to a freshly prepared set of ...


Lumbar Decompression Surgery: Does Chronic Steroid Use Increase The Risk Of Postoperative Infectious Complications? – A Study Of The National Surgical Quality Improvement Program (Nsqip) Database, Shane Sobrio, Mikel Thista, Raj Rao, Alex Gu, Chapman Wei, Warren Yu Apr 2018

Lumbar Decompression Surgery: Does Chronic Steroid Use Increase The Risk Of Postoperative Infectious Complications? – A Study Of The National Surgical Quality Improvement Program (Nsqip) Database, Shane Sobrio, Mikel Thista, Raj Rao, Alex Gu, Chapman Wei, Warren Yu

GW Research Days 2016 - Present

Intro: It has long been established that corticosteroids have a negative impact on the human immune system’s ability to function at an optimal level. Many past studies have shown that patient’s will have higher rates of infection if they are taking chronic steroids. What has yet to be established is just how much of an increased risk patients on chronic steroids have for infection after undergoing lumbar decompression surgeries, of which there are thousands per year. We hypothesize that patients on chronic steroids will have higher rates of surgical site infections and higher rates of other infections (UTI ...


The Tempo Trial At 5 Years: Transoral Fundoplication (Tif 2.0) Is Safe, Durable, And Cost-Effective., Karim S Trad, William E Barnes, Elizabeth R Prevou, Gilbert Simoni, Jennifer A Steffen, Ahmad B Shughoury, Mamoon Raza, Jeffrey A Heise, Mark A Fox, Peter G Mavrelis Apr 2018

The Tempo Trial At 5 Years: Transoral Fundoplication (Tif 2.0) Is Safe, Durable, And Cost-Effective., Karim S Trad, William E Barnes, Elizabeth R Prevou, Gilbert Simoni, Jennifer A Steffen, Ahmad B Shughoury, Mamoon Raza, Jeffrey A Heise, Mark A Fox, Peter G Mavrelis

Surgery Faculty Publications

BACKGROUND: Questions remain about the therapeutic durability of transoral incisionless fundoplication (TIF). In this study, clinical outcomes were evaluated at 5 years post-TIF 2.0.

METHODS: A total of 63 chronic gastroesophageal reflux disease (GERD) sufferers with troublesome symptoms refractory to proton pump inhibitor (PPI) therapy, absent or ≤2 cm hiatal hernia, and abnormal esophageal acid exposure were randomized to the TIF group or PPI group. Following the 6-month evaluation, all patients in the PPI group elected for crossover to TIF; therefore, all 63 patients underwent TIF 2.0 with EsophyX

RESULTS: Of 63 patients, 60 were available at 1 ...


Mechanical Pleurodesis Is Not A Contraindication To Lung Transplantation, Alexa Thibodeau Feb 2018

Mechanical Pleurodesis Is Not A Contraindication To Lung Transplantation, Alexa Thibodeau

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Shigemura N, Bhama J, Gries CJ, et al. Lung transplantation in patients with prior cardiothoracic surgical procedures. American Journal of Transplantation. 2012;12(5):1249-1255. doi: 10.1111/j.1600-6143.2011.03946.x


Bow Hunter's Syndrome In A Patient With A Right Hypoplastic Vertebral Artery And A Dynamically Compressible Left Vertebral Artery, David Z. Cai, Ryan P. Roach, John P. Weaver, Gerald T. Mcgillicuddy, Zachary M. Mansell, Jonathan P. Eskander, Mark S. Eskander Jan 2018

Bow Hunter's Syndrome In A Patient With A Right Hypoplastic Vertebral Artery And A Dynamically Compressible Left Vertebral Artery, David Z. Cai, Ryan P. Roach, John P. Weaver, Gerald T. Mcgillicuddy, Zachary M. Mansell, Jonathan P. Eskander, Mark S. Eskander

Open Access Articles

This is a case report of a 48-year-old man with multiple transient ischemic attacks and a known hypoplastic right vertebral artery (VA) who presented after a syncopal event while turning his head to the left. The objective of this study is to demonstrate the necessity of proper diagnosis and management of cerebrovascular pathology including imaging and surgical intervention in patients with known anatomical anomalies. This study was conducted at Massachusetts, United States of America. Our patient's history was significant for a hypoplastic right VA and a stenotic segment of the right VA at the C3-C4 junction. There was also ...


Administering Dexamethasone Prior To Peripheral Nerve Blocks, Jacob Millwood Dec 2017

Administering Dexamethasone Prior To Peripheral Nerve Blocks, Jacob Millwood

Doctoral Nursing Capstone Projects

Post-operative pain creates burdens for the patient and their family members while also drastically increasing the price of cost to the healthcare system. The Institute of Medicine Committee on Advancing Pain Research, Care, and Education states that the annual economic cost of chronic pain in adults is $560-630 billion (IOM, 2011). Regional anesthesia has been shown to provide potent analgesia that often times leads to a reduction in systemic analgesic requirements, opioid related side effects, general anesthesia requirements, and possibly the incidence of chronic post-operative pain. There are several adjunct medications that can be combined with peripheral nerve blocks to ...


Retrieval Analysis Of Necropsy Total Hip Replacements: Considerations Beyond The Implant, Julie Alyse Lowell Dec 2017

Retrieval Analysis Of Necropsy Total Hip Replacements: Considerations Beyond The Implant, Julie Alyse Lowell

Theses and Dissertations (ETD)

Introduction. Total hip arthroplasty (THA) surgery is one of the most commonly performed and successful orthopedic procedures in the United States. More than 300,000 primary THAs and 40,000 revision THAs performed in the United States every year. While the need for revision surgeries can stem from a variety of causes, there have been, to the author’s knowledge, no studies attempting to correlate the concentrations of certain inflammatory cytokines to metal ion concentrations found in the tissue surrounding the implant, amount of polyethylene wear, or strength of the interface of the modular taper. The purpose of this study ...


Carcinoids And Capsules: A Case Series Highlighting The Utility Of Capsule Endoscopy In Patients With Small Bowel Carcinoids, Michael G. Noujaim, Jonathan Green, May Min, Christopher R. Schlieve, Krunal Patel, Mitchell A. Cahan, David R. Cave Dec 2017

Carcinoids And Capsules: A Case Series Highlighting The Utility Of Capsule Endoscopy In Patients With Small Bowel Carcinoids, Michael G. Noujaim, Jonathan Green, May Min, Christopher R. Schlieve, Krunal Patel, Mitchell A. Cahan, David R. Cave

Open Access Articles

Background: Neuroendocine tumors (NETs) or carcinoids arise at many different sites of the gastrointestinal tract. The small intestine is the most common site for NETs. Diagnosing small bowel carcinoids remains challenging given their non-specific presentations and the overall low incidence of small bowel tumors. Video capsule endoscopy (VCE) has significanly improved our ability to detect small bowel malignancies. We explore the value of VCE in the initial workup and management of a series of small bowel carcinoid patients.

Methods: We retrospectively analyzed adult patients undergoing surgical management for small bowel lesions from July 2005 to September 2015 at a tertiary ...


The Outcome Of Thoracentesis Versus Chest Tube Placement For Hepatic Hydrothorax In Patients With Cirrhosis: A Nationwide Analysis Of The National Inpatient Sample, Ali Ridha, Yasir Al-Abboodi, Matthew J. Fasullo Nov 2017

The Outcome Of Thoracentesis Versus Chest Tube Placement For Hepatic Hydrothorax In Patients With Cirrhosis: A Nationwide Analysis Of The National Inpatient Sample, Ali Ridha, Yasir Al-Abboodi, Matthew J. Fasullo

Open Access Articles

There are only a few studies with a small sample size of patients that have compared the risks of using chest tubes versus thoracentesis in hepatic hydrothorax. It has been shown that many complications may arise secondary to chest tube placement and is associated with increased morbidity and mortality. In this retrospective study, patients with cirrhosis were identified from the 2009 National Inpatient Sample by using ICD-9 codes; we evaluated the risk of chest tube versus thoracentesis in a largest population with hepatic hydrothorax to date to measure the mortality and the length of stay. A total of 140,573 ...


Assessment Of Chronic Disease To Determine Appropriateness Of Implantable Cardioverter-Defibrillator Therapy, Bilal M. Omery, Maharaj Singh, Randy S. Turkel, Robyn Shearer, Arshad Jahangir, M. Eyman Mortada, Jasbir S. Sra, Indrajit Choudhuri Nov 2017

Assessment Of Chronic Disease To Determine Appropriateness Of Implantable Cardioverter-Defibrillator Therapy, Bilal M. Omery, Maharaj Singh, Randy S. Turkel, Robyn Shearer, Arshad Jahangir, M. Eyman Mortada, Jasbir S. Sra, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Implantable cardioverter-defibrillator (ICD) therapy is considered appropriate when a patient is felt to have a reasonable expectation of 1-year survival. Chronic diseases have been estimated to be associated with greater than 10% annual mortality and may reduce benefits of ICD therapy. Frailty has been estimated to be associated with greater than 20% annual mortality and has been suggested to contraindicate ICD therapy.

Purpose: Determine a risk score that may identify patients in whom ICD implantation may not be appropriate.

Methods: Patients who received an ICD for primary and secondary prevention from 2008 through 2013 at the Aurora Health Care ...


Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan Nov 2017

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting ...


Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle Nov 2017

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: We ...


Acute Appendicitis After Liver Transplantation: A Case Report And Review Of The Literature, S. E. Sheppard, Hazel Marecki, Charles M. Psoinos, Babak Movahedi, Matthew J. Furman, Adel Bozorgzadeh, Paulo N.A. Martins Nov 2017

Acute Appendicitis After Liver Transplantation: A Case Report And Review Of The Literature, S. E. Sheppard, Hazel Marecki, Charles M. Psoinos, Babak Movahedi, Matthew J. Furman, Adel Bozorgzadeh, Paulo N.A. Martins

Open Access Articles

Acute appendicitis is one of the most common etiologies for acute abdomen. However, fewer than 30 cases of acute appendicitis after liver transplantation have so far been reported in the literature. Previous case studies have concluded that acute appendicitis after liver transplantation may present differently than in non-immunosuppressed patients and thus may lead to more complications. Herein, we describe the fourth case of laparoscopic appendectomy in a 40-year-old female presenting with an acute abdomen, 10 years after orthotopic liver transplantation for autoimmune hepatitis. Additionally, we review the literature, and emphasize the importance for laparoscopic, rather than open appendectomy after liver ...


Anatomic Humeral Head Replacement With A Press-Fit Prosthesis: An In Vivo Radiographic Study, Bryan Vopat, Jeremy Truntzer, Daniel Aaron, Jack Anavian, Joel Schwartz, Andrew Green Oct 2017

Anatomic Humeral Head Replacement With A Press-Fit Prosthesis: An In Vivo Radiographic Study, Bryan Vopat, Jeremy Truntzer, Daniel Aaron, Jack Anavian, Joel Schwartz, Andrew Green

Open Access Articles

Successful total shoulder arthroplasty is, in part, dependent on anatomic reconstruction of the glenohumeral joint. The purpose of this study was to evaluate the post-operative anatomy of total shoulder arthroplasty with an anatomic implant design in patients with primary glenohumeral osteoarthritis and compare it to published normative anatomic measurements. Fifty-one patients (56 shoulders) with primary glenohumeral osteoarthritis were treated with a press-fit humeral component as part of a total shoulder arthroplasty (Aequalis, Tornier, Edina, Minnesota). Analysis of postoperative true anterior posterior radiographs was performed with use of a custom software algorithm. The mean humeral inclination (head-shaft angle), mean humeral implant ...


Vaginal Cuff Dehiscence Presenting With Free Air 60 Days After Robotic-Assisted Hysterectomy, Daniel Munger, M. Iannamorelli, C. Galvez, C. Service Oct 2017

Vaginal Cuff Dehiscence Presenting With Free Air 60 Days After Robotic-Assisted Hysterectomy, Daniel Munger, M. Iannamorelli, C. Galvez, C. Service

Open Access Articles

Introduction: The vast majority of patients presenting with pneumoperitoneum have visceral organ perforation and require urgent diagnostic laparoscopy. Nonsurgical causes are relatively rare and may be attributed to multiple etiologies.

Case Presentation: Here we describe the case of a 38-year-old Caucasian female who presented to the emergency department with three days of cramping, epigastric abdominal pain. Her physical exam was notable for tenderness to palpation in the epigastric area and abdominal and chest X-rays showed free air under the diaphragm. Free air around the porta hepatis was verified on CT scan. Approximately 90% of pneumoperitoneum cases are due to perforation ...


Risks Of Peg Tube Placement In Patients With Cirrhosis-Associated Ascites, Yasir Al-Abboodi, Ali Ridha, Matthew J. Fasullo, Tarek H. Naguib Sep 2017

Risks Of Peg Tube Placement In Patients With Cirrhosis-Associated Ascites, Yasir Al-Abboodi, Ali Ridha, Matthew J. Fasullo, Tarek H. Naguib

Open Access Articles

This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. We then examined multiple factors including sex, race, chronic illness including hypertension, congestive heart failure, and others and their influence on the inpatient mortality of all cirrhotic patients who had PEG placement. A total of 38,175 inpatient PEG tube placements were identified. Only 583 ...


Elective Surgery Type & Screen, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman Aug 2017

Elective Surgery Type & Screen, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Maine Medical Center

Elective Surgery Type and Screen


Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery In High Surgical Risk Patients With Left Main Or Three-Vessel Coronary Artery Disease, Tonga Nfor, Kambiz Shetabi, Wael Hassan, Quinta Nfor, Jayant Khitha, Anjan Gupta, Tanvir Bajwa, Suhail Allaqaband Aug 2017

Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery In High Surgical Risk Patients With Left Main Or Three-Vessel Coronary Artery Disease, Tonga Nfor, Kambiz Shetabi, Wael Hassan, Quinta Nfor, Jayant Khitha, Anjan Gupta, Tanvir Bajwa, Suhail Allaqaband

Aurora Cardiology Fellows

Purpose Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass graft surgery (CABG) in patients with unprotected left main or three-vessel coronary artery disease (LM-3VD) have excluded patients at high surgical risk. We compared clinical outcomes after PCI with drug-eluting stents to CABG in high surgical risk patients with LM-3VD. Methods Patients with symptomatic LM-3VD who had Society of Thoracic Surgeons (STS)-predicted operative mortality >5% and were undergoing either PCI with drug-eluting stents or CABG at a tertiary care center from January 2009 to December 2010 were enrolled in this nonrandomized prospective study. Results Mean STS score ...


Induced Remodeling Of Porcine Tendons To Human Anterior Cruciate Ligaments By Alpha-Gal Epitope Removal And Partial Cross-Linking, Kevin R. Stone, Ann Walgenbach, Uri Galili Aug 2017

Induced Remodeling Of Porcine Tendons To Human Anterior Cruciate Ligaments By Alpha-Gal Epitope Removal And Partial Cross-Linking, Kevin R. Stone, Ann Walgenbach, Uri Galili

Open Access Articles

This review describes a novel method developed for processing porcine tendon and other ligament implants that enables in situ remodeling into autologous ligaments in humans. The method differs from methods using extracellular matrices (ECMs) that provide postoperative orthobiological support (i.e., augmentation grafts) for healing of injured ligaments, in that the porcine bone-patellar-tendon-bone itself serves as the graft replacing ruptured anterior cruciate ligament (ACL). The method allows for gradual remodeling of porcine tendon into autologous human ACL while maintaining the biomechanical integrity. The method was first evaluated in a preclinical model of monkeys and subsequently in patients. The method overcomes ...


Re-Tubularization Of Highly-Ischemic Anti-Mesenteric Border (Rehab): A Novel Bowel Preservation Technique In Complex Gastroschisis., Richard J. Hendrickson, Ashwini S. Poola, Katherine W. Gonzalez, Joel Lim, Tolulope A. Oyetunji Jul 2017

Re-Tubularization Of Highly-Ischemic Anti-Mesenteric Border (Rehab): A Novel Bowel Preservation Technique In Complex Gastroschisis., Richard J. Hendrickson, Ashwini S. Poola, Katherine W. Gonzalez, Joel Lim, Tolulope A. Oyetunji

Manuscripts, Articles, Book Chapters and Other Papers

Complex gastroschisis with bowel necrosis poses an operative challenge. Surgeons must weigh the decision between resection versus preservation of ischemic bowel. As one of the leading causes of short bowel syndrome, aggressive resection in complicated gastroschisis subjects children to prolonged dependence on parenteral nutrition and its attendant complications. Herein, we describe a novel technique aimed towards bowel preservation in complex gastroschisis patients with severe bowel ischemia with the ultimate goal for enteral autonomy.


A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey Jl Carson Mar 2017

A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey Jl Carson

Western Research Forum

Background:

Breast cancer accounts for 25% of all cancer cases among women. In breast-conserving surgery, a common treatment, the tumour is excised with a healthy tissue margin. However, detection of the margin can be difficult. Current techniques to guide excision are often insufficient, and re-excision can occur up to 25% of the time.

Methods:

Photoacoustic imaging is a hybrid imaging modality that combines the advantages of optical imaging and ultrasound while using safe non-ionizing light. This project involves the development of a novel imaging system with a new scanner design to overcome common limitations and provide images to aid in ...


Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner Jan 2017

Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

In discussing an article investigating the causes for delay of first-case operating room start times included in this issue of the Journal of Patient-Centered Research and Reviews, the editor uses elements of complexity science and chaos theory to explain that such stubborn problems rarely stem from one of a few isolated causes. Taking a whole systems approach that utilizes flexibility, cross training, enhanced communication, common sense and perhaps mathematical models is suggested to effect positive change.


Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani Jan 2017

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black ...


Attenuation Of Postoperative Adhesions Using A Modeled Manual Therapy (Data Files), Geoffrey M. Bove, Susan L. Chapelle, Katherine E. Hanlon, Michael P. Diamond, David J. Mokler Jan 2017

Attenuation Of Postoperative Adhesions Using A Modeled Manual Therapy (Data Files), Geoffrey M. Bove, Susan L. Chapelle, Katherine E. Hanlon, Michael P. Diamond, David J. Mokler

Biomedical Sciences Faculty Publications

These files include data and figures utilized to research and communicate the following:

Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations, and represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. Based on the hypothesis that postoperative adhesions develop from a lack of movement of the abdominopelvic organs, we proposed a relatively simple treatment approach using a modified manual therapy technique that mobilizes abdominopelvic structures in the immediate postoperative period while they are otherwise rendered ...


Functional Hemispherotomy In Rasmussen Syndrome In The Absence Of Classic Mri Findings, Yasunori Nagahama, Charuta Joshi, Brian Dlouhy, Angela Y Wu, Taylor J Abel, Gary Baumbach, Hiroto Kawasaki Dec 2016

Functional Hemispherotomy In Rasmussen Syndrome In The Absence Of Classic Mri Findings, Yasunori Nagahama, Charuta Joshi, Brian Dlouhy, Angela Y Wu, Taylor J Abel, Gary Baumbach, Hiroto Kawasaki

Department of Neurosurgery Publications

A 7-year-old previously healthy girl presented with a left-sided focal seizure without impaired consciousness and subsequently developed epilepsia partialis continua. Initial MRI was normal, and the subsequent images only showed a focal T2/FLAIR hyperintense area without cortical atrophy. She was diagnosed with Rasmussen syndrome by pathology and promptly treated with functional hemispherotomy. Rasmussen syndrome is a rare progressive neurological disorder, the only definitive cure for which is hemispheric disconnection. The disease presents a management dilemma, especially early in disease course without characteristic neuroimaging features. A high index of suspicion, multidisciplinary approach, and clear timely communication with the family are ...


Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md Nov 2016

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Errington Thompson

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.


Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani Nov 2016

Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani

Mehiar El Hamdani, MD

Introduction: We are presenting three cases (out of similar several cases) where tibio-pedal approach was performed as an initial primary approach for limb salvage in patients with CLI secondary to Infra-popliteal (IP) disease. We consider this approach to be a necessary evolution in endovascular intervention. Discussion: Retrograde pedal access is safe, feasible with high technical success rate and a relatively low procedural complication rate, with low 30 days mortality and low rate of major adverse cardiac events. Freedom from major adverse limb events and limb salvage are both high at 1 year follow up. It allows quick therapy and short ...


Standardization Of Postoperative Transitions Of Care To The Pediatric Intensive Care Unit Enhances Efficiency And Handover Comprehensiveness, Anthony Sochet, Ashley Simms, Grace Ye, Nihal Godiwala, Lauren Hebert, Christine O. Corriveau Nov 2016

Standardization Of Postoperative Transitions Of Care To The Pediatric Intensive Care Unit Enhances Efficiency And Handover Comprehensiveness, Anthony Sochet, Ashley Simms, Grace Ye, Nihal Godiwala, Lauren Hebert, Christine O. Corriveau

Pediatrics Faculty Publications

Introduction: To determine the impact of standardization of postoperative transitions of care to the pediatric intensive care unit on handover efficiency and the quality of healthcare data exchange.

Methods: This was a prospective, pre–post observational study after standardization of postoperative transitions in a 44-bed pediatric intensive care unit in a 313-bed tertiary care pediatric hospital from April to July 2015. Standardization was completed using a multidisciplinary handover checklist. Primary outcomes were efficiency expressed as mean handover duration and the comprehensiveness of healthcare data exchange.

Results: Forty-seven postoperative transitions were observed of which 23 were preintervention and 24 were postintervention ...


Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani Oct 2016

Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani

Marshall Journal of Medicine

Introduction:

We are presenting three cases (out of similar several cases) where tibio-pedal approach was performed as an initial primary approach for limb salvage in patients with CLI secondary to Infra-popliteal (IP) disease. We consider this approach to be a necessary evolution in endovascular intervention.

Discussion:

Retrograde pedal access is safe, feasible with high technical success rate and a relatively low procedural complication rate, with low 30 days mortality and low rate of major adverse cardiac events. Freedom from major adverse limb events and limb salvage are both high at 1 year follow up. It allows quick therapy and short ...