Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), 2024 Otterbein University
Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson
Doctor of Nursing Practice Scholarly Projects
When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …
Barriers To And Facilitators Of Using Cognitive Aids In Perioperative Emergencies: An Integrative Review, 2024 Australian College of Perioperative Nurses (ACORN)
Barriers To And Facilitators Of Using Cognitive Aids In Perioperative Emergencies: An Integrative Review, Simon Almoite, Paula Foran
Journal of Perioperative Nursing
Problem identification: Perioperative emergencies, although infrequent, may lead to significant morbidity and mortality associated with anaesthesia and/or surgery. Human factor errors account for between 43 to 65 per cent of sentinel events in the perioperative environment. Cognitive aids were introduced to reduce a user’s cognitive workload and assist in adherence to key interventions during emergencies. Despite the availability of these aids, implementation of their use remains low. This integrative literature review will identify the barriers to and facilitators of the implementation of cognitive aids during perioperative emergencies.
Literature search: An electronic database search of EBSCO databases (CINAHL Complete, Health Source: …
Assessment Of General Surgery Resident Wellness From The Perspectives Of Family, Friends, And Loved Ones, 2024 Department of Internal Medicine, Faculty of Medicine, University of Ottawa
Assessment Of General Surgery Resident Wellness From The Perspectives Of Family, Friends, And Loved Ones, Dana Unninayar, Benjamin Sc Fung, Gordon Best, Isabelle Raiche
Journal of Wellness
Introduction: Surgical trainees have high rates of burnout compared to residents from other specialties. However, burnout is underreported by trainees, limiting potential interventions to improve wellness. Loved ones are an underused resource for assessing wellness and detecting burnout among residents. The purpose of this study is to assess the perceptions and concerns regarding resident wellness and burnout, as well as strategies to improve wellness, from the perspective of loved ones.
Methods: This cross-sectional survey study was conducted in 2022 at an urban academic center after ethics board approval. An anonymous 18-question survey to assess resident burnout, wellness, and …
Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, 2024 Wayne State University School of Medicine
Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer
Clinical Research in Practice: The Journal of Team Hippocrates
A clinical decision report using:
You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868
for a patient with a recurrent diverticulitis complicated by abscess formation.
Efficacy Of Observational Care Versus Antibiotic Therapy For Treatment Of Acute Uncomplicated Diverticulitis, 2024 Wayne State University School of Medicine
Efficacy Of Observational Care Versus Antibiotic Therapy For Treatment Of Acute Uncomplicated Diverticulitis, Morgan Mooty, Abbie R. Bauer
Clinical Research in Practice: The Journal of Team Hippocrates
A clinical decision report using:
van Dijk ST, Daniels L, Ünlü Ç, et al. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. Am J Gastroenterol. 2018;113(7):1045-1052. https://doi.org/10.1038/s41395-018-0030-y
for a patient with acute uncomplicated diverticulitis.
Pediatric Appendicitis Or Not? A Retrospective Cohort Study From A Single Institution - Our Management And Factors Determining The Disease, 2024 Department of Radiology, Faculty of Medicine, Chulalongkorn University & King Chulalongkorn Memorial Hospital
Pediatric Appendicitis Or Not? A Retrospective Cohort Study From A Single Institution - Our Management And Factors Determining The Disease, Nimmita Srisan, Teerasak Phewplung, Katawaetee Decharun, Prapapan Rajatapiti, Paisarn Vejchapipat
Chulalongkorn Medical Journal
Purpose: The aims were to assess our treatment guidelines and to determine factors in differentiating children with acute appendicitis from other diseases.
Methods: Pediatric surgery consultations for suspected appendicitis from October 2019 to October 2021 was retrospectively studied. The treatment guidelines of children with suspected appendicitis were elucidated. Moreover, factors identifying the diagnosis of appendicitis were analyzed using multi-variate logistic regression.
Results: Ninety-one children were consulted for suspected appendicitis. Forty-one children (45.1%) were promptly successfully treated without observation or ultrasonography, except one negative appendectomy (2.4%). The other 50 children (54.9%), showed equivocal clinical symptoms and signs, requiring further management either …
Endoscopic Management Of Boerhaave Syndrome: Are Outcomes Better Than Surgery? A Case Report And Review Of Literature, 2024 Gastroenterology and Hepatology Fellow, Department of Medicine, University of California-Riverside.
Endoscopic Management Of Boerhaave Syndrome: Are Outcomes Better Than Surgery? A Case Report And Review Of Literature, Ammar Qureshi, Uvesh Mansuri, Mona Roknsharifi, Youssef Ghobrial, Artin Asgeri, Mehrdad Asgeri
Journal of Community Hospital Internal Medicine Perspectives
Boerhaave syndrome (BS) is a rare clinical diagnosis associated with a high morbidity and mortality rate. Diagnosis of this condition is usually delayed which can lead to a very poor outcome. The timing of presentation and time to management plays a very important role in the prognosis and selection of the management method. With the advances seen in therapeutic endoscopy, many authors have been exploring the possibility of shifting the focus of management from surgery to interventional endoscopy. We present a case report of a patient presenting with BS that was successfully managed endoscopically. We also reviewed the literature on …
Rapid (Reducing The Anxiety Of Patients In Interventional And Diagnostic) Radiologic Procedures: A Review Of The Literature, 2024 Wayne State University School of Medicine
Rapid (Reducing The Anxiety Of Patients In Interventional And Diagnostic) Radiologic Procedures: A Review Of The Literature, Unie Háng, Nathan Sim, Harika K. Bollineni, Arif Musa Md, Foaz Kayali Md, Roger Kakos Md, Monte Harvill Md, Ali Harb Md
Medical Student Research Symposium
Abstract Title: RAPID (Reducing the Anxiety of Patients in Interventional and Diagnostic) Radiologic Procedures: A Review of the Literature
Background: Pre-procedural anxiety is a prevalent concern that can be associated with negative effects for patients including perceived pain. Most interventional radiologic procedures are performed under local anesthesia with minimal sedation if any, which may not be sufficient in relaxing the patient. Effective patient education with appropriate pain management and anxiety control can improve comfort and can yield optimal post-procedural outcomes.
Methods: A search was done with the PubMed database for studies concerning patient anxiety in radiologic procedures. Search terms included, …
The Long-Term Economic Implications Of Burn Injury For Burn Survivors, 2024 Wayne State University
The Long-Term Economic Implications Of Burn Injury For Burn Survivors, Jacob M. Dougherty Bs, Hannan A. Maqsood Mbbs, Zhaohui Fan Md Mph, Stewart C. Wang Md Phd, Mark R. Hemmila Md, Naveen F. Sangji Md Mph
Medical Student Research Symposium
Introduction: The long-term economic implications of burn injury on patients and payors has not been well described. Burn injury can be costly due to prolonged intensive care, wound care, rehabilitation, psychological care, and reconstructive surgery that may be required well after the initial injury. We investigated index and post-acute payor and out-of-pocket (OOP) costs related to burn injury for in-patient care at 30 days, and up to 36 months post-discharge to understand the long-term economic implications for burn survivors.
Methods: An observational cohort study was conducted using a commercial claims database from IBM Watson Health® Marketscan. Patients age ≤ …
Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, 2024 Wayne State University
Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md
Medical Student Research Symposium
Introduction and Objectives: Female sexual dysfunction (FSD) is commonly associated with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). FSD manifests as abnormalities in sexual desire, arousal, orgasm, pain, distress, and satisfaction. Our primary objective was to assess the impact of micronized amniotic membrane injections (AM) on FSD and lower urinary tract symptoms using comprehensive measures, including the multi-domain Female Sexual Function Index (FSFI), the Pain Visual Analog Scale (VAS), and the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI).
Methods: Study participants included patients diagnosed with IC/BPS and FSD refractory to traditional therapies. Under general anesthesia, these …
Structured Textbook Review And Individualized Learning Plans Successfully Remediate Underperforming Residents And Improve General Surgery Program Performance On The Absite, 2024 Grand Strand Medical Center
Structured Textbook Review And Individualized Learning Plans Successfully Remediate Underperforming Residents And Improve General Surgery Program Performance On The Absite, Aaron Pinnola, Christoph Kaufmann
HCA Healthcare Journal of Medicine
Background
We endeavored to create an evidence-based curriculum to improve general surgery resident fund of knowledge. Global and resident-specific interventions were employed to this end. These interventions were monitored via multiple choice question results on a weekly basis and American Board of Surgery In-Training Examination (ABSITE) performance.
Methods
This study was performed in a prospective manner over a 2-year period. A structured textbook review with testing was implemented for all residents. A focused textbook question-writing assignment and a Surgical Council on Resident Education (SCORE)-based individualized learning plan (ILP) were implemented for residents scoring below the 35th percentile on the ABSITE. …
Use Of Technology In Training Periop 101 Students, 2024 Thomas Jefferson University Hospital
Use Of Technology In Training Periop 101 Students, John Carroll, Bsn, Rn. Cnor. Tcrn, Rnfa, Annamarie R. Vrobel, Bsn, Rv, Cpt, Sarah Germanovich, Msn, Rn, Cnor, Tcrn
Jefferson Hospital Staff Papers and Presentations
Presented at the 2024 Association of periOperative Registered Nurses (AORN) Global Surgical Conference & Expo.
What Did We Learn About Vads In 2023?, 2024 Indiana University
What Did We Learn About Vads In 2023?, Maya Guglin
The VAD Journal
This is our 10th annual literature review on mechanical circulatory support (MCS) devices. All of our previous reports were well received by the readers.1-9
In this paper, we summarized the most interesting and important, from our standpoint, publications from 2023. There may be some slight overlap with the end of 2022, because some papers were published online first, and the year of publication changed when they became available in print.
For the seventh time this year, we wrote a section on extracorporeal membrane oxygenation (ECMO), which primarily addresses new developments in veno-arterial ECMO.
Readers who wish to supplement …
Late Cardiotoxicity From The Tyrosine Kinase Inhibitor, Dasatinib: Pleural Effusions, Pulmonary Arterial Hypertension, And Right Heart Failure, 2024 Jefferson University
Late Cardiotoxicity From The Tyrosine Kinase Inhibitor, Dasatinib: Pleural Effusions, Pulmonary Arterial Hypertension, And Right Heart Failure, Mark Jay Zucker, Andrew M. Zucker
The VAD Journal
Despite the remarkable progress made over the past few decades in the management of patients with both solid and hematologic malignancies, radiation- and chemotherapy-related cardiotoxicity remains an ongoing problem. This is true even for newer highly targeted therapies, including tyrosine kinase inhibitors (TKIs). This report presents a case of late/severe right heart dysfunction secondary to pulmonary hypertension, developed after ten years of therapy with dasatinib. We also review the history of this known, but often unrecognized, and potentially reversible complication, and we suggest treatment options. Additionally, this case highlights the remarkable effectiveness of TKIs in patients with chronic myelogenous leukemia …
Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair, 2024 Thomas Jefferson University
Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair, Carlo Coadonato, Neel K. Patel, John Hayden Sonnier, Gregory Connors, Matthew Sabitsky, Emma Johnson, Donald W. Mazur, Shyam Brahmabhatt, Kevin Freedman
Rothman Institute Faculty Papers
Background:
Ruptures of the quadriceps tendon present most frequently in older adults and individuals with underlying medical conditions.
Purpose:
To examine the relationship between patient-specific factors and tear characteristics with outcomes after quadriceps tendon repair.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
A retrospective review was conducted on all patients who underwent quadriceps tendon repair between January 1, 2016, and January 1, 2021, at a single institution. Patients <18 years and those with chronic quadriceps tendon tears (>6 weeks to surgery) were excluded. Information was collected regarding patient characteristics, presenting symptoms, tear characteristics, physical examination findings, and postoperative outcomes. Poor outcome was defined as a need for …18>
A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, 2024 University of South Dakota, Sanford School of Medicine
A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, Carter A. Schulz, Joshua D. Mohs, Andrew M. Reuter
Aesculapius Journal (Health Sciences & Medicine)
Case summary: A 15-year-old female presented with chest pain, dyspnea, and weight loss. A chest X-ray and subsequent CT scan revealed a large anterior mediastinal mass with cervical lymphadenopathy and pericardial effusion. Two biopsies under general anesthesia were performed, with the latter confirming classic Hodgkin lymphoma, nodular sclerosis subtype.
Discussion: This case underscores the significant clinical challenges posed by anterior mediastinal masses due to their proximity to vital cardiovascular and respiratory structures. Physiologic changes during general anesthesia can exacerbate these challenges. Preoperative assessment, including imaging and symptom evaluation, is crucial to guide operative planning. It is key to individualize the …
Chatgpt Can Offer Satisfactory Responses To Common Patient Questions Regarding Elbow Ulnar Collateral Ligament Reconstruction, 2024 Thomas Jefferson University
Chatgpt Can Offer Satisfactory Responses To Common Patient Questions Regarding Elbow Ulnar Collateral Ligament Reconstruction, William Johns, Alec Kellish, Dominic Farronato, Michael G. Ciccotti, Sommer Hammoud
Rothman Institute Faculty Papers
PURPOSE: To determine whether ChatGPT effectively responds to 10 commonly asked questions concerning ulnar collateral ligament (UCL) reconstruction.
METHODS: A comprehensive list of 90 UCL reconstruction questions was initially created, with a final set of 10 "most commonly asked" questions ultimately selected. Questions were presented to ChatGPT and its response was documented. Responses were evaluated independently by 3 authors using an evidence-based methodology, resulting in a grading system categorized as follows: (1) excellent response not requiring clarification; (2) satisfactory requiring minimal clarification; (3) satisfactory requiring moderate clarification; and (4) unsatisfactory requiring substantial clarification.
RESULTS: Six of 10 ten responses were …
Interobserver Reliability In The Classification Of Thoracolumbar Fractures Using The Ao Spine Tl Injury Classification System Among 22 Clinical Experts In Spine Trauma Care, 2024 Thomas Jefferson University
Interobserver Reliability In The Classification Of Thoracolumbar Fractures Using The Ao Spine Tl Injury Classification System Among 22 Clinical Experts In Spine Trauma Care, Jose A. Canseco, Taylor Paziuk, Gregory D. Schroeder, Marcel F. Dvorak, Cumhur F. Öner, Lorin M. Benneker, Emiliano Vialle, Shanmuganathan Rajasekaran, Mohammad El-Sharkawi, Richard J. Bransford, Rishi M. Kanna, Martin Holas, Sander Muijs, Eugen Cezar Popescu, Charlotte Dandurand, Jin W. Tee, Gaston Camino-Willhuber, Mohamed M. Aly, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich J. Spiegl, Klaus Schnake, Alexander R. Vaccaro
Rothman Institute Faculty Papers
STUDY DESIGN: Reliability study utilizing 183 injury CT scans by 22 spine trauma experts with assessment of radiographic features, classification of injuries and treatment recommendations.
OBJECTIVES: To assess the reliability of the AOSpine TL Injury Classification System (TLICS) including the categories within the classification and the M1 modifier.
METHODS: Kappa and Intraclass correlation coefficients were produced. Associations of various imaging characteristics (comminution, PLC status) and treatment recommendations were analyzed through regression analysis. Multivariable logistic regression modeling was used for making predictive algorithms.
RESULTS: Reliability of the AO Spine TLICS at differentiating A3 and A4 injuries (N = 71) (K = …
Expert Opinion, Real-World Classification, And Decision-Making In Thoracolumbar Burst Fractures Without Neurologic Deficits?, 2024 Thomas Jefferson University
Expert Opinion, Real-World Classification, And Decision-Making In Thoracolumbar Burst Fractures Without Neurologic Deficits?, Gaston Camino-Willhuber, Sebastian Bigdon, Charlotte Dandurand, Marcel F. Dvorak, Cumhur F. Öner, Klaus Schnake, Sander Muijs, Lorin M. Benneker, Emiliano Vialle, Jin W. Tee, Ory Keynan, Harvinder S. Chhabra, Andrei F. Joaquim, Eugen C. Popescu, Jose A Canseco, Martin Holas, Rishi M. Kanna, Mohamed M. Aly, Nader Fallah, Gregory D. Schroeder, Ulrich Spiegl, Mohammad El-Skarkawi, Richard J. Bransford, Shanmuganathan Rajasekaran, Alexander R. Vaccaro
Rothman Institute Faculty Papers
STUDY DESIGN: Retrospective analysis of prospectively collected data.
OBJECTIVES: To compare decision-making between an expert panel and real-world spine surgeons in thoracolumbar burst fractures (TLBFs) without neurological deficits and analyze which factors influence surgical decision-making.
METHODS: This study is a sub-analysis of a prospective observational study in TL fractures. Twenty two experts were asked to review 183 CT scans and recommend treatment for each fracture. The expert recommendation was based on radiographic review.
RESULTS: Overall agreement between the expert panel and real-world surgeons regarding surgery was 63.2%. In 36.8% of cases, the expert panel recommended surgery that was not performed …
The Ao Spine Thoracolumbar Injury Classification System And Treatment Algorithm In Decision Making For Thoracolumbar Burst Fractures Without Neurologic Deficit, 2024 Thomas Jefferson University
The Ao Spine Thoracolumbar Injury Classification System And Treatment Algorithm In Decision Making For Thoracolumbar Burst Fractures Without Neurologic Deficit, Barry T.S. Kweh, Jin Wee Tee, Charlotte Dandurand, Alexander R. Vaccaro, Benneker M. Lorin, Klaus Schnake, Emiliano Vialle, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Richard J. Bransford, Rishi M. Kanna, Mohamed M. Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen C. Popescu, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Sebastian Frederick Bigdon, Ulrich Spiegel, Marcel Dvorak, Cumhur F. Öner, Gregory Schroeder
Rothman Institute Faculty Papers
STUDY DESIGN: Prospective Observational Study.
OBJECTIVE: To determine the alignment of the AO Spine Thoracolumbar Injury Classification system and treatment algorithm with contemporary surgical decision making.
METHODS: 183 cases of thoracolumbar burst fractures were reviewed by 22 AO Spine Knowledge Forum Trauma experts. These experienced clinicians classified the fracture morphology, integrity of the posterior ligamentous complex and degree of comminution. Management recommendations were collected.
RESULTS: There was a statistically significant stepwise increase in rates of operative management with escalating category of injury (P < .001). An excellent correlation existed between recommended expert management and the actual treatment of each injury category: A0/A1/A2 (OR 1.09, 95% CI 0.70-1.69, P = .71), A3/4 (OR 1.62, 95% CI 0.98-2.66, P = .58) and B1/B2/C (1.00, 95% …