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Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan 2018 The University of Western Ontario

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis ...


Targeted Delivery Of Bioactive Molecules For Vascular Intervention And Tissue Engineering, Hannah A. Strobel, Elisabet I. Qendro, Eben Alsberg, Marsha W. Rolle 2018 Worcester Polytechnic Institute

Targeted Delivery Of Bioactive Molecules For Vascular Intervention And Tissue Engineering, Hannah A. Strobel, Elisabet I. Qendro, Eben Alsberg, Marsha W. Rolle

Open Access Articles

Cardiovascular diseases are the leading cause of death in the United States. Treatment often requires surgical interventions to re-open occluded vessels, bypass severe occlusions, or stabilize aneurysms. Despite the short-term success of such interventions, many ultimately fail due to thrombosis or restenosis (following stent placement), or incomplete healing (such as after aneurysm coil placement). Bioactive molecules capable of modulating host tissue responses and preventing these complications have been identified, but systemic delivery is often harmful or ineffective. This review discusses the use of localized bioactive molecule delivery methods to enhance the long-term success of vascular interventions, such as drug-eluting stents ...


Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes 2018 College of Our Lady of the Elms

Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes

Online Journal of Health Ethics

This manuscript explores ethical implications on treatment for youth with diagnosed gender dysphoria. The ethical considerations outlined and analyzed in this essay involve illuminating an understanding of whether the administration of pubertal suppression with GnRH agonists, and cross-sex hormones to children with gender dysphoria is morally justified as treatment to manage their psychological distress, or if safer more understood alternatives exist. This essay emphasizes that as health care professionals we must ensure youth with gender dysphoria receive adequate medical treatment and care however, this essay concludes through extensive literature review, that the use of inconclusive and under researched methods to ...


A Comparative Study Of Single And Dual Perfusion During End-Ischemic Subnormothermic Liver Machine Preservation, Isabel M. A. Bruggenwirth, Carolina Moore, Paria Mahboub, Max F. Thijssen, Xiaofei E, Henri G. D. Leuvenink, Pranoti Mandrekar, Xiaofei Wang, Timothy F. Kowalik, Robert J. Porte, Paulo N.A. Martins 2018 University of Massachusetts Medical School

A Comparative Study Of Single And Dual Perfusion During End-Ischemic Subnormothermic Liver Machine Preservation, Isabel M. A. Bruggenwirth, Carolina Moore, Paria Mahboub, Max F. Thijssen, Xiaofei E, Henri G. D. Leuvenink, Pranoti Mandrekar, Xiaofei Wang, Timothy F. Kowalik, Robert J. Porte, Paulo N.A. Martins

Open Access Articles

Background: It remains controversial if arterial perfusion in addition to portal vein perfusion during machine preservation improves liver graft quality. Comparative studies using both techniques are lacking. We studied the impact of using single or dual machine perfusion of donation after circulatory death rat livers. In addition, we analyzed the effect of pulsatile versus continuous arterial flow.

Methods: Donation after circulatory death rat livers (n = 18) were preserved by 6 hours cold storage, followed by 1 hour subnormothermic machine perfusion (20 degrees C, pressure of 40/5 mm Hg) and 2 hours ex vivo warm reperfusion (37 degrees C, pressure ...


Association Between Sarcopenia And Functional Status In Liver Transplant Patients, Natasha H. Dolgin, Andrew J. Smith, Samantha G. Harrington, Babak Movahedi, Paulo N.A. Martins, Adel Bozorgzadeh 2018 University of Massachusetts Medical School

Association Between Sarcopenia And Functional Status In Liver Transplant Patients, Natasha H. Dolgin, Andrew J. Smith, Samantha G. Harrington, Babak Movahedi, Paulo N.A. Martins, Adel Bozorgzadeh

Open Access Articles

OBJECTIVES: A growing body of evidence shows that frailty and functional performance predict liver transplant outcomes. The Organ Procurement and Transplant Network uses the Karnofsky Performance Status scale to adjust for transplant center case mix in assessing quality measures. This study explores the strength of the relationship between Karnofsky Performance Status scores and objective measures of frailty.

MATERIALS AND METHODS: This observational study includes 136 adult, first-time liver transplant recipients at UMass Memorial (2006-2015) who had 2 abdominal computed tomography scans available (at < /= 90 days pretransplant and > /= 7 days before that). We analyzed the relationship between Karnofsky Performance Status and muscle wasting using absolute ...


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 2018 Juntendo University

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 ...


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 2018 University of Massachusetts Medical School

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 ...


The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability In Malignant Solid Tumor Cells In A Dose-Dependent Manner, Warren Rowe, Xiaoqian Cheng, Lawan Ly, Taisen Zhuang, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady 2018 Jerome Canady Research Institute for Advanced Biological and Technological Sciences

The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability In Malignant Solid Tumor Cells In A Dose-Dependent Manner, Warren Rowe, Xiaoqian Cheng, Lawan Ly, Taisen Zhuang, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady

Open Access Articles

To determine appropriate treatment doses of cold atmospheric plasma (CAP), the Canady Helios Cold Plasma Scalpel was tested across numerous cancer cell types including renal adenocarcinoma, colorectal carcinoma, pancreatic adenocarcinoma, ovarian adenocarcinoma, and esophageal adenocarcinoma. Various CAP doses were tested consisting of both high (3 L/min) and low (1 L/min) helium flow rates, several power settings, and a range of treatment times up to 5 min. The impact of cold plasma on the reduction of viability was consistently dose-dependent; however, the anti-cancer capability varied significantly between cell lines. While the lowest effective dose varied from cell line to ...


Ultrasound Guided Placement Of Single-Lumen Peripheral Intravenous Catheters In The Internal Jugular Vein, Tony Zitek, Elizabeth Busby, Heather Hudson, John D. McCourt, Jamie Baydoun, David E. Slattery 2018 University of Nevada, Las Vegas School; University Medical Center of Southern Nevada, Department of Emergency Medicine; Kendall Regional Medical Center

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

School of Medicine Faculty Publications

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


Relapsed Ovarian High-Grade Serous Carcinoma With Long-Term Survival Associated With Synchronous Primary Squamous Cell Carcinoma Of The Colon, Karla Sladoljev, Ena Perin, Ani Mihaljević Ferrari, Marko Klarić, Alemka Brnčić-Fischer, Senija Eminović, Danijela Vrdoljak-Mozetič, Emina Babarovic 2018 School of Medicine University of Rijeka, University of Rijeka, Croatia

Relapsed Ovarian High-Grade Serous Carcinoma With Long-Term Survival Associated With Synchronous Primary Squamous Cell Carcinoma Of The Colon, Karla Sladoljev, Ena Perin, Ani Mihaljević Ferrari, Marko Klarić, Alemka Brnčić-Fischer, Senija Eminović, Danijela Vrdoljak-Mozetič, Emina Babarovic

Proceedings in Obstetrics and Gynecology

High-grade serous ovarian cancer (HGSOC) is the most common and also the most aggressive subtype of ovarian cancer while squamous cell carcinoma (SCC) of the colon is an extremely rare histologic subtype of all colonic malignancies with poor prognosis.

Here we report a unique case of synchronous primary SCC of the colon and second recurrence of HGSOC in a patient with 15-years survival. Our patient developed two recurrent HGSOCs with disease-free survival time of five and nine years, respectively. The second recurrence of HGSOC was associated with the synchronous primary SCC of the ascending colon and was further complicated with ...


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 2018 University of Massachusetts Medical School

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 2018 University of Massachusetts Medical School

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 ...


Video Capsule Endoscopy As A Tool For Evaluation Of Obscure Overt Gastrointestinal Bleeding In The Intensive Care Unit, Shahrad Hakimian, Salmaan Jawaid, Yurima Guilarte-Walker, Jomol Mathew, David R. Cave 2018 University of Massachusetts Medical School

Video Capsule Endoscopy As A Tool For Evaluation Of Obscure Overt Gastrointestinal Bleeding In The Intensive Care Unit, Shahrad Hakimian, Salmaan Jawaid, Yurima Guilarte-Walker, Jomol Mathew, David R. Cave

Open Access Articles

Background and study aims: Video capsule endoscopy (VCE) is a minimally invasive tool that helps visualize the gastrointestinal tract from the esophagus to the right colon without the need for sedation or preparation. VCE is safe with very few contraindications. However, its role and safety profile in the intensive care unit (ICU) population have not been reported. The aim of this study is to evaluate the safety, efficacy, and feasibility of VCE use in ICU patients. Patients and methods: We conducted a single-center retrospective observational study of patients who underwent VCE for evaluation of obscure overt gastrointestinal bleeding in the ...


Comparing Efficacy Of Lumen-Apposing Stents To Plastic Stents In The Endoscopic Management Of Mature Peripancreatic Fluid Collections: A Single-Center Experience, Matthew J. Fasullo, Yasir Al-Azzawai, Joan Kheder, Jeffrey Abergel, Wahid Y. Wassef 2018 University of Massachusetts Medical School

Comparing Efficacy Of Lumen-Apposing Stents To Plastic Stents In The Endoscopic Management Of Mature Peripancreatic Fluid Collections: A Single-Center Experience, Matthew J. Fasullo, Yasir Al-Azzawai, Joan Kheder, Jeffrey Abergel, Wahid Y. Wassef

Open Access Articles

Introduction: Mature peripancreatic fluid collection (MPFC) is a known and often challenging consequence of acute pancreatitis and often requires intervention. The most common method accepted is the "step-up approach," which consists of percutaneous drainage followed, if necessary, by minimally invasive retroperitoneal necrosectomy. Our paper aims to distinguish between plastic stents and lumen-apposing stents in the endoscopic management of MPFC in terms of morbidity, mortality, and haste of fluid collection resolution.

Methods: A retrospective analysis was performed at UMass Memorial Medical Center in patients with a diagnosis of MPFC. Utilizing medical records, clinical data, radiology, as well as endoscopic evidence, patients ...


Selective Use Of Pericardial Window And Drainage As Sole Treatment For Hemopericardium From Penetrating Chest Trauma, Paul J. Chestovich MD, Christopher F. McNicoll, Douglas R. Fraser, Purvi P. Patel, Deborah A. Kuhls, Esmeralda Clark, John J. Fildes 2018 University of Nevada, Las Vegas

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

School of Medicine Faculty Publications

Background

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

Methods

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


Unique Surgical Approach To A Twisted Ileal-Anal Pouch, Hannah Buettner, Maria X. Kiely, Mengdi Yao, James Yoo, Lilian Chen 2018 University of Massachusetts Medical School

Unique Surgical Approach To A Twisted Ileal-Anal Pouch, Hannah Buettner, Maria X. Kiely, Mengdi Yao, James Yoo, Lilian Chen

Open Access Articles

Total proctocolectomy with ileal pouch-anal anastomosis can restore gastrointestinal continuity in patients requiring colectomy for ulcerative colitis, however, it can be associated with high morbidity. Reoperation for pouch-related complications is technically challenging and often leads to deterioration of pouch function or need for permanent stoma. We report a case of acute on chronic small bowel obstruction secondary to a 360-degree twist in the small bowel introduced during creation of the ileal-anal pouch. Our novel approach at repair has not been reported in past literature which included resection and re-anastomosis of the small bowel proximal to the pouch allowing for pouch ...


Inertial Sensor-Based Variables Are Indicators Of Frailty And Adverse Post-Operative Outcomes In Cardiovascular Disease Patients, Rahul Soangra, Thurmon E. Lockhart 2018 Chapman University

Inertial Sensor-Based Variables Are Indicators Of Frailty And Adverse Post-Operative Outcomes In Cardiovascular Disease Patients, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one’s gait speed is not completely associated with one’s risk of falls, gait speed is a quick robust measure ...


Integration Of Complementary And Alternative Medicine Into The Healthcare System In The United States, Nikki Lu 2018 University of Washington – Tacoma

Integration Of Complementary And Alternative Medicine Into The Healthcare System In The United States, Nikki Lu

Global Honors Theses

Chronic diseases are a prevalent issue around the world and chronic diseases are hard to prevent due to various systemic factors in the healthcare system. This paper mainly focused on socioeconomic issues and highlighted a few systemic factors in the US healthcare system. These factors have created various health disparities, inequities among socially constructed groups, and financial expenditures in the US healthcare system. Socioeconomic factors significantly impact the health and healthcare among socially constructed groups. Additionally, in this paper there are current approaches in addressing these healthcare factors such as social determinants of health and precision medicine as well as ...


Failure Of Primary Total Knee Arthroplasty: Establishing A Baseline For Retrieval Analysis Using Well-Functioning Necropsy Specimens, Meredith Perkins 2018 University of Tennessee Health Science Center

Failure Of Primary Total Knee Arthroplasty: Establishing A Baseline For Retrieval Analysis Using Well-Functioning Necropsy Specimens, Meredith Perkins

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis of the knee. While many patients have positive functional and pain outcomes following primary TKA, a subset of patients have suboptimal outcomes, such as unexplained pain or aseptic loosening of the implant components necessitating revision of the index procedure. The understanding of the exact etiology of these suboptimal outcomes of primary TKA is in its infancy. In order to elucidate the etiology of failure in primary TKAs, a baseline for the factors contributing to arthroplasty failure and dissatisfaction must first be established. The purpose of this study was ...


A Web-Based Treatment Decision Support Tool For Patients With Advanced Knee Arthritis: Evaluation Of User Interface And Content Design, Hua Zheng, Milagros C. Rosal, Wenjun Li, Amy Borg, Wenyun Yang, David C. Ayers, Patricia D. Franklin 2018 University of Massachusetts Medical School

A Web-Based Treatment Decision Support Tool For Patients With Advanced Knee Arthritis: Evaluation Of User Interface And Content Design, Hua Zheng, Milagros C. Rosal, Wenjun Li, Amy Borg, Wenyun Yang, David C. Ayers, Patricia D. Franklin

Open Access Articles

BACKGROUND: Data-driven surgical decisions will ensure proper use and timing of surgical care. We developed a Web-based patient-centered treatment decision and assessment tool to guide treatment decisions among patients with advanced knee osteoarthritis who are considering total knee replacement surgery.

OBJECTIVE: The aim of this study was to examine user experience and acceptance of the Web-based treatment decision support tool among older adults.

METHODS: User-centered formative and summative evaluations were conducted for the tool. A sample of 28 patients who were considering total knee replacement participated in the study. Participants' responses to the user interface design, the clarity of information ...


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