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Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, MD, Chadwick J. Knight, MD 2016 Marshall University

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 2016 Marshall University school of Medicine

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 ...


Neurosurgical Ultrasound Pose Estimation Using Image-Based Registration And Sensor Fusion - A Feasibility Study, Utsav Pardasani 2016 The University of Western Ontario

Neurosurgical Ultrasound Pose Estimation Using Image-Based Registration And Sensor Fusion - A Feasibility Study, Utsav Pardasani

Electronic Thesis and Dissertation Repository

Modern neurosurgical procedures often rely on computer-assisted real-time guidance using multiple medical imaging modalities. State-of-the-art commercial products enable the fusion of pre-operative with intra-operative images (e.g., magnetic resonance [MR] with ultrasound [US] images), as well as the on-screen visualization of procedures in progress. In so doing, US images can be employed as a template to which pre-operative images can be registered, to correct for anatomical changes, to provide live-image feedback, and consequently to improve confidence when making resection margin decisions near eloquent regions during tumour surgery.

In spite of the potential for tracked ultrasound to improve many neurosurgical procedures ...


Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner 2016 Aurora UW Medical Group, Aurora Health Care

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

Journal of Patient-Centered Research and Reviews

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.


Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin 2016 University of Massachusetts Medical School

Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin

Celeste A. Lemay

Objective: To better understand the education needs of patients electing to have TJR in managing their pain in the post-operative period after discharge from the hospital.

Methods: An exploratory, descriptive, qualitative design. Convenience sample of people who reported that they had not received information about pain management prior to TJR surgery were recruited from 9 surgeon practices in 8 states to participate in telephone interviews, utilizing open-ended questions. Questions included: recollection of pre-op class attended and content; experiences with surgical pain after surgery and how it was managed; experiences with pain medicine; experience using non-medicine related pain reduction methods; suggestions ...


Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin

Celeste A. Lemay

Objective: We evaluated receipt of pre-operative pain management education in a national prospective cohort on post-operative pain and function.

Methods: Preoperative, 2 week and 6 month postoperative data from a nationally representative cohort of 1404 primary unilateral TJR patients with a date of surgery between May 2011 and December 2014. Data included demographics, comorbid conditions, operative joint pain severity (HOOS/KOOS), musculoskeletal disease burden, physical function (SF36 PCS), and mental health (SF36 MCS). At 2 weeks post-op, patients were asked if they had received information prior to surgery about pain management options and if so, how helpful the information was ...


6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin 2016 University of Massachusettts Medical School

6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin

Leslie R. Harrold

Background/Purpose: The increase in total knee replacements (TKRs) between 1979 and 2006 is staggering. Debate is growing regarding the appropriate utilization of TKRs. We examined pain, function, quality of life (QOL), and satisfaction at 6-month post-surgery by pain and function at time of surgery. Methods: Data came from the nationally representative FORCE-TJR cohort of patients from 150 surgeons. Participants had primary, unilateral TKRs due to osteoarthritis between 2011 and 2014. Their knee pain (KOOS), physical functions (SF36), and QOL were measured at pre- and 6 months post-surgery. We classified patients as having high or low pre-operative pain (KOOS Pain ...


Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri 2016 Regenerative Medicine Center, Aurora Research Institute, Aurora Health Care

Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri

Indrajit Choudhuri

Background: Many patients undergoing open heart surgery have sinus node dysfunction and atrial fibrillation, leading to adverse outcomes. Mesenchymal stem cells (MSC) delivered at the time of surgery may have a reparative effect on atrial tissue, thereby improving sinus node function and reducing or preventing atrial fibrillation. Stem cell delivery to the atrium is entirely unstudied. This is a significant gap in medical research, as atrial disease contributes significantly to health care costs. Purpose: The purpose of this pilot study is to establish a technique to deliver MSC to the atria through an open-chest model, to assess the safety of ...


Role Of Tsh And Excess Heart Age In Predicting Atrial Fibrillation Recurrence Post-Ablation, Aditya Vaze, Adedotun Ogunsua, Jakub Pach, David D. McManus 2016 University of Massachusetts Medical School

Role Of Tsh And Excess Heart Age In Predicting Atrial Fibrillation Recurrence Post-Ablation, Aditya Vaze, Adedotun Ogunsua, Jakub Pach, David D. Mcmanus

UMass Center for Clinical and Translational Science Research Retreat

Background: The association between atrial fibrillation (AF) and thyroid disease as defined by thyroid stimulating hormone (TSH) is established in literature. However, the relationship between TSH and recurrence of AF post ablation has not been established.

Methods: We studied 207 patients (60.54±9.39yrs, 35.7% female) with persistent or paroxysmal AF who underwent either Cryo or RFA ablation between April 2011 and Jan 2015 at our center. Patients were stratified into hypothyroid (TSH > >4.5 U/mL), euthyroid (TSH 0.5-4.5 U/mL) and hyperthyroid (TSH < 0.5 U/mL) based on pre procedure testing. Heart age was computed based on Framingham risk factors. Excess heart age was defined as the difference between actual age and heart age. Logistic regression and cox-proportional hazards model were implemented using R statistical software (v3.2.0).

Results: There was a statistically significant lower rate of AF recurrence ...


Total Hip Arthroplasty And Mental Health Status, Uyen-Sa D.T. Nguyen, Thomas Perneger, Patricia D. Franklin, Christophe Barea, Pierre Hoffmeyer, Anne Lubbeke 2016 University of Massachusettts Medical School

Total Hip Arthroplasty And Mental Health Status, Uyen-Sa D.T. Nguyen, Thomas Perneger, Patricia D. Franklin, Christophe Barea, Pierre Hoffmeyer, Anne Lubbeke

UMass Center for Clinical and Translational Science Research Retreat

Purpose. Total hip arthroplasty (THA) effectively restores function and alleviates pain in patients with end-stage hip osteoarthritis. Pain affects mood through its effect on disability and fatigue. Few studies have examined mental health as a consequence of pain or function after THA. We assessed change in mental health 1-year post-surgery, and examined whether change in pain and function predict change in mental health.

Methods. We used data from a prospective THA registry that began in 1996 at a large public Geneva University hospital. We included surgeries performed 2010 and 2012-2014, with demographic information, body mass index (BMI), co-morbidities, baseline and ...


Effect Of Left Atrial Function Index On Late Atrial Fibrillation Recurrence After Pulmonary Vein Isolation, Mayank Sardana, Owusu Asamoah, Glenn Stokken, Matthew Spring, Amir Y. Shaikh, Adedotun Ogunsua, Barinder Hansra, Deego Mohamud, Michael Gagnier, Summer Aldrugh, Nada Esa, Kevin C. Floyd, Clifford Browning, Cynthia Ennis, Kevin Donahue, Lawrence S. Rosenthal, Gerard P. Aurigemma, David D. McManus 2016 University of Massachusetts Medical School

Effect Of Left Atrial Function Index On Late Atrial Fibrillation Recurrence After Pulmonary Vein Isolation, Mayank Sardana, Owusu Asamoah, Glenn Stokken, Matthew Spring, Amir Y. Shaikh, Adedotun Ogunsua, Barinder Hansra, Deego Mohamud, Michael Gagnier, Summer Aldrugh, Nada Esa, Kevin C. Floyd, Clifford Browning, Cynthia Ennis, Kevin Donahue, Lawrence S. Rosenthal, Gerard P. Aurigemma, David D. Mcmanus

UMass Center for Clinical and Translational Science Research Retreat

Background: Although the rates of catheter ablation (CA) for atrial fibrillation (AF) are rapidly increasing, there are few predictors of outcome to help inform appropriate patient selection for this procedure. Traditional echocardiographic measures of atrial structure do not significantly reclassify risk of AF recurrence over and above the clinical risk factors. Left Atrial Function Index (LAFI) is a rhythm-independent measure of atrial function. We hypothesized that baseline LAFI would relate to AF recurrence after CA.

Methods: Pre-procedural echocardiograms from 170 participants, who underwent CA for AF and were enrolled in the UMMC AF Treatment Registry, were analyzed. LAFI was calculated ...


Comparison Of Diabetic Remission Rates Following Roux En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini 2016 University of Massachusetts Medical School

Comparison Of Diabetic Remission Rates Following Roux En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Bariatric surgery is being increasingly investigated as treatment for Type II Diabetes Mellitus (T2DM). As Sleeve Gastrectomy (SG) surpasses Roux-en-Y Gastric Bypass (RYGB) as the new standard in bariatric surgery, it is still unknown if its efficacy in achieving remission is comparable to RYGB. This study compared diabetic remission rates between SG and RYGB in order to identify the predictive factors for remission and the mechanisms of achieving remission.

Methods: This was a retrospective cohort study comparing all diabetic patients undergoing RYGB and SG at an academic medical center from 1/1/11-7/1/15. Patients were followed preoperatively ...


Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin 2016 University of Massachusetts Medical School

Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Objective: To better understand the education needs of patients electing to have TJR in managing their pain in the post-operative period after discharge from the hospital.

Methods: An exploratory, descriptive, qualitative design. Convenience sample of people who reported that they had not received information about pain management prior to TJR surgery were recruited from 9 surgeon practices in 8 states to participate in telephone interviews, utilizing open-ended questions. Questions included: recollection of pre-op class attended and content; experiences with surgical pain after surgery and how it was managed; experiences with pain medicine; experience using non-medicine related pain reduction methods; suggestions ...


6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin 2016 University of Massachusettts Medical School

6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Background/Purpose: The increase in total knee replacements (TKRs) between 1979 and 2006 is staggering. Debate is growing regarding the appropriate utilization of TKRs. We examined pain, function, quality of life (QOL), and satisfaction at 6-month post-surgery by pain and function at time of surgery.

Methods: Data came from the nationally representative FORCE-TJR cohort of patients from 150 surgeons. Participants had primary, unilateral TKRs due to osteoarthritis between 2011 and 2014. Their knee pain (KOOS), physical functions (SF36), and QOL were measured at pre- and 6 months post-surgery. We classified patients as having high or low pre-operative pain (KOOS Pain ...


Differences In Complication Rates Between Roux-En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini 2016 University of Massachusetts Medical School

Differences In Complication Rates Between Roux-En-Y Gastric Bypass And Longitudinal Sleeve Gastrectomy, Zachary Weitzner, Julie Flahive, Gordon Fitzgerald, Donald Czerniach, Philip Cohen, John Kelly, Richard A. Perugini

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Sleeve Gastrectomy (SG) has surpassed Roux-en-Y Gastric Bypass (RYGB) as the most commonly performed bariatric operation. Though the beneficial effect of SG on Type 2 Diabetes Mellitus is less than that of RYGB, it is perceived to have a lower complication rate. The purpose of this study was to quantify the complication rates between of SG and RYGB in a severely obese diabetic population.

Methods: This was a retrospective cohort study that included all diabetic patients undergoing RYGB and SG at an academic medical center from January 1, 2011 to July 1, 2015. Patients were followed at 6 week ...


Translating Comparative Tjr Outcomes For Performance Improvement To Guide Surgical Quality Improvement, Hua Zheng, Wenjun Li, Celeste Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Translating Comparative Tjr Outcomes For Performance Improvement To Guide Surgical Quality Improvement, Hua Zheng, Wenjun Li, Celeste Lemay, David Ayers, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Background/Purpose: With the CMS decision to publicly report hospital-specific post-operative total joint replacement (TJR) complications and readmissions, orthopedic surgeons need new sources of post-operative outcome data to monitor and improve post-hospital care. The AHRQ funded research program, Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR), developed methods to capture longitudinal patient-reported outcomes (PROs) and comprehensive post-TJR medical and surgical events, and established a web reporting system to return comparative outcome reports to participating surgeons and hospitals in order to monitor and improve quality and outcomes.

Methods: This national cohort/registry captures post-TJR measures directly from ...


Predicting Early Failure In Total Knee Arthroplasty: A Critical Review Of Oxinium Femoral Components, Steven DiSegna, Wenyun Yang, Patricia D. Franklin 2016 University of Massachusetts Medical School

Predicting Early Failure In Total Knee Arthroplasty: A Critical Review Of Oxinium Femoral Components, Steven Disegna, Wenyun Yang, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Retrospectively, it has been shown that significant patient-reported pain 6 months following total knee arthroplasty (TKA) is associated with a 7 times greater revision rate at 5 years. Our goal is to use the FORCE-TJR registry to prospectively evaluate if postoperative pain and function scores can predict increased revision rate 5 years following TKA. Our preliminary analyses have focused on one implant reported by Australia to have a significantly high 5-year revision rate: Oxinium femoral components. Materials and Methods: FORCE-TJR matched implant catalog numbers to the international implant library to define TKA patients who received oxinium femoral components and ...


Implementation And Utilization Of Mobile Technology In Adolescent Bariatric Surgery Patients, Jonathan Green, Jeremy T. Aidlen, Sherry L. Pagoto, Jennifer Bram 2016 University of Massachusetts Medical School

Implementation And Utilization Of Mobile Technology In Adolescent Bariatric Surgery Patients, Jonathan Green, Jeremy T. Aidlen, Sherry L. Pagoto, Jennifer Bram

UMass Center for Clinical and Translational Science Research Retreat

Obesity is the most prevalent chronic disease of childhood. Obese adolescents are likely to become obese adults with significant associated co-morbidities and early mortality. In Massachusetts, 30% of children ages 10-17 are overweight or obese. It is projected that 48% of Massachusetts’ adults will be obese by 2030. In March of 2015, the Good Fit Adolescent Weight and Wellness Center opened, with a goal of addressing this issue with a proven multidisciplinary approach.

Mobile technology continues to develop at a rapid pace. Adolescent access to mobile technology on smart phones and tablets continues to increase. Mobile fitness tracker applications are ...


Does The Indication For Breast Surgery Impact Surgical Outcomes? A Contemporary Analysis Of The Acs-Nsqip Database, Connie Lee, Ann-Kristin U. Friedrich, Anne C. Larkin, B. Marie Ward, Ashling O'Connor, Robert M. Quinlan, Giles F. Whalen, Jennifer LaFemina 2016 University of Massachusetts Medical School

Does The Indication For Breast Surgery Impact Surgical Outcomes? A Contemporary Analysis Of The Acs-Nsqip Database, Connie Lee, Ann-Kristin U. Friedrich, Anne C. Larkin, B. Marie Ward, Ashling O'Connor, Robert M. Quinlan, Giles F. Whalen, Jennifer Lafemina

UMass Center for Clinical and Translational Science Research Retreat

Background. There is limited data about whether perioperative outcomes differ based on the indication for breast surgery. Herein we aim to assess if breast surgery for prophylaxis, compared to that for malignancy, impacts surgical outcomes.

Methods. All women who underwent simple or subcutaneous mastectomy were identified from the 2007-2012 ACS-NSQIP database. Patients were identified by their ICD-9 codes and categorized into two groups. Group 1 consisted of patients diagnosed with breast cancer or carcinoma in situ; group 2 consisted of patients diagnosed with a genetic predisposition to malignant neoplasm of the breast (i.e., BRCA mutation). Demographic and preoperative variables ...


Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Objective: We evaluated receipt of pre-operative pain management education in a national prospective cohort on post-operative pain and function.

Methods: Preoperative, 2 week and 6 month postoperative data from a nationally representative cohort of 1404 primary unilateral TJR patients with a date of surgery between May 2011 and December 2014. Data included demographics, comorbid conditions, operative joint pain severity (HOOS/KOOS), musculoskeletal disease burden, physical function (SF36 PCS), and mental health (SF36 MCS). At 2 weeks post-op, patients were asked if they had received information prior to surgery about pain management options and if so, how helpful the information was ...


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