Digital Commons Network^™

Implementation Facilitation To Introduce And Support Emergency Department-Initiated Buprenorphine For Opioid Use Disorder In High Need, Low Resource Settings: Protocol For Multi-Site Implementation-Feasibility Study, Ryan P. Mccormack, John Rotrosen, Phoebe Gauthier, Gail D’Onofrio, David A. Fiellin, Lisa A. Marsch, Patricia Novo, David Liu, E. Jennifer Edelman, Sarah Farkas, Abigail G. Matthews, Caroline Mulatya, Dagmar Salazar, Jeremy Wolff, Randolph Knight, William Goodman, Kathryn Hawk

Dartmouth Scholarship

Background: For many reasons, the emergency department (ED) is a critical venue to initiate OUD interventions. The prevailing culture of the ED has been that substance use disorders are non-emergent conditions better addressed outside the ED where resources are less constrained. This study, its rapid funding mechanism, and accelerated timeline originated out of the urgent need to learn whether ED-initiated buprenorphine (BUP) with referral for treatment of OUD is generalizable, as well as to develop strategies to facilitate its adoption across a variety of ED settings and under real-world conditions. It both complements and uses methods adapted from Project ED …

Can A Large-Landscape Conservation Vision Contribute To Achieving Biodiversity Targets?, Mark Hebblewhite, Jodi A. Hilty, Sara Williams, Harvey Locke, Charles Chester, David Johns, Gregory Kehm, Wendy L. Francis

Political Science Faculty Publications and Presentations

Founded in 1993, the Yellowstone to Yukon (Y2Y) vision was one of the earliest large-landscape conservation visions. Despite growing recognition of large-landscape conservation strategies, there have been few tests to date of conservation gains achieved through such approaches. We tested for conservation gains in the Y2Y region of North America following initiation of the Y2Y conservation vision in 1993 using a counterfactual spatiotemporal comparison and tracking change in five different conservation metrics. First, we enumerated the area of land within Y2Y in designated protected areas. We then compared the rate of change of protected area growth before- and after-initiation of …

A Late Cretaceous True Polar Wander Oscillation, Ross N. Mitchell, Christopher J. Thissen, David A.D. Evans, Sarah P. Slotznick, Rodolfo Coccioni, Toshitsugu Yamazaki, Joseph L. Kirschvink

Dartmouth Scholarship

True polar wander (TPW), or planetary reorientation, is well documented for other planets and moons and for Earth at present day with satellites, but testing its prevalence in Earth’s past is complicated by simultaneous motions due to plate tectonics. Debate has surrounded the existence of Late Cretaceous TPW ca. 84 million years ago (Ma). Classic palaeomagnetic data from the Scaglia Rossa limestone of Italy are the primary argument against the existence of ca. 84 Ma TPW. Here we present a new high-resolution palaeomagnetic record from two overlapping stratigraphic sections in Italy that provides evidence for a ~12° TPW oscillation from …

Predictive Modeling Of Depression And Anxiety Using Electronic Health Records And A Novel Machine Learning Approach With Artificial Intelligence, Matthew D. Nemesure, Michael V. Heinz, Raphael Huang, Nicholas C. Jacobson

Dartmouth Scholarship

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are highly prevalent and impairing problems, but frequently go undetected, leading to substantial treatment delays. Electronic health records (EHRs) collect a great deal of biometric markers and patient characteristics that could foster the detection of GAD and MDD in primary care settings. We approached the problem of predicting MDD and GAD using a novel machine learning pipeline to re-analyze data from an observational study. The pipeline constitutes an ensemble of algorithmically distinct machine learning methods, including deep learning. A sample of 4,184 undergraduate students completed the study, undergoing a general health …

Cost Talk: Protocol For A Stepped-Wedge Cluster Randomized Trial Of An Intervention Helping Patients And Urologic Surgeons Discuss Costs Of Care For Slow-Growing Prostate Cancer During Shared Decision-Making, Mary C. Politi, Rachel C. Forcino, Katelyn Parrish, Marie Anne Durand, A. James O’Malley, Glyn Elwyn

Dartmouth Scholarship

Background: Costs of care are important to patients making cancer treatment decisions, but clinicians often do not feel prepared to discuss treatment costs. We aim to (1) assess the impact of a conversation-based decision aid (Option Grid) containing cost information about slow-growing prostate cancer management options, combined with urologic surgeon training, on the frequency and quality of patient-urologic surgeon cost conversations, and (2) examine the impact of the decision aid and surgeon training on decision quality. Methods: We will conduct a stepped-wedge cluster randomized trial in outpatient urology practices affiliated with a large academic medical center in the USA. We …

“It’S Way More Than Just Writing A Prescription”: A Qualitative Study Of Preferences For Integrated Versus Non-Integrated Treatment Models Among Individuals With Opioid Use Disorder, Elizabeth C. Saunders, Sarah K. Moore, Olivia Walsh, Stephen A. Metcalf, Alan J. Budney, Patricia Cavazos-Rehg, Emily Scherer, Lisa A. Marsch

Dartmouth Scholarship

Background: Increasingly, treatment for opioid use disorder (OUD) is offered in integrated treatment models addressing both substance use and other health conditions within the same system. This often includes offering medications for OUD in general medical settings. It remains uncertain whether integrated OUD treatment models are preferred to non-integrated models, where treatment is provided within a distinct treatment system. This study aimed to explore preferences for integrated versus non-integrated treatment models among people with OUD and examine what factors may influence preferences. Methods: This qualitative study recruited participants (n = 40) through Craigslist advertisements and flyers posted in treatment programs …

Impact Of Oncotype Dx Testing On Er+ Breast Cancer Treatment And Survival In The First Decade Of Use, Evelien Schaafsma, Baoyi Zhang, Merit Schaafsma, Chun Yip Tong, Lanjing Zhang, Chao Cheng

Dartmouth Scholarship

Background: The Oncotype DX breast recurrence score has been introduced more than a decade ago to aid physicians in determining the need for systemic adjuvant chemotherapy in patients with early-stage, estrogen receptor (ER)+, lymph node-negative breast cancer. Methods: In this study, we utilized data from The Surveillance, Epidemiology, and End Results (SEER) Program to investigate temporal trends in Oncotype DX usage among US breast cancer patients in the first decade after the introduction of the Oncotype DX assay. Results: We found that the use of Oncotype DX has steadily increased in the first decade of use and that this increase …

The Impact Of Particulate Electron Paramagnetic Resonance Oxygen Sensors On Fluorodeoxyglucose Imaging Characteristics Detected Via Positron Emission Tomography, Philip E. Schaner, Ly Binh An Tran, Bassem I. Zaki, Harold M. Swartz, Eugene Demidenko, Benjamin B. Williams, Alan Siegel, Periannan Kuppusamy, Ann Barry Flood, Bernard Gallez

Dartmouth Scholarship

During a first-in-humans clinical trial investigating electron paramagnetic resonance tumor oximetry, a patient injected with the particulate oxygen sensor Printex ink was found to have unexpected fluorodeoxyglucose (FDG) uptake in a dermal nodule via positron emission tomography (PET). This nodule co-localized with the Printex ink injection; biopsy of the area, due to concern for malignancy, revealed findings consistent with ink and an associated inflammatory reaction. Investigations were subsequently performed to assess the impact of oxygen sensors on FDG-PET/CT imaging. A retrospective analysis of three clinical tumor oximetry trials involving two oxygen sensors (charcoal particulates and LiNc-BuO microcrystals) in 22 patients …

Rational Design Of On-Chip Gold Plasmonic Nanoparticles Towards Ctdna Screening, Amogha Tadimety, Ziqian Wu, John H. Molinski, Russell Beckerman, Congran Jin, Lauren Zhang, Timothy J. Palinski, John X.J. Zhang

Dartmouth Scholarship

This paper demonstrates the design, synthesis, simulation, and testing of three distinct geometries of plasmonic gold nanoparticles for on-chip DNA screening towards liquid biopsy. By employing a seed-mediated growth method, we have synthesized gold nanospheres, nanorods, and nanobipyramids. In parallel, we developed numerical simulations to understand the effects of nanoparticle geometry on the resonance features and refractive index sensitivity. Both experimental and simulation results were compared through a series of studies including in-solution and on-chip tests. We have thoroughly characterized the impact of nanoparticle geometry on the sensitivity to circulating tumor DNA, with immediate implications for liquid biopsy. The results …

A Framework To Identify Structured Behavioral Patterns Within Rodent Spatial Trajectories, Francesco Donnarumma, Roberto Prevete, Domenico Maisto, Simone Fuscone, Emily M. Irvine, Matthijs A.A. Van Der Meer, Caleb Kemere, Giovanni Pezzulo

Dartmouth Scholarship

Animal behavior is highly structured. Yet, structured behavioral patterns—or “statistical ethograms”—are not immediately apparent from the full spatiotemporal data that behavioral scientists usually collect. Here, we introduce a framework to quantitatively characterize rodent behavior during spatial (e.g., maze) navigation, in terms of movement building blocks or motor primitives. The hypothesis that we pursue is that rodent behavior is characterized by a small number of motor primitives, which are combined over time to produce open-ended movements. We assume motor primitives to be organized in terms of two sparsity principles: each movement is controlled using a limited subset of motor primitives (sparse …

Gaussian-Preserved, Non-Volatile Shape Morphing In Three-Dimensional Microstructures For Dual-Functional Electronic Devices, Ziao Tian, Borui Xu, Guangchao Wan, Xiaomin Han, Zengfeng Di, Zi Chen, Yongfeng Mei

Dartmouth Scholarship

Motile plant structures such as Mimosa pudica leaves, Impatiens glandulifera seedpods, and Dionaea muscipula leaves exhibit fast nastic movements in a few seconds or less. This motion is stimuli-independent mechanical movement following theorema egregium rules. Artificial analogs of tropistic motion in plants are exemplified by shape-morphing systems, which are characterized by high functional robustness and resilience for creating 3D structures. However, all shape-morphing systems developed so far rely exclusively on continuous external stimuli and result in slow response. Here, we report a Gaussian-preserved shape-morphing system to realize ultrafast shape morphing and non-volatile reconfiguration. Relying on the Gaussian-preserved rules, the transformation …

Sprd: A Surface Plasmon Resonance Database Of Common Factors For Better Experimental Planning, Purushottam B. Tiwari, Camelia Bencheqroun, Mario Lemus, Taryn Shaw, Marilyn Kouassi-Brou, Adil Alaoui, Aykut Üren

Dartmouth Scholarship

Background: Surface plasmon resonance is a label-free biophysical technique that is widely used in investigating biomolecular interactions, including protein-protein, protein-DNA, and protein-small molecule binding. Surface plasmon resonance is a very powerful tool in different stages of small molecule drug development and antibody characterization. Both academic institutions and pharmaceutical industry extensively utilize this method for screening and validation studies involving direct molecular interactions. In most applications of the surface plasmon resonance technology, one of the studied molecules is immobilized on a microchip, while the second molecule is delivered through a microfluidic system over the immobilized molecules. Changes in total mass on …

Structural Analysis Of Cross Α-Helical Nanotubes Provides Insight Into The Designability Of Filamentous Peptide Nanomaterials, Fengbin Wang, Ordy Gnewou, Charles Modlin, Leticia C. Beltran, Chunfu Xu, Zhangli Su, Puneet Juneja, Gevorg Grigoryan, Edward H. Egelman, Vincent P. Conticello

Dartmouth Scholarship

The exquisite structure-function correlations observed in filamentous protein assemblies provide a paradigm for the design of synthetic peptide-based nanomaterials. However, the plasticity of quaternary structure in sequence-space and the lability of helical symmetry present significant challenges to the de novo design and structural analysis of such filaments. Here, we describe a rational approach to design self-assembling peptide nanotubes based on controlling lateral interactions between protofilaments having an unusual cross-α supramolecular architecture. Near-atomic resolution cryo-EM structural analysis of seven designed nanotubes provides insight into the designability of interfaces within these synthetic peptide assemblies and identifies a non-native structural interaction based on …

Elevated Temperature And Browning Increase Dietary Methylmercury, But Decrease Essential Fatty Acids At The Base Of Lake Food Webs, Pianpian Wu, Martin J. Kainz, Fernando Valdés, Siwen Zheng, Katharina Winter, Rui Wang, Brian Branfireun, Celia Y. Chen, Kevin Bishop

Dartmouth Scholarship

Climate change scenarios predict increases in temperature and organic matter supply from land to water, which affect trophic transfer of nutrients and contaminants in aquatic food webs. How essential nutrients, such as polyunsaturated fatty acids (PUFA), and potentially toxic contaminants, such as methylmercury (MeHg), at the base of aquatic food webs will be affected under climate change scenarios, remains unclear. The objective of this outdoor mesocosm study was to examine how increased water temperature and terrestrially-derived dissolved organic matter supply (tDOM; i.e., lake browning), and the interaction of both, will influence MeHg and PUFA in organisms at the base of …

The Association Between Protease Inhibitors And Anal Cancer Outcomes In Veterans Living With Hiv Treated With Definitive Chemoradiation: A Retrospective Study, Alison K. Yoder, David S. Lakomy, Yongquan Dong, Suchismita Raychaudhury, Kathryn Royse, Christine Hartman, Peter Richardson, Donna L. White, Jennifer R. Kramer, Lilie L. Lin, Elizabeth Chiao

Dartmouth Scholarship

Background: The incidence of anal squamous cell carcinoma has been increasing, particularly in people living with HIV (PLWH). There is concern that radiosensitizing drugs, such as protease inhibitors, commonly used in the management of HIV, may increase toxicities in patients undergoing chemoradiation. This study examines treatment outcomes and toxicities in PLWH managed with and without protease inhibitors who are receiving chemoradiation for anal cancer. Methods: Patient demographic, HIV management, and cancer treatment information were extracted from multiple Veterans Affairs databases. Patients were also manually chart reviewed. Among PLWH undergoing chemoradiation for anal carcinoma, therapy outcomes and toxicities were compared between …

Structure Of The Master Regulator Rns Reveals An Inhibitor Of Enterotoxigenic Escherichia Coli Virulence Regulons, Charles R. Midgett, Kacey Marie Talbot, Jessica L. Day, George P. Munson, F. Jon Kull

Dartmouth Scholarship

Enteric infections caused by the gram-negative bacteria enterotoxigenic Escherichia coli (ETEC), Vibrio cholerae, Shigella flexneri, and Salmonella enterica are among the most common and affect billions of people each year. These bacteria control expression of virulence factors using a network of transcriptional regulators, some of which are modulated by small molecules as has been shown for ToxT, an AraC family member from V. cholerae. In ETEC the expression of many types of adhesive pili is dependent upon the AraC family member Rns. We present here the 3 Å crystal structure of Rns and show it closely resembles ToxT. Rns crystallized …

Fabrication Of Monodisperse Magnetic Nanorods For Improving Hyperthermia Efficacy, Shan Zhao, Nanjing Hao, John X.J. Zhang, P. Jack Hoopes, Fridon Shubitidze, Zi Chen

Dartmouth Scholarship

Background: Hyperthermia is one of the promising cancer treatment strategies enabled by local heating with the use of tumor-targeting magnetic nanoparticles (MNP) under a non-invasive magnetic field. However, one of the remaining challenges is how to achieve therapeutic levels of heat (without causing damages to regular tissues) in tumors that cannot be effectively treated with anti-tumor drug delivery. Results: In this work, we report a facile method to fabricate magnetic nanorods for hyperthermia by one-step wet chemistry synthesis using 3-Aminopropyltrimethoxysilane (APTMS) as the shape-controlling agent and ferric and ferrous ions as precursors. By adjusting the concentration of APTMS, hydrothermal reaction …

Development And Evaluation Of A Deep Neural Network For Histologic Classification Of Renal Cell Carcinoma On Biopsy And Surgical Resection Slides, Mengdan Zhu, Bing Ren, Ryland Richards, Matthew Suriawinata, Naofumi Tomita, Saeed Hassanpour

Dartmouth Scholarship

Renal cell carcinoma (RCC) is the most common renal cancer in adults. The histopathologic classification of RCC is essential for diagnosis, prognosis, and management of patients. Reorganization and classification of complex histologic patterns of RCC on biopsy and surgical resection slides under a microscope remains a heavily specialized, error-prone, and time-consuming task for pathologists. In this study, we developed a deep neural network model that can accurately classify digitized surgical resection slides and biopsy slides into five related classes: clear cell RCC, papillary RCC, chromophobe RCC, renal oncocytoma, and normal. In addition to the whole-slide classification pipeline, we visualized the …

Meta-Analysis Of Neural Systems Underlying Placebo Analgesia From Individual Participant Fmri Data, Matthias Zunhammer, Tamás Spisák, Tor D. Wager, Ulrike Bingel, Lauren Atlas, Fabrizio Benedetti, Christian Büchel, Jae Chan Choi, Luana Colloca, Davide Duzzi, Falk Eippert, Dan Mikael Ellingsen, Sigrid Elsenbruch, Stephan Geuter, Ted J. Kaptchuk, Simon S. Kessner, Irving Kirsch, Jian Kong, Claus Lamm, Siri Leknes

Dartmouth Scholarship

The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high …

Amagmatic Hydrothermal Systems On Mars From Radiogenic Heat, Lujendra Ojha, Suniti Karunatillake, Saman Karimi, Jacob Buffo

Dartmouth Scholarship

Long-lived hydrothermal systems are prime targets for astrobiological exploration on Mars. Unlike magmatic or impact settings, radiogenic hydrothermal systems can survive for >100 million years because of the Ga half-lives of key radioactive elements (e.g., U, Th, and K), but remain unknown on Mars. Here, we use geochemistry, gravity, topography data, and numerical models to find potential radiogenic hydrothermal systems on Mars. We show that the Eridania region, which once contained a vast inland sea, possibly exceeding the combined volume of all other Martian surface water, could have readily hosted a radiogenic hydrothermal system. Thus, radiogenic hydrothermalism in Eridania could …

Characterizing Rescue Performance In A Tertiary Care Medical Center: A Systems Approach To Provide Management Decision Support, Susan P. Mcgrath, Todd Mackenzie, Irina Perreard, George Blike

Dartmouth Scholarship

Background: Allocation of limited resources to improve quality, patient safety, and outcomes is a decision-making challenge health care leaders face every day. While much valuable health care management research has concentrated on administrative data analysis, this approach often falls short of providing actionable information essential for effective management of specific system implementations and complex systems. This comprehensive performance analysis of a hospital-wide system illustrates application of various analysis approaches to support understanding specific system behaviors and identify leverage points for improvement. The study focuses on performance of a hospital rescue system supporting early recognition and response to patient deterioration, which …

Reducing Transphobic Attitudes: A Cross-National Investigation Of College Students In Japan And The United States, Kazusa Seko

Dissertations and Theses

Transgender people routinely experience discrimination and mistreatment. Although transphobic attitudes vary from country to country, a more in-depth understanding of these attitudes is needed. Using a semi-structured online survey, this study investigates college students' attitudes toward transgender people in Japan and the United States, a cross-national comparison that aims to deepen our understanding of how transphobic attitudes are shaped and what opportunities exist to reduce transphobia amongst college students. Results show that Japanese students express more transphobic attitudes than U.S. students do; and that U.S. students had more experience with gender-based educational content and were more likely to know someone …

Raps Sheet, December 2021, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

University Metrics Annual Report, Office Of Institutional Research And Planning

Office of the President Publications and Presentations

At the request of the PSU Board of Trustees in 2019-2020, the President and his executive team developed a set of metrics in the areas of finance, undergraduate and graduate enrollment, and student success. The metrics were approved by the Board of Trustees on August 20, 2020.

For each metric, actual performance is charted against three-year goals, and the results are reported annually to the Board and the PSU Faculty Senate. A narrative report, summary chart, and Excel spreadsheets containing the underlying data are available as supplemental files and also through the University Metrics link on the Office of the …

Reflections On Teaching Against White Supremacy During A Time Of Social Rupture And Transformation, Erica Fonesca, Stéphanie Wahab

School of Social Work Faculty Publications and Presentations

Social Justice and Social Work is a foundational course required for all social work students in the master’s of social work program at Portland State University. Although the course has long focused on interrupting oppressions including White supremacy, teaching the course during the fall of 2020 required a nimble dance between our familiar modes of teaching and the need for spontaneous adaptation and creativity. The unique landscape for this course included teaching the course remotely (Zoom), inside a university embattled around the arming of its security force (that killed a Black man in 2018), in a city targeted by an …

Tactile Materials In Practice: Understanding The Experiences Of Teachers Of The Visually Impaired, Mahika Phutane, Julie Wright, Brenda Veronica Castro, Lei Shi, Simone R. Stern, Holly Lawson, Shiri Azenkot

Special Education Faculty Publications and Presentations

Teachers of the visually impaired (TVIs) regularly present tactile materials (tactile graphics, 3D models, and real objects) to students with vision impairments. Researchers have been increasingly interested in designing tools to support the use of tactile materials, but we still lack an in-depth understanding of how tactile materials are created and used in practice today. To address this gap, we conducted interviews with 21 TVIs and a 3-week diary study with eight of them. We found that tactile materials were regularly used for academic as well as non-academic concepts like tactile literacy, motor ability, and spatial awareness. Real objects and …

‘I Still Desire To Have A Child’: A Qualitative Analysis Of Intersectional Hiv - And Childlessness-Related Stigma In Rural Southwestern Uganda, Madeline Pratt, Moran Owembabazi, Winnie Muyindike, Angela Kaida, Jeanne M. Marrazzo, David Bangsberg, Mwebesa B. Bwana, Christina Psaros, Janet Turan, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

This study explored the intersecting forms of stigma experienced by HIV-sero different couples with unmet reproductive goals in rural Uganda. The parent mixed-methods study, which included 131 HIV-exposed women with plans for pregnancy, offered comprehensive HIV prevention counselling and care over a nine month period. In-depth interviews were conducted with 37 women and seven male partners to explore care experiences and the use of safer conception strategies. This secondary analysis explored how challenges conceiving informed pregnancy plans and HIV prevention behaviours. The following themes were developed (1) partnership conflicts arise from HIV- and infertility-related forms of stigma, contributing to gender-based …

Factors Controlling Longshore Variations Of Beach Changes Induced By Hurricane Hermine Along Pinellas County Beaches, West-Central Florida, Wenhan Zhai

USF Tampa Graduate Theses and Dissertations

Hurricane Hermine, 2016, impacted the coast of west-central Florida and generated high waves superimposed on elevated wave levels which caused significant beach erosion. A total of 122 profiles, spaced about 300 m apart, were surveyed 2 weeks before and one week after the storm to examine the beach changes along three barrier islands along the coast of west-central Florida. including Sand Key, Treasure Island and Long Key. In order to investigates the longshore variations of beach/nearshore changes induced by storm, several parameters were defined and calculated including beach volume changes, berm height, beach width, foreshore slope, as well as sandbar …

Thrombosis With Thrombocytopenia Syndrome After Administration Of Azd1222 Or Ad26.Cov2.S Vaccine For Covid-19: A Systematic Review, Usama Waqar, Shaheer Ahmed, Syed M H Ali Gardezi, Muhammad Sarmad Tahir, Zain Ul Abidin, Ali Hussain, Natasha Bahadur Ali, Syed Faisal Mahmood

Medical College Documents

Background: Cases of thrombosis with thrombocytopenia syndrome (TTS) have been reported following vaccination with AZD1222 or Ad26.COV2.S. This review aimed to explore the pathophysiology, epidemiology, diagnosis, management, and prognosis of TTS.
Methods: A systematic review was conducted to identify evidence on TTS till 4th September 2021. Case reports and series reporting patient-level data were included. Descriptive statistics were reported and compared across patients with different sexes, age groups, vaccines, types of thrombosis, and outcomes.
Findings: Sixty-two studies reporting 160 cases were included from 16 countries. Patients were predominantly females with a median age of 42.50 (22) years. AZD1222 was administered …

Surgical Management Of Subclavian And Proximal Axillary Artery Injuries, Zia Ur Rehman, Suleman Yousaf, Tehmeed Ahmad

Department of Surgery Docs

Subclavian and proximal axillary arterial injuries are rare and difficult to manage. Eight patients were managed from January 2008 to December 2018 at The Aga Khan University Hospital, Karachi, Pakistan with mean age of 36.13 ± 14.48 years. All patients had penetrating injuries, from gunshot in 5 (62.5%), bomb blast in 2 (25%), and stab wound in 1 (12.5%) case. Six (75%) patients presented in haemodynamically stable condition. The mean time between the injury and patient presentation was 28 ± 8.39 hours. The injuries were approached via supraclavicular incision in 3 (37.5%) patients, infraclavicular incisions in 2 (25%) patients and …