Medicine and Health Sciences Commons^™

Time-Frequency Fingerprint Analysis In Seeg Source-Space To Identify The Epileptogenic Zone, Yash Shashank Vakilna, Deniz Atilgan, Johnson Hampson, Chinmay Chinara, Takfarinas Medani, Richard M Leahy, Nuria Lacuey, Samden D Lhatoo, Sandipan Pati, John C Mosher, Jay R Gavvala

Faculty, Staff and Student Publications

This case study highlights the application of seizure fingerprint analysis in the source-space of stereo-EEG (SEEG) data to accurately localize the epileptogenic zone (EZ) in patients with complex cortical malformations. A 25-year-old female with extensive bilateral perisylvian polymicrogyria (PMG) presented with intractable focal seizures. The source-level analysis performed in Brainstorm using the sLORETA imaging algorithm subsequently showed EZ fingerprint analysis. The patient underwent MR-guided laser interstitial thermal therapy (LITT), targeting the identified EZ, resulting in postoperative seizure freedom with minimal complications. Extending the analysis from the sensor-space to the source-space could further enhance surgical planning and improve outcomes in complex …

Generation Of Induced Pluripotent Stem Cell Lines (Rfsci003-A, Rfsci004-A) From Monozygotic Twins Discordant For Age-Related Macular Degeneration, Naresh Rajendran, Wendy Runyon, Sam Hu, Ajeet Singh, Rinki Ratnapriya, Ritu Kumar, Karl Csaky, Srinivasa R Sripathi

Faculty, Staff and Students Publications

Age-related macular degeneration (AMD) has significant genetic component, yet monozygotic twins frequently exhibit discordance in disease status, highlighting the role of non-genetic factors. To enable comparative studies of AMD pathogenesis, we generated two induced pluripotent stem cell (iPSC) lines from peripheral blood mononuclear cells (PBMCs) of a monozygotic twin pair discordant for AMD. These iPSC lines offer a unique genetically matched resource to investigate molecular differences between affected and unaffected twins, as well as their responses to genetic, epigenetic, and environmental contributors to AMD development.

Socioeconomic Disadvantage, All-Cause And Cause-Specific Mortality In Patients Treated With Maintenance Dialysis: A Mediation Analysis Of Geographical Inequity And Multimorbidity, Farzaneh Boroumand, Wai H. Lim, Shuvo Bakar, Ryan Gately, Pedro Lopez, Dharshana Sabanayagam, Anita Van Zwieten, Lin Zhu, Germaine Wong, Armando Teixeira-Pinto

Research outputs 2022 to 2026

Rationale & Objective: Social gradient in health (a “social gradient in health” refers to the observed pattern in which individuals with lower socioeconomic status typically experience poorer health outcomes than those with higher socioeconomic status. This indicates that health disparities exist across different social levels, with the most disadvantaged groups experiencing the worst health outcomes) is significant and established in patients with kidney failure, but the pathways of this relationship are unknown. We aimed to assess the mediating effects of multimorbidity and geographical remoteness in the socioeconomic status (SES)-death associations. Study Design: A cohort study. Setting & Participants: All patients …

Management Of Atypical Haemolytic Uraemic Syndrome With Triggers: Diagnostic And Treatment Algorithms From An Asia-Pacific Perspective, Hee Gyung Kang, Danny Hsu, Noritoshi Kato, Jin Seok Kim, Masayoshi Okumi, Min Hua Tseng, Kun Hua Tu, Desmond Yat Hin Yap, Wai H. Lim

Research outputs 2022 to 2026

Complement-amplifying events/conditions associated with thrombotic microangiopathy (TMA) include pregnancy/postpartum period, severe hypertension, autoimmune diseases, drug exposures, infections and organ transplantation. Some of these ‘triggers’ may exist comorbidly with atypical haemolytic uraemic syndrome (aHUS; a complement-mediated form of TMA), unmask previously undiagnosed aHUS, or occur secondary to aHUS, thus creating a considerable diagnostic challenge. A major goal in patients presenting with TMA is to differentiate complement-mediated aHUS from other causes of TMA such that appropriate targeted treatment with complement 5 (C5) inhibitors can be initiated rapidly to avoid irreversible end-organ damage. To this end, nephrologists and haematologists from Australia, Hong Kong, …

Antimicrobial Resistance Of Clostridioides (Clostridium) Difficile In Cambodia, Lengsea Eng, Papanin Putsathit, Su Chen Lim, Jessica M. Chisholm, Deirdre A. Collins, Archie C.A. Clements, Kefyalew Addis Alene, Thomas V. Riley

Research outputs 2022 to 2026

Background/Objectives: Antimicrobial resistance (AMR) remains a major topic of interest in infectious disease management. We studied AMR in Clostridioides difficile isolated in Cambodia. Methods: Agar dilution susceptibility testing was performed according to the CLSI guidelines to determine minimal inhibitory concentrations (MICs) of 10 antimicrobials for 192 isolates of C. difficile from four populations in Cambodia: hospitalised adults, hospitalised children, children from an outpatient department (OPD), and healthy adolescents in the community. Results: Using the CLSI MIC breakpoints for anaerobes and EUCAST breakpoints for C. difficile, all isolates were susceptible to vancomycin, metronidazole, fidaxomicin, and amoxicillin/clavulanic acid, and none were resistant …

Parent Needs, Recommendations, And Systemic Challenges Affecting Pediatric Hypertension Detection, Abbas H. Zaidi, Erica D. Sood, Sarah De Ferranti, Samuel Gidding, Varsha Zadokar, Jonathan M. Miller, Anne E Kazak

Department of Pediatrics Faculty Papers

Pediatric hypertension (HTN) affects 3%-5% of children in the United States, yet only 25% are diagnosed and 60% lack recommended follow-up care. Skepticism about elevated blood pressure (BP) readings and reluctance to use antihypertensive medications by parents and clinicians highlight the need for stakeholder-informed strategies to address these challenges. This study examined parents' perceived needs, their recommended strategies to improve HTN detection, and contextual health system challenges. Parents and clinicians from 10 pediatric primary care clinics participated in semi-structured qualitative interviews. Only parents of children with documented stage 2 BP readings and a HTN diagnosis, but with gaps in care …

Potential Biological Hazards In Health Clinics: Key Strategies For Enhancing Worker Safety In Malaysia, Subki Ahmad, Normah Awang, Ermie Abdull Hamid, Anuar Ithnin, Nurul Farahana Kamaludin, Noraizah Muhd Nor

Makara Journal of Health Research

Background: Biological hazards in health clinics may lead to acute or chronic health issues for healthcare workers. This study aims to identify potential biological hazards within health clinics, with a focus on the knowledge, attitude, and practice (KAP) of healthcare workers, in order to improve their safety.

Methods: Samples from environmental surfaces were collected and cultured to identify bacterial pathogens. A cross-sectional study involving 203 healthcare workers was conducted using a questionnaire derived from CDC-adapted guidelines. Descriptive analysis and multivariate regression were used to assess KAP.

Results: Bacterial growth was observed in all clinics. The Kruskal-Wallis Test …

Risk Factors Of Acute Gastroenteritis And The Implementation Of Community-Based Total Sanitation In Banyuwangi, Indonesia: A Cross-Sectional Study, Citra Al Karina, Juniastuti Juniastuti, Budi Utomo, I Made Dwi Mertha Adnyana

Makara Journal of Health Research

Background: In Banyuwangi Regency, Indonesia, diarrhea remains a major health problem, even though the community-based total sanitation (CBTS) program has been implemented for ten years. This household survey study aimed to identify the risk factors of acute gastroenteritis (AGE) and to evaluate the implementation of CBTS in Banyuwangi Regency.

Methods: A cross-sectional study was conducted in Banyuwangi Regency. Characteristic data from patients with AGE were collected from the two primary healthcare working areas, followed by collecting data of their family members and CBTS in their houses. Data were obtained through interviews and direct observation. The CBTS evaluation results …

Self-Medication Behavior Of Dental Students With Oral Ulceration Lesions: A Cross-Sectional Study In Yogyakarta, Indonesia, Fita Fathaya Iriana, Hendri Susanto, Rosa Amalia

Journal of Dentistry Indonesia

Objective: Self-medication refers to medication behavior for self-diagnosed symptoms. Oral ulcers are self-medicated lesions in the oral cavity. Dental students have different knowledge about oral cavity lesions and may self-medicate using drugs. This study aimed to determine the self-medication behavior of dental students for oral ulcers. Methods: This cross-sectional study was conducted on dental students in the Faculty of Dentistry from different batch years. Purposive sampling was used to select students with oral ulcer lesions in the last six months. A validated and reliable questionnaire was used to assess self-medication behavior. Data collection using the online form. Student behavior …

Whole-Genome Sequence-Based Association Analysis Of African American Individuals With Bipolar Disorder And Schizophrenia, Runjia Li, Sarah A Gagliano Taliun, Kevin Liao, Matthew Flickinger, Janet L Sobell, Giulio Genovese, Adam E Locke, Rebeca Rothwell Chiu, Jonathon Lefaive, Jiongming Wang, Taylor Martins, Sinéad Chapman, Anna Neumann, Robert E Handsaker, Donna K Arnett, Kathleen C Barnes, Eric Boerwinkle, David Braff, Brian E Cade, Myriam Fornage, Richard A Gibbs, Karin F Hoth, Lifang Hou, Charles Kooperberg, Ruth J F Loos, Ginger A Metcalf, Courtney G Montgomery, Alanna C Morrison, Zhaohui S Qin, Susan Redline, Alexander P Reiner, Stephen S Rich, Jerome I Rotter, Kent D Taylor, Karine A Viaud-Martinez, Tim B Bigdeli, Stacey Gabriel, Sebastian Zollner, Albert V Smith, Goncalo Abecasis, Steve A Mccarroll, Michele T Pato, Carlos N Pato, Michael Boehnke, James Knowles, Hyun Min Kang, Roel A Ophoff, Jason Ernst, Laura J Scott

Faculty, Staff and Student Publications

In studies of individuals of primarily European genetic ancestry, common and low-frequency variants and rare coding variants have been found to be associated with the risk of bipolar disorder (BD) and schizophrenia (SZ). However, less is known for individuals of other genetic ancestries or the role of rare non-coding variants in BD and SZ risk. We performed whole-genome sequencing (∼27X) of African American individuals: 1,598 with BD, 3,295 with SZ, and 2,651 unaffected controls (InPSYght study). We increased power by incorporating 14,812 jointly called psychiatrically unscreened ancestry-matched controls from the Trans-Omics for Precision Medicine (TOPMed) Program for a total of …

Biofluid Biomarkers Aid In Diagnosing And Developing Improved Treatments For People With Alzheimer's Disease, Jonatan A. Lopez

University Honors Theses

Dementia is a disease in which daily life is disrupted by a loss of cognitive function. Late-onset Alzheimer's disease (AD) is the most common dementia that largely begins to affect individuals in their mid 60s or older. AD was selected as the focus of this paper because it is the most common form of dementia, accounting for 50-70% of dementia cases. A typical diagnostic approach used by physicians starts with a simple clinical test, the Mini-Mental State Examination (MMSE), when cognitive decline is suspected in a patient. Then if there is enough evidence to suggest AD, a physician would order …

Educational Point-Of-Care Ultrasound Discovers Adrenal Cortical Carcinoma, A Case Report: Clinical Implications And Review Of The Literature, Minh Q. Nguyen, Moshe Bengio, Vu H. Tran

HCA Healthcare Journal of Medicine

Introduction

Point-of-care ultrasound (POCUS) has become an indispensable tool for emergency physicians in assessing intra-abdominal pathology due to its real-time visualization, portability, and cost-effectiveness. While POCUS is not traditionally focused on adrenal gland assessment, incidental findings of adrenal masses during examinations have been reported. Our patient presented with a chronic obstructive pulmonary disease (COPD) exacerbation and was found to have a large adrenal mass, discovered incidentally, during thoracic ultrasound.

Case Presentation

This case report presents the discovery of an adrenal mass in a patient with respiratory distress due to a COPD exacerbation, emphasizing the importance of sonographers’ ability to identify …

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …

Investigating Extracellualr Vesicles Role In The Pathogenesis Of Acute Lung Injury, Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Tierney Day, Anca Dobrian, John D. Catravas

Cardiovascular Research Symposium

Background: Extracellular vesicles (EVs) are small lipid-bound particles containing proteins and RNAs, whose role in intercellular communication and signaling is critical for homeostasis or inflammatory responses. Patients with acute lung injury display changes in EVs number, cargo content and signature compared to healthy individuals.

Hypothesis: We have hypothesized that EVs may play a role in the pathogenesis of acute lung, by transferring harmful mediators of inflammation and disrupting recipient cells homeostasis.

Methods: C57BL/6j mice (8-10 weeks old, 25g BW) were intratracheally instilled with 50µL of 5*1010- 11 EVs isolated from Human Lung Microvascular Endothelial cells (HLMVEC) exposed to 1 µg …

"Lost To Follow Up:" A Case Of An Adult Congenital Heart Defect Patient Who Faced Morbidity In Adulthood After Lacking Transitional Care Following Medical Intervention In Childhood, Mackenzie Kelley, Ashish Saini

Cardiovascular Research Symposium

CASE PRESENTATION: This patient is a 40 y.o. male with a BMI of 46.2 kg/m2 who presented to the ED with fluid overload, shortness of breath, and orthopnea. The patient was tachycardic and physical exam revealed anasarca and ascites. The patient reported chronic lower extremity and scrotal edema so severe that he had been unable to walk and was mainly homebound for the past two years. The patient’s past medical history was significant for hypertension, alcohol use disorder with history of withdrawal, and a cardiac murmur which the patient attributed to a “hole in the heart” for which he had …

Ice Guided Percutaneous Pseudoaneurysm Coil Embolization, Moudar Jano, Amir M. Hassani, Matthew R. Summers

Cardiovascular Research Symposium

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta …

Association Of Physical Activity And Neighborhood Deprivation With Extracellular Vesicle Characteristics In African American Women With Obesity, Anca D. Dobrian, Yvonne Baumer, Tiffany Powell-Wiley, Lizzy Aquino-Peterson, Noel Miller

Cardiovascular Research Symposium

Association of Physical Activity and Neighborhood Deprivation with Extracellular Vesicle Characteristics in African American Women with Obesity

Predicting Cardiovascular Mortality In Hampton Roads Using Social Determinants Of Health, Mohan D. Pant, Aditya Chakraborty, Prachi P. Chavan, George Mcleod, Brett J. Sierra, Glenn A. Yap, Brian C. Martin, Ebbie Kalan, Gregory T. Scott

Cardiovascular Research Symposium

Background: In Virginia’s Hampton Roads (HR) region, minority populations experience notably higher mortality rates than white populations. Despite abundant research on the association between social determinants of health (SDOH) and cardiovascular mortality rates at the state and national levels, there is a lack of research examining this association in the HR region.

Objective: The main objective of this study is to train and validate a geospatial-temporal predictive model to examine the association between SDOH and cardiovascular mortality, in the HR region.

Methods: Utilizing a longitudinal dataset (2010–2021) from the Virginia Department of Health and the U.S. Census Bureau, we trained …

Role Of Cd45 Dependent Signaling In B-Cell Subsets In Atherosclerosis, Shelby Ma, Elena Galkina, Aravindan Balaguru

Cardiovascular Research Symposium

No abstract provided.

Clonal Hematopoiesis And Thromboembolic Diseases: A Review, Jaekeun Jung, Jee Hyuk Byun, Janghee Woo

Cardiovascular Research Symposium

Clonal hematopoiesis of indeterminate potential (CHIP) has been identified as a novel risk factor for cardiovascular diseases, primarily mediated by CHIP-induced systemic inflammation. Emerging evidence suggests that CHIP may also contribute to the risk of thromboembolic diseases. This review highlights recent findings on the impact of CHIP on various thromboembolic conditions, such as deep vein thrombosis, pulmonary embolism, chronic thromboembolic pulmonary hypertension, and ischemic stroke. Studies have demonstrated an association between CHIP and an increased risk of deep vein thrombosis, pulmonary embolism, chronic thromboembolic pulmonary hypertension and ischemic stroke. CHIP-induced systemic inflammation may amplify vascular endothelial damage and complement cascade …

Student Nurse-Led Hypertension Management In A Rural Free Clinic, Leslie Okhirkhian

Cardiovascular Research Symposium

This pilot project seeks to evaluate the effect of nurse-led assessments and education on blood pressure control among adult patients with prehypertension and hypertension who attend a free health clinic located inside of a rural community in Southeastern Virginia. A leading, modifiable risk factor for cardiovascular disease is hypertension, yet disparities in consistent healthcare access and education disproportionately affect rural populations. Nurse-led interventions are a promising strategy for improving hypertension control through personalized education, blood pressure monitoring, and follow-up.

Methods: Participants with a diagnosis of prehypertension or hypertension were recruited from a free rural health clinic (n=20). Over a 7-week …

Socioeconomic, Behavioral, And Health Profiles Of Women With Eclampsia: Findings From The 2020–2022 National Pregnancy Risk Assessment Monitoring System Data, Jessi Bates, Gurgen Grigoryants, Hongyun Fu

Cardiovascular Research Symposium

Background: Eclampsia is a severe obstetric complication with significant maternal health implications, disproportionately affects women with certain sociodemographic and health risk factors. This study investigates the characteristics and outcomes of women who experienced eclampsia using data from the national Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods: This analysis included a sample of 729 women with eclampsia from the 2020–2022 PRAMS (N = 238,575). Descriptive statistics, chi-square tests, and multivariate logistic regression were conducted to examine patterns and factors associated with preterm-birth, low birth weight (LBW), and cesarean delivery.

Results: Over half of the women were aged ≥35 years (50.6%), unmarried …

Hiv-1 Controllers Possess A Unique Cd8+ T Cell Activation Phenotype And Loss Of Control Is Associated With Increased Expression Of Exhaustion Markers, Amber D. Jones, Zachary Capriotti, Erin Santos, Angel Lin, Rachel Van Duyne, Stephen Smith, Zachary Klase

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

BACKGROUND: HIV-1 controllers are a rare population of individuals that exhibit spontaneous control of HIV-1 infection without antiretroviral therapy. Understanding the mechanisms by which HIV-1 controllers maintain and eventually lose this ability would be highly valuable in HIV-1 cure or vaccine research. Previous work revealed the ability of CD8+ T cells isolated from HIV-1 controllers to suppress HIV-1 replication in matched CD4+ T cells and PBMCs ex vivo and suggested the loss of control may be tied to CD8+ T cell exhaustion.

RESULTS: We explored whether CD8+ T cell exhaustion plays a role in the maintenance and loss of control …

The Immunophenotypic And Genetic Characterization Of Pediatric T -L Ymphoblastic Leukemia With A Mature Immunophenotype, Mahsa Khanlari, Wei Wang, Parastou Tizro, Mohammad K Eldomery

Faculty, Staff and Student Publications

Not available.

Should We Subtype Gastric Intestinal Metaplasia In Gastric Biopsies, A Single Institution's Experience, Haibo Wang, Yu Liu, Asra Feroze, Zengying Wu, Jonathan D. Somma, Zhiyan Fu

School of Medicine Faculty Publications

Gastric intestinal metaplasia (GIM) is considered a risk factor for gastric dysplasia and adenocarcinoma. While surveillance endoscopies are often performed, particularly for incomplete GIM, the clinical value of histologic subtyping (complete, incomplete, or mixed) remains unclear. This study evaluated the progression risk of different GIM subtypes diagnosed through random gastric biopsies and their association with various clinical factors. Archived pathology data from 206 gastric biopsy cases were analyzed, including 52 negative controls, 56 complete GIM, 54 incomplete GIM, and 44 mixed GIM. Histologic slides were reviewed for subtype confirmation and other pathological changes; clinical data were extracted from medical records. …

Optimizing Pharmacologic Treatment For Neonatal Opioid Withdrawal Syndrome (Optimize Now): A Symptom-Based Dosing Approach Study Protocol For A Multi-Center, Cluster Crossover Design Randomized Controlled Trial, Leslie W. Young, Denise C. Babineau, Abhik Das, Sara Demauro, Walter K. Kraft, Scott Lorch, Michele C. Walsh, Stephanie Merhar, Lori A. Devlin

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

BACKGROUND: Opioid use and misuse during pregnancy rose from 1.5 to 6.5 per 1000 deliveries between 1999 and 2014 and continues as a significant public health concern. A fivefold increase in neonatal opioid withdrawal syndrome (NOWS) has accompanied the increase in opioid use. The Eating, Sleeping, Consoling care approach (ESC) has been shown to improve outcomes for infants with NOWS and is quickly becoming the standard of care for infants affected by opioid use disorder. Quality improvement initiatives following the implementation of ESC provide some evidence to suggest that symptom-based (i.e., as needed, PRN, just in time) dosing of opioid …

The 9th Annual Lafora Science Symposium: A Rare Epilepsy Community Makes Progress Towards Clinical Readiness, Meredith I. Williams, Katherine J. Donahue, Pascual Sanz, Souad Messahel, Jose M. Serratosa, Jordi Duran, Roberto Michelucci, Lorenzo Muccioli, Antonio Delgado-Escueta, Viet-Hong Nguyen, Berge A. Minassian, Matthew S. Gentry

Pharmacy Faculty Articles and Research

Lafora disease (LD) is a fatal childhood progressive myoclonus epilepsy and glycogen storage disease that is caused by recessive mutations in either EPM2A or EPM2B. The hallmarks of LD are cytoplasmic, aberrant glycogen-like aggregates, called Lafora bodies (LBs), that drive disease progression. The 9th Annual Lafora Science Symposium was held in San Diego, California and brought together over 70 researchers, clinicians, academic trainees, and friends and family members of patients with LD and 80 attendees joined virtually. This symposium focused primarily on international collaborations for therapeutic development and biomarker identification and strategies for preparing the Lafora community for upcoming …

External Validation Of Calculator For Cesarean Delivery During Induction Of Labor, Claudia J. Ibarra, Rachel L. Wiley, Han-Yang Chen, Estefania Guthrie, Ipsita Ghose, Hector Mendez-Figueroa, Suneet P. Chauhan

School of Medicine Faculty Publications

OBJECTIVE: To validate a published risk calculator to predict cesarean delivery (CD) among singletons undergoing induction of labor. METHODS: Our retrospective cohort study included singletons undergoing induction of labor. A predicted CD score was calculated for each individual based on a previously developed calculator. External validation of the calculator was assessed by the discriminative power of the model by using the area under the receiver operating characteristic curve, and by a calibration curve. The score was categorized as less than 10%, 10% to less than 30%, and 30% or greater. The primary outcome was CD. The secondary outcomes were a …

Segmental Atrophy Of The Liver: Review Of A Rare Pseudotumor, Ayesha Younus, Yu Liu, Ellen E. Connor, Zeng-Ying Wu, Hwajeong Lee, Zhi-Yan Fu

School of Medicine Faculty Publications

Segmental atrophy (SA) of the liver is a rare, often underrecognized, benign condition that presents as a mass lesion, mimicking a neoplasm, which poses a significant diagnostic challenge. Given its rarity, only a limited number of case reports and series have been published, resulting in sparse literature on the entity. This review aims to summarize the clinicopathologic and diagnostic features of SA and thus improve its recognition.

Are Orthopaedic Trauma Surgeons At Risk Of Occupational Noise-Induced Hearing Loss?, Vincent W. Lau, Stephanie A. Kwan, Jack Graham, Gregory K. Deirmengian

Rothman Institute Papers

OBJECTIVES: Orthopaedic surgeons are at risk of occupational, noise-induced hearing loss due to exposure to instruments in the operating room. The primary objective of this study was to determine whether orthopaedic trauma procedures exceed recommended decibel (dB) limits. The secondary objective was to demonstrate which actions during a case create the highest sound levels.

METHODS: Intraoperative recordings were taken during orthopaedic trauma surgeries and classified into open reduction internal fixation (ORIF), intramedullary nailing, closed reduction percutaneous pinning, external fixation, soft tissue procedures, or a combination thereof. Recordings were taken of drilling, screw insertion, suctioning, saw use, and mallet striking. Decibel …