Medicine and Health Sciences Commons^™

Resilience Of Patients Undergoing Knee And Shoulder Arthroscopy Procedures, Jillian Mazzocca, Natalie Lowenstein, Connor Crutchfield, Jamie Collins, Elizabeth Matzkin

Student Papers, Posters & Projects

INTRODUCTION: Resilience is a person's capacity to overcome adversity. The purpose was to determine what patient factors correlate with resilience using the Brief Resilience Score. We hypothesize that characteristics of female sex, younger age, Workers' Compensation status, and preoperative opioid use are predictors of a lower preoperative resilience score and that patients with positive psychosocial factors would have higher resilience scores.

METHODS: Eight hundred nine patients undergoing knee or shoulder arthroscopy were preoperatively categorized into low, normal, and high-resilience groups. Preoperative patient-reported outcome measures (PROMs) and demographics were assessed. Statistical analyses evaluated differences in demographics and PROMs between resilience groups. …

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …

Prevalence Of Post-Liver Transplant Complications And Nash-Related Cirrhosis In Postmenopausal Women, Natalia Salinas Parra, Michelle Schafer, Heather M. Ross, John Bruckbauer, Brian Yan, Sarah L. Chen, Adnan Khan Do, Danielle M. Tholey, Dina Halegoua-De Marzio

Student Papers, Posters & Projects

INTRODUCTION AND OBJECTIVES: Compared to premenopausal women, postmenopausal women are at greater risk of developing NAFLD and NASH, two common indications for liver transplantation (LT). We aim to determine the prevalence of NASH-related cirrhosis in postmenopausal women from a cohort of LT patients and investigate their post-LT complications.

MATERIALS AND METHODS: Chart review of 1200 LT patients from 2002-2020 was performed. Postmenopausal women were defined as women over 51 and compared to a control group of men over 51. Prevalence of LT indications was determined. Subgroup analysis assessed cardiovascular disease risk. BMI and ASCVD risk scores were calculated at the …

Severe Ocular Alkali Injury Managed With An Externally Sutured Amniotic Membrane And Customized Symblepharon Ring, Sophia S. Lam, Bonnie Sklar, Marisa Schoen, Christopher J. Rapuano

Student Papers, Posters & Projects

Alkali injuries are ocular emergencies that require immediate evaluation and therapy to preserve vision. Severe alkali injuries can result in long‑term vision‑threatening sequelae including symblepharon, corneal ulceration, corneal scarring, limbal stem cell deficiency, xerophthalmia, cicatricial changes of the eyelid and adnexa, glaucoma, uveitis, and permanent vision loss. Treatment is aimed at neutralizing the pH, controlling inflammation, and restoring the ocular surface. Here, we present the case of a 35‑year‑old male who sustained direct ocular exposure to sodium hydroxide, resulting in significant corneal and conjunctival epithelial defects despite aggressive initial medical therapy. The patient subsequently received a large, externally sutured amniotic …

A National Multi-Institutional Analysis Of Predictors Of Surgical Site Complications And Unplanned Reoperation After Paramedian Forehead Flap Reconstruction, Garrett Ni, Rohan Brebion, Pablo A. Baltodano, Michael C. Coronado, Nicholas Elmer, Theresa K. Webster, Huaqing Zhao, Xiaoning Lu, Sthefano Araya, Sameer Patel

Student Papers, Posters & Projects

Background: Although postoperative complications of paramedian forehead flap (PMFF) are generally low, surgical site complications and unplanned reoperation can still occur. Recent literature suggests infection to be the most common complication following PMFF reconstruction. This study sought to determine the patient and preoperative factors associated with surgical site complications and unplanned reoperations at a national level.

Methods: Patients who underwent PMFF reconstruction from the ACS-NSQIP 2007 - 2019 database were analyzed to determine composite surgical site morbidity and unplanned return to the operating room. Patient and operative factors were also analyzed to assess independent risk factors for surgical site morbidity …

Radiation Of Meningioma Dural Tail May Not Improve Tumor Control Rates., Keenan Piper, Siyuan Yu, Mohammad Taghvaei, Christian Fernandez, Nikolaos Mouchtouris, Rupert D Smit, Clifford Yudkoff, Sarah Collopy, Maikerly Reyes, Pascal Lavergne, Michael Karsy, Giyarpuram Prashant, Wenyin Shi, James J. Evans

Student Papers, Posters & Projects

Introduction: Dural tails are thickened contrast-enhancing portions of dura associated with some meningiomas. Prior studies have demonstrated the presence of tumor cells within the dural tail, however their inclusion in radiation treatment fields remains controversial. We evaluated the role of including the dural tail when treating a meningioma with stereotactic radiation and the impact on tumor recurrence.

Methods: This is a retrospective, single-institution, cohort study of patients with intracranial World Health Organization (WHO) grade 1 meningioma and identified dural tail who were treated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) from January 2012 to December 2018. SRS and …

Postoperative Delirium After Major Orthopedic Surgery., Michael K. Urban, Mayu Sasaki, Abigail M. Schmucker, Steven K. Magid

Student Papers, Posters & Projects

BACKGROUND: Postoperative delirium (POD) is one of the most common complications in older adult patients undergoing elective surgery. Few studies have compared, within the same institution, the type of surgery, risk factors and type of anesthesia and analgesia associated with the development of POD.

AIM: To investigate the following three questions: (1) What is the incidence of POD after non-ambulatory orthopedic surgery at a high-volume orthopedic specialty hospital? (2) Does surgical procedure influence incidence of POD after non-ambulatory orthopedic surgery? And (3) For POD after non-ambulatory orthopedic surgery, what are modifiable risk factors?

METHODS: A retrospective cohort study was conducted …

The Operative Management In Bariatric Acute Abdomen (Oba) Survey: Long-Term Complications Of Bariatric Surgery And The Emergency Surgeon's Point Of View., Belinda De Simone, Luca Ansaloni, Massimo Sartelli, Yoram Kluger, Fikri M. Abu-Zidan, Walter L. Biffl, Arianna Heyer, Federico Coccolini, Gian Luca Baiocchi, Oba Trial Supporters

Student Papers, Posters & Projects

Background: The number of bariatric procedures is increasing worldwide. No consensus or guidelines about the emergency management of long-term complications following bariatric surgery are currently available. The aim of this study is to investigate by a web survey how an emergency surgeon approaches this unique group of patients in an emergency medical scenario and to report their personal experience.

Method: An international web survey was sent to 197 emergency surgeons with the aim to collect data about emergency surgeons' experience in the management of patients admitted in the emergency department for acute abdominal pain after bariatric surgery. The survey was …

Transcatheter Arterial Embolization Versus Surgery For Refractory Non-Variceal Upper Gastrointestinal Bleeding: A Meta-Analysis., Antonio Tarasconi, Gian Luca Baiocchi, Vittoria Pattonieri, Gennaro Perrone, Hariscine Keng Abongwa, Sarah Molfino, Nazario Portolani, Massimo Sartelli, Salomone Di Saverio, Arianna Heyer, Luca Ansaloni, Federico Coccolini, Fausto Catena

Student Papers, Posters & Projects

Background: Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or referred to transcatheter arterial embolization (TAE)?

Objectives: To carry out a systematic review of the literature and to perform a meta-analysis of studies that directly compare TAE and surgery in patients with refractory NVUGIB.

Materials and methods: We searched PubMed, Ovid MEDLINE, and Embase. A combination of the MeSH terms "gastrointestinal bleeding"; "gastrointestinal hemorrhage"; "embolization"; "embolization, therapeutic"; and "surgery" were used (("gastrointestinal bleeding" or "gastrointestinal hemorrhage") and ("embolization" or "embolization, therapeutic") …

The Addition Of Simvastatin Administration To Cold Storage Solution Of Explanted Whole Liver Grafts For Facing Ischemia/Reperfusion Injury In An Area With A Low Rate Of Deceased Donation: A Monocentric Randomized Controlled Double-Blinded Phase 2 Study., Duilio Pagano, Elisabetta Oliva, Simone Khouzam, Fabio Tuzzolino, Davide Cintorino, Sergio Li Petri, Fabrizio Di Francesco, Calogero Ricotta, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Federico Costanzo, Angelo Luca, Salvatore Gruttadauria

Student Papers, Posters & Projects

BACKGROUND: Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure.

PATIENT AND METHODS: We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare …

Allergic Contact Dermatitis To 2-Octyl Cyanoacrylate After Surgical Repair: Humidity As A Potential Factor, Avi Bitterman, Karanjit Sandhu

Student Papers, Posters & Projects

Allergic contact dermatitis to 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, NJ) after surgical repair is an extremely rare condition with few reported cases. In recent years, contact dermatitis to Dermabond has been reported with increasing frequency.Cyanoacrylates are the most commonly used surgical adhesives and rely on their rapid polymerization to prevent sensitization from antigen presenting cells (APCs), because APCs are only capable of monomeric recognition of cyanoacrylates. It is thought that arid climates may contribute to increased sensitization of cyanoacrylates because water drives the polymerization reaction, decreasing the number of monomers capable of recognition by APCs. With less water present in …

Exploring Patient And Family Satisfaction In Pediatric Neurological Surgery, Randa R. Barsoom, Todd A. Maugans, James F. Burrows, Paul Rosen

Student Papers, Posters & Projects

Introduction Patient and family satisfaction during outpatient visits is correlated with a continuance of care and likelihood to recommend the practice to others. Additionally, patient-family satisfaction can determine the success of the practice and influence medical outcomes. Utilizing a well-validated surveys instrument, patient and family satisfaction can be explored in the office setting. Methods During a consecutive 36 month period, a standardized and validated patient satisfaction survey instrument was provided to the family members of patients who presented to two pediatric neurosurgery clinics associated with Nemours Children's Health System. The completed surveys were analyzed statistically to identify correlations between overall …

Development And Implementation Of A Clinical Pathway Approach To Simulation-Based Training For Foregut Surgery., Kiyoyuki W. Miyasaka, Joseph Buchholz, Denise Lamarra, Giorgos C. Karakousis, Rajesh Aggarwal

Student Papers, Posters & Projects

INTRODUCTION: Contemporary demands on resident education call for integration of simulation. We designed and implemented a simulation-based curriculum for Post Graduate Year 1 surgery residents to teach technical and nontechnical skills within a clinical pathway approach for a foregut surgery patient, from outpatient visit through surgery and postoperative follow-up.

METHODS: The 3-day curriculum for groups of 6 residents comprises a combination of standardized patient encounters, didactic sessions, and hands-on training. The curriculum is underpinned by a summative simulation "pathway" repeated on days 1 and 3. The "pathway" is a series of simulated preoperative, intraoperative, and postoperative encounters in following up …