Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Transcutaneous Energy Transmission: Can We Do It Now?, Yuriy Pya

The VAD Journal

The percutaneous driveline used in contemporary LVADs presents a continuous risk of infection for the duration of support. Minimizing infection in durable mechanical circulatory support systems requires total implantation of all components and energy transfer by means other than percutaneous drivelines. A novel coplanar energy transfer (CET) system, similar to the original transcutaneous energy transfer (TET) design, is unique by incorporating two large rings with coil-within-the-coil topology to ensure strong resonance power. The CET system consists of an internal integrated controller, a battery coupled with an internal thoracic coil ring, and the LVAD pump. External equipment includes a power transmission …

The Clinical Relevance Of Cement Volume In Percutaneous Vertebral Augmentation, Ravi G. Mirpuri, Madhuri Are, Virginia Hardie, Michael J. Warden, Robin High

Graduate Medical Education Research Journal

Introduction: Vertebroplasty and Kyphoplasty are two forms of percutaneous vertebral augmentation (PVA), in which polymethylmethacrylate cement is used to stabilize vertebral compression fractures (VCF). This study sought to evaluate the relationship between cement volume and clinical outcomes, including pain reduction, opioid use, and complication rate.

Methods: Retrospective chart review produced 88 patients who received PVA at a tertiary care outpatient pain clinic. Cement volume, type of PVA, gender, level (thoracic vs lumbar) were collected, as well as clinical outcomes of numeric pain score (NPS) reduction, opioid percent change (OPC), and complications. Both pre-procedure and post-procedure (between 2-4 weeks) data were …

Axillary Artery Variation: The Rule Not The Exception, Cameron M. Thiele, Danielle A. Thornburg, Sonya E. Van Nuland, Natalie R. Langley

School of Medicine Faculty Publications

Introduction: Anatomic morphology commonly depicted in atlases or textbooks is often emphasized in gross anatomy classrooms; however, considerable variation may be observed in cadavers during dissection, particularly in the vascular system. This study statistically assesses the frequency of the classic versus variant axillary artery branching pattern and compares these observations to the incidence of variation described in the literature. Material and Methods: Axillary artery branching pattern was studied in 62 cadaver limbs. A Chi square goodness of fit test with post hoc analyses on the adjusted standardized residuals was used to evaluate branching patterns. Results: A statistically significant difference existed …

Characterizing Recurrence Following Hybrid Ablation In Patients With Persistent Atrial Fibrillation, David C. Kress, Lynn Erickson, Tadele W. Mengesha, David Krum, Jasbir Sra

Journal of Patient-Centered Research and Reviews

Purpose: It is It is widely accepted that atrial fibrillation (AF) accounts for half of arrhythmia recurrences following endocardial catheter ablation of AF. An epicardial-endocardial approach (hybrid) has emerged as an alternative to endocardial ablation alone for the treatment of AF, yet recurrence after a hybrid procedure has not been well characterized. This retrospective study is aimed at characterizing recurrence following hybrid ablation for patients with persistent AF.

Methods: Patients with persistent AF (N = 108) received both endocardial and epicardial ablation of the posterior left atrial wall using catheter ablation and a small midline surgical approach (hybrid). Presence of …

Internal Hernia As A Late Complication Of Roux-En-Y Gastric Bypass Procedure, Samantha Purton, Gabriel Meshekow, My Myers, Edgar Mercado, Allan Katz

West Florida Division GME Research Day 2020

As the prevalence of obesity continues to rise, so does the popularity of bariatric surgery. Previously the Roux-en-Y gastric bypass was the most common bariatric procedure, but now falls second to the gastric sleeve. It remains a relevant procedure, however, accounting for 17% of bariatric procedures in 2018. Due to its prevalence, it is important that the radiologist be familiar with the procedure and its complications such as leak, obstruction, stricture, or, as in this case, internal herniation through a mesenteric defect. Internal hernias are more commonly associated with the laparoscopic approach versus open. This is likely due to fewer …

Non-Invasive Peripheral Venous And Arterial Line Air Detector For Embolization Prevention, Alexandria Kwong, Kevin Shu, Dylan Meinster

Biomedical Engineering

The scope of this project includes designing a non-invasive bubble detector for peripheral venous and arterial lines. For minimally invasive cardiac procedures, arterial and venous access is necessary for these procedures as is constant flow through the tubing to prevent clotting and to administer drugs. Air bubbles are common in these lines and can be consequential if enough air is introduced into the human system. Air embolisms are the most common and relevant issues during these procedures. The goal of this device is to create an attachable detector for air bubbles in saline that can also terminate flow and alert …

Assisting Children With Velocardiofacial Syndrome Who Have Developmental Disabilities And Delays Associated With Speech, Communication, And Education, Mckenzie K. Holty

Honors Thesis

Children with velocardiofacial syndrome (VCFS) have a variety of complex needs. Research shows that VCFS is characterized by a combination of medical problems, developmental delays, and learning disabilities, which vary from child to child. This syndrome also puts adolescents at a higher risk for developing psychiatric and psychotic disorders. The complexity of symptoms that can arise from VCFS can influence the ability of these children to communicate, socialize, and learn effectively. This literature review aims to discuss literature for caregivers, educators, and physicians to aid children effectively and understand their challenges relating to speech, communication, and education. This topic is …

Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, William R. Judson, John D. Murphy, Phillip H. Sussman, John N. Harker

West Florida Division GME Research Day 2020

• Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.^{1, 2}
• Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.¹ The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.^{3, 4}
• Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy. …

Fracture Blisters, Jessica Khabra, Jinal K. Patel, Gauthier L. Stepman, Kulveer Dabb, Kenny Hernandez, Debra Angelo, Johnathan Frunzi

West Florida Division GME Research Day 2020

Fracture blisters are tense vesicles or bullae that develop on edematous skin following some acute long bone fractures. Fracture blisters are infrequently seen, as the reported incidence is 2.9% to 6.6%.¹ This rare complication, may not regularly be encountered by Physicians in the hospital. Fracture blisters typically occur within 24-48 hours following high energy trauma injuries & may last up to several weeks. Ultimately, this condition can lead to prolonged hospital stay due to an increased risk of infection and delay in surgical intervention.² Early recognition of this dermatologic complication may be helpful in reducing hospital stays.

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Demographic Predictors Of Adult Behaviors In The Pediatric Postoperative Environment, Natasha H. Hikita, Amber Osorno, Carlie Taurosa, Michelle A. Fortier, Zeev N. Kain, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience postoperative pain. If poorly treated, pediatric postoperative pain may lead to various negative health outcomes. Adult behaviors may be associated with child experiences in the postoperative environment. For example, adult behaviors such as distraction, humor, and coping advice divert a child’s attention away from their pain and thus, may significantly reduce child postoperative distress. In contrast, adult behaviors such as empathy, reassurance, and apology direct a child’s attention towards their pain which may increase a child’s overall postoperative distress. Moreover, patient demographic factors, like child ethnicity, may significantly alter the frequency of use of these …

A Rare Cause Of Pneumoperitoneum, Robert Zusman, George Michael, Anna E. Augustin, My Myers, Dudith Pierre-Victor

West Florida Division GME Research Day 2020

Pneumoperitoneum is most commonly associated with a perforated viscus. When free air is seen on imaging, the most common course of action is an emergent exploratory laparotomy. However, pneumoperitoneum may not always be indicative of a perforated bowel. In the case described below, we will discuss a patient who developed acute peritonitis and pneumoperitoneum after undergoing chest compressions during cardiopulmonary resuscitation (CPR) and positive pressure mechanical ventilation.

Single Vs. Multiple Laparoscopies: Pain Status One Year Post-Hysterectomy For Chronic Pelvic Pain, Ghadear Shukr, Madeleine R. Gonte, Victoria Webber, David Eisenstein

Medical Student Research Symposium

Despite the prevalence of chronic pelvic pain (CPP)— affecting one in seven women in the U.S.— its cause is often unknown. As such, an evaluation of our current approaches to the work-up of CPP is warranted. Laparoscopy is considered a gold standard tool in the evaluation of CPP with 40% of all laparoscopies in the U.S. performed for this condition [1]. However, limited data exists portraying the clinical importance and outcomes for repeat diagnostic laparoscopies. This is a retrospective case-control study to determine the incidence of multiple laparoscopies for CPP over the past 10 years, and to compare outcomes between …

Application Of Laser Technology In The Non-Surgical Management Of Periprosthetic Joint Infection (Pji); Novel Insights From Peri-Implantitis, Kareem Giovanni Elhage, Mohamed Awad, Ahmad Hasan, Brendan Farley, Khaled Saleh

Medical Student Research Symposium

Introduction: The management of periprosthetic joint infection (PJI) is challenging, and its socio-economic impact is significant. Moreover, the incidence of MRSA and other resistant organisms are on the rise. Recently, laser technology has been incorporated into treatment protocols of dental peri-implantitis. This review explores the possibility of using laser technology to manage peri-implantitis.

Methods: This article will provide a detailed, comprehensive, and perspective review of the existing evidence of laser technology in management of dental peri-implantitis.

Results: Dental literature investigated the efficacy of several types of lasers. It was shown that diode lasers improved periodontal probing depth (PPD) and bleeding …

Impact Of Treatment Modality On Overall Survival In Localized Ductal Prostate Adenocarcinoma: A National Cancer Database Analysis, Chandler Bronkema, Sohrab Arora, Nikola Rakic, Akshay Sood, Deepansh Dalela, Jacob Keeley, Marcus Jamil, James O. Peabody, Craig G. Rogers, Mani Menon, Firas Abdollah

Medical Student Research Symposium

INTRODUCTION AND OBJECTIVE: Ductal adenocarcinoma is considered a rare histological variant of prostate adenocarcinoma (PCa). Given the rarity of this subtype, optimal treatment strategies for men with nonmetastatic ductal PCa is largely unknown. We aimed to describe the impact of surgery, radiotherapy, and systemic therapy on overall survival (OS) in men with nonmetastatic ductal PCa.

METHODS: We retrospectively selected 2209 cases of ductal PCa, diagnosed between 2004 and 2015, within the National Cancer Database (NCDB). Exclusion of metastatic patients yielded a total sample of 1993 individuals. Cox regression analysis tested the impact of treatment (surgery, radiotherapy, systemic therapy and no …

Early Comfort Care Following Operative Intervention For Traumatic Injury, Melissa Hoffman, Michaal Schurr, Rachel Morris, Terrie Smith, Sheri Denslow

General Surgery

See additional files.

Lavender Aromatherapy: Ready For Prime-Time Office Use?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the perioperative use of lavender aromatherapy and its potential to relieve pain and anxiety during minor primary care office procedures.

Surgeons’ Views On Shared Decision-Making, Suraj Kannan, Jayhyun Seo, Kevin R. Riggs, Gail Geller, Emily F. Boss, Zackary D. Berger

Journal of Patient-Centered Research and Reviews

Purpose: Shared decision-making (SDM) has a significant role in surgical encounters, where decisions are influenced by both clinician and patient preferences. Herein, we sought to explore surgeons’ practices and beliefs about SDM.

Methods: We performed a qualitative study consisting of semi-structured individual interviews with 18 surgeons from private practice and academic surgery practices in Baltimore, Maryland. We purposively sampled participants to maximize diversity of practice type (academic vs private), surgical specialty, gender, and experience level. Interview topics included benefits and challenges to patient involvement in decision-making, communicating uncertainty to patients, and use of decision aids. Interviews were audio-recorded and transcribed. …

A Feasibility Study Of Lavender Aromatherapy In An Awake Craniotomy Environment, Kailah Cathey, Nichole Gunyon, Nancy Chung, Nancy Conway, Diane Ames, Maharaj Singh, Amin B. Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Integrative medicine interventions are needed for awake craniotomies, as many patients experience anxiety. Lavender aromatherapy significantly reduces anxiety or pain in a variety of surgical procedures. This feasibility study used lavender aromatherapy during awake craniotomies to determine the number of patients who would consent and complete the study, the technicality of lavender aromatherapy use, and acceptance by operating room (OR) staff.

Methods: We approached 40 consecutive patients (≥18 years old). Exclusion criteria were pulmonary issues or sensitivity to lavender. Outcome measures in consented patients were enrollment and completion rates, anxiety and pain as measured by the Visual Analog Scale …

Flexor Tenotomy For The Treatment Of Hallux Ulcers, Nathalia Esmeral, Val E. Haddon, Chase G. Dahl, Erin Lewis, David Khakshoor

Podiatry

Aims: To assess and evaluate the relationship between flexor tenotomies in a clinical setting and the time course for healing neuropathic, diabetic and structural deformity hallux ulcers.

Methods: This retrospective study analyzes the medical files of 1,471 patients treated for digital foot ulcers by flexor tenotomies between September 2011 and January 2019. For the intent of this particular research, focus was preserved towards the effect of flexor tenotomy on healing time to address hallux ulcers. A total of 97 patients between the ages of 41 and 86 years old underwent flexor tenotomy for the treatment of hallux ulcers with a …

Robotically Steered Needles: A Survey Of Neurosurgical Applications And Technical Innovations, Michel A. Audette, Stéphane P.A. Bordas, Jason E. Blatt

Computational Modeling & Simulation Engineering Faculty Publications

This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue …

The Positive Effects Of Exercise On Active Transplant Recipients And Its Impact On Medication Adherence, Travane Morrison

Theses

Organ failure is a life-threatening condition (Daugirdas et al, 2014). Non-adherence to medication is one of the main causes of the failure of a transplanted organ (Oberlin et al, 2016). In an effort to combat non-adherence to medication, research had employed intervention studies to tackle the main cause of non-adherence (Chisholm-Burns, 2013). The aims of this project are three fold. Firstly it aims to find if complications associated with organ transplant affect the individual’s medication adherence. Secondly, it explores the connections between exercise and medication adherence. Thirdly the research explores if exercise assists with possible complications associated with an organ …

The Efficacy Of Acute Normovolemic Hemodilution Compared To Cell Salvage As A Blood Transfusion Alternative, Julia Yu

Capstone Showcase

Blood transfusions are currently the treatment of choice for significant blood loss. However, there are a variety of reasons for which they cannot be utilized. Current alternatives are acute normovolemic hemodilution (ANH) and cell 1 This study analyzes whether ANH or cell salvage is more effective in minimizing blood loss in perioperative or trauma patients. Multiple different studies involving either ANH or cell salvage were compared to each other. However, due to the lack of research conducted in either method, results obtained were largely inconclusive.

Torsion Of An Accessory Spleen In A Child With Biliary Atresia Splenic Malformation Syndrome., David A. Simon, Nathan R. Fleishman Md, Pamala Choi, Jason D. Fraser, Ryan T. Fischer

Manuscripts, Articles, Book Chapters and Other Papers

Torsion of an accessory spleen is an exceedingly rare cause of abdominal pain in pediatric patients. The diagnosis is frequently challenging as presentation is variable and diagnostic imaging can be aspecific. The current case describes an unusual presentation of a torted accessory spleen in a 5-year-old girl with biliary atresia splenic malformation syndrome who initially presented with non-specific abdominal symptoms and fever. The diagnosis was made following fine-needle aspiration of a suspected intraabdominal abscess. The case highlights the diagnostic challenge of accessory splenic torsion and stresses the importance of its inclusion on the differential diagnosis of pediatric patients, especially those …

Analgesic Efficacy Of Perineural Dexmedetomidine With Bupivacaine In Adductor Canal Block For Post Total Knee Arthroplasty: A Randomized Controlled Trial, Vachira Udompornmongkol

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objectives: The primary objective was to study the anaนาlgesic efficacy of perineural dexmedetomidine with bupivacaine in adductor canal block (ACB) in patients undergoing total knee arthroplasty (TKA) and the secondary objectives were to investigate the ambulation ability and the side effects. Materials and Methods: Sixty patients aged 18-85 years, ASA status I-III underwent primary, unilateral TKA under spinal anesthesia. They were randomized into 2 groups; Group C received 20 ml 0.25% bupivacaine and Group D received 20 ml 0.25% bupivacaine plus 0.5 mcg/kg dexmedetomidine for ACB. The primary outcome was 1st rescue analgesic duration. 24-hour morphine consumption, postoperative pain score, …

Is Add-On Budesonide-Impregnated Nasal Dressing Useful Following Endoscopic Sinus Surgery With Perioperative Oral Steroid?, Onusa Taweewuthisub

Chulalongkorn University Theses and Dissertations (Chula ETD)

Some chronic rhinosinusitis with nasal polyps patients undergoing endoscopic sinus surgery (ESS) have unfavorable results despite proper postoperative treatments including oral and topical steroids. Steroid-impregnated absorbable nasal dressing has been shown to improve outcomes of the surgery. In some clinical practices, budesonide-impregnated nasal dressing is used together with perioperative oral steroid but the additional benefits of it are still unknown. This study aims to determine whether budesonide-impregnated nasal dressing had any benefits following ESS when a short course of oral steroid was given in perioperative period. This is a prospective, double-blinded, within person randomized, placebo-controlled study conducted in tertiary care …

Vaginal Atrophy Treatment Using Microablative Fractional Carbon Dioxide Laser: A Randomized Patient And Evaluator-Blinded Sham-Controlled Trial, Purim Ruanphoo

Chulalongkorn University Theses and Dissertations (Chula ETD)

Introduction: In recent years, microablative fractional carbon dioxide (CO2) laser becomes popular in treatment of vaginal symptoms including vaginal atrophy. This study aimed to evaluate efficacy of vaginal CO2 laser in treatment of vaginal atrophy, compared to the sham procedure. Methods: Between June 2016 and May 2017, postmenopausal women with moderate to severe intensity of any symptoms of vaginal atrophy were invited to the study. A total of 88 women were randomized for treatment with vaginal CO2 laser or sham procedure every 4 weeks for 3 sessions. The participants were blinded to the intervention they received. The operator was also …

Open Surgery With Intraoperative Enteroscopy In Jejunoileal Massive Bleeding In Pediatric Patient: An Evidence-Based Case Report, Rini Y. Husni, Kshetra Rinaldhy

The New Ropanasuri Journal of Surgery

Introduction. A case report of surgical exploratory laparotomy with intraoperative enteroscopy (IOE) as a treatment in massive jejunoileal bleeding in children.

Method. We conducted a literature search on databases such as Cochrane, PubMed, ScienceDirect, and Google Scholar. Abstract and title screening was done based on exclusion criteria, inclusion criteria, and double filtering. The selected article then reviewed using critical appraisal tools based on its validity, importance, and applicability. Selected articles were benchmark to the discussion.

Results. The application of open surgery with IOE as the final treatment that can be recommended in the critical or life-threatening condition …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

Ulnar Collateral Ligament Reconstruction With Traditional Docking Compared To Novel Surgical Techniques, Kayley D. Guy, Brendon P. Mcdermott, Kaitlin Gallagher, Tyrone Washington

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Ulnar Collateral Ligament Reconstruction (UCLR) is a surgical procedure on one of the main ligaments that provides normal stability for the elbow joint against excessive valgus stress. Damage to this ligament is common in athletes performing overhead throwing activities, primarily baseball players, due to excessive valgus stress during the throwing motion. The most common form of treatment for this type of injury is reconstructive surgery of the ligament, especially if athletes wish to return to sport participation. This type of surgery is extremely invasive and requires extensive post-operative rehabilitation in order to facilitate return to play. To date, many …