Medical Specialties Commons^™

Benign Granulomatous Polyp Obstructing The Bronchus., Saulat H. Fatimi, Ali Khawaja, Ranish Deedar-Ali-Khawaja, Mehar Hoda, Salima Ahmed Bhimani

Department of Surgery Docs

Abstract

Inflammatory endobronchial polyps are rarely encountered. We report a case of a 14 years old girl with a benign granulomatous polyp originating in the bronchus. Computed tomography scan showed an intraluminal soft tissue opacity while fiberoptic bronchoscopy revealed a large soft tissue mass completely occluding the left lower lobe. Rigid bronchoscopy under general anaesthesia identified a fleshy mass in the left main stem bronchus which was excised via bronchoscopy. The histopathology showed benign polyp with non-specific inflammation. The patient's symptoms improved subsequently and no recurrence was reported till two years of follow-up

The Identification And Classification Of Flow Disruptions In The Operating Room During Laparoscopic Cholecystectomy And Open Hernia Repair Procedures, Sacha N. Duff

Doctoral Dissertations and Master's Theses

The operating room is one of the most complex work environments in healthcare; it is estimated that at least 7% of adverse events due to medical error occur in the operating room. Flow disruptions are events that cause a "break" in the primary surgical task, or the loss of any team member's situational awareness. An empirical link between flow disruptions and surgical errors in the OR has been established; therefore, identifying and classifying the specific flow disruptions present during different types of procedures should facilitate the development of evidence-based interventions. The goal of this study was to identify and classify …

Abdominal Tuberculosis With Massive Jejunal Haemorrhage, Abdul Rehman Alvi, Tanveer Ui Haq, Amyn Pardhan

Department of Surgery Docs

ABSTRACT Jejunum is a rare site of involvement in intestinal tuberculosis (TB) and massive lower gastrointestinal haemorrhage is an even rare reported condition. The authors report a 15-year-old female student, who presented with fever, anaemia, hypoalbunemia and developed massive lower gastrointestinal haemorrhage during hospital stay. The diagnosis of abdominal TB was established on tissue biopsy; tissue culture was positive for Mycobacterium TB. Optimal outcome was achieved with aggressive resuscitation, repeated mesenteric angio-embolization and anti-tuberculosis chemotherapy

An Old Problem With A New Therapy: Gastrointestinal Bleeding In Ventricular Assist Device Patients And Deep Overtube-Assisted Enteroscopy., Konrad Sarosiek, Linda J Bogar, Mitchell I Conn, Brendan O'Hare, Hitoshi Hirose, Md, Phd, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Conventional algorithms for diagnosis and treatment of gastrointestinal bleeding (GIB) in patients with nonpulsatile ventricular assist devices (VADs) may take days to perform while patients require transfusions. We developed a new algorithm based on deep overtube-assisted enteroscopy (DOAE) to facilitate a rapid diagnosis and treatment. From 2004 to 2012, 84 patients who underwent VAD placement in our institution, were evaluated for episodes of GIB. Our new algorithm for the management of GIB using DOAE was evaluated by dividing the episodes into three groups: group A (traditional management without enteroscopy), group B (traditional management with enteroscopy performed >24 hours after presentation), …

Nfat5 Represses Canonical Wnt Signaling Via Inhibition Of Β-Catenin Acetylation And Participates In Regulating Intestinal Cell Differentiation, Qingding Wang, Yuning Zhou, Piotr G. Rychahou, Chunming Liu, Heidi L. Weiss, B. Mark Evers

Surgery Faculty Publications

The intestinal mucosa undergoes a continual process of proliferation, differentiation, and apoptosis, which is regulated by multiple signaling pathways. The Wnt/β-catenin pathway has a critical role in this process. Previously, we have shown that the calcineurin-dependent nuclear factor of activated T cell (NFAT) is involved in the regulation of intestinal cell differentiation, as noted by the alteration of brush-border enzyme intestinal alkaline phosphatase (IAP) activity. Here, we show that calcineurin-independent NFAT5 interacts with β-catenin to repress Wnt signaling. We found that overexpression of NFAT5 inhibits, whereas knockdown of NFAT5 increases, TOPflash reporter activity and the expression of …

Faculty And Staff Updates, Department Of Surgery, June 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Progressive Hair Coil Strangulation Of Penis, Shahzad Ms, Mohammed Shamim

Section of General Surgery

Strangulation of penis by hair strands is a well-known, but uncommon clinical entity. We report two cases occurring in circumcised boys causing progressive painless disfigurement of penis with strands of hair coiled around the penile shafts, strangulating the penis. Primary repair was done in one case and delayed primary repair was done in the other, both with satisfactory results.

Craniocerebral Injuries In War Against Terrorism --- A Contemporary Series From Pakistan, Muhammad-Umair Bashir, Muhammad-Zubair Tahir, Ehsan Bari, Sehreen Mumtaz

Section of Neurosurgery

Objective: Terrorism-related bomb attacks on civilian population have increased dramatically over the last decade. Craniocerebral injuries secondary to improvised explosive devices have not been widely reported in the context of unarmored civilians. This series intends to report the spectrum of these injuries secondary to suicidal and implanted bombs as encountered at the Aga Khan University Hospital, Pakistan (AKUH). Further, a few pertinent management guidelines have also been discussed.
Methods: The hospital database and clinical coding during a 5-year period were examined for head injuries secondary to terrorism-associated blasts. In addition to patient demographics, data analysis for our series included initial …

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …

Predictors Of Treatment Outcomes In Geriatric Patients With Odontoid Fractures: Aospine North America Multi-Centre Prospective Gof Study., Michael G Fehlings, Ranganathan Arun, Alex R. Vaccaro, Paul M Arnold, Jens R Chapman, Branko Kopjar

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Multicenter prospective cohort study.

OBJECTIVE: To identify patient and treatment characteristics associated with treatment success or failure in the management of odontoid fractures.

SUMMARY OF BACKGROUND DATA: Odontoid fractures are the most common cervical spine fractures in the elderly and represent a significant management challenge with widely divergent views regarding operative versus nonoperative management.

METHODS: A total of 159 patients 65 years and older with radiographically confirmed type II odontoid fractures were enrolled at 10 sites in the United States and 1 site in Canada between January 2006 and May 2009. Subjects were followed at 6 and 12 …

Extracorporeal Membrane Oxygenation For Bridge To Decision And To Recovery., Hitoshi Hirose, Md, Phd, Shingeki Tabaka, Md, James Diehl, Md, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Extracorporeal life support has advanced from its humble beginnings over 3 decades ago, with the first description of its success in a patient with Acute Respiratory Distress Syndrome (ARDS), going as far back as 1971. The indications for extracorporeal membrane oxygenation (ECMO) therapy include refractory respiratory and/or cardiac failure, and ECMO is now being increasingly used in adult patients. In this case report, we present a patient who had traveled from India to the United States, where she developed acute decompensated biventricular failure and shock, requiring ECMO placement as a bridge to a decision. During her first few days on …

Rhinoscleroma Presenting As A Nasal-Palatal Mass With Airway Obstruction, Mark C. Domanski, Alexander Rivero, David E. Kardon

Surgery Faculty Publications

We report a case of a 45-year-old male with severe rhinoscleroma. The patient presented to the emergency room with dyspnea from a long-standing nasal-palatal mass. A tracheostomy was required for airway control. While dyspnea in the presence of an upper airway mass is typical of malignancy, consideration of non-oncological etiologies is important. We review the epidemiology, pathology, diagnosis, and treatment of rhinoscleroma.

Debate At The Royal College Summit On The Future Of General Surgery

Data and Test Instruments

Royal College of Physicians and Surgeons of Canada Task Force to address the Future of General Surgery, in Ottawa 13 May 2013: Dr Vivian McAlister debating with Dr Bill Pollett

Chevalier Jackson, M.D. (1865-1958): Il Ne Se Repose Jamais., Phi D Nguyen, B.A., Scott W. Cowan, Md, Charles J. Yeo, Md, Nathaniel R. Evans Iii, M.D.

Department of Surgery Gibbon Society Historical Profiles

In the final year of the American Civil War, 1865, Chevalier Jackson was born on the 4th of November just outside Pittsburgh, Pennsylvania. The eldest of three sons of a poor, livestock-raising family, Jackson was raised in a period of social and political unrest. He was perhaps an even more unrestful boy. The description of his childhood days from his father’s father—Il ne se repose jamais, ‘‘He never rests’’—would ultimately reflect the man, doctor, and evangelist Jackson would later become.1 Indeed, he never did rest, Jackson would tirelessly pave the way for modern bronchoscopy and endoscopy as a whole; bringing …

Faculty And Staff Updates, Department Of Surgery, May 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A two page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, important dates, committee meetings, scholarly activity, abstracts, and more.

Factors Affecting The Outcomes In Bilateral Total Knee Arthroplasty: A Case Report, Laura K. Parry

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The purpose of this case study was to determine the effects of femoral nerve block use during total knee arthroplasty on the return of quadriceps activation and functional outcomes in a single patient. This case study focused on an individual case consisting of simultaneous bilateral knee replacement. The individual received a femoral nerve block in one knee and traditional anesthesia in the other. We considered the improvement in functional outcomes following surgery. It was expected that the femoral nerve block will delay the activation of the quadriceps muscle and the return of functional measures. However, the femoral nerve block will …

The Impact Of Introduction Of The Canadian Ct – Head Rule On The Use Of Ct-Scan On Minor Head Injury Patients At Aga Khan University Hospital, Nairobi, Ramadhani Omari Abdalla

Master of Medicine in General Surgery

Background: Head injury is a common traumatic condition seen in Kenya. Among the head injury patients seen at the Aga Khan University Hospital Nairobi, minor head injury patients are the highest proportion of non–fatal trauma patients. Minor head injury is described as witnessed loss on consciousness, definite amnesia or witnessed disorientation in a patient with a GCS score of 13–15 who has suffered a traumatic event. There has been considerable disagreement about the indication for a Computed Axial Tomography Scan of the Head (CT-head) in the large number of patients clinically classified as minor. The Canadian CT Head Rule was …

State-By-State Variation In Emergency Versus Elective Colon Resections: Room For Improvement., Augustine C. Obirieze, Mehreen Kisat, Caitlin W. Hicks, Tolulope A. Oyetunji, Eric B. Schneider, Darrell J. Gaskin, Elliott R. Haut, David T. Efron, Edward E. Cornwell, Adil H. Haider

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Compared with elective surgical procedures, emergency procedures are associated with higher cost, morbidity, and mortality. This study seeks to investigate potential state-by-state variations in the incidence of emergent versus elective colon resections.

METHODS: A retrospective analysis of all adult patients (aged ≥18 years) included in the Nationwide Inpatient Sample from 2005 to 2009 who underwent hemicolectomy (right or left) or sigmoidectomy was conducted. Discharge-level weights were applied, and generalized linear models were used to assess the odds of a patient undergoing emergent versus elective colon surgery nationally and for each state after adjusting for patient and hospital factors. Odds …

Conservative Management Of Invasive Cervical Resorption: A Case Report, Fahad Umer, Samira Adnan, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

Abstract

Invasive cervical resorption is a condition that affects the root surface area below the epithelial attachment. Multiple treatment modalities are advocated, involving exposure of the invasive defect, removal of the granulation tissue and sealing with various restorative materials. This report demonstrates conservative treatment of a patient presenting with peri-apical periodontitis in upper right central and lateral incisors, along with Class II invasive resorption defect cervically on the mesial aspect of the central incisor, as a result of trauma. As the patient was not willing for any surgical intervention, only ortho-grade root canal treatment was carried out in both teeth, …

Multimodal Endovascular Management Of Acute Ischemic Stroke In Patients Over 75 Years Old Is Safe And Effective., George M Ghobrial, Nohra Chalouhi, Lana Rivers, Samantha Witte, Justin Davanzo, Richard Dalyai, Michelle L Gardecki, Pascal Jabbour, Fernando Gonzalez, Aaron S Dumont, Robert H Rosenwasser, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

INTRODUCTION: Greater attention has been directed to endovascular recanalization of acute ischemic stroke in septuagenarians and above.

TECHNIQUE: A retrospective chart review was conducted to include patients treated for acute ischemic stroke from 2006 to 2012. All patients underwent initial neurological assessment and non-contrast head CT. Patients treated from 2009 to 2012 additionally received emergent CT angiogram and CT perfusion. 51 patients met the clinical and radiographic criteria and underwent multimodal endovascular revascularization for acute ischemic events.

RESULTS: All patients underwent cerebral angiography and met angiographic criteria for endovascular thrombolysis. 34 patients (67%) were older than 80 years of age. …

Completely Steroid-Free Immunosuppression In Liver Transplantation: A Randomized Study., Carlo B. Ramirez, Md, Cataldo Doria, Md, Phd, Adam M. Frank, Md, Stephen T. Armenti, Ignazio R. Marino, Md

Department of Surgery Faculty Papers

INTRODUCTION: Corticosteroids (CS) have been standard immunosuppression to prevent and treat rejection. However, CS are associated with increased risk of infection, obesity, hypertension, hyperlipidemia, diabetes, and accelerated hepatitis C virus (HCV) recurrence post-orthotopic liver transplantation (OLT). This study assesses the safety and efficacy of CS-free immunosuppressive regimen in adult OLT.

METHODS: A two-yr, prospective, randomized study of CS with delayed withdrawal (CS) or CS-free regimen with basiliximab, tacrolimus, and enteric-coated mycophenolate sodium (EC-MPS) was performed in 39 patients (CS=20; CS-free=19). CS group received intra-operative methylprednisolone weaned by six months. HCV patients had HCV PCR pre-OLT and 0.5, one, three, and …

Comparison Of Chronic Persistent And Post-Operative Atrial Fibrillation On Long Term Survival In Patients Undergoing Cardiac Valve Surgery, Nasir Shariff, Ravi V. Desai Md, Sherrine Eid, Michael J. Weiss, Matthew W. Martinez, Sultan M. Siddique, Ronald S. Freudenberger Md

Department of Medicine

No abstract provided.

To Re-Excise Or Not To Re-Excise: Positive Margins After Excision Of Non-Melanoma Skin Cancers, Ramon Garza, Iii Md, Courtney Edwards Md, Bharat Ranganath Md, Nathan F. Miller Bs, Joshua M. Adkinson Md, Kirsten S. Bellucci Md, Robert X. Murphy Jr, Md, Ms

Department of Surgery

No abstract provided.

A Case Of Congenital Unilateral Absence Of The Vas Deferens, Bi Mo, Vishnu Garla, Lawrence M. Wyner M.D.

Surgery

Background

Congenital unilateral absence of the vas deferens occurs in 0.5%–1.0% of males. It has been associated with various genitourinary abnormalities, including renal agenesis. We report a case of congenital unilateral absence of the vas deferens found incidentally during vasectomy in a patient with known unilateral renal agenesis.

Case presentation

A 24-year-old male presented to our urology clinic requesting vasectomy. His past history was significant for left renal agenesis. Following successful right vasectomy, several attempts to locate the left vas deferens were unsuccessful. We diagnosed congenital unilateral absence of the vas deferens. Follow-up semen analysis showed azoospermia.

Conclusion

As vasectomies …

Early Prediction Of Trauma Patient Discharge Disposition, Ronald Beaulieu, Priti Parikh, Akpofure Peter Ekeh, Ronald J. Markert, Mary C. Mccarthy

Department of Surgery Faculty Publications

Objective: Do pre-injury and early hospital admission characteristics help predict patient discharge disposition? Background: Total one-year treatment cost of adult major trauma in the United States is estimated at $30 billion annually, with 58% of the cost due to the index hospitalization. Increased length of stay (LOS) increases morbidity and delays rehabilitation. Prediction of discharge to a location other than home through univariate risk factor methodology and development of a multivariable binary logistic regression model allows early discharge planning. Methods: A one-year Level 1 trauma center registry dataset was used to develop a predictive model of discharge disposition using 2836 …

The Cutting Edge Spring 2013, Wright State University Department Of Surgery

The Cutting Edge Newsletter

An eight page newsletter created by the Department of Surgery documenting current affairs of the department. This issue highlights the arrival of a new faculty member, an announcement for the ACS Fellowship Program, research news, and more.

Faculty And Staff Updates, Department Of Surgery, April 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A four page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Slow Birth Of New-Wave Medical Journalism, Vivian Mcalister

Data and Test Instruments

Half a century has passed since Sir Theodore Fox reflected upon his recently completed 40-year tenure as editor of The Lancet. He titled his farewell lecture series “Crisis in communication: the functions and future of medical journals.”1 Even though the number of journals had dramatically increased by the 1960s, submissions had proliferated to such an extent that Fox’s principal regret was the increasing fraction he was forced to refuse. In the late 19th century, the surgeon general of the United States was able to catalogue the entire body of medical knowledge up to that time in a volume that would …

Burn Disaster Management Planning: A Preparedness Toolkit (Poster), Brian S. Joho Msn, Rn, Daniel D. Lozano Md, Patrick Pagella Msn, Arnp, Michael Wargo Mba, Rn, Hamed Amani Md, Facs

Patient Care Services / Nursing

No abstract provided.