Medical Specialties Commons^™

Incivility In Healthcare Settings: Manifestations, Root Causes, And Downstream Effects On Patient Care And Productivity, Theresa P. Yeo, Anne Belcher, Charles J. Yeo

College of Nursing Faculty Papers & Presentations

PURPOSE: To investigate the prevalence and effects of incivility in healthcare and educational settings

METHODS: Review of the literature

SEARCH STRATEGY: CINAHL, PubMed, Joint Commission sites searched using terms: incivility, workplace violence, disruptive behavior, bullying

Addressing The Challenges Of Practicing Breast Cytology In A Tertiary Teaching Hospital In Kenya, Neeta Kumar, Shahin Sayed, Zahir Moloo, Rajendra Chauhan

General Surgery, East Africa

Objectives: To assess diagnostic accuracy of breast cytology through histological correlation and identify reasons for diagnostic pitfalls.

Methods: A total of 2700 cases were reported in cytology during the study period of 14 months, of which 1100 (40%) were from breast lesions. Only 96 (9%) cases had histological follow up in the form of core biopsy, lumpectomy and/or mastectomy. The cases in which cytology diagnosis did not match with histology diagnosis were reviewed by two pathologists and reasons for the diagnostic pitfalls in cytology were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of cytology were …

Microsurgical Reconstruction Of Large, Locally Advanced Cutaneous Malignancy Of The Head And Neck, Joseph L. Hill, Brian Rinker

Surgery Faculty Publications

Large, locally advanced cutaneous malignancy of the head and neck region is rare. However, when present, they impart a significant reconstructive challenge. These cancers have a tendency to invade peripheral tissues covering a large surface area as well as expose deeper structures such as skull, dura, orbit, and sinus after resection. Complicating the reconstructive dilemma is the high incidence of individuals who have undergone previous surgery in the region as well as adjuvant radiation therapy, which may preclude the use of local flaps or skin graft. Free tissue transfer provides a reconstructive surgeon the ability to provide well-vascularized tissue with …

Surgical Site Infections In Gynecologic Oncology Patients: A Retrospective Study Of Patient Characteristics And Intraoperative Parameters, Christine C. Chen Md, Joanne N. Quiñones Md, Msce, Richard Boulay Md, M Bijoy Thomas Md, Martin Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

A Cost Analysis Of Postoperative Pain Management In Endometrial Cancer Patients: Robotic Department Of Surgery Vs. Laparoscopy Department Of Surgery, Martin A. Martino Md, Jocelyn Shubella, Rachel Miller Pa-C, Joycelyn C. Schindler Md, Sharon R. Kimmel Phd, Mha, Shamol Williams Msii, Richard Boulay Md, M Bijoy Thomas Md

Department of Obstetrics & Gynecology

No abstract provided.

Developing A Multidisciplinary Perioperative Safety Course, William Bond Md, Ms, Hope L. Johnson Msn, Rn, Cnor, Michael Pasquale Md, Facs, Fccm, Melissa B. Walsh Bs, Deborah Arnold Msn, Rn, Cmsrn, Matthew W. Leclair, Kelly L. Lago Ms, Jeanne P. Luke Msn, Rn, Cnor

Department of Emergency Medicine

No abstract provided.

Appendiceal Mucocele Intussusception, Christine W. Du Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Experience Of Resident Assistant Does Not Influence Incidence Of Common Bile Duct Injuries During Laparoscopic Cholecystectomy, Ryan A. Lawless Md, Dale A. Dangleben Md, Charles Scagliotti Md, Judith A. Olenwine Ms, C-Tagme, John J. Hong Md, Michael M. Badellino Md

Department of Surgery

No abstract provided.

Laparoscopic Repair Of Incarcerated Obturator Hernia, Danielle Press Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Ventral Hernia Repairs: 10 Year Single Institution Review At Thomas Jefferson University Hospital, Frederick C. Sailes, Md, Jason Walls, Md, Daria Guelig, Md, Mike Mirzabeigi, Ma, William D. Long, Ms, Albert Crawford, Phd, John H. Moore Jr, Md, Facs, Steven E. Copit, Md, Gary A. Tuma, M.D, James Fox, Md

Department of Surgery Faculty Papers

Abstract

Background Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Ramirez 1 et al describes the “component separation” technique to mobilize the rectus-abdominus internal oblique and external oblique flap to correct the defect. The recurrence rate of incisional hernias increases to 20% after gastric bypass or extensive weight loss.2 The incidence of ventral hernias after failed recurrent hernia repair increases to 40%.3 It has been reported that utilizing the sliding myofascial flap repair technique, the recurrence rate was reduced to 8.5%.4

Materials and Methods This …

The Potential Role Of Innate Immunity In The Pathogenesis Of Post-Operative Adhesions, Jennell White

Wayne State University Dissertations

Post-operative adhesion development occurs in the vast majority of patients following abdominal surgery and is a natural occurrence of peritoneal-wound healing. These fibrous bands may form within the first 5-7 days post-surgery and have the ability to cause a distortion in the normal anatomical positioning of abdominal organs. Consequently, adhesions are major contributors to small bowel obstruction, infertility, and severe pelvic and abdominal pain. Physiological processes responsible for adhesion formation remain obscure though it is believed to involve cell migration, proliferation, and differentiation of several cell types including mesothelial cells, fibroblasts, and inflammatory and immune cells. Substances released from these …

Tuberculous Colitis, Firas G. Madbak Md, Dale A. Dangleben Md, Facs

Department of Surgery

No abstract provided.

Neo-Adjuvant Chemotherapy And Radiation Therapy In Patients With Stage Iiia (N2) Non-Small Cell Lung Cancer (Nsclc): A Retrospective Analysis With Lessons Learned, Eliot L. Friedman Md, Michael F. Szwerc Md, Charles Andrews Md, Robert Kruklitis Md, Kathleen A. Leies, Ferdy Santiago

Department of Medicine

No abstract provided.

Risk Factors Affecting Surgical Outcomes In Patients Undergoing Hypothermic Circulatory Arrest During Aortic Surgeries: A 10-Year Study, Bree Ann Young, James K. Wu, Martin E. Matsumura Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Raymond L. Singer Md

Department of Medicine

No abstract provided.

Stem Cells For Spinal Cord Regeneration: Current Status, Zain A. Sobani, Syed A. Quadri, Ather Enam

Section of Neurosurgery

Background: Nearly 11,000 cases of spinal cord injury (SCI) are reported in the United States annually. Current management options give a median survival time of 38 years, however, no rehabilitative measures are available. Stem cells have been under constant research given their ability to differentiate into neural cell lines replacing non functional tissue. Efforts have been made to establish new synapses and provide a conducive environment, by grafting cells from autologous and fetal sources, including embryonic or adult stem cells, Schwann cells, genetically modified fibroblasts, bone stromal cells, and olfactory ensheathing cells and combinations/ variants thereof.
Methods: In order to …

2010 Newsmakers: Celebrating Our Own, Paul Mayne, Jason Winders

Data and Test Instruments

How will we remember 2010? Probably through these faces. This year, the Western News starts a new, if not wholly original, tradition. Our Newsmakers 2010 section celebrates the best of research, academia and volunteer spirit that we have to offer on this campus. We spotlight, in brief words and striking images, the accomplishments of some of our favourites from the last year. One of the most powerful women in Canada. A student with an eye for the greater good. And a man who would do anything, including posing with a zebra, for the United Way. A football coach. A ground-breaking …

A Pioneer Of Urologic Surgery From A Small Town In Ontario, Canada: A Tribute To Abraham Groves (1847-1935)., Yves Caumartin, Vivian Mcalister, Patrick Luke

Data and Test Instruments

Background: Abraham Groves worked as a general practitioner and surgeon in the small town of Fergus, Ontario, Canada. Several priority claims have been attributed to Groves’ life in surgery, including aseptic surgery (1874), appendectomy (1883) and the use of surgical gloves (1885). He was also an early practitioner of urological surgery. Objective: The purpose of this paper is to describe and objectively assess his contributions as a pioneer in urological surgery. Methods: A systematic search of contemporary journals was made for articles by or about Groves. These articles and his 1934 autobiography were reviewed. The information was assessed not only …

Microdiscectomy For Lumbosacral Disc Herniation And Frequency Of Failed Disc Surgery, Muhammad Shahzad Shamim, Maria Adnan Parekh, Muhammad Ehsan Bari, Ather Enam, Faraz Khursheed

Section of Neurosurgery

Background: Microdiscectomy for lumbosacral disc herniations is one of the most commonly performed neurosurgical procedures. The Patient demographics, symptomatology, and recovery are highly variable, and surgical outcomes depend on several factors, including Patient demographics. Failed disc surgery refers to failure of improvement in Patient's symptoms following microdiscectomy, and has been observed to occur in up to 12% of Patients. To date, no study form Pakistan has looked into Patient demographics and failed disc surgery rates within the local context.
Objective:The aim of this study was to review the demographics of the Patient population presenting for surgical treatment of lumbosacral …

Portable Ultrasonography In Mass Casualty Incidents: The Caveat Examination, Stanislaw P. Stawicki, James M. Howard, John P. Pryor, David P. Bahner, Melissa L. Whitmill, Anthony J. Dean

Department of Surgery Faculty Publications

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use …

Complete Omental Torsion Associated With Left Inguinal Hernia: Case Report And Review Of The Literature, Patty T. Liu Md, Erik J. Teicher Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Caval Agenesis With Hypoplastic Left Kidney In A Trauma Patient On Warfarin For Deep Vein Thrombosis (Poster), Ryan A. Lawless Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Western News: Rewriting The Record On Legs, Lesley Craig, Paul Mayne

Data and Test Instruments

No abstract provided.

Civilian Versus Military Trauma Management, Vivian Mcalister

Data and Test Instruments

In the 21st century, military and civilian trauma surgeons bring similar solutions to similar problems, learning one from another

Intracranial Cavernous Angiomas, Syed Faraz Kazim, Atta-Ul-Aleem Bhatti, Ather Enam

Section of Neurosurgery

Objective: To describe the clinical presentation, diagnosis, and management of patients presenting with intracranial cavernous angiomas (CAs) at a tertiary care hospital in Pakistan.
Study Design: Case series. Place and Duration of Study: Section of Neurosurgery, The Aga Khan University Hospital (AKUH), Karachi, from January 1990 to September 2008.
Methodology: A retrospective case note review of all patients diagnosed with intracranial CAs at AKUH during the study period. The studied variables included patient demographics, clinical presentation, family history of intracranial CAs or other space occupying lesions, modality of diagnosis, management, and outcome. Results were described as frequency percentages.
Results: During …

Cardiac Surgery In Octogenarians, Asmatullah Khan, Hassan Khan, Saulat H. Fatimi, Asadullah Khan

Section of Cardiothoracic Surgery

In Europe and North America, cardiac surgery can be done successfully on octogenarians, but differences in patient selection, surgical and bypass techniques prevent us from concluding similarly in Pakistan. This study investigated the short and long-term outcomes of cardiac surgery in octogenarians operated over a 5 years period at The Aga Khan University Hospital, from January 2001 to December 2006. Seventeen octogenarians, (mean age 81.7 ± 2.3) underwent coronary artery bypass graft (CABG). Thirty-days hospital mortality was reported in only 1 patient. Surgical complication of any kind was reported in 13 (76.5%) patients with pleural effusion being the commonest in …

A Severe Case Of Necrotizing Fasciitis Of The Abdomen: A Survivor Story, Karin Mcconville Md, Dale A. Dangleben Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Back To The Suture: The Two 5 Mm Port Laparoscopic Appendectomy, James Lee Md, Margaret Moore Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Grown Up Congenital Heart Disease Patient Presenting For Non Cardiac Surgery: Anaesthetic Implications, Mohammad Hamid, Mansoor Ahmed Khan, Mohammad Irfan Akhtar, Hameedullah, Saleemullah, Khalid Samad, Fazal Hameed Khan

Department of Anaesthesia

Congenital heart disease patients surviving to adulthood have increased over the years due to various reasons. These patients are admitted in the hospital for non cardiac surgeries and other procedures more often than normal adult population. Management of grown up congenital heart disease patient presents a challenge during perioperative period for cardiologists, surgeons, intensivists and particularly for the anaesthetist. Management issues include psychological and physiological impact on the patient, complexity of defects, presence of previous palliative procedure, impact of anaesthetic agents on shunting and myocardium, endocarditis prophylaxis and associated extra cardiac anamolies.

Pp32 (Anp32a) Expression Inhibits Pancreatic Cancer Cell Growth And Induces Gemcitabine Resistance By Disrupting Hur Binding To Mrnas., Timothy K Williams, Christina L Costantino, Nikolai A Bildzukewicz, Nathan G Richards, David W Rittenhouse, Lisa Einstein, Joseph A Cozzitorto, Judith C Keen, Abhijit Dasgupta, Myriam Gorospe, Gregory E Gonye, Charles J Yeo, Agnieszka K Witkiewicz, Jonathan R Brody

Department of Surgery Faculty Papers

The expression of protein phosphatase 32 (PP32, ANP32A) is low in poorly differentiated pancreatic cancers and is linked to the levels of HuR (ELAV1), a predictive marker for gemcitabine response. In pancreatic cancer cells, exogenous overexpression of pp32 inhibited cell growth, supporting its long-recognized role as a tumor suppressor in pancreatic cancer. In chemotherapeutic sensitivity screening assays, cells overexpressing pp32 were selectively resistant to the nucleoside analogs gemcitabine and cytarabine (ARA-C), but were sensitized to 5-fluorouracil; conversely, silencing pp32 in pancreatic cancer cells enhanced gemcitabine sensitivity. The cytoplasmic levels of pp32 increased after cancer cells are treated with certain stressors, …

Should We Be Concerned About Jejunoileal Atresia During Repair Of Duodenal Atresia?, Shawn D. St Peter, Danny C. Little, Katherine A. Barsness, Daniel R. Copeland, Casey M. Calkins, Suzanne Yoder, Steve S. Rothenberg, Saleem Islam, Kuojen Tsao, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: During repair for duodenal atresia, it has been emphasized that inspection of the small bowel to identify a second atresia is required. The laparoscopic approach for repair of duodenal atresia has been criticized for its limitation to perform this step. Given that duodenal atresia and jejunoileal atresias do not share common embryologic origins, we question the validity of this concern. Therefore, we conducted a multicenter retrospective review of duodenal atresia patients to quantify the incidence of jejunoileal atresia in this population.

METHODS: After institutional review board approval (IRB #07-12-187X), a retrospective review was conducted on all patients who have …