Medical Specialties Commons^™

Screen Positives For Potential St-Segment Elevation Myocardial Infarction: Door To Electrocardiogram By Sex And Race, Sarah Galla, Gautam Pathak, Dalia Owda, Amit Bahl, James Ziadeh, Susan Bork, Robert Swor, Karen Childers, Maya Yiadom, David A. Berger

Conference Presentation Abstracts

Background and Objectives: Detection of ST-segment elevation myocardial infarctions (STEMI) are dependent on early acquisition of an ECG. American Heart Association guidelines require performing an ECG within 10 min for patients presenting with symptoms warranting STEMI screening. A delay in ECG acquisition causes delays in diagnosis and treatment, which is associated with worsened outcomes. However, previous work has shown there is limited success at achieving a door to ECG (D2E) time of Methods: This is a retrospective chart review study in which D2E time was measured for patients positive for STEMI ECG screening criteria in a large health system with …

The Rural Medicine Curriculum: The Missing Piece Of Urban Residency Education, Robert Calleja, Bophal Hang

Conference Presentation Abstracts

Intro/Background: Critical Access Hospitals (CAHs) have staffing shortages as most recent graduates of emergency medicine (EM) recidency programs pursue jobs in urban environments. It is presumed that this is due to limited exposure to rural EM scenarios throughout training, leading to hesitancy to practice in these situations as a new graduates with minimal single provider experience. Review of MedEd Portal demonstrates no curriculum filling this deficit in EM training, leading to the development of this curriculum. Purpose/Objective: The goal of the curriculum was to inspire further interest and preparedness to work in rural/critical access hospitals (CAHs). The hope was that …

Improving Diversity, Equity, And Inclusion In Pediatric Surgery: An Innovative Mentorship Program, Amelia E. Gavulic, Insiyah Campwala, Natalie Moreno, Grace M. Mallampalli, Yousef Ibrahim, Anthony Stallion, Sabina Siddiqui, Marjorie J. Arca, Samir K. Gadepalli, Erika A. Newman

Conference Presentation Abstracts

Abstract: Purpose: Representation among pediatric surgeons does not reflect the pediatric patient population. In line with the Association of Pediatric Surgery Training Program Directors (APSTPD)’s mission to broaden cognitive diversity and representation in the workforce via leadership development and longitudinal mentorship, the Alliance of Pediatric Surgeons Growing and Advancing Representation (APGAR) was created with national collaboration. One year later, we report on the composition of APGAR and the perspectives of its members. Methods: Seventeen mentorship groups (“pods”) were formally established with representatives from each premedical learner level from high school students to pediatric surgery fellows and attendings. Pods were led …

Using Age-Adjusted D-Dimer Vs Traditional D-Dimer To Rule Out Acute Aortic Syndrome, Jacob Nelson, Divyani Patel, Sylvia Kashat, Gorune Geloian, Karen Childers, David A. Berger, Brett Todd

Conference Presentation Abstracts

Background and Objectives: Acute aortic syndromes (AS), including aortic dissection, are rare and life-threatening diagnoses. Early diagnosis is critical as mortality increases by 1%–2% per hour after symptom onset. D-dimer (DD) Methods: In this retrospective chart review, we identified all patients who presented to any Emergency Department (ED) at a multicenter health system between 2012 and 2021, received a D-dimer test, and underwent CTA Dissection, CTA Coronary Study, or CTA Triple Rule-Out. Patients under the age of 18, pregnant, had prior dissection or thoracic aorta repair, or who presented altered/unresponsive were excluded. For patients with multiple presentations, the first visit …

Comparing Outcomes Of Mechanical And Manual Cardiopulmonary Resuscitation In Out-Of-Hospital Cardiac Arrest: A Retrospective Cohort Study, Margaret Beyer, Fabirce I. Mowbray, Nicole Wannis, David A. Berger, Christine M. Brent, Robert Dunne, Theresa A. Shields, Matthew T. Ball, Joseph Miller, Howard Klausner

Conference Presentation Abstracts

Background and Objectives: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in the United States, with over 350,000 per year. Despite improvements in care, OHCA outcomes remain low. Chest compressions can be administered manually or via an automated mechanical device. Mechanical CPR (mCPR) devices are designed to achieve return of spontaneous circulation (ROSC) by delivering consistent compression depth and rate. This retrospective cohort of the Michigan Cardiac Arrest Registry to Enhance Survival (CARES) compared survival to hospital discharge with good neurological status (CPC 1 or 2) between manual and mechanical CPR. Methods: The CDC collaborated with Emory University …

Assessing The Diagnostic Accuracy Of Ti-Rads In Pediatric Thyroid Nodules: A Multi-Instutional Review, Shachi Srivatsa, Ameer Al-Hadidi, Joseph R. Stanek, Kyle Horvath, Lauren N. Parsons, Claudia Martinez-Rios, Amanda Hopp, Samuel Engle, Matthew Plunk, Gail Shapira-Zaltsberg, Sapna Nagar, Sean E. Masters, Sayf Al-Katib, Rennard B. Tucker, Lamya Atwah, Summit Shah, Adam Bobbey, Robert Hoffman, Jennifer H. Aldrink

Conference Presentation Abstracts

Abstract: Purpose: Thyroid nodules are uncommon in children and adolescents but carry an increased risk of malignancy when present. The Thyroid Imaging Reporting and Data System (TI-RADS) is an adult-validated ultrasound-based risk assessment providing a prediction of malignant potential for thyroid nodules, thereby guiding recommendations for fine needle aspiration biopsy (FNAB). Minimal data exist regarding the applicability of TI-RADS to predict malignancy in pediatric thyroid nodules. This study aims to analyze the performance of TI-RADS for children and adolescents with thyroid nodules, hypothesizing that applying TI-RADS criteria would improve accuracy and reduce the number of recommended FNAB compared to American …

Neuraxial Vs. General Anesthesia In Total Hip Arthroplasty For Femoral Neck Fracture: A Comparison Of Postoperative Complications, Kevin X. Farley, Hassan Mouzailhem, Robert S. Dean, Mark Karadsheh, Leonardo Cavinatto, Jacob Wilson, Drew Moore

Conference Presentation Abstracts

OBJECTIVE: Rates of complications with differing anesthetic choices has not been directly compared for patients undergoing total hip arthroplasty (THA) for femoral neck fractures. This study sought to directly compare neuraxial vs. general anesthetic use and compare postoperative outcomes for patients undergoing THA for a femoral neck fracture. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing THA for a femoral neck fracture. Anesthetic type was identified and categorized as neuraxial (spinal, epidural) or general. Demographic and comorbid variables were collected. Days from admission to surgery was also identified. Postoperative complications …

Trends And Outcomes Of Same-Day Discharge Total Ankle Arthroplasty In The United States: A National Analysis From 2012-2021, Kevin X. Farley, Robert S. Dean, Ricky Sareini, Elijah Auch, Zachary Vaupel, Paul T. Fortin

Conference Presentation Abstracts

OBJECTIVE: Same-day discharge Total Ankle Arthroplasty (TAA) is becoming more common. This study sought to report the percentage of patients within a national database that had a same-day discharge following TAA, and to compare the complication rates for patients that had same-day discharge to those that had a short hospital stay. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing TAA. All patients discharged to their home on the day of surgery were identified. A comparison cohort of patients with a hospital stay of 1 to 2 days who were then …

New-Onset Depression Following Total Shoulder Arthroplasty: The Impact Of Preoperative Patient Factors And Postoperative Complications, Kevin X. Farley, Robert S. Dean, Eric R. Wagner, Michael B. Gottschalk, J Michael Wiater

Conference Presentation Abstracts

OBJECTIVE: Depression has been well studied as a risk factor for postoperative complications following total shoulder arthroplasty (TSA). However, little is known about new-onset depression (NOD) following TSA. The purpose of this study is to determine the incidence of NOD following TSA and identify risk factors for its occurrence. METHODS: This was a retrospective review of patients undergoing TSA in the Truven Health MarketScan database. NOD was identified. Patients with preoperative depression were excluded from analysis. Postoperative complications were identified, including the development of a prosthetic joint infection (PJI), need for revision surgery, and postoperative dislocation. If a complication occurred …

Risk Factors For Failure Of Same-Day Discharge Total Knee Arthroplasty, Kevin X. Farley, Robert S. Dean, Eli Auch, Mark Karadsheh, Drew Moore

Conference Presentation Abstracts

OBJECTIVE: Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA and (2) if there are differences in early complications between cemented and uncemented TKA. METHODS: We retrospectively reviewed data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) database of primary TKA patients from 2017 to 2021 at a single health system (six hospitals). Uncemented TKA (uncemented fixation for femur and tibia) patients were analyzed for demographics and …

National Incidence And Economic Burden Of Revision Shoulder Arthroplasty In The United States: Projections Through 2030, Kevin X. Farley, Robert S. Dean, Eric R. Wagner, Michael B. Gottschalk, J Michael Wiater

Conference Presentation Abstracts

PURPOSE: This study sought to use an all-payor inpatient claims database to investigate the incidence and national cumulative costs of revision shoulder arthroplasty in the United States, including those being performed for PJI. In addition, we also aimed to project the incidence and national economic impact of revision shoulder arthroplasty in the US through 2030. METHODS: The National Inpatient Sample (NIS) was used to estimate the annual number of revision shoulder arthroplasties performed between 2008 and 2019 using ICD procedure codes. Cumulative national costs were estimated. Septic revision shoulder arthroplasties were identified (i.e., cases being done for a prosthetic joint …

Uncemented Total Knee Arthroplasty Is On The Rise. A Retrospective Review From The Michigan Arthroplasty Registry Collaborative Quality Initiative (Marcqi), Michael E. Sacchetti, Sarah Fried, Madeleine Declercq, Jacob H. Keeley, Robert Runner

Conference Presentation Abstracts

OBJECTIVE: Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA and (2) if there are differences in early complications between cemented and uncemented TKA. METHODS: We retrospectively reviewed data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) database of primary TKA patients from 2017 to 2021 at a single health system (six hospitals). Uncemented TKA (uncemented fixation for femur and tibia) patients were analyzed for demographics and …

Biomechanical Comparison Of A Novel Circular Glenoid With Peripheral Ring Fixation To A Standard Anchor Pegged Glenoid In Total Shoulder Arthroplasty, Adam Khan, Andrew Jawa, J Michael Wiater, Derek J. Cuff, Anand M. Murthi, Matthew J. Smith, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: Current standard total shoulder pegged glenoid component designs have a high rate of loosening, which accounts for the most common long term reason for surgical failure. Glenoid design, method of fixation, and implantation version all play a role in component stability. With current designs, 51% of standard glenoid components shift at 2 years. This study aimed to compare the biomechanical stability of a novel circular glenoid with peripheral ring fixation to a standard anchor pegged glenoid. Additionally, we compared the estimated bone removal for the glenoid design types. METHODS: Biomechanical testing [Figure 1] was performed to assess the glenoid …

Shoulder Arthroplasty Evolution: Comparing Reverse, Anatomic, And Hemiarthroplasty Trends And Outcomes In Key Demographics At A High-Volume Institution, James Fuchs Gannon, Mitchell Thomas Pfennig, Anthony Arveschoug, Betina Bremer Hinckel, J Michael Wiater, Leonardo M. Cavinatto

Conference Presentation Abstracts

The field of shoulder arthroplasty has changed markedly since the inception of the reverse total shoulder arthroplasty (RTSA) in 2004. With yearly gains of 32%, the RTSA now encompasses the largest portion of shoulder arthroplasty procedures. In contrast, the anatomic total shoulder arthroplasty (ATSA) and hemiarthroplasty (HA) have steadied or decreased in usage. Some have offered several explanations for these trends, such as expanding indications for the RTSA, in particular for pathologies traditionally treated with ATSA such as glenohumeral arthritis with an intact rotator cuff and no major bone loss/deformity. Others have cited superior postoperative outcomes of the RTSA over …

Patient Perception Of Different Autografts In Anterior Cruciate Ligament Reconstruction Using A Validated Online Survey Marketplace, Robert Dean, Tanner J. Hafen, Collin Braithwaite, Kevin Xavier Farley, Robert F. Laprade, Joseph Guettler, James Bicos

Conference Presentation Abstracts

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is the gold standard treatment for ACL tears. ACL graft reconstruction is commonly performed with an autograft. Common autograft modalities include bone-patellar tendon-bone (BPTB), quadriceps tendon (QT), and hamstring tendon (HT) grafts. This study sought to evaluate the general population’s perception of the use of BPTB, QT, and HT autografts in ACL reconstruction. METHODS: A prospective cohort study was performed utilizing a 35-question survey. Participants were paid, and the survey was distributed via a clinically, validated, public, online marketplace in June 2023. After collecting baseline demographics, participants were queried on whether they held a …

Effect Of Vitamin E Enhanced Highly Cross-Linked Polyethylene On Wear Rate And Particle Debris In Anatomic Total Shoulder Arthroplasty: A Biomechanical Comparison To Ultrahigh-Molecular-Weight Polyethylene, Adam Khan, Andrew Jawa, Matthew J. Smith, J Michael Wiater, Derek J. Cuff, Anand M. Murthi, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: Particle-induced osteolysis resulting from polyethylene wear remains a source of implant failure in anatomic total shoulder designs. Modern polyethylene components are irradiated in an oxygen-free environment to induce polyethylene cross-linking, but an unfortunate byproduct of this process is free radical production. Melting or heat annealing is one method of reducing free radicals but can compromise the component’s mechanical properties. The antioxidant, Vitamin E, has been introduced as an alternative adjuvant to neutralize free radicals. Specifically, in anatomic shoulder arthroplasty with a ceramic head component, the vitamin E-enhanced polyethylene showed improved wear compared to the conventional highly-cross linked polyethylene. This …

The Effect Of Marijuana On Postoperative Spine Patients' Emergency Room Visits, Readmission Rates, And Opioid Consumption, Vincent Buddle, James Feng, Maximillian Young-Kyu Lee, Ahyoung L. Park, Daniel K. Park

Conference Presentation Abstracts

INTRODUCTION: The social, political, and legal natural of marijuana has recently seen significant changes, particularly in favor of both medical and recreational use. Since being classified as a Schedule I substance in 1970 by the United States federal government, all but four states have legalized some form of its use. These changes have and will continue to lead to a significant number of orthopaedic patients using marijuana in the perioperative surgical setting. The objectives of this study are to 1) compare the 90-day rates of postoperative emergency department (ED) visits and 90-day readmission rates with patients whom tested positive for …

Patient Perception Of Allograft Versus Autograft In Anterior Cruciate Ligament Reconstruction Using A Valaidated Online Survey Marketplace, Tanner J. Hafen, Robert Dean, Collin Braithwaite, Joseph Guettler, Robert F. Laprade, James Bicos

Conference Presentation Abstracts

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is the gold standard treatment for ACL tears. Reconstruction is accomplished through the use of an allograft or autograft. This study sought to evaluate the general population’s perception of the use of allografts and autografts in ACL reconstruction. METHODS: A prospective cohort study was performed utilizing a 35-question survey. Participants were paid, and the survey was distributed via a clinically validated, public, online marketplace in June 2023. After collecting baseline demographics, participants were queried on whether they held a preference for ACL reconstruction with an allograft or an autograft. All respondents then sequentially completed …

1756 Evaluating The Impact Of Prophylactic Intrathecal Chemotherapy In Diffuse Large B Cell Lymphoma (Dlbcl) Patients With High Central Nervous System International Prognostic Index (Cns-Ipi) Scores: A Comprehensive Review And Meta-Analysis, Kadhim Al-Banaa, Alfarooq Alshaikhli, Shyam Poudel, Shiva Shrotria, Can Wang, Paul Hanona, Swathi Gopishetty, Precious Idogun, Daniel Ezekwudo, Ishmael Jaiyesimi

Conference Presentation Abstracts

No abstract provided.

Breast Cancer In Pms2 Related Lynch Syndrome: Evidence Of A Possible Association?, Ujjwal Karki, Tara Rangarajan, Dana Zakalik

Conference Presentation Abstracts

Background: Lynch syndrome (LS) is a hereditary cancer predisposition syndrome caused by pathogenic variants (PVs) in mismatch repair genes, MLH1, MSH2, MSH6, and PMS2. LS is associated with increased risk of colorectal, and endometrial cancers but breast cancer risk is uncertain, with some studies suggesting MSH6 and PMS2 PVs may have a higher risk for breast cancer. Our study outlines the incidence and clinical characteristics of breast cancer in PMS2-related LS identified at a large academic center. Methods: Patients with PMS2 PVs identified between July 2009 and May 2023 were selected from a database at the Nancy and James Grosfeld …

Nrg-Br008: A Phase Iii Randomized Trial Of Radiotherapy Optimization For Low-Risk Her2-Positive Breast Cancer (Hero), L Braunstein, M Mitchell, H Bandos, W Sikov, A Khan, Peter Chen, P Ganz, R Jagsi, J White, R Cecchini

Conference Presentation Abstracts

Background: Breast radiotherapy (RT) is the standard of care for patients with early-stage breast cancer (BC) who undergo breast-conserving surgery (BCS). However, the magnitude of benefit of RT is less clear in BCS patients with low-risk disease who receive effective systemic therapy. Among patients with early-stage HER2-positive (HER2+) BC, 10-year locoregional recurrence has been reported as low as 1.5% following BCS, adjuvant chemotherapy and HER2-targeted therapy, and RT. Given these exceedingly favorable outcomes, with the addition of HER2-directed therapy, we seek to evaluate the feasibility of omitting RT among patients with early-stage HER2+ BC following BCS and appropriate systemic therapy. …

Characteristics Of Breast Cancer In Carriers Of Pathogenic Variant In Atm In A Large Academic Health Center, Ujjwal Karki, Tara Rangarajan, Dana Zakalik

Conference Presentation Abstracts

Background: Pathogenic variants (PVs) in ATM are associated with an increased risk of breast, pancreas, and other cancers. The clinical and pathological characteristics of ATM-associated breast cancers have not been well defined. Methods: Patients who underwent multigene panel testing between December 2012 and May 2023 and were identified to harbor ATM PVs were included in the study. We analyzed demographics, germline findings, histopathology, genomic recurrence score, and management of ATM PV carriers with breast cancer. Results: A total of 222 individuals were identified to have PVs in ATM, of whom 184 (83%) were female. The majority were Caucasian (n = …

Loco-Regional Irradiation In Patients With Biopsy-Proven Axillary Node Involvement At Presentation Who Become Pathologically Node-Negative After Neoadjuvant Chemotherapy: Primary Outcomes Of Nrg Oncology/Nsabp B-51/Rtog 1304, E Mamounas, H Bandos, J White, T Julian, A Khan, S Shaitelman, M Torres, Frank Vicini, P Ganz, Andrew Muskovitz

Conference Presentation Abstracts

No abstract provided.

A Mssic Study Reveals Non- Modifiable Risk Factors Were Associated With Post-Operative Hematoma Following Acdf, Richard Easton, Matthew Lipphardt, Matthew Easton, Nicholas Papakonstantinou, Lonni Schultz, Hsueh-Han Yeh, Cecile Pestano

Posters

Introduction

Post-operative hematoma (POH) following anterior cervical discectomy (ACDF) is uncommon . Although rare, POH is recognized as a potentially catastrophic post-operative complication . There is limited information as to who is vulnerable . From a large database, the authors sought to identify common modifiable and non-modifiable risk factors for developing POH and its associated clinical outcomes.

Materials and Methods

The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide quality improvement initiative . ACDF cases in MSSIC registry from 2014-2018 were identified . Patients who developed POH (POH) were compared to those who did not (non-POH) . Chi-square and …

Evaluation Of The Success Rate Of Endoscopic Dacryocystorhinostomy With Early Bicanalicular Stent Removal, Lauren N. Demaria, Evan H. Black, Dianne M. Schlachter

Conference Presentation Abstracts

No abstract provided.

Teprotumumab As Monotherapy For Dysthyroid Optic Neuropathy: A Multicenter Study, Giannis Moustafa, Irina Belinsky, Cat Burkat, Stella Chung, Brent Hayek, Alon Kahana, Amina Malik, John Nguyen, Sathyadeepak Ramesh, Sarah Turner, Alison Watson, Roman Shinder

Conference Presentation Abstracts

No abstract provided.

Anterior Cervical Discectomy And Fusion After Presentation To The Acute Care Setting: A Comparison Of Post-Operative Outcomes, Alex Miller, James Whaley, Daniel Park

Conference Presentation Abstracts

Introduction: For patients presenting with cervical radiculopathy or cervical myelopathy, surgical treatment is typically pursued after discussion in the outpatient setting. Yet, there exists a group of patients presenting to the acute care setting with intractable pain or progressive neurologic deficits who are indicated for operative treatment outside of outpatient evaluation. Given the differences in initial management and pre-operative optimization, it is unclear if surgical and post-operative outcomes differ between these populations. Materials and Methods: This was a retrospective cohort study from an academic medical center. Surgical case logs from the institution’s electronic medical record were used to identify patients …

When Plasticity Becomes Pathological: Sequential Decreases In Basolateral Amygdala Response To Threat Cues Predict Failure To Recover From Ptsd, Alyssa Roeckner, Esther Lin, Rebecca Hinrichs, Nathaniel G. Harnett, Lauren A M. Lebois, Sanne J H Van Rooij, Timothy D. Ely, Tanja Jovanovic, Vishnu P. Murty, Robert A. Swor

Articles

No abstract provided.

Defining High-Risk Percutaneous Coronary Intervention: Characteristics Of Patients Undergoing Contemporary Percutaneous Coronary Intervention With Axial-Flow Mechanical Support, Aditya S. Bharadwaj, Alexander G. Truesdell, Alejandro Lemor, Julia B. Thompson, Arsalan Abu-Much, Yiran Zhang, Simon R. Dixon

Conference Presentation Abstracts

No abstract provided.

Performance Of Existing Risk Models In Impella-Supported High-Risk Percutaneous Coronary Interventions: The Protect Iii Cvad Study, Tayyab Shah, Alejandro Lemor, Julia B. Thompson, Majd B. Prothy, Mamas Mamas, Tim Kinnaird, Simon R. Dixon

Conference Presentation Abstracts

No abstract provided.