Surgery Commons^™

The Burden Of Burns: An Analysis Of Public Health Measures, Anastasiya Ivanko, Anna Garbuzov, Jonathan E. Schoen, Randy S. Kearns, Denise Danos, Erica Murata, Bart D. Phillips, Herb A. Phelan Iii, Jeffrey D. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

The Consequences Of A Career In Burn Surgery: An Economic Analysis To Aid Prospective Clinicians, Jeffrey E. Carter, Anastasiya Ivanko, Jonathan E. Schoen, Herb A. Phelan Iii, William L. Hickerson, Randy D. Kearns

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

An Analysis Of Burn Icu Days From The National Injury Resource Database, Anastasiya Ivanko, Jonathan E. Schoen, William L. Hickerson, Herb A. Phelan Iii, Bart D. Phillips, Jeffery E. Carter, Denise Danos

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Use Of The Burn Care Quality Platform (Bcqp) For Modern Burn Care Benchmarking, Madeline G. Lechtenberg, Jeffrey E. Carter, Denise Danos, Bart D. Phillips, Erica Murata, Jonathan E. Schoen, Herb A. Phelan Iii

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Empowering Emergency Responders To Treat On Scene Alleviates Hospital Strain During Disaster Events, Anastasiya Ivanko, Jonathan E. Schoen, Elizabeth Lacy, Carl A. Flores, Randy D. Kearns, Herb A. Phelan Iii, Jeffrey E. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Comparison Of Prehospital Finger Thoracostomy And Needle Thoracostomy Performed By Ground Emergency Medical Services, Angelo Ciaraglia, Alison Smith, Benjamin Axtman, Brian Eastridge, Ronald Stewart, Susannah Nicholson, Donald Jenkins

School of Medicine Faculty Publications

Introduction: Tension pneumothorax related to chest trauma is a rapidly lethal condition that requires immediate treatment, often prior to arrival at definitive ca.re. Recent concerns regarding the safety and efficacy of needle thoracostomy (NT) have led to alternatives. Finger thoracostomy (FT) is a potential life-sav­ing treatment performed by prehospital providers as an alternative to NT. We hypothesize that FT has improved rates of prehospital thoracic decompression and is a safe alternative to NT. Materials and Methods: Retrospective cohort study of consecutive adult trauma patients presenting to a Level 1 trauma center who sustained chest trauma. A matched cohort of patients …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Anesthetic Management Of Unanticipated Subglottic Stenosis In A Patient Undergoing Coronary Artery Bypass Graft Surgery, Claudia Wei, Dominique Wreh, Jacy Gressen, Anvinh Nguyen

Faculty, Staff and Students Publications

A 62-year-old female presented for a scheduled coronary artery bypass graft (CABG) and was found to have an unexpected subglottic stenosis during routine intubation. The case was aborted and six days later, the patient underwent lasering of the stenotic subglottic region and airway balloon dilation. In this case report, causes of subglottic stenosis and surgical/anesthetic management of the condition are discussed. The management of subglottic stenosis in this patient was complicated by concurrent severe coronary artery disease (CAD) involving the left main coronary artery and timing of airway surgery relative to interventions for her CAD. In situations of undiagnosed subglottic …

Developing And Piloting An Online Course On Osteoporosis Using A Multidisciplinary Multi-Institute Approach- A Cross-Sectional Qualitative Study, Lena Jafri, Hafsa Majid, Arsala Jameel Farooqui, Sibtain Ahmed, Muhammad Umer Naeem Effendi, Maseeh Uz Zaman, Qamar` Riaz, Noreen Nasir, Syeda Sadia Fatima, Sarah Nadeem, Rizwan Haroon Rashid, Aysha Habib

Department of Pathology and Laboratory Medicine

Introduction: Postgraduate medical trainees (PGs) in developing nations face various educational hurdles due to limited access to quality resources and training facilities. This study aimed to assess the effectiveness of e-learning, particularly Massive Open Online Courses (MOOCs), within postgraduate medical education. It involved the development of a customized online course focused on osteoporosis for PGs and an examination of their perspectives and preferences concerning online learning methods like Virtual Learning Environment (VLE) platforms.
Methods: The study was conducted from January 2018 to December 2020. A multi-institutional, multidisciplinary team was assembled to design an osteoporosis course on the VLE platform. PGs …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Whole Blood In Trauma, Jason P. Prevelige

Pacific Journal of Health

Abstract: Hemorrhage is a leading cause of death in trauma patients. Whole blood administration in trauma has gained a renewed interest in recent years, however the concept is not new at all, with its origins spanning over 100 years. Field experience in United States’ military conflicts has provided important data on the efficacy of whole blood in reducing mortality and amount of blood product administration. Civilian trials however have not necessarily shown similar results. The safety of whole blood however does not seem to be in question given the available data, and is an acceptable option for blood replacement in …

Survival After Emergency Clamshell Thoracotomy With Bilateral Atrial Appendage Injuries, Jennifer Austin, Enrique Alvarez, Alicia Lay, Christian Minshall

North Texas GME Research Forum 2024

INTRODUCTION: The probability of survival is poor in patients who require a resuscitative thoracotomy, reported in the literature to be 9-20%. Outcomes are worse in patients who have suffered blunt trauma compared to penetrating trauma reported between 2-7%. Many studies have been done to evaluate clinical predictors of survival versus mortality. We present a case of high-mechanism blunt trauma with a high injury severity score of 34 who survived after an emergency clamshell thoracotomy with full neurological recovery.

CASE PRESENTATION: This case highlights a 28-year-old male who arrived as a transfer to a level 1 trauma center following high mechanism …

From Angiogram To Fasciotomy: Rare Occurrence Of Compartment Syndrome In An Elderly Patient With Dvt, Maya Itani, Bita Crystal Behaeddin, Alan Patrus, Rafael Bustamante

East Florida Division GME Research Day 2024

No abstract provided.

The Effects Of Social Support On Recovery Outcomes Of Hip Fracture Patients, Preshecca Ragavan

Williams Honors College, Honors Research Projects

This literature review, completed under the guidance of Ms. Anuja Sarode-Paciorek from Summa Health - Akron, will investigate the effects of social support on the recovery outcomes of hip fracture patients. As part of this literature review, I will collect and analyze several scientific journal articles previously published on this topic to gain an overview of what prior knowledge clinical researchers have already gathered about this topic. As part of the analyses, each article will be thoroughly read and briefly summarized. Then, these summaries will be used to compile a list of a few strengths and a list of a …

Association Between Emergency Medical Service Agency Volume And Mortality In Trauma Patients, David S Silver, Jason L Sperry, Jamison Beiriger, Liling Lu, Francis X Guyette, Stephen Wisniewski, Ernest E Moore, Martin Schreiber, Bellal Joseph, Chad T Wilson, Bryan Cotton, Daniel Ostermayer, Erin E Fox, Brian G Harbrecht, Mayur Patel, Joshua B Brown

Faculty, Staff and Student Publications

Objective: The aim of this study was to evaluate the association of annual trauma patient volume on outcomes for emergency medical services (EMS) agencies.

Background: Regionalization of trauma care saves lives. The underlying concept driving this is a volume-outcome relationship. EMS are the entry point to the trauma system, yet it is unknown if a volume-outcome relationship exists for EMS.

Methods: A retrospective analysis of prospective cohort including 8 trauma centers and 20 EMS air medical and metropolitan ground transport agencies. Patients 18 to 90 years old with injury severity scores ≥9 transported from the scene were included. Patient and …

The Role Of Diagnostic Laparoscopy In Management Of Non-Specific Abdominal Pain: A Prospective Observational Study, Suraj Pai, Ashfaque Mohammed

Manipal Journal of Medical Sciences

Non-specific abdominal pain (NSAP) presents a diagnostic challenge due to its varied etiologies and often inconclusive clinical and radiological findings. Diagnostic laparoscopy has emerged as a valuable minimally invasive tool that allows direct visualization of the abdominal cavity, facilitating early and accurate diagnosis. This study evaluates the role of diagnostic laparoscopy in patients presenting with NSAP, highlighting its diagnostic accuracy, safety profile, and impact on clinical management. Evidence suggests that laparoscopy not only aids in identifying underlying pathologies—ranging from appendicitis and gynecological disorders to early peritonitis—but also reduces unnecessary laparotomies and hospital stay duration. Additionally, therapeutic interventions can often be …

Accuracy Of Swept Source Biometry Device In Detecting Macular Diseases Compared With Swept Source Oct, Sidra Zafar, Taha Muneer Ahmed, Rashid Baig, Irfan Jeeva, Rehman Siddiqui

Department of Ophthalmology & Visual Sciences

Objective: To assess the diagnostic accuracy of the IOLMaster 700 foveal scans to detect foveal pathology compared with a standard swept-source optical coherence tomography (SS-OCT) device.
Results: One hundred seventy eye scans of 95 patients were included in the final analyses. Ninety-nine (58.2%) scans were classified as abnormal by SS-OCT. Mean sensitivity of the biometry device was 67.5% (range: 51-84%) and mean specificity was 69.5% (range: 44-95%). Intra-class correlation coefficients were 0.912 and 0.835, for reader 1 and 2, respectively. Area under the curve for receiver operating curve was 0.726. Foveal scans of the IOLMaster 700 can provide clinically useful …

Exploring The Uncommon: A Case Report On Localized Peritonitis Caused By Ingested Toothpick, Narmeen Asif, Salva Shariq, Abdul Rehman Alvi

Department of Surgery Docs

Introduction: Bowel perforation is a serious emergency. Occasionally, sharp objects like toothpicks can get stuck in narrow parts of the small intestine, potentially resulting in impaction, obstruction, or perforation.
Presentation of case: A 20-year-old male arrived at our hospital's emergency department with sudden, severe abdominal pain persisting for 24 h. On examination, his abdomen showed tenderness, and bowel sounds were reduced. Contrast-enhanced computed tomography (CECT) indicated possible small intestine inflammation due to a foreign object and a diagnostic laparoscopy revealed a hyperemic terminal ileum.
Discussion: This case involves ileal perforation from an unnoticed toothpick ingestion. Detecting foreign object perforations is …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

Recognizing Postural Orthostatic Tachycardia Syndrome In Primary Care, Brittney Hulsey

PA Faculty Publications

Postural orthostatic tachycardia syndrome (POTS) is a complex autonomic disorder characterized by abnormal tachycardia on standing. This disorder predominantly affects young women, with a peak incidence between ages 20 and 30 years. POTS often is associated with a variety of symptoms, including dizziness, palpitations, fatigue, generalized weakness, anxiety, and exercise intolerance, which can significantly impair patient quality of life. Primary care providers (PCPs) often are the first healthcare professionals to whom patients present. This article provides an overview of POTS, including diagnostic criteria and the importance of a thorough clinical evaluation to rule out other causes of symptoms. PCPs play …

Large Right Lower Quadrant Abdominal Mass, Isheeta Madeka, Cannon Greco-Hiranaka, Ozlem Kulak, Wilbur Bowne

Jefferson Hospital Staff Papers and Presentations

No abstract provided.

Best Therapeutic Practices In The Management Of Obstetric Sepsis, Gabriel Petre Gorecki, Oana Denisa Balalau, Diana Elena Comandasu, Anca Daniela Stanescu, Dana Rodica Tomescu

Journal of Mind and Medical Sciences

Background. Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods. To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 …

Diabetes Mellitus: Interdisciplinary Medical, Surgical And Psychological Therapeutic Approach, Bogdan Socea, Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Cristian Balalau, Tiberiu Ștefăniță Tenea-Cojan, Doina Andrada Mihai, Ioana Paunica

Journal of Mind and Medical Sciences

Diabetes mellitus is a complex and widespread metabolic disease, having extremely complex implications (biological, psychological, social) for patients. Understanding the pathophysiology of diabetes (majorly influenced by various factors such as genetic predisposition, age, lifestyle choices, etc.) is essential for the prevention of this condition and the establishment of effective treatment strategies. The latest and relevant literature data related to the epidemiology, pathophysiology, and treatment of diabetes are presented, after an exhaustive review of the articles published on this topic and indexed in the WOS, PubMed, Scopus and Google Scholar databases. Preventing or delaying the onset of diabetes can be achieved …

How Did That Get There? A Case Series Of Adolescent Foreign Bodies, Justin Ian Hanson, Paul Bomar, Sarah Kleist, Denver Rogalla, Lori Crihfield, Scott Gutovitz

HCA Healthcare Journal of Medicine

Introduction

Pediatric foreign bodies (FBs) come in many shapes and sizes, and the method by which they enter the body can greatly impact the level of acuity at presentation. Most FBs in children are found in those younger than 5 years old, but the following 3 cases were found in adolescent patients.

Case Presentation

We report on 3 adolescent patients who presented to a single community-based emergency department with the chief complaint of abdominal pain and were found to have complications of abdominal FBs. If undiagnosed, the initial indolent courses of FBs can lead to serious complications, as shown in …

Sindrom Respons Inflamasi Sistemik, Yefta Moenadjat

Department of Surgery Teaching Materials and Monographs

Materi perkuliahan memuat uraian respons inflamasi pascatrauma yang berkembang menjadi sindrom respons inflamasi sistemik, berakhir dengan kegagalan organ multipel ditinjau dari aspek biomolekuler.

Buku ini merupakan bagian pertama dari seri inflamasi yang disusun dalam bentuk digital dan dipublikasi menurut konsep lisensi Commons Attribution-NonCommercial 4.0 International License untuk tujuan diseminasi.

A Clinical Review Of Antibiotic Therapy Versus Appendectomy For Treatment Of Acute Uncomplicated Appendicitis, Taylor Mcclard

SIU Journal of Medical Science Scholarly Works

Purpose: The purpose of this manuscript is to review the efficacy of antibiotic therapy in the treatment of acute uncomplicated appendicitis versus standard appendectomy.

Method: A PubMed literature search was conducted with keywords of acute appendicitis, antibiotics, and appendectomy. The publication date was limited to the last five years. Sample size less than 100 people, patient population less than five years of age, and articles examining only acute complicated appendicitis were excluded. Pertinent articles reviewing the efficacy of antibiotics compared to appendectomy serve as the basis for this clinical review.

Results: Antibiotic therapy alone could be a …

Burn Injury Assessment Study (Bias): Is There Room To Improve?, Jeffrey Carter, Herbert Phelan, John Friedstat, William Hickerson, James Holmes, James Hwang, Steven Kahn, Alisa Savetamal, Jeffrey Shupp

School of Medicine Faculty Publications

55th Annual Meeting of the American Burn Association, ABA 2023, May 16 - 19, 2023, Dallas, TX

Common Misperceptions Of Child Abuse In Toddler Femur Fractures, Olivia Pruss, Jonathan Warren, Vincent Staggs, Grace Tideman, Collin Erickson, William L. Hennrikus, Richard M. Schwend

Research Days

Background: Current AAOS guidelines recommend that all children younger than thirty-six months with a femur fracture be evaluated for child abuse. However, the chance for abuse in walking-age children is highly unlikely at less than 20%.

Objectives/Goal: The purpose of this study is to identify how a patient’s age and femur fracture morphology impact the likelihood that providers assess a fracture as non-accidental and their decision to pursue further investigation of possible child abuse.

Methods/Design: This was a questionnaire study completed by clinicians from multiple specialties. There were 5 subgroup populations (6, 12, 18, 24, 35 months old) combined with …

Accidental Extravasation Of Mitomycin C Into The Subcutaneous Tissue, Johnathon Chung, Brooke Walterscheid, Jose Lopez-Vera, Hytham Rashid, Mike K. Liang

HCA Healthcare Journal of Medicine

Introduction

Mitomycin C (MMC) is a common chemotherapeutic agent used to treat a variety of solid tumors. Cutaneous adverse events are rare, but MMC is a known vesicant reported to cause tissue necrosis and sloughing, erythema, and ulceration if incorrectly infused into the subcutaneous tissue. Definitive treatment of extravasation injuries due to MMC depends on the severity of the cutaneous manifestation, which includes stopping the infusion, removing the catheter, or possible debridement.

Case Presentation

We present the case of a 70-year-old female with extensive soft-tissue injury secondary to extravasation of MMC that required hospital admission and surgical intervention to remove …

Diagnosis And Management Of Colon Cancer Patients Presenting In Advanced Stages Of Complications, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Anca Silvia Dumitriu, Stana Paunica, Daniela Gabriela Bălan, Bogdan Socea

Journal of Mind and Medical Sciences

Colorectal cancer is an important health problem with a significant impact on the individual and society. Malignancy (including colorectal cancer) is usually slightly symptomatic in its initial stages. This causes cancer to be discovered in some patients accidentally (either through screening tests in predisposed individuals or during routine investigations for other diseases), while in other patients the colorectal cancer is discovered in late stages, when the symptoms are much more intense due to complications. Unfortunately, such advanced cases of the disease have high rates of morbidity and mortality even with treatment. Current treatment methods are usually complex, interdisciplinary, causing significant …