Surgery Commons^™

Cyanosis-Associated Coagulopathy In Neonates Undergoing Cardiopulmonary Bypass: A Scoping Review, Lily Crickmar

Student Works

2. Structured summary:

A. Background: Patients with cyanotic congenital heart disease exhibit coagulation abnormalities related to chronic hypoxemia, which may increase the risk of bleeding and thrombosis, particularly during cardiopulmonary bypass.

B. Objective: This scoping review mapped the existing literature on coagulation disturbances and perioperative hemostatic outcomes in pediatric patients with cyanotic congenital heart disease.

C. Methods: 14 studies meeting the inclusion criteria were identified through structured database searching. The data were collected and synthesized descriptively due to heterogeneity in study design, patient populations, and coagulation assessment methods.

D. Results: Across studies, cyanotic patient physiology was associated with platelet dysfunction, …

Indicators Of Fontan Circulatory Failure In Pediatric Patients: A Scoping Review Of Early Clinical And Hemodynamic Factors, Marina Mcmahon

Student Works

Structured Summary

a. Background/Introduction:

For patients with single ventricle congenital heart disease, the Fontan procedure is the definitive palliative procedure. Although advancements have been made in the surgical technique and management, the Fontan circulation is inefficient and prone to progressive dysfunction. Elevated central venous pressure, non-pulsatile pulmonary blood flow, and reduced cardiac output can lead to many complications, and eventual failure. These conditions can lead to protein losing enteropathy, plastic bronchitis, and hepatic fibrosis which often indicate advanced decline. Though a known problem, there is a lack of standardized criteria to guide optimal intervention timing of Fontan revision prior to …

All-Inside Endoscopic Zone 1 Flexor Hallucis Longus Transfer: A Cadaveric Feasibility Study., Kevin D Martin, Yi Wei, Adam G F Smith, Franco Piscitani, Luke M Martin, Brian Steginsky, Brian Tscholl, Nathaniel A Bates

Surgery Articles

BACKGROUND: Endoscopic flexor hallucis longus (FHL) tendon transfer addresses chronic Achilles tendon ruptures. Traditional percutaneous plantar incisions gain FHL length but risk neurovascular injury. This study evaluated the feasibility of an all-inside endoscopic FHL zone 1 tenotomy and transfer technique, which avoids plantar incisions by using zone 1 of the FHL tendon. We hypothesized that this technique would (1) provide sufficient tendon length, (2) avoid neurovascular damage, and (3) securely anchor the FHL tendon without tunnel blowout.

METHODS: Ten cadaveric all-inside endoscopic zone 1 FHL tendon transfers were performed without fluoroscopic guidance. Specimens were independently assessed post hoc by 2 …

Pharmacologic Interventions To Reduce Cardiopulmonary Bypass Induced Inflammation In Cardiac Surgery: A Scoping Review, Wyatt Anderson

Student Works

ABSTRACT

1. Structured summary

Background

Cardiopulmonary bypass (CPB) is essential in cardiac surgery but can trigger a systemic inflammatory response that contributes to postoperative complications. The scoping review conducted has a purpose to map the existing literature on pharmacologic interventions to mitigate CPB related inflammation. While several interventions demonstrated potential anti-inflammatory effects, findings were inconsistent, and no standardized pharmacologic approach is currently agreed upon.

Methods

This scoping review followed PRISMA-ScR guidelines.Both PubMed, and CINAHL were screened for studies published between 2000 and 2024 that evaluated pharmacologic interventions aimed at reducing CPB related inflammation. After screening and duplicate removal, 10 studies met …

Addition Of Prg4 To Optimize The Anti‑Adhesive Properties Of Tissue Barrier Sepraflm®, Ava J. Marks, Khaled A. Elsaid, Ling X. Zhang, Timmy Lin, Janette Baird, Tannin A. Schmidt, Gregory D. Jay

Pharmacy Faculty Articles and Research

Purpose

Postsurgical adhesion remains a significant clinical challenge. Seprafilm^® is widely used as a barrier to reduce adhesion formation, however its efficacy may be inconsistent. Recombinant human proteoglycan-4 (rhPRG4), a surface-active, anti-inflammatory glycoprotein found in synovial fluid inhibits cell and protein adhesion. This study investigated whether coating Seprafilm with rhPRG4 could enhance its anti-adhesive potential.

Methods

Macrophages (J774), human fibroblast-like synoviocytes (HFLS), and melanoma (A375) cells were cultured on tissue culture wells treated with rhPRG4 or bovine submaxillary mucin (BSM) to determine optimal seeding density. Seprafilm sheets were coated with rhPRG4 or BSM (0.78–200 µg/mL). Cell adhesion was quantified …

Hydatid Cyst In The Right Ventricle Leading To Tricuspid Stenosis And Heart Failure: A Case Report, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Shafaq Saleem, Muhammad Ahsan, Sarah Rahman, Azeen Razzaq, Ali Iqbal, Muhammad Sohaib Alvi, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Cystic hydatid infection is a parasitic disease caused by the larval stages of Echinococcus granulosus, most commonly involving the liver and lungs. Cardiac involvement is rare, accounting for less than 2% of cases, with the left ventricle being the most commonly affected site. Involvement of the right ventricle is extremely uncommon and may lead to life-threatening complications such as tricuspid valve obstruction and hemodynamic compromise.

CASE PRESENTATION: We report a rare case of a 42-year-old patient who presented to the emergency department with exertional dyspnea, hemoptysis, chest pain, syncope, peripheral edema, and signs of right-sided heart failure. The patient …

A Rare Presentation Of Extra-Appendiceal Mucinous Neoplasm Of The Anus, Pincus Joshua, Marianne Estrada, Lance Horner University Of Nevada, Las Vegas

School of Medicine Research Poster Showcase

Introduction: Mucinous neoplasm of the anus is an uncommon malignancy, representing less than 3% of all anal cancers. Even more rare is extra-appendiceal mucinous neoplasm. As a result, limited literature exists to define diagnostic strategies and optimal management. Our case report details the presentation and management of a patient with recurrent mucinous neoplasm of the anus. Methods: A retrospective chart review was performed which includes clinic documentation., operative notes, pathology reports. Results: The patient is a 76-year-old male with a history of T3N0M0 anal mucinous carcinoma diagnosed in 2015 and treated with neoadjuvant chemoradiation with complete pathological response. In 2024, …

Horseshoe Kidneys In Transplantation: Underutilization Despite Comparable Quality And Favorable Outcomes: Unos Registry Analysis (2007-2023), Abigail W. Cheng, Samrawi Misiker, Roberto Sagaribay, Kavita Batra

School of Medicine Research Poster Showcase

Introduction: Horseshoe kidneys (HSKs) are the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals and often discovered incidentally. Historically excluded from transplantation due to complex anatomy, advances in surgical techniques have made HSK transplantation increasingly feasible. Although successful procurement and transplantation have been described in case reports, national-level data comparing donor characteristics and organ utilization between HSK and non-HSK donors remain limited. This study characterizes donor demographics, clinical profiles, and organ utilization of HSK donors using the United Network for Organ Sharing (UNOS) database.

Methods: A retrospective analysis of the UNOS kidney transplant registry was performed, …

A “Found-Down” Non-Traumatic Compartment Syndrome Of Upper Extremity Requiring Amputation, Nicholas Ray, Aileen Ebadat

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Selfwrap-Assisted Arteriovenous (Save) Fistulas Study: Updates And Preliminary Safety Data, Sydney Parker, Ahmad Lambert, Shir Yelovitch, Mike Barakat, Tim Boire, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Dual Antiplatelet Therapy And Bleeding Risk In Carotid Endarterectomy, Sara Khan, Sydney Parker, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Gastric Outlet Obstruction And Bowel Perforation Secondary To Ingestion Of Multiple Foreign Bodies: A Case Review, Kassidy Fix, Mark Jay Cheek

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Case Report Of Carcinosarcoma Of The Ampulla Of Vater With A Monoclonal Histologic Variant, Peter D. Park, Christopher Oxner

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Obesity As A Barrier To Living Kidney Donation: A Decade Of Donor Pre-Screening From A High-Volume Center, Courtney Evans, Nassir Thalji, Tamer Shaker, Ranjeeta Chand, Matthias Kapturczak

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Reducing Surgical Site Infection After Colorectal Surgery: A Multidisciplinary Review Of Process Improvement, Robin Daemmrich, Quentin Dipasquale, Deborah Klepac, Nick Mathers, Travis Holloway

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Mycobacterial Soft Tissue Infection Following Gluteal Fat Grafting: A Case Report And Review Of Surgical Asepsis Implications, Sophia Ahmed, Chandra Ellis

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Clinical Applications Of Topical Platelet-Rich Plasma In Cardiac Surgery: A Scoping Review, Jaron M. Davis

Student Works

Background: Postoperative wound complications persist as a significant challenge within adult cardiac surgery. Deep and superficial sternal wound infections, along with complications at saphenous vein harvest sites, are linked to increased morbidity, extended hospital stays, and substantial healthcare expenses. Topical platelet-rich plasma (PRP), commonly known as platelet gel, has been suggested as a biologically active adjunct that may facilitate tissue repair and mitigate postoperative complications. While PRP has garnered attention in surgical practice, the overall scope and consistency of the supporting evidence in cardiac surgery remain ambiguous.

Objective: The purpose of this scoping review is to map and describe the …

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …

Dasatinib And Quercetin Senolytic Treatment Delays Early Onset Intervertebral Disc Degeneration In Sm/J Mice, Emanuel J. Novais, Olivia K. Ottone, Sanjana Jagannath, Esther Jesutofunmi Akande, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Genetic background is a major determinant of disc degeneration, a leading cause of chronic back pain and disability. Herein, we demonstrate that premature disc cell senescence contributes to early-onset degeneration in SM/J mice and test two systemic senotherapeutic strategies to mitigate it: Navitoclax (Nav.) and a cocktail of Dasatinib and Quercetin (DQ). While Nav. treatment did not improve severe degeneration in SM/J mice or senescence status, DQ-treated mice showed lower grades of degeneration and a decreased abundance of senescence markers, including p19ARF, p21, and the senescence-associated secretory phenotype (SASP). DQ improved disc cell viability and phenotype retention and retarded fibrosis …

Acute Traumatic Aortic Injury: What The Radiologist Needs To Know, Kristina Ramirez-Garcia, Catalina Jaramillo, Emma Ferguson, Jason Au, Erika Odisio, Gustavo S Oderich, Daniel Ocazionez, Cihan Duran, Thanila Macedo

Faculty, Staff and Students Publications

Acute traumatic aortic injury (ATAI) is a rare but life-threatening consequence of blunt trauma that requires prompt diagnosis and accurate imaging assessment. This review presents an imaging-based approach to ATAI, with emphasis on computed tomography angiography (CTA) as the first-line modality for diagnosis, grading, treatment planning, and follow-up. CTA enables the detection of both direct and indirect signs while also allowing for the assessment of lesion severity, extent, and associated findings that may influence management. Familiarity with common mimics and anatomic variants improves diagnostic confidence and helps avoid false positive interpretations. Careful protocol optimization, including multiphasic acquisition, bolus timing, and …

The Use Of Radiofrequency In The Treatment Of Erectile Dysfunction, Sarah Ponce, Nikola Rakic, Beatriz Hernandez, Mohit Khera

Faculty, Staff and Students Publications

No abstract provided.

Structure-Preserving Multivariate Hypothesis Testing For Mass Spectrometry Imaging And Single-Cell Data, Keziah E Liebenberg, Erin Craig, Robert Tibshirani, Livia S Eberlin

Faculty, Staff and Students Publications

Motivation: Mass spectrometry imaging (MSI) and single-cell RNA sequencing (scRNA-seq) offer high-resolution views into tissue and cellular heterogeneity. However, conventional statistical analyses often treat sub-measurements (pixels or cells) as independent, ignoring their nested origin from individual samples. This assumption inflates the effective sample size, increases false discoveries, and undermines biological interpretation. Pixel- or cell-level averaging avoids this but sacrifices spatial or cellular resolution.

Results: We evaluated block-SAM on both simulated and real-world datasets. In DESI-MSI data from kidney, lung, and ovarian tumors, block-SAM consistently identified fewer-but more reliable-differential features compared to traditional-SAM. For example, in the kidney dataset, traditional-SAM identified …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

The Use Of Large Language Models In Enhancing Patient Education Materials For Pancreatic Neuroendocrine Tumors, Brendan Dolan, Aniela Crayton, Emerson Woodbury, Miguel Tzita, Eliza Beal Md, Gregory Dyson Phd

Medical Student Research Symposium

Background:

Incidence and prevalence of Pancreatic Neuroendocrine Tumors (PNETs) has increased in recent years. More than half of American adults endorse utilizing the internet within the past year to search for medical information. This study aims to investigate the use of Large Language Models (LLMs), a popular type of artificial intelligence, to improve the efficacy of online patient education materials (oPEMs) in providing accurate and digestible information to patients with a PNET diagnosis.

Methods: Content from 36 web pages related to PNET was transferred to two popular LLMs, Chat GPT and Google Gemini, with the prompt “rewrite the following text …

Organ Procurement Organization Utilization Of Portable Hypothermic Oxygenated Machine Perfusion In Liver Transplantation: The First Us Experience, Christine E. Haugen, Muhammad Bilal Moeen-Ud-Din, Abdalla M. Hadhoud, Achintya Kaw, James R. Butler, James V. Guarrera, Sherry Quire, Ralph C. Quillin

Department of Surgery Faculty Papers

BACKGROUND: Advanced machine perfusion techniques have increased the use of hard-to-place organs, effectively changing the liver transplantation landscape. Liver transplantation machine perfusion has been driven largely by industry or individual transplant centers. We describe the implementation of a portable, organ procurement organization-initiated hypothermic oxygenated machine perfusion strategy for liver transplantation as a proof of concept.

METHODS: Surgeons and staff at a regional organ procurement organization (Indiana Donor Network) were trained to use and cannulate liver allografts using a portable hypothermic oxygenated machine perfusion platform. We evaluated all liver transplantations recovered and placed on hypothermic oxygenated machine perfusion (N = 18) …

What Is New In Temporary Mechanical Circulatory Support In 2024-2025?, Maya Guglin

The VAD Journal

This review covers the most interesting publications on temporary mechanical circulatory support in 2024-2025. We include the latest research on intra-aortic balloon pumps, Impella devices, and veno-arterial extracorporeal membrane oxygenation.

The 2025 Accra Declaration On Upskilling And Cost- Effective Cardiac Surgery In Africa, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres

General Surgery, East Africa

The Pan-African Society for Cardiothoracic Surgery (PASCaTS) organized the 1st Pan-African Cardiothoracic Surgery Summit on 21 to 24 February 2025 in Accra, Ghana. The summit brought together leading specialists from across Africa, China, Europe, South America and the USA to address the growing burden of cardiovascular disease, to share their vision for the fight against cardiovascular disease, to raise standards in the diagnosis, treatment and recovery of patients thereby improving procedural safety and clinical outcomes in Africa. The experts agreed on the need for cost effectiveness in cardiac surgery, simulation skills training, an African regional cardiothoracic surgery database, African heart …

Association Of Higher Body Mass Index With Imaging Escalation And Operative Complexity In Pediatric Appendicitis, Ryan T. Davis, Sahithi Pemmasani, Margaret Menoch

Conference Presentation Abstracts

Background: Obesity may complicate clinical assessment and ultrasound (US) evaluation in children with appendicitis, potentially increasing reliance on computed tomography (CT). At the same time, national pediatric quality-improvement initiatives and ALARA-driven imaging pathways emphasize reducing CT use and promoting US-first approaches. Data examining how body mass index (BMI) influences diagnostic pathways within these modern low-radiation protocols are limited.

Objective: To determine whether higher BMI is associated with greater CT utilization, escalation from US to CT, nondiagnostic US examinations, emergency department (ED) length of stay (ED-LOS), and operative duration in children with appendicitis.

Design/Methods: This retrospective cohort study included patients < 18 years with surgically confirmed appendicitis presenting to a tertiary pediatric ED from January 1, 2010, to December 31, 2023. Consistent with prior dataset methodology, encounters were identified through structured EHR query using ICD-10 and CPT codes and restricted to unique first visits. A total of 2,275 children were included; BMI was available for 2,012 (88%). BMI was analyzed in quartiles. Imaging modality (US-only, CT-only, or CT after US) and operative duration (proxy for case complexity) were evaluated. χ² and Wilcoxon tests and odds ratios (OR) with 95% CI were used. IRB approval was obtained (Corewell Health IRB No. 2024-128).

Results: …

Predictors Of Total Hip Arthroplasty Among Patients With Chronic Comorbidities: A Multivariate Analysis Of A Medically Underserved Region, Blake C. Martin, Manoj Peiris

School of Medicine Publications

Background

THA is a common orthopedic procedure that is expected to increase in the coming years. Obesity and osteoarthritis are major factors that increase the risk of individuals requiring THA. The Rio Grande Valley (RGV) is a distinctive health professional shortage area with high rates of obesity, arthritis, and diabetes. This study aims to examine the relationship between chronic medical conditions and the need for THA in this at-risk, medically underserved population.

Methods

This investigation employed a retrospective chart review encompassing patient records from January 1, 2018, through January 1, 2025, using the University of Texas Rio Grande Valley electronic …

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …