Surgery Commons^™

Perinatal Obsessive-Compulsive Symptoms And Maternal-Infant Bonding: A Longitudinal Examination Of Depression And Relationship Quality, Journa Njoh, Jonathan S Abramowitz, Rashelle Musci, Mary C Kimmel, Lauren M Osborne, Jack Samuels, Paul Nestadt, Gerald Nestadt, Eric A Storch

Faculty, Staff and Students Publications

Background

Perinatal obsessive–compulsive (OC) symptoms are common and distressing, yet their impact on early parenting outcomes such as maternal-infant bonding remains poorly understood. Although prior research links maternal depression and anxiety to bonding difficulties, less is known about how perinatal OC symptoms relate to maternal-infant bonding over time, or the extent to which maternal-partner relationship quality is associated with these outcomes, and whether depressive symptoms explain observed associations.

Methods

Data were drawn from a longitudinal study of 256 pregnant women recruited from two U.S. sites between 2020 and 2023. Participants completed self-report and clinician-administered assessments at 20 weeks (PGWK20), 34 …

Influenza Infection Has Higher Risk Of Postoperative Complications Than Covid-19 In Shoulder Arthroplasty Patients, Jad J Lawand, Umar Ghilzai, Caleb Witsken, Dion Birhiray, Abdullah Ghali, Youssef M Khalafallah, Rohan G Reddy, Sameer R Khawaja, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic has captured the attention of healthcare systems worldwide, and testing remains a mainstay of preoperative testing before all surgical procedures, including shoulder arthroplasty. Other viral illnesses, specifically influenza, while still having severe complications, are either overshadowed by testing for COVID-19 or not tested at all.

METHODS: A multi-institutional cohort study using the TriNetX network examined patients undergoing total or hemi shoulder arthroplasty from January 2020 to March 2024. Matched cohorts were created: one with influenza and one with COVID-19 infection, 14 days before surgery.

RESULTS: A total of 3233 and 18,209 patients were included in the …

Increasing Utilization Trends Of Robotic Assistance In Orthopaedic Surgery, Anish K. Ponna, Alec Giakas, Anthony A. Khoudary, Spencer N. Uggla, Sina Ramtin, Yousef A. Soliman, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.

METHODS: A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were …

Predicting Trauma Admission In Anticoagulated Geriatric Patients Presenting With A Ground Level Fall, Y-Nhi H. Bui Ms, Trevor Glad Bmus, Dylan Jack Bs, Michael Martyak

Knowledge and Creativity Expo

Our study undertook a rigorous investigation into an expanding trauma patient population, tackling some of the significant challenges with this patient population in trauma triage. Our research has not only addressed key questions, but has also paved the way for future inquiries by offering innovative perspectives. This presentation is particularly important given the current advancements and interests in geriatric trauma. We hope that our findings will influence ongoing projects and spark collaborations among diverse research communities.

Practice Patterns And Inpatient Outcomes In Lung Abscess: A Cross Sectional Study, Saikou Saidy, Ali Iqbal, Saqib H. Baig

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background: Lung abscess is typically managed with antibiotics, but drainage procedures are sometimes performed when there is inadequate clinical response or when source control is needed. Real-world inpatient practice patterns remain incompletely described in contemporary U.S. data. Our aim was to evaluate national inpatient practice patterns, predictors of procedural intervention, and associated in-hospital outcomes and resource utilization among patients hospitalized with lung abscess managed conservatively, with bronchoscopic drainage, or with percutaneous drainage.

Methods: Using the National Inpatient Sample (NIS) (2016–2018), we identified adult (18 years and older) hospitalizations with a principal diagnosis of lung abscess [International Classification of Diseases, 10th …

Concomitant Subacromial Decompression Remains Commonly Performed During Rotator Cuff Repair: A Trinetx Study, Madison Baldauf, Zachary Krumm, Savannah Ward, Katherine Worcester, Kevin Bonner Md

Knowledge and Creativity Expo

Introduction:

Arthroscopic rotator cuff repair (RCR) is among the most frequently performed shoulder procedures in the US and is often accompanied by concomitant subacromial decompression (SAD). In recent years some studies have called into question the benefit of SAD in this setting. The topic is controversial as many surgeons still feel SAD is indicated. This study aims to characterize the changes in proportion of SAD performed concomitantly with RCR over recent years using TriNetX.

Methods:

The TriNetX database was queried for all patients undergoing arthroscopic rotator cuff repair from 2013 to 2025. Cohorts were established using the Current Procedural Terminology …

Extracorporeal Membrane Oxygenation In Trauma Before And After Covid-19: Associations Of Utilization, Timing, And Outcomes, Ryan Mancoll, William Rice, Theodore Chin, Grayson Mast M.D, Samantha Olafson M.D.

Knowledge and Creativity Expo

Objectives:

The COVID-19 pandemic expanded and altered general ECMO utilization and provider experience; however, any impact on trauma-specific ECMO practice following this shift remains unclear. We hypothesize that trauma ECMO utilization patterns, timing of initiation, and outcomes have differed following COVID-19.

Methods:

We conducted a retrospective cohort study of trauma patients receiving ECMO (2017-2024) using the American College of Surgeons Trauma Quality Improvement Program (TQIP) Participant Use Files. The primary exposure was the COVID era (2017-2019 vs. 2021-2024). Primary outcomes included ECMO utilization, time to initiation, and in-hospital mortality; secondary outcomes included discharge disposition, major complications, and length of stay …

Modulation Of Biomolecular Aggregate Morphology And Condensate Infectivity., Josephine C Ferreon, Kyoung-Jae Choi, My Diem Quan, Phoebe S Tsoi, Cristopher C Ferreon, Ulas Coskun, Shih-Chu Jeff Liao, Allan Chris M Ferreon

Faculty, Staff and Students Publications

Neurodegenerative diseases feature diverse pathological protein aggregates, including Lewy bodies in Alzheimer's disease (AD) and skein-like filaments in amyotrophic lateral sclerosis (ALS). The physical mechanisms underlying this morphological diversity remain unclear. Here, we demonstrate that aggregation of the prion-like domain of hnRNPA1 (A1PrD), implicated in AD and ALS, is driven by solution composition and phase transition dynamics. Utilizing 3D timelapse and fluorescence lifetime imaging microscopy, we show that solution conditions modulate phase separation, gelation, and fibrillation, resulting in distinct structures such as fibril, gel, and starburst morphologies. Homotypic and heterotypic interactions between A1PrD and RNA were observed to shift the …

External Fixation Assisted Intramedullary Total Femur Arthroplasty: A Case Report, Matthew Hnatow, Blake Martin, Emma Herrera

School of Medicine Publications

Introduction:Total femur replacement (TFR) is a salvage procedure for patients with multiple failed hip and knee arthroplasties and is associated with high complication rates. Intramedullary TFR has emerged as a technique to preserve critical soft tissue attachments; however, maintaining limb length, alignment, and rotation remains challenging.

Case Presentation: We describe a novel case of intramedullary TFR utilizing external fixation to address these technical challenges. A 64-year-old male with subsidence of a hinged knee tumor prosthesis to the level of the greater trochanter underwent intramedullary TFR. External fixation was applied to the residual femoral and tibial bones to maintain …

Immunotherapy Of Tsa-1.C4 Or In Combination With Bnz Confers Protection Against Trypanosoma Cruzi Infection With A Distinct Cytokine Response, Landy Magaly Pech-Pisté, Victor Dzul-Huchim, Christian Florian Teh-Poot, Fabian Gusovsky, Kathryn Jones, Peter Hotez, Liliana Estefanía Villanueva-Lizama, Maria Elena Bottazzi, Jaime Ortega-Lopez, Julio Vladimir Cruz-Chan

Faculty, Staff and Students Publications

Chagas disease is a poverty-related neglected tropical disease caused by the protozoan Trypanosoma cruzi affecting approximately 6.3 million people, predominantly in the Americas. Approximately 30% of T. cruzi infections progress to chronic cardiomyopathy and 10% of these cases end in death from cardiac failure. The first-line drug Benznidazole (BNZ) require a prolonged treatment regimen and can be highly toxic. Here, we evaluate a therapeutic vaccine in T. cruzi-infected mice, based on the recombinant Trypomastigote Surface Antigen 1 (TSA-1.C4) protein and the emulsified adjuvant E6020, and in combination with a suboptimal dose of BNZ. We observed a reduced burden parasite in …

Impact Of Depression And Anxiety On Outcomes Following Muscle-Preserving Transforaminal Lumbar Interbody And Fusion., Sahil Garg, Sean M Muir, Kyle Jamar, Alexa Dietrich, Patrick Young, Sonny Gill

Surgery Articles

Background: The impact of concurrent diagnoses of anxiety and depression has not been extensively studied in spine surgery. We hypothesize that a muscle-sparing technique may be associated with decreased postoperative pain and improved strength postoperatively compared to open techniques, decreasing the stress of the postoperative recovery process. Therefore, this study aims to assess the benefits that a modified muscle-preserving lumbar fusion technique (Wiltse transforaminal lumbar interbody and fusion (W-TLIF)) would have on this subset of patients.

Methods: One hundred twenty subjects who underwent a single-level W-TLIF were identified with a recorded diagnosis status associated with mental health. The subjects underwent …

The Prospects Of Car T-Cell Therapies In Changing The Therapeutic Algorithm Of Neurologic Autoimmunities, Marinos C. Dalakas

Department of Neurosurgery Faculty Papers

T cells, genetically modified to express chimeric antigen receptors (CAR T), successfully used in hemato-oncologic malignancies, are showing promising and sustained benefits in refractory autoimmune neurological diseases, including Myasthenia Gravis, stiff-person syndrome, neuromyelitis optica, myositis, autoimmune neuropathies, and multiple sclerosis. Several reported patients with a steadily progressive disease and evolving disability unresponsive to available therapies, including rituximab and new biologics, after 2-3 months of treatment with CARs targeting CD19-positive, antibody-secreting, long-lived plasma cells, and plasmablasts exhibit impressive, long-lasting, and drug-free clinical improvements with the potential for immune reset shifting immunity to a healthy state without the need for continuing more …

Label-Free Microfluidic Modulation Spectroscopy Monitors Rna Origami Structure And Stability, Phoebe S Tsoi, Lathan Lucas, Allan Chris M Ferreon, Ewan K S Mcrae, Josephine C Ferreon

Faculty, Staff and Students Publications

RNA origami enables genetically encoded, single-stranded RNA nanostructures that can self-assemble through co-transcriptional folding and are increasingly deployed as scaffolds for biosensing, synthetic biology, and nanomedicine. A recurring practical bottleneck is scalable, solution-phase readout of whether a designed scaffold has reached its intended base-paired architecture, whether it undergoes slow maturation or kinetic trapping, and how its stability is distributed across motifs. Here, we adapt microfluidic modulation spectroscopy (MMS) as a label-free structural biosensor for RNA folding by exploiting the rich 1760–1600 cm−1 vibrational fingerprints of RNA bases and base pairs. MMS alternates between sample and composition-matched buffer measurements in a …

Incidence Of Venous Thromboembolism In Women Receiving Transdermal Oestradiol/Testosterone With Micronised Progesterone In Accordance With Nice Guidelines, Amy Neville, Dan Reisel, John Benton, Mohit Khera, Louise Newson

Faculty, Staff and Students Publications

Background: Despite growing evidence supporting the long-term safety of hormone replacement therapy (HRT), concerns persist about certain adverse health outcomes, including venous thromboembolism (VTE). The aim of the study is to evaluate the risk of VTE in peri- and postmenopausal women treated with transdermal 17β-oestradiol with micronised progesterone or intrauterine progesterone (levonorgestrel) via the Mirena coil, in a real-world clinical setting.

Methods: The study included peri- and postmenopausal women attending a private menopause clinic between January 1, 2023, and December 31, 2023. Patients were actively undergoing treatment with transdermal oestradiol and progesterone in the form of micronised oral progesterone or …

2. Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery, Jacinta Smith

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Reducing Surgical Site Infections Post Cesarean Section Through Multi-Modal Standardized Education, Ari Meyers, Fereshteh Pirayesh, Tracie Tolme

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before Or After Surgery? Results From A Social Media Cohort, John M. Gaddis, Amanda J. Wheeler, Erika Shults, Charles South, Stephen T. Duncan, Joel Wells

School of Medicine Publications

This study aimed to analyse the symptomatic differences of hip dysplasia before or after separate surgical interventions, including pain location and characteristics, severity, patient-reported outcomes, and a body pain diagram. A REDCap-based survey was distributed through social media from October 2023 to May 2024 and targeted individuals with current or past hip pain. The survey gathered data on demographics, comprehensive hip-specific history, and various patient-reported outcome measures. Of 509 completed surveys, 287 respondents reported a diagnosis of hip dysplasia and were divided into cohorts based on treatment history: no surgery (n = 65), post-periacetabular osteotomy (PAO) (n = 162), post-THA …

Quality Of Robotic Segmentectomy Vs. Video-Assisted Thoracoscopic Segmentectomy In Non-Small Cell Lung Cancer: A Retrospective Cohort Study, Sneha S. Alaparthi, Anurag Ishwar, Isheeta Madeka, Annie Ho, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

Background & Methods

• Lung cancer remains a leading cause of cancer death worldwide. Sub lobar resection (segmentectomy) has proved to be a safe and effective alternative to lobectomy in recent literature.
• Our objective is to compare quality of resection between robotic assisted (RVATS) and video assisted (VATS) thoracoscopic segmentectomy. Our hypothesis is that robotic segmentectomy will allow for an improved oncologic resection.
• Retrospective cohort study of National Cancer Database (NCDB). Patients >18 undergoing RVATS or VATS segmentectomy for clinical N0M0, ≤ 2 cm between 2010-2020.
• Quality of oncologic resection assessed with presence and number of nodes examined, margin positivity, upstaging, …

Good Judgment In Action: Enhancing Surgeon Feedback Through Simulation, Spencer Wilhelm, Jacob Applegarth, Nathan Novotny, Ngan Nguyen

Conference Presentation Abstracts

Introduction: Effective intraoperative feedback is a cornerstone of surgical training, but remains inconsistently delivered. Surgeons who never received structured feedback during their own training lack the tools to deliver it effectively. At our institution, low faculty engagement scores on an Accreditation Council for Graduate Medical Education (ACGME) survey prompted a residency-wide needs assessment, which revealed that most attendings provide feedback perceived by residents as ineffective. To address this, we developed a simulation-based faculty development program grounded in the “Debriefing with Good Judgment” model. Our study aims to evaluate whether this structured intervention can improve the quality and consistency of feedback …

Quality Of Life In Patients With P16+ Oropharyngeal Cancer Receiving Accelerated Radiation Therapy With Either Cisplatin Or Cetuximab In The Nrg/Rtog 1016 Randomized Controlled Trial, Jolie Ringash, Pedro A Torres-Saavedra, Maura L Gillison, Jimmy J Caudell, David J Adelstein, Paul M Harari, Erich M Sturgis, Ethan Basch, Shlomo A Koyfman, Greg A Krempl, Dukagjin M Blakaj, James Edward Bates, Thomas J Galloway, Christopher U Jones, Beth M Beadle, Jonathan Harris, Quynh-Thu Le, Sue S Yom, Benjamin Movsas

Faculty, Staff and Students Publications

Purpose: NRG/RTOG 1016 was a phase III randomized noninferiority de-escalation trial comparing cetuximab versus cisplatin, concurrent with accelerated radiation 70 Gy/6 weeks, in p16+ oropharyngeal cancer. Quality of life (QOL) was a secondary endpoint.

Methods and materials: Eligible/consenting patients among the first 400 entered completed the EORTC QLQ-C30/H&N35 at baseline, end of treatment, 3, 6, and 12 months posttreatment, to provide 90% power to detect an effect size of 0.5 in the between-arm change in QOL scores from baseline to 6 months. We report completion, responsiveness, and patterns over time across domains between arms, considering a difference of >10 points …