Surgery Commons^™

Five Year Evaluation Of The Complications Observed In Porcelain Fused To Metal (Pfm) Crowns Placed At A University Hospital, Shizrah Jamal, Rabia Ghafoor, Farhan Raza Khan, Kamil Zafar

Section of Dental-Oral Maxillofacial Surgery

Objective: To determine the frequency of complications in crowns cemented over a 5-year period in a tertiary care hospital and also to report the survival of these crowns.
Methods: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from March 2017 to March 2018 and comprised porcelain fused-to-metal crowns placed on the anterior or posterior teeth that were fabricated at the institutional laboratory and were placed in institutional dental clinics in the preceding 5 years. Porcelain-fused to-metal The crowns were clinically and radio-graphically evaluated in a duration of two months for presence/absence of complications. Factors associated …

Prospective Study Of Military Special Operations Medical Personnel And Lower Extremity Fracture Immobilization In An Austere Environment, Kevin Martin, Trevor Mcbride, Alicia Unangst, Jaime Chisholm

Department of Orthopaedic Surgery Faculty Papers

Background: Austere fracture immobilization equipment and techniques are often overlooked, with few studies critically evaluating the process. The purpose of this study was to evaluate current austere splinting techniques and equipment used for lower extremity fractures while field testing a new 1-step spray-on foam splint.

Methods: This is a prospective analysis of austere splinting techniques. A cadaveric model with a distal third tibia-fibula fracture was used for testing. The specimens were placed in an austere environment and participants immobilized the injury with standard equipment (structural aluminum malleable [SAM] splint, 6-in. ACE wrap) while being critically evaluated. The specimens were also …

Are "Replicants" The Spine Surgeons Of The Future?, Jens R Chapman, Jeffrey C Wang, Karsten Wiechert

Articles, Abstracts, and Reports

No abstract provided.

Surgical And Oncological Implications Of Aberrant Arterial Anatomy In Patients Undergoing Pancreatoduodenectomy, Muhammad Rizwan Khan, Saleema Begum, Dawar Burhan Khan, K. M. Inam Pal

Section of General Surgery

Whipple's pancreatoduodenectomy is a complex surgical procedure and any aberrant arterial anatomy may have serious surgical implications. The objective of our study was to analyse the frequency of aberrant hepatic artery and compare the outcomes in patients with normal anatomy. Clinical data and computed tomography scans of 45 consecutive patients who underwent Whipple's procedure from 2007 to 2016 were reviewed. Group 'A' included patients with aberrant hepatic artery while group 'B' with normal anatomy. Aberrant hepatic artery was present in 11 (24%) patients and type V was the most common variant (n=5, 45%). Morbidity rate in group A was 82% …

Elective Abdominal Aortic Aneurysm Repair Complicated With Chylous Ascites, Zia Ur Rehman

Department of Surgery Docs

No abstract provided.

Reflections On Texas Back Institute Internship, Shelby Jones

The Eleanor Mann School of Nursing Undergraduate Honors Theses

For my honors project, I chose to do the experimental option to gain more knowledge on topics that we do not spend much time covering in nursing school. I had the privilege to complete an internship with the Texas Back Institute, their main office is located in Plano, Texas. I worked closely the Scoliosis and Spine Tumor Center that is a branch of their team, and completed my internship from May to the first week of August 2019. I worked 20 hours a week during my internship between the clinic and the hospital. I was able to observe physicians in …

Trends, Survival Outcomes, And Predictors Of Non-Adherence To Mastectomy Guidelines For Non-Metastatic Inflammatory Breast Cancer: Stage-Stratified Propensity Scoring Analysis Of Ncdb, Mohamad Sebai, Patrick Karabon, David Lee, Sayee Kiran, Nayana Dekhne

Articles

Background/Objective: Current National Comprehensive Cancer Network (NCCN) guidelines recommend modified radical mastectomy (MRM) as the surgical treatment of choice for nonmetastatic inflammatory breast cancer (IBC). Using data from the National Cancer Database (NCDB), our study compared the national trends and outcomes of breast-conserving surgery (BCS) vs. MRM for the treatment of IBC. Methods: NCDB data from 2004 to 2014 were retrospectively analyzed. Patients’ demographics, tumor characteristics, and overall mortality (OM) trends were compared between BCS and MRM cases of IBC. Univariate, multivariate, and propensity score weighted analyses were done to compare study groups and build a predictive model for undergoing …

The National Burden Of Orthopedic Injury: Cross-Sectional Estimates For Trauma System Planning And Optimization, Molly P. Jarman, Michael J. Weaver, Adil H. Haider, Ali Saleem, Mitchel B. Harris

Department of Surgery Docs

Background: Management of orthopedic injuries is a critical component of comprehensive trauma care. As patterns of injury incidence and recovery change in the face of emerging injury prevention efforts and technologies and an aging US population, assessment of the burden of orthopedic injury is essential to optimize trauma system planning. We sought to estimate the incidence of orthopedic injury requiring emergency orthopedic surgery in the United States.
Methods: Using nationally representative samples from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we estimated the incidence of orthopedic injury, polytrauma with orthopedic injury, and emergency operative orthopedic …

Mycobacterium Abscessus: A Rare Cause Of Peri-Ductal Mastitis In Endemic Regions, Aisha Shaikh, Lubna Mushtaque Vohra

Department of Surgery Docs

Mycobacterium abscessus is a rapidly growing non-tuberculous, multi-drug resistant mycobacterium (NTM). Its common clinical presentation includes pulmonary infection followed by wide spectrum of skin and soft tissue infections. Chronic breast conditions, such as peri-ductal mastitis are rarely caused by NTM. Due to an intrinsic and acquired drug resistance to conventional antibiotics and anti-tuberculous therapy, it is often managed with a combination of antibiotics with or without surgical adjuncts. It is important to consider NTM in patients with chronic mastitis who show suboptimal response to initial broad-spectrum antibiotics, and especially when symptoms recur after complete resolution. This case report describes peri-ductal …

Demographic Predictors Of Adult Behaviors In The Pediatric Postoperative Environment, Natasha H. Hikita, Amber Osorno, Carlie Taurosa, Michelle A. Fortier, Zeev N. Kain, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience postoperative pain. If poorly treated, pediatric postoperative pain may lead to various negative health outcomes. Adult behaviors may be associated with child experiences in the postoperative environment. For example, adult behaviors such as distraction, humor, and coping advice divert a child’s attention away from their pain and thus, may significantly reduce child postoperative distress. In contrast, adult behaviors such as empathy, reassurance, and apology direct a child’s attention towards their pain which may increase a child’s overall postoperative distress. Moreover, patient demographic factors, like child ethnicity, may significantly alter the frequency of use of these …

Complete Response To Stage Iv Colorectal Adenocarcinoma With Disease-Free Survival At 24 Months: Case Report And Overview Of The Literature, Madison N. Crank 6746693, Arslan Iqbal, Michael Abdelmasseh, Mohamed Alsharedi, Doreen Griswold, Alysia Browne, Juan R. Sanabria

Marshall Journal of Medicine

Over 150,000 new cases of colon cancer were diagnosed in the US in 2019. Stage and age at diagnosis are important prognostic factors for overall survival (OS). For the age group 70-79, the OS for females with poorly differentiated stage IV colon cancer at 1, 2 and 5 years after surgery is 39%, 15%, and 2%, respectively. We present a case of a 77-year-old female with significant cardiac history. She was diagnosed with stage IV colorectal cancer complicated with enteric fistula. Due to her initial performance status and comorbidities, she was not a candidate for surgery or systemic chemotherapy. Nonetheless, …

The Spectrum Of Large Adrenal Masses: A Case Series, Jo Cooke-Barber, Sarah E. Hatef, Analise Mcgreal, Andrew Schwemmer, Christopher Senkowski

HCA Healthcare Journal of Medicine

Background: Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center.

Methods: A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the …

Brain Injury And Dementia In Pakistan: Current Perspectives, Maheen M. Adamson, Sadia Shakil, Tajwar Sultana, Muhammad Abul Hasan, Fatima Mubarak, Ather Enam, Muhammad A. Parvaz, Adeel Razi

Department of Radiology

Alzheimer's disease (AD) is the most common form of dementia, accounting for 50-75% of all cases, with a greater proportion of individuals affected at older age range. A single moderate or severe traumatic brain injury (TBI) is associated with accelerated aging and increased risk for dementia. The fastest growth in the elderly population is taking place in China, Pakistan, and their south Asian neighbors. Current clinical assessments are based on data collected from Caucasian populations from wealthy backgrounds giving rise to a "diversity" crisis in brain research. Pakistan is a lower-middle income country (LMIC) with an estimated one million people …

What Outcomes Matter To Patients After Joint Or Spine Surgery?, Robin R. Whitebird, Leif I. Solberg, Christine K. Norton, Jeanette Y. Ziegenfuss, Stephen E. Asche, Elizabeth S. Grossman

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcome measures (PROMs) are increasingly used in clinical care, but there have been few studies of what patients identify as the most important outcomes.

Methods: Semi-structured interviews were conducted with 65 patients undergoing hip or knee replacement, spinal discectomy/laminotomy, or a spinal fusion. Interviews focused on outcomes patients identified as important, perceived usefulness of standardized PROMs measures, and contextual situations important to their care. Data were analyzed using a directed content analysis approach.

Results: Patients identified desired outcomes that were unique and important to them. Their preferred outcomes focused in the areas of freedom from pain, getting back …

What Did We Learn About Vads In 2019?, Maya Guglin

The VAD Journal

This is our 6th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports for 2014, 2015, 2016, 2017, 2018 were published as open access articles and were well received by the readers. In this paper, we summarize the most interesting and important, from our standpoint, publications from 2019. As we have done for the past two years, a section on extracorporeal membrane oxygenation (ECMO) is included and primarily addresses new developments in veno-arterial ECMO use.

Organ Preservation For Advanced Laryngeal Cancer: Experience With Concurrent Chemoradiation Therapy, Asif Ali Arain, Muhammad Shaheryar Ahmed Rajput, Shabbir Akhtar, Arsalan A. Rajput, Mohammad Adeel, Ahmad Hatem, Ahmed Nadeem Abbasi

Section of Otolaryngology, Head & Neck Surgery

Introduction: The larynx is a part of the upper respiratory tract that performs many essential functions including breathing, speaking, and swallowing. For this reason, the quality of life is significantly affected by laryngeal cancer and its treatment. Therefore, the focus of management for the last few decades has been on preserving the function of a larynx without compromising survival. This study was done with the purpose of reviewing our experience of organ preservation approach with concurrent chemoradiation therapy (CCRT) for locally advanced cancers of larynx.
Methods: A retrospective chart review was carried out for the data of pathology reports and …

Diabetes Mellitus And Necrotizing Fasciitis – A Deadly Combination; Case Report, Alexandra Toma, Laura Mazilu, Andra Iulia Suceveanu, Florentina Gherghiceanu, Camelia Sandu, Cristina Bica, Liliana Florina Andronache, Ioana Paunica, Lavinia Alexandra Moroianu

Journal of Mind and Medical Sciences

Necrotizing fasciitis is a rapidly destructive affliction of soft tissues, with a mortality rate that may reach 73% of the cases. It is characterized by a progressive inflammation and extended necrosis of the subcutaneous tissue and the fascia. Necrotizing fasciitis was first described in 1848, and later in 1920 Meleney identified 20 patients in China in which the infection was presumably triggered by hemolytic streptococcus, linking pathological bacteria to the condition. In 1952, Wilson coined the term necrotizing fasciitis although without successfully identifying the specific pathological bacteria involved. In most cases, both risk and aggravating factors are present, the main …

Duodenal Carcinoid Tumour – A Case Report, Vasile Negrean, Cristina Buchman, Mirela Georgiana Perne, Mircea Milaciu, Iacob Domsa, Teodora Gabriela Alexescu, Ioana Para, Olga Hilda Orasan

Journal of Mind and Medical Sciences

Duodenal carcinoids are rare tumours of the small intestine with heterogenous clinical and pathological characteristics. The long-term prognosis is very good if discovered in the early stages. We present the case of a patient with a non-functional duodenal carcinoid tumour discovered incidentally during an upper gastrointestinal endoscopy. The diagnosis was confirmed through immunohistochemistry. Treatment consisted of the endoscopic resection of the tumour and the surveillance of the patient for the following 2 years, with no signs of recurrence. We have conducted a literature review regarding the clinical manifestations, diagnosis, treatment, and follow-up of patients with this type of tumours.

Therapeutic Approach For Amyand’S Hernia; A Case Report, Sorin Berbece, Valeriu Ardeleanu, Vlad Denis Constantin, Ioana Paunica, Alexandra Toma

Journal of Mind and Medical Sciences

In very few cases stated in the literature, the vermiform appendix might be contained in a hernial sac. This distinctive pathology is described as Amyand's hernia and has the very small occurrence of about 1%. We report the case of a 62-year-old man that presented for a reducible tumoral mass located in the right inguinal region. Amyand’s hernia was the intraoperative diagnostic. We performed hernioplasty (using the Lichtenstein tension-free mesh repair with a composite polypropylene mesh) without appendectomy. This case matches the type 1 Lossanoff and Basson’s classification and has no facile management. Due to the clinical specificities of each …

Warty Carcinoma Of Uterine Cervix - Review Of The Literature And Case Report, Octavian Gabriel Olaru, Catalina Monica Pena, Oana Denisa Balalau, Anca Daniela Stanescu

Journal of Mind and Medical Sciences

Introduction. The Histological Classification of Epithelial Tumors of the Uterine Cervix of the World Health Organization includes inter alia warty carcinoma as a variant of squamous cell carcinoma. Until now several case reports and studies have shown that this particular cancer is associated with human papillomavirus/ HPV infection.

Case presentation. A 58-year-old woman presented with a vegetant cervical tumour. Biopsy samples were collected from the tumour, and the histological exam successively confirmed the warty cell carcinoma. Additional tests revealed the presence of single human papillomavirus/ type-45. An immunohistochemistry exam was performed in order to confirm the diagnosis, and …