Surgery Commons^™

Neonatal Intestinal Dysbiosis In Necrotizing Enterocolitis, N. Denning, J. M. Prince

Journal Articles

No abstract provided.

Age And Other Risk Factors Influencing Long-Term Mortality In Patients With Traumatic Cervical Spine Fracture., M. Bank, K. Gibbs, C. Sison, N. Kutub, A. Paptheodorou, S. Lee, A. Stein, O. Bloom

Journal Articles

To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age.Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population.We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the …

B-1a Cells Protect Mice From Sepsis-Induced Acute Lung Injury, M. Aziz, Y. Ode, M. Zhou, M. Ochani, N. E. Holodick, T. L. Rothstein, P. Wang

Journal Articles

No abstract provided.

The Protective Role Of Human Ghrelin In Sepsis: Restoration Of Cd4 T Cell Proliferation, M. Zhou, M. Aziz, M. Ochani, W. Yang, A. Sharma, P. Wang

Journal Articles

No abstract provided.

Assessment Of A Mouse Xenograft Model Of Primary Colorectal Cancer With Special Reference To Perfluorooctane Sulfonate, Jeffrey H. Wimsatt, Caitlin Montgomery, Laurel S. Thomas, Charity Savard, Rachel Tallman, Kim Innes, Nezar Jrebi

Faculty & Staff Scholarship

Colorectal cancer ranks third among the most commonly diagnosed cancers in the United States. Current therapies have a range of side effects, and the development of a reliable animal model to speed the discovery of safe effective preventative therapies would be of great value. A cross-sectional study in a large Appalachian population recently showed an association between low circulating levels of perfluorooctane sulfonate (PFOS) and a reduced prevalence of colorectal cancer. A study using APCmin(C57BL/6J-ApcMin/J) mice prone to familial adenomatous polyposis found PFOS was protective when exposure occurred during tumor development. To test the possible benefit of PFOS on spontaneous …

Robotic Tapp Ventral Hernia Repair: Early Lessons Learned At An Inner City Safety Net Hospital, M. Kennedy, K. Barrera, A. Akelik, Y. Constable, M. Smith, P. Chung, G. Sugiyama

Journal Articles

No abstract provided.

Gastric Banding Surgery Versus Continuous Positive Airway Pressure For Obstructive Sleep Apnea: A Randomized Controlled Trial, J. P. Bakker, A. Tavakkoli, M. Rueschman, W. Wang, R. Andrews, A. Malhotra, R. L. Owens, A. Anand, K. A. Dudley, S. R. Patel

Journal Articles

No abstract provided.

Current Options For The Emergency Management Of Diverticular Disease And Options To Reduce The Need For Colostomy, D. Theodoropoulos

Journal Articles

No abstract provided.

Lung Epithelial Cell-Derived Il-25 Negatively Regulates Lps-Induced Exosome Release From Macrophages, Z. G. Li, M. J. Scott, T. Brzóska, P. Sundd, Y. H. Li, T. R. Billiar, M. A. Wilson, P. Wang, J. Fan

Journal Articles

© 2018 The Author(s). Background: Acute lung injury (ALI) is a major component of multiple organ dysfunction syndrome (MODS) following pulmonary and systemic infection. Alveolar macrophages (AMΦ) are at the center of ALI pathogenesis. Emerging evidence has shown that cell-cell interactions in the lungs play an important regulatory role in the development of acute lung inflammation. However, the underneath mechanisms remain poorly addressed. In this study, we explore a novel function of lung epithelial cells (LEPCs) in regulating the release of exosomes from AMΦ following LPS stimulation. Methods: For the in vivo experiments, C57BL/6 wildtype (WT) mice were treated with …

How To Be A Leader: A Course For Residents., D. A. Hill, J. Jimenez, S. M. Cohn, M. R. Price

Journal Articles

BACKGROUND:Physicians are required to assume a leadership role as part of their career. For most, this is not an innate characteristic and must be developed throughout their medical training. There are few residency courses designed to assist in the enhancement of these leadership skills. We created and implemented a novel course on leadership, utilizing weekly presentations designed to stimulate discussions and improve the leadership qualities of trainees. METHODS:Senior residents provided leadership lectures stimulated by assigned readings from the book "The Founding Fathers on Leadership." The traits and characteristics demonstrated throughout course readings and discussions were subsequently incorporated into everyday resident …

Safety And Efficacy Of A 3-Dimensional Stent Retriever With Aspiration-Based Thrombectomy Vs Aspiration-Based Thrombectomy Alone In Acute Ischemic Stroke Intervention A Randomized Clinical Trial, R. G. Nogueira, D. Frei, J. F. Kirmani, O. Zaidat, D. Lopes, A. S. Turk, D. Heck, B. Mason, D. Langer, A. Siddiqui, +9 Additional Authors

Journal Articles

No abstract provided.

First Results On Survival From A Large Phase 3 Clinical Trial Of An Autologous Dendritic Cell Vaccine In Newly Diagnosed Glioblastoma, L. M. Liau, K. Ashkan, D. D. Tran, J. L. Campian, J. E. Trusheim, C. S. Cobbs, J. A. Heth, M. Salacz, M. Schulder, M. L. Bosch, +59 Additional Authors

Journal Articles

© 2018 The Author(s). Background: Standard therapy for glioblastoma includes surgery, radiotherapy, and temozolomide. This Phase 3 trial evaluates the addition of an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax®-L) to standard therapy for newly diagnosed glioblastoma. Methods: After surgery and chemoradiotherapy, patients were randomized (2:1) to receive temozolomide plus DCVax-L (n = 232) or temozolomide and placebo (n = 99). Following recurrence, all patients were allowed to receive DCVax-L, without unblinding. The primary endpoint was progression free survival (PFS); the secondary endpoint was overall survival (OS). Results: For the intent-to-treat (ITT) population (n = 331), median OS (mOS) was …

Aerobic Exercise Training And Inducible Inflammation: Results Of A Randomized Controlled Trial In Healthy, Young Adults., R. P. Sloan, P. A. Shapiro, P. S. Mckinley, M. Bartels, D. Shimbo, V. Lauriola, W. Karmally, M. Pavlicova, C. J. Choi, K. J. Tracey, +3 Additional Authors

Journal Articles

Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 …

A Cold-Inducible Rna-Binding Protein (Cirp)-Derived Peptide Attenuates Inflammation And Organ Injury In Septic Mice, F. Zhang, M. Brenner, W. Yang, P. Wang

Journal Articles

No abstract provided.

Spontaneous Dna Damage To The Nuclear Genome Promotes Senescence, T Redox Imbalance And Aging, Andria R. Robinson, Matthew J. Yousefzadeh, Tania A. Rozgaja, Jin Wang, Xuesen Li, Jeremy S. Tilstra, Chelsea H. Feldman, Siobhan Q. Gregg, Caroline H. Johnson, Erin M. Skoda, Marie-Celine Frantz, Harris Bell-Temin, Hannah Pope-Varsalona, Aditi U. Gurkar, Luigi A. Nasto, Rena A.S. Robinson, Heike Fuhrmann-Stroissnigg, Jolanta Czerwinska, Sara J. Mcgowan, Nadiezhda Cantu-Madellin, Jamie B. Harris, Salony Maniar, Mark A. Ross, Christy E. Trussoni, Nicholas F. Larusso, Eugenia Cifuentes-Pagano, Patrick J. Pagano, Barbara Tudek, Nam V. Vo, Lora H. Rigatti, Patricia L. Opresko, Donna B. Stolz, Simon C. Watkins, Christin E. Burd, Claudette M. St, Croix, Gary Siuzdak, Nathan A. Yates, Paul D. Robbins, Yinsheng Wang, Peter Wipf, Eric E. Kelley, Laura J. Neidernhofer

Faculty & Staff Scholarship

Accumulation of senescent cells over time contributes to aging and age-related diseases. However, what drives senescence in vivo is not clear. Here we used a genetic approach to determine if spontaneous nuclear DNA damage is sufficient to initiate senescence in mammals. Ercc1-/Δ mice with reduced expression of ERCC1-XPF endonuclease have impaired capacity to repair the nuclear genome. Ercc1-/Δ mice accumulated spontaneous, oxidative DNA damage more rapidly than wild-type (WT) mice. As a consequence, senescent cells accumulated more rapidly in Ercc1-/Δ mice compared to repair-competent animals. However, the levels of DNA damage and senescent cells in Ercc1-/Δ mice never exceeded that …

An Adult With A Remnant Urachus Anomaly Diagnosed In The Emergency Department., Alan Lucerna, James Lee, James Espinosa, Risha Hertz, Victor Scali

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The urachus is a midline tubular structure that stretches from the apex of the bladder and connects to the umbilicus. Urachal remnants result from incomplete regression of the fetal urachus in infancy. We report the case of a 21-year-old male who presented to the emergency department with purulent drainage from his umbilicus in association with a chronic intermittent "pulling sensation" in the umbilicus and suprapubic areas. An infected urachal remnant was diagnosed and was treated with an oral antibiotic and ultimately with outpatient excision of the remnant. Such cases are rare but have the potential to progress to sepsis. In …

Circulation First – The Time Has Come To Question The Sequencing Of Care In The Abcs Of Trauma; An American Association For The Surgery Of Trauma Multicenter Trial, Paula Ferrada, Rachael A. Callcut, David J. Skarupa, Therese M. Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M. Nygaard, Martin A. Schreiber, Toby Enniss, Michelle Mcnutt, Herb Phelan, Kira Smith, Forrest O. Moore, Irene Tabas, Joseph Dubose, Aast Multi-Institutional Trials Committee

Surgery Publications

Background

The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence.

Methods

This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee. We performed a retrospective analysis of all patients that presented to trauma centers with presumptive hypovolemic shock indicated by pre-hospital or emergency department …

Transaortic Gunshot Wound Through Perivisceral Segment Successfully Managed By Placement Of Thoracic Stent Graft, Jared T. Feyko, Peter Zmijewski, Cara Lyle, Allison Wilson, Luke Marone

Faculty & Staff Scholarship

We describe a 36-year-old woman who presented to our facility after sustaining a gunshot wound to the epigastric region. The gunshot resulted in injury to the left lobe of the liver and the twelfth thoracic vertebral body as well as in a through- and-through injury to the abdominal aorta at the level of the celiac axis. The vascular injury was managed successfully by placement of a thoracic stent graft with coverage of the celiac axis. This case demonstrates the feasibility of managing this uncommon injury with endovascular techniques. (J Vasc Surg Cases and Innovative Techniques 2018;4:24-6.)

Review Of Risk Assessment Tools To Predict Morbidity And Mortality In Elderly Surgical Patients Brief Title: Review Of Surgical Risk Assessment Tools, Gilgamesh Eamer, Mohamed Al-Amoodi, Jayna Holroyd-Leduc, Darryl Rolfson, Lindsey Warkentin, Rachel Khadaroo

School of Medicine and Health Sciences Student Works

Background

Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions.

Data sources

We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients. We then sought the original articles describing each assessment tool and subsequent validation studies.

Conclusions

We identified risk …

Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch

Theses and Graduate Projects

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature …