Revascularization Impact: Quality Of Life Enhancement In Chronic Limb-Threatening Ischemia, Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus, Grigore Tinica

Journal of Mind and Medical Sciences

Introduction. Globally, over 230 million people have peripheral artery disease, often undiagnosed, leading to chronic limb-threatening ischemia. Revascularization is vital for preventing amputation and improving quality of life. While specific questionnaires for severe ischemia are lacking, the SF-36 questionnaire is widely used to assess quality of life, with variations like SF-12 and SF-8 for larger cohorts. Objectives. Our aim was to assess how different lower limb revascularization methods affect the postoperative quality of life in patients with chronic limb-threatening ischemia. Methods. This study was conducted at the St. Pantelimon Emergency Hospital of Bucharest, Romania. It included 166 adult patients with …

Follow-Up Care After Metabolic Surgery – A Prospective Study In The North-Eastern Region Of Romania, Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei

Journal of Mind and Medical Sciences

Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. …

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 …

Endoscopic Approach To Recurrent Inguinal Hernia After Previous Open Surgery, Doru Moga, Dragos Serban, Bogdan Geavlete, Crenguta Serboiu, Bogdan Serban, Ana Maria Dascalu, Valentin Oprea

Journal of Mind and Medical Sciences

Background. The management of a recurrent inguinal hernia varies depending on multiple factors. In the case of recurrent inguinal hernias after open anterior repair, the laparoscopic approach is recommended. TEP and TAPP procedures are considered to have similar results. The purpose of the study is to evaluate on our sample if there are differences between primary inguinal hernia cases and recurrent hernia after laparoscopic TAPP and TEP procedures. Materials and Methods. We retrospectively reviewed the medical records of 300 patients who underwent laparoscopic inguinal hernia repairs at our hospital from March 2013 to March 2023. Results. Of the 300 patients, …

Sentinel Node Biopsy For Personalized Breast Cancer Management; Advances And Controversies, Rahim Al Moushaly, Daniel Ion, Octavian Andronic, Bogdan Socea, Alexandru Cosmin Palcau, Dan Nicolae Paduraru

Journal of Mind and Medical Sciences

Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary lymph node staging, providing valuable prognostic information while minimizing complications compared to axillary lymph node dissection. However, there are ongoing debates and controversies surrounding SLNB in specific cases. Studies have explored the use of SLNB in neoadjuvant chemotherapy, emphasizing the need for customized therapy decisions. Factors such as age, tumor characteristics, and treatment response influence the selection of SLNB or axillary lymph node dissection. Additionally, the presence of extranodal extension, micrometastases, and isolated tumor cells has been evaluated to determine the need for lymphadenectomy. The importance of accurate …

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 …

Gastric Cancer; Actualities And Perspectives Of Early Diagnosis And Targeted Therapy, Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Anca Dumitriu, Stana Paunica, Cristian Balalau, Stefăniță Tenea Cojan, Dragos Epistatu, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Gastric cancer is an extremely aggressive form of malignancy that, if left untreated, is life-threatening. Improved survival rates depend on early detection of the disease, as well as on the combination of different forms of treatment (surgery, chemotherapy, radiotherapy, immunotherapy, etc.). Screening methods have brought real benefit in early detection of malignancies, but many cases are still diagnosed at advanced stages. The current study is a review related to actualities and perspectives of early diagnosis and targeted therapy of gastric cancer. After an extensive review of the literature, epidemiological, diagnostic and treatment data are presented. The open surgical approach is …

Barrett's Esophagus As A Premalignant Condition; Medical And Surgical Therapeutic Management, Vlad Denis Constantin, Adrian Silaghi, Laura Florentina Rebegea, Stana Paunica, Anca Silvia Dumitriu, Doina Andrada Mihai, Ioana Paunica, Dragos Epistatu

Journal of Mind and Medical Sciences

Barrett's esophagus (BE) represents a special clinical entity, which may have reduced symptoms, but an increased potential for malignant degeneration. The factors that lead to the appearance of Barrett's esophagus are multiple, the most important being gastro-esophageal reflux, as well as smoking and obesity. BE occurs as a result of damage of the esophageal mucosa, caused by acid/basic gastroesophageal reflux and resulting in the transformation of the epithelium from squamous to intestinal type. The diagnosis of BE is primarily based on endoscopic examination. This method has not only a diagnostic role, but also a therapeutic one through the minimally invasive …

Implications Of Covid-19 On A Rapidly Growing Thymoma Case, Neeraja Narayanan, Shoaleh Motamedi, Christian Lalonde, Mikko Tauriainen

HCA Healthcare Journal of Medicine

Introduction

Thymomas are a rare form of slow-growing malignancy that originate from thymic epithelial cells presenting as an anterior mediastinal mass. Although most are asymptomatic, they can have a variety of presentations, such as local thoracic symptoms, superior vena cava syndrome, or paraneoplastic syndromes. Local compressive thoracic symptoms include shortness of breath, chest pain, and cough. Superior vena cava syndrome presents with respiratory, vascular, or neurologic symptoms. Paraneoplastic syndromes, such as myasthenia gravis, are due to abnormal T-cell maturation leading to an increased risk of autoimmune conditions.

Case Presentation

We report a case of a 71-year-old White male with multiple …

Surgical Resection Of An Isolated Superficial Temporal Artery Aneurysm, Jake L. Rosen, Archana Babu, Mohammed Irfan Ali, Michael A. Nooromid

Department of Surgery Faculty Papers

In the present report, we describes a case of surgical resection of an isolated superficial temporal artery aneurysm without underlying systemic pathology. Although aneurysms of this sort most commonly occur in the setting of recent trauma, this case demonstrates an uncommon presentation. We hope to further contribute to the literature regarding this condition.

Nitrous Oxide Administration In General Anesthesia Patients, Kaley Smith, Karen Colorafi, Kenn Daratha, Braden Hemingway

Central Division Nurse Clinical Inquiry Conference

Abstract:

Background:

Nitrous oxide is an inexpensive and fast-acting gas used in a variety of inpatient and outpatient perioperative settings to hasten the onset of and emergence from general anesthesia. Problematically, nitrous oxide has been identified as a risk factor for postoperative nausea and vomiting (PONV), one of the most common adverse events after anesthesia. Unresolved PONV is linked to increased pain, wound dehiscence, aspiration, and longer stays in the recovery area and/or hospital. An Apfel Simplified Risk Score can be calculated to predict PONV based on four patient characteristics: female sex, non-smoker, history of PONV or motion sickness, and …

Rates Of Postoperative Pneumonia In Healthy Adults Receiving Neostigmine Versus Sugammadex: A Multi-Center Evidence-Based Practice Project, Kirstie Gorthy, Braden Hemingway, Karen Colorafi, Kenn Daratha

Central Division Nurse Clinical Inquiry Conference

Abstract:

Background

Residual neuromuscular blockade increases morbidity and mortality following surgery with general anesthesia and paralysis. Optimal antagonism of pharmacologic muscle relaxation is critical to avoiding residual weakness and subsequent pneumonia. The clinical question that guided the investigation of the evidence was, ‘Among healthy adults requiring neuromuscular blockade during general anesthesia for elective, noncardiac surgery, does the use of sugammadex compared to neostigmine for reversal of neuromuscular blockade influence the rate of postoperative pneumonia within seven days?’

Purpose

The primary purpose of this evidence-based practice project was to describe the rates of pneumonia among healthy adults antagonized with neostigmine or …

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …

Robotic First Rib Resection In Thoracic Outlet Syndrome: A Systematic Review Of Current Literature, Maikerly Reyes, Sneha Alaparthi, Johannes B. Roedl, Marisa Moreta, Nathaniel R. Evans, Tyler Grenda, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

Thoracic outlet syndrome (TOS) involves the compression of neurovascular structures in the thoracic outlet. TOS subtypes, including neurogenic (nTOS), venous (vTOS), and arterial (aTOS) are characterized by distinct clinical presentations and diagnostic considerations. This review explores the incidence, diagnostic challenges, and management of TOS with a focus on the innovative approach of Robotic First Rib Resection (R-FRR). Traditional management of TOS includes conservative measures and surgical interventions, with various open surgical approaches carrying risks of complications. R-FRR, a minimally invasive technique, offers advantages such as improved exposure, reduced injury risk to neurovascular structures, and shorter hospital stays. A comprehensive literature …

Penyembuhan Luka: Aspek Seluler Dan Biomolekuler, Yefta Moenadjat

Department of Surgery Teaching Materials and Monographs

Mengulas aspek seluler dan molekuler penyembuhan luka di setiap fase, dimulai dari hemostasis, inflamasi dan resolusi inflamasi, proliferasi, dan maturasi. Pada bagian terakhir dulas pula gangguan proses penyembuhan luka (luka kronik, non–healing wound) yang kerap dijumpai di klinik.

Re-Stratification Of Patients With Copy-Number Low Endometrial Cancer By Clinicopathological Characteristics, Li Liwei, Li He, Dai Yibo, Zhao Luyang, Shen Zhihui, Kang Nan, Shen Danhua, Wang Junzhu, Wang Zhiqi, Wang Jianliu

Faculty, Staff and Student Publications

Objective: To stratify patients with copy-number low (CNL) endometrial cancer (EC) by clinicopathological characteristics.

Methods: EC patients who underwent surgery between June 2018 and June 2022 at Peking University People's Hospital were included and further classified according to TCGA molecular subtyping: POLE ultramutated, microsatellite instability high (MSI-H), CNL, and copy-number high (CNH). Clinicopathological characteristics and prognosis of CNL patients were retrospectively reviewed. The Cox proportional hazards regression model was applied to perform univariate and multivariate analysis, and independent risk factors were identified. Differentially expressed genes (DEGs) according to overall survival (OS) were screened based on the transcriptome of CNL cases …

The Effect Of Heat-Moisture Treatment Changed The Binding Of Starch, Protein And Lipid In Rice Flour To Affect Its Hierarchical Structure And Physicochemical Properties, Seung Hee Yoo, Mi Jin Jue, Yu-Hee Kim, Sooyoung Cho, Won-Joong Kim, Kye-Min Kim, Jong In Han, Heeseung Lee

Faculty, Staff and Student Publications

Dexmedetomidine prevents postoperative cognitive dysfunction by inhibiting high-mobility group box 1 (HMGB1), which acts as an inflammatory marker. This study investigated the HMGB1 levels and the cognitive function using a Mini-Cog© score in elderly patients undergoing orthopedic surgery with dexmedetomidine infusion. In total, 128 patients aged ≥ 65 years were analyzed. The patients received saline in the control group and dexmedetomidine in the dexmedetomidine group until the end of surgery. Blood sampling and the Mini-Cog© test were performed before the surgery and on postoperative days 1 and 3. The primary outcomes were the effect of dexmedetomidine on the HMGB1 levels …

Repurposing The Fda-Approved Anthelmintic Pyrvinium Pamoate For Pancreatic Cancer Treatment: Study Protocol For A Phase I Clinical Trial In Early-Stage Pancreatic Ductal Adenocarcinoma, Francesca M. Ponzini, Christopher W. Schultz, Benjamin E. Leiby, Shawnna Cannaday, T. Yeo, James Posey, Wilbur B. Bowne, Charles Yeo, Jonathan R. Brody, Harish Lavu, Avinoam Nevler

Department of Surgery Faculty Papers

BACKGROUND: Recent reports of the utilisation of pyrvinium pamoate (PP), an FDA-approved anti-helminth, have shown that it inhibits pancreatic ductal adenocarcinoma (PDAC) cell growth and proliferation in-vitro and in-vivo in preclinical models. Here, we report about an ongoing phase I open-label, single-arm, dose escalation clinical trial to determine the safety and tolerability of PP in PDAC surgical candidates.

METHODS AND ANALYSIS: In a 3+3 dose design, PP is initiated 3 days prior to surgery. The first three patients will be treated with the initial dose of PP at 5 mg/kg orally for 3 days prior to surgery. Dose doubling will …

Assessing Kidney Transplantation Using Ecmo-Supported Donors Within A Kdpi-Based Allocation System, Peter J. Altshuler, Devon J. Pace, William A. Preston, Sage Vincent, Ashesh P. Shah, Jaime M. Glorioso, Warren R. Maley, Adam M. Frank, Carlo B. Ramirez, Sharon West, Richard Hasz Jr., Adam S. Bodzin

Department of Surgery Faculty Papers

Background.

Organ donors supported by extracorporeal membrane oxygenation (ECMO) have historically been considered high-risk and are judiciously utilized. This study examines transplant outcomes using renal allografts from donors supported on ECMO for nondonation purposes.

Methods.

Retrospective review of the Gift of Life (Pennsylvania, New Jersey, Delaware) organ procurement organization database, cross-referenced to the Organ Procurement and Transplantation Network database, assessed kidney transplants using donors supported on venoarterial (VA) and venovenous (VV) ECMO for nondonation purposes. Transplants using VA- and VV-ECMO donors were compared with Kidney Donor Profile Index (KDPI)-stratified non-ECMO donors. Regression modeling of the entire ECMO and non-ECMO populations …

Use Of Point Of Care Ultrasound In The Pre-Op Evaluation Of Dialysis Patients Needing Creation Of Permanent Arteriovenous Access – Preliminary Study, Urvashi Mathur, Sotero Peralta

Research Colloquium

Background: Non-invasive ultrasound evaluation is part of the preoperative evaluation of patients needing creation of arteriovenous access. This study requires patients to return for an additional visit for imaging or visit an outpatient imaging facility. These visits produce delays in surgery and increase costs in healthcare. Point of care ultrasound examination at the same time of initial physician visit, allows to decrease cost, improvement of anatomical planning, and decrease timing of surgery.

Methods: We reviewed the UTRGV Vascular Surgery Database from January to December 2020, for patients who has elective outpatient arteriovenous access creation, in which has pre-operative evaluation with …