Effect of physician specialty training on pediatric appendectomy outcomes: an NSQIP-P analysis.

Purpose: Appendectomies are the most common abdominal emergency surgery in pediatric patients. Both pediatric and general surgeons are credentialed to perform this procedure, however pediatric surgeons are specialized in pediatrics. This study seeks to determine differences in pediatric appendectomy outcomes between general and pediatric surgeons.

Hybrid Reconstruction Approach for Polychromatic Computed Tomography in Highly Limited-Data Scenarios.

Conventional strategies aimed at mitigating beam-hardening artifacts in computed tomography (CT) can be categorized into two main approaches: (1) postprocessing following conventional reconstruction and (2) iterative reconstruction incorporating a beam-hardening model. While the former fails in low-dose and/or limited-data cases, the latter substantially increases computational cost. Although deep learning-based methods have been proposed for several cases of limited-data CT, few works in the literature have dealt with beam-hardening artifacts, and none have addressed the problems caused by randomly selected projections and a highly limited span.

Deep Learning-Based Estimation of Radiographic Position to Automatically Set Up the X-Ray Prime Factors.

Radiation dose and image quality in radiology are influenced by the X-ray prime factors: KVp, mAs, and source-detector distance. These parameters are set by the X-ray technician prior to the acquisition considering the radiographic position. A wrong setting of these parameters may result in exposure errors, forcing the test to be repeated with the increase of the radiation dose delivered to the patient.

Statistical image reconstruction with beam-hardening compensation for X-ray CT by a calibration step (2DIterBH).

Background: The beam-hardening effect due to the polychromatic nature of the X-ray spectra results in two main artifacts in CT images: cupping in homogeneous areas and dark bands between dense parts in heterogeneous samples. Post-processing methods have been proposed in the literature to compensate for these artifacts, but these methods may introduce additional noise in low-dose acquisitions. Iterative methods are an alternative to compensate noise and beam-hardening artifacts simultaneously.

Time from surgery end to discharge following total knee arthroplasty: implications for same day discharge.

Background: Understanding the average time from surgery to discharge is important to successfully and strategically schedule cases planned for same day discharge (SDD) for total knee arthroplasty (TKA). The purpose of this study was to (1) evaluate the average time to discharge following unilateral TKA performed in a community hospital and (2) describe patient characteristics and peri-operative factors that may impact SDD.

Methods: This retrospective review included 75 patients having achieved SDD following unilateral TKA between March 2017 and September 2021 at a high-volume multi-specialty community hospital.

Enriched mesoporous bioactive glass scaffolds as bone substitutes in critical diaphyseal bone defects in rabbits.

In the field of orthopedic surgery, there is an increasing need for the development of bone replacement materials for the treatment of bone defects. One of the main focuses of biomaterials engineering are advanced bioceramics like mesoporous bioactive glasses (MBG´s). The present study compared the new bone formation after 12 weeks of implantation of MBG scaffolds with composition 82,5SiO-10CaO-5PO-x 2.

Osteogenic Potential of a Biomaterial Enriched with Osteostatin and Mesenchymal Stem Cells in Osteoporotic Rabbits.

Mesoporous bioactive glasses (MBGs) of the SiO-CaO-PO system are biocompatible materials with a quick and effective in vitro and in vivo bioactive response. MBGs can be enhanced by including therapeutically active ions in their composition, by hosting osteogenic molecules within their mesopores, or by decorating their surfaces with mesenchymal stem cells (MSCs). In previous studies, our group showed that MBGs, ZnO-enriched and loaded with the osteogenic peptide osteostatin (OST), and MSCs exhibited osteogenic features under in vitro conditions.

In vivo behavior in rabbit radius bone defect of scaffolds based on nanocarbonate hydroxyapatite.

Bone defects treatment may require the use of biomaterials that behave as a support and promote bone regeneration. Limitations associated with the use of autografts and allografts make it necessary to design new synthetic bone substitutes. Some of the most promising biomaterials currently under investigation are based on nanocarbonate hydroxyapatite (nCHA).

An Inclusive Analysis of Racial and Ethnic Disparities in Orthopedic Surgery Outcomes.

Background: Despite increasing attention, disparities in outcomes for Black and Hispanic patients undergoing orthopedic surgery are widening. In other racial-ethnic minority groups, outcomes often go unreported. We sought to quantify disparities in surgical outcomes among Asian, American Indian or Alaskan Native, and Native Hawaiian or Pacific Islander patients across multiple orthopedic subspecialties.

Sexually Transmitted Infection Diagnoses at Children's Hospitals During COVID-19.

Objectives: COVID-19 mitigation strategies resulted in changes in health care access and utilization, which could negatively impact adolescents at risk for sexually transmitted infections (STIs). We evaluated changes in STI diagnoses during adolescent visits at children's hospitals during COVID-19.

Methods: We conducted a retrospective cohort study using the Pediatric Health Information System database comparing adolescent (11-18 years) hospital visits with an STI diagnosis by International Classification of Diseases, 10th revision, code during COVID-19 (2020) to pre-COVID-19 (2017-2019).

National analysis of over and under-triage rates in relation to trauma population risk factors and associated outcomes across various levels trauma centers.

Introduction: Over and under-triage represent a misallocation of resources that can affect patient outcomes. The purpose of this study is to evaluate over and under-triage rates in relation to risk factors and associated outcomes of trauma patients nationwide.

Methods: A retrospective cohort study using the Trauma Quality Improvement Program from 2017 to 2020.

A National Analysis of Racial and Sex Disparities Among Interhospital Transfers for Emergency General Surgery Patients and Associated Outcomes.

Introduction: Studies focusing on Emergency General Surgery (EGS) and Interhospital Transfer (IHT) and the association of race and sex and morbidity and mortality are yet to be conducted. We aim to investigate the association of race and sex and outcomes among IHT patients who underwent emergency general surgery.

Methods: A retrospective review of adult patients who were transferred prior to EGS procedures using the National Surgery Quality Improvement Project from 2014 to 2020.

Is Operative Time Associated With Obesity-related Outcomes in TKA?

Background: Obesity-based cutoffs in TKA are premised on higher rates of postoperative complications. However, operative time may be associated with postoperative complications, leading to an unnecessary restriction of TKA in patients with obesity. If operative time is associated with these obesity-related outcomes, it should be accounted for in order to ensure all measurable factors associated with negative outcomes are examined for patients with obesity after TKA.

Robotic Surgery for Pediatric Choledochal Cysts: An American Case Series and Literature Review.

Introduction: Choledochal cysts are rare congenital biliary cystic dilations. The US incidence rate varies between 5 and 15 cases per 1,000,000 people. In contrast, Asians, which are a large subset of the population of Hawaii, have an incidence of approximately one in every 1000 births.

Retrospective Study of EMS Scene Times and Mortality in Penetrating Trauma Patients: Improving Transport Standards and Patient Outcomes.

Background: This study aimed to determine the impact of emergency medical service (EMS) scene time variability on adult and pediatric trauma patient outcomes with moderate or severe penetrating injuries.

Methods: This retrospective study analyzed the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) database between 2017 and 2020 to evaluate the relationship between EMS scene time on adult and pediatric patients with moderate to severe injuries. Primary outcomes included Dead on Arrival (DOA) to the Emergency Department (ED), ED mortality, 24-hour mortality, and in-hospital mortality.

Middle meningeal artery embolization for symptomatic chronic subdural hematoma in the setting of severe transfusion-refractory thrombocytopenia: A case study and review of literature.

Background: Surgical decompression for the treatment of chronic subdural hematomas (cSDHs) is irrefutably effective; however, its utility in managing cSDH in patients with comorbid coagulopathy remains controversial. The optimal threshold for platelet transfusion in cSDH management is <100,000/mm, according to guidelines from the American Association of Blood Banks GRADE framework. This threshold may be unachievable in refractory thrombocytopenia, though surgical intervention may still be warranted.

Mindfulness-based Cognitive Therapy to Improve Sleep Quality in Older Adults with Insomnia.

There is a high prevalence of insomnia in older adults, which has negative consequences for their well-being and quality of life. The recommendation for first-line treatments is to administer non-pharmacological interventions. The objective of this research was to verify the effectiveness of Mindfulness-Based Cognitive Therapy in older adults with subclinical and moderate insomnia, studying its impact on sleep quality.

Preoperative Educational Classes in Elderly Patients May Not be Necessary Prior to Elective Joint Arthroplasty.

Preoperative arthroplasty classes decrease complications and readmissions, however, in-person classes are inconvenient for elderly patients with mobility limitations. This retrospective review included 232 patients (305 joints) with in-person preoperative educational classes (IPC) and 155 patients (192 joints) with telephone preoperative educational classes (TC). Compared to IPC, TC patients had a shorter length of stay (P<.

A novel beam stopper-based approach for scatter correction in digital planar radiography.

X-ray scatter in planar radiography degrades the contrast resolution of the image, thus reducing its diagnostic utility. Antiscatter grids partially block scattered photons at the cost of increasing the dose delivered by two- to four-fold and posing geometrical restrictions that hinder their use for other acquisition settings, such as portable radiography. The few software-based approaches investigated for planar radiography mainly estimate the scatter map from a low-frequency version of the image.

The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic.

Introduction: Surgical databases are useful for examining outcomes and case volume to improve care, while public interest data has the potential to track the supply and demand of medical services in specific communities. However, the relationship between public interest data and case volume from surgical databases, specifically during disruptive instances like the coronavirus pandemic, is unknown. Therefore, the purpose of this study is to determine how public interest data is related to the case volume of coronavirus and other surgical procedures performed during the coronavirus pandemic.

National Analysis of Motor Vehicle Collision-Associated Mortality Among Opioid Users From 2010 to 2020: The Need for Effective Prevention Policies.

The purpose of this study is to evaluate the trends in the incidence of opioid-associated motor vehicle fatalities in the United States (US) over the past decade and identify geographic or demographic trends. We conducted a retrospective repeated cross-sectional study utilizing the CDC WONDER Multiple Cause of Death Database to gather data on opioid-associated motor vehicle fatalities from 2010 to 2020. The southern US experienced the highest percent increase in opioid-related fatalities from 2010 to 2020 (263.

Does Operative Time Modify Obesity-related Outcomes in THA?

Background: Most orthopaedic surgeons refuse to perform arthroplasty on patients with morbid obesity, citing the higher rate of postoperative complications. However, that recommendation does not account for the relationship of operative time (which is often longer in patients with obesity) to obesity-related arthroplasty outcomes, such as readmission, reoperation, and postoperative complications. If operative time is associated with these obesity-related outcomes, it should be accounted for and addressed to properly assess the risk of patients with obesity undergoing THA.

Racial Disparities in General Surgery Outcomes.

Introduction: While disparities in Black and Hispanic and Latino patients undergoing general surgeries are well described, most analyses leave out Asian, American Indian or Alaskan Native (AIAN), and native Hawaiian or Pacific Islander patients. This study identified general surgery outcomes for each racial group in the National Surgical Quality Improvement Program.

Methods: National Surgical Quality Improvement Program was queried to identify all procedures conducted by a general surgeon from 2017 to 2020 (n = 2,664,197).

Efficacy of Telehealth in Preoperative Pediatric Surgery Consultations.

Introduction: The Coronavirus disease 2019 pandemic created a sudden need to transition outpatient pediatric surgical care to a telehealth platform, allotting little time to study the efficacy of these changes. In particular, the accuracy of telehealth preoperative assessment remains unclear. Therefore, we sought to study the prevalence of errors in diagnosis and procedure cancellations between preoperative in-person evaluations and telehealth evaluations.