Comparative Analysis of Healthcare Quality Between the University Hospital of the West Indies and Public Hospitals in Jamaica.

Objective This study aims to assess the quality of healthcare services at the University Hospital of the West Indies (UHWI), a quasi-public hospital, compared to public hospitals in Jamaica, examining both patient and clinician perceptions. Methods This cross-sectional study included one hundred patients (30 males, 70 females) aged 22 to 95, and 52 clinicians (29 females, 23 males) from 10 hospitals, comprising UHWI and nine public hospitals, were surveyed. Quality assessment encompassed structural adequacy, time management, privacy protection, competency, and healthcare standards.

Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) is a chronic disease characterized by recurrent painful abscesses and chronic sinus tracts in intertriginous areas. In the United States, HS disproportionally affects adults of African-American heritage. Depending on the severity of disease, the consequences of HS can be far-reaching, significantly affecting mental health and quality of life.

Isolation and Quarantine for Coronavirus Disease 2019 in the United States, 2020-2022.

Background: Public health programs varied in ability to reach people with coronavirus disease 2019 (COVID-19) and their contacts to encourage separation from others. For both adult case patients with COVID-19 and their contacts, we estimated the impact of contact tracing activities on separation behaviors from January 2020 until March 2022.

Methods: We used a probability-based panel survey of a nationally representative sample to gather data for estimates and comparisons.

Cerebral Hyperperfusion Syndrome Presenting As Status Epilepticus Following Carotid Endarterectomy.

Cerebral Hyperperfusion Syndrome (CHS) is a rare syndrome, commonly described as a prodrome of symptoms including a severe ipsilateral headache, focal neurological deficits, intracerebral hemorrhage, and occasionally includes seizures or encephalopathy. Our case involves a 76-year-old man who underwent a left carotid endarterectomy (CEA) for symptomatic high-grade stenosis of his left carotid artery. Post-operative day one, the patient was seen and examined in the early morning and found to be doing well, with blood pressures well-controlled and at his neurologic baseline.

Biomarkers of Seizure Activity in Patients With Intracranial Metastases and Gliomas: A Wide Range Study of Correlated Regions of Interest.

Studies quantifying cortical metrics in brain tumor patients who present with seizures are limited. The current investigation assesses morphometric/volumetric differences across a wide range of anatomical regions, including temporal and extra-temporal, in patients with gliomas and intracranial metastases (IMs) presenting with seizures that could serve as a biomarker in the identification of seizure expression and serve as a neuronal target for mitigation. In a retrospective design, the MR sequences of ninety-two tumor patients [55% gliomas; 45% IM] and 34 controls were subjected to sophisticated morphometric and volumetric assessments using BrainSuite and MATLAB modules.

Sustained Carbohydrate Antigen 19-9 Response to Neoadjuvant Chemotherapy in Borderline Resectable Pancreatic Cancer Predicts Progression and Survival.

Background: As neoadjuvant therapy of borderline resectable pancreatic cancer (BRPC) is becoming more widely used, better indicators of progression are needed to help guide therapeutic decisions.

Materials And Methods: A retrospective review was performed on all patients with BRPC who received 24 weeks of neoadjuvant chemotherapy. Patients with chemotoxicity or medical comorbidities limiting treatment completion and nonexpressors of carbohydrate antigen 19-9 (CA19-9) were excluded.

Effect of Tranexamic Acid on Blood Loss, D-Dimer, and Fibrinogen Kinetics in Adult Spinal Deformity Surgery.

Background: Antifibrinolytics such as tranexamic acid reduce operative blood loss and blood product transfusion requirements in patients undergoing surgical correction of scoliosis. The factors involved in the unrelenting coagulopathy seen in scoliosis surgery are not well understood. One potential contributor is activation of the fibrinolytic system during a surgical procedure, likely related to clot dissolution and consumption of fibrinogen.

Gemcitabine and Taxane Adjuvant Therapy with Chemoradiation in Resected Pancreatic Cancer: A Novel Strategy for Improved Survival?

Background: Gemcitabine-taxane combination chemotherapy has demonstrated a survival benefit clinically in metastatic pancreatic cancer (PC). The authors present their experience with gemcitabine and docetaxel (gem/tax)-based adjuvant treatment (Rx) after surgery with curative intent.

Methods: Patients with de novo resectable PC from January 2010 to December 2015 were identified from the authors' institutional database and registry.

Patient-Reported Outcome Measures: Utility for Predicting Spinal Surgery in an Integrated Spine Practice.

Background: For the majority of patients, spinal surgery is an elective treatment. The decision as to whether and when to pursue surgery is complicated and influenced by myriad factors, including pain intensity and duration, impact on functional activities, referring physician recommendation, and surgeon preference. By understanding the factors that lead a patient to choose surgery, we may better understand the decision-making process, improve outcomes, and provide more effective care.

The Seattle spine score: Predicting 30-day complication risk in adult spinal deformity surgery.

Background: Complication rates in complex spine surgery range from 25% to 80% in published studies. Numerous studies have shown that surgeons are not able to accurately predict whether patients are likely to face post-operative complications, in part due to biases based on individual experience. The purpose of this study was to develop and evaluate a predictive risk model and decision support system that could accurately predict the likelihood of 30-day postoperative complications in complex spine surgery based on routinely measured preoperative variables.

Real-World Single-Center Experience with Sofosbuvir-Based Regimens for the Treatment of Chronic Hepatitis C Genotype 1 Patients.

Background/aims: The approval of sofosbuvir (SOF), a direct-acting antiviral, has revolutionized the treatment of chronic hepatitis C virus (HCV).

Methods: We assessed the sustained virological response (SVR) of SOF-based regimens in a real-world single-center setting for the treatment of chronic HCV genotype 1 (G1) patients. This was a retrospective review of chronic HCV G1 adult patients treated with a SOF-based regimen at Virginia Mason Medical Center between December 2013 and August 2015.

A systematic multidisciplinary initiative for reducing the risk of complications in adult scoliosis surgery.

OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality.

Five-Year Actual Overall Survival in Resected Pancreatic Cancer: A Contemporary Single-Institution Experience from a Multidisciplinary Perspective.

Background: Successful surgical resection combined with effective perioperative therapy is essential for maximizing long-term survival for pancreatic adenocarcinoma.

Patients And Methods: All patients with pancreatic adenocarcinoma who underwent curative resection at our institution from January 2003 to May 2010 were reviewed. Demographic and clinical details were retrospectively collected from medical records and cancer registry data.

Preoperative, Intraoperative, and Postoperative Standing Lordosis After Pedicle Subtraction Osteotomy: An Analysis of Radiographic Parameters and Surgical Strategy.

Study Design: Retrospective consecutive case series.

Objectives: The objective of this study was to investigate the relationship between intraoperative and postoperative lumbar spine measurements after pedicle subtraction osteotomy (PSO). We analyzed the amount of lordosis lost between the prone intraoperative image and the final upright standing film.

Localized pancreatic cancer with positive peritoneal cytology as a sole manifestation of metastatic disease: a single-institution experience.

Background: Pancreatic cancer patients with positive peritoneal cytology (PPC) as a sole metastatic site are poorly characterized. Whether they behave similarly to other stage IV patients is unknown.

Methods: Patients with stage IV disease at our institution between 2003 and 2013 were identified.

Rare long-term survivors of pancreatic adenocarcinoma without curative resection.

Long-term outcome data in pancreatic adenocarcinoma are predominantly based on surgical series, as resection is currently considered essential for long-term survival. In contrast, five-year survival in non-resected patients has rarely been reported. In this report, we examined the incidence and natural history of ≥ 5-year survivors with non-resected pancreatic adenocarcinoma.

Survival and clinical outcome after endoscopic duodenal stent placement for malignant gastric outlet obstruction: comparison of pancreatic cancer and nonpancreatic cancer.

Background: Data on endoscopic stenting of malignant gastric outlet obstruction (GOO) are based on studies predominantly involving patients with pancreatic adenocarcinoma.

Objective: To compare survival and clinical outcome after stent placement for GOO due to pancreatic cancer compared with nonpancreatic cancer.

Design: Retrospective study.

HIV risk, prevention, and testing behaviors among men who have sex with men--National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008.

Problem/condition: Approximately 1.1 million persons in the United States are living with human immunodeficiency virus (HIV) infection. More than half of those infected are men who have sex with men (MSM).

A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders.

Background: Despite widespread recommendations regarding posture during computer use, associations between specific postures and musculoskeletal health are not well characterized.

Methods: Six hundred and thirty-two newly hired computer users were followed prospectively to evaluate associations between posture and neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms and musculoskeletal disorders. Participants' postures were measured at entry and they reported symptoms on weekly diaries.

A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders.

Background: A prospective study of computer users was performed to determine the occurrence of and evaluate risk factors for neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms (MSS) and disorders (MSD).

Methods: Individuals (n = 632) newly hired into jobs requiring > or = 15 hr/week of computer use were followed for up to 3 years. At study entry, workstation dimensions and worker postures were measured and medical and psychosocial risk factors were assessed.