Hepatopulmonary syndrome is a frequent cause of dyspnea in the short telomere disorders.

Background: Telomere syndromes have their most common manifestation in idiopathic pulmonary fibrosis and emphysema. The short telomere defect in these patients may manifest systemically as bone marrow failure and liver disease. We sought to understand the causes of dyspnea in telomerase and telomere gene mutation carriers who have no parenchymal lung disease.

Risk factors for conversion from laparoscopic to open surgery: analysis of 2138 converted operations in the American College of Surgeons National Surgical Quality Improvement Program.

Minimal access procedures have influenced surgical practice and patient expectations. Risk of laparoscopic conversion to open surgery is frequently cited but vaguely quantified. The present study examines three common procedures to identify risk factors for laparoscopic conversion to open (LCO) events.

Risk of perforation increases with delay in recognition and surgery for acute appendicitis.

Background: Appendicitis remains a common indication for urgent surgical intervention in the United States, and early appendectomy has long been advocated to mitigate the risk of appendiceal perforation. To better quantify the risk of perforation associated with delayed operative timing, this study examines the impact of length of inpatient stay preceding surgery on rates of perforated appendicitis in both adults and children.

Methods: This study was a cross-sectional analysis using the National Inpatient Sample and Kids' Inpatient Database from 1988-2008.

Assessing trainee impact on operative time for common general surgical procedures in ACS-NSQIP.

Objective: To examine the effect of surgical trainee involvement on operative time for common surgical procedures. Laparoscopic appendectomy, laparoscopic cholecystectomy, and open inguinal hernia repair comprise 17.7% of the total cases sampled in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.

Telomere length is a determinant of emphysema susceptibility.

Rationale: Germline mutations in the enzyme telomerase cause telomere shortening, and have their most common clinical manifestation in age-related lung disease that manifests as idiopathic pulmonary fibrosis. Short telomeres are also a unique heritable trait that is acquired with age.

Objectives: We sought to understand the mechanisms by which telomerase deficiency contributes to lung disease.