Defining Duplex Ultrasound Criteria for In-Stent Restenosis of the Superior Mesenteric Artery.

Background: This study sought to define duplex ultrasound (DUS) velocity criteria predicting ≥70% stenosis in superior mesenteric artery (SMA) stents by correlating in-stent peak systolic velocity (PSV) with computed tomographic angiography (CTA) measurements of percent stenosis.

Methods: A retrospective review of 109 patients undergoing SMA stenting between 2003 and 2018 was conducted at a single institution. Thirty-seven surveillance duplex ultrasound studies were found to have a CTA performed within 30 days of study completion.

Case report: Hybrid approach in the management of a complete persistent sciatic artery aneurysm.

Introduction: Persistent sciatic artery (PSA) is a rare embryological vascular anomaly with a prevalence between 0.025-0.06%.

Aortoenteric Fistula through a Thrombosed Graft.

BACKGROUND Aortoenteric fistula is a dreadful and uncommon complication after abdominal aortic aneurysm repair. Continuous friction against the intestine and the aortic graft along with local inflammation is thought to be the major cause of aortoenteric fistula formation, although it is unexpected to have fistula formation with a thrombosed aortic graft. CASE REPORT Here, we report a case of an aortoenteric fistula between a thrombosed aortoiliac bypass graft and the duodenum in a 75-year-old male patient who presented with a 2-month history of melena.

Neoadjuvant Adjuvant Chemotherapy for Resectable Pancreatic Adenocarcinoma: A National Cancer Database Analysis.

There is controversy regarding the role of neoadjuvant adjuvant chemotherapy for pancreatic cancer (PAC). Neoadjuvant therapy has been touted as a method to improve survival in PAC patients. This study's objective is to investigate predictors and potential benefits of neoadjuvant therapy in resectable PAC patients.

Disparities in compliance with the Oncotype DX breast cancer test in the United States: A National Cancer Data Base assessment.

Background: Oncotype DX (ODX) is a multi-gene tumor assay for breast cancer patients. Our objective is to assess whether eligible ODX patients received the test and whether recommendations were followed based on respective risk.

Methods: We retrospectively analyzed testing in patients deemed eligible for ODX using the National Cancer Data Base.

Survival benefits of remote ischemic conditioning in sepsis.

Background: Sepsis remains the leading cause of death in the surgical intensive care unit. Prior studies have demonstrated a survival benefit of remote ischemic conditioning (RIC) in many disease states. The aim of this study was to determine the effects of RIC on survival in sepsis in an animal model and to assess alterations in inflammatory biochemical profiles.

Analgesic Choice in Management of Rib Fractures: Paravertebral Block or Epidural Analgesia?

Background: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB).

Methods: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures.

Overuse of helicopter transport in the minimally injured: A health care system problem that should be corrected.

Background: Mortality benefit has been demonstrated for trauma patients transported via helicopter but at great cost. This study identified patients who did not benefit from helicopter transport to our facility and demonstrates potential cost savings when transported instead by ground.

Methods: We performed a 6-year (2007-2013) retrospective analysis of all trauma patients presenting to our center.

A critical analysis of secondary overtriage to a Level I trauma center.

Background: Trauma centers often receive transfers from lower-level trauma centers or nontrauma hospitals. The aim of this study was to analyze the incidence and pattern of secondary overtriage to our Level I trauma center.

Methods: We performed a 2-year retrospective analysis of all trauma patients transferred to our Level I trauma center and discharged within 24 hours of admission.

Superiority of frailty over age in predicting outcomes among geriatric trauma patients: a prospective analysis.

Importance: The Frailty Index (FI) is a known predictor of adverse outcomes in geriatric patients. The usefulness of the FI as an outcome measure in geriatric trauma patients is unknown.

Objective: To assess the usefulness of the FI as an effective assessment tool in predicting adverse outcomes in geriatric trauma patients.

A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury.

Background: A definitive consensus on the standardization of practice of a routine repeat head CT (RHCT) scan in patients with traumatic intracranial hemorrhage is lacking. We hypothesized that in examinable patients without neurologic deterioration, RHCT scan does not lead to neurosurgical intervention (craniotomy/craniectomy).

Study Design: This was a 3-year prospective cohort analysis of patients aged 18 years and older, without antiplatelet or anticoagulation therapy, presenting to our level 1 trauma center with intracranial hemorrhage on initial head CT and a follow-up RHCT.

Smartphone surgery: how technology can transform practice.

Rural trauma care has been regarded as being the "challenge for the next decade." Trauma patients in rural areas face more struggles than their urban counterparts because of the absence of specialized trauma care, delay in providing immediate care to trauma victims, and longer transport times to reach a trauma center. Telemedicine is a promising tool for facilitating rural trauma care.

Shock index predicts mortality in geriatric trauma patients: an analysis of the National Trauma Data Bank.

Background: Heart rate and systolic blood pressure are unreliable in geriatric trauma patients. Shock index (SI) (heart rate/systolic blood pressure) is a simple marker of worse outcomes after injury. The aim of this study was to assess the utility of SI in predicting outcomes.

Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis.

Background: The rate of mortality and factors predicting worst outcomes in the geriatric population presenting with trauma are not well established. This study aimed to examine mortality rates in severe and extremely severe injured individuals 65 years or older and to identify the predictors of mortality based on available evidence in the literature.

Methods: We performed a systematic literature search on studies reporting mortality and severity of injury in geriatric trauma patients using MEDLINE, PubMed, and Web of Science.

Clinical outcomes in traumatic brain injury patients on preinjury clopidogrel: a prospective analysis.

Background: Patients receiving antiplatelet medications are considered to be at an increased risk for traumatic intracranial hemorrhage after blunt head trauma. However, most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate clinical outcomes and the requirement of a repeat head computed tomography (RHCT) in patients on preinjury clopidogrel therapy.

Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study.

Background: Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy.

Methods: Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled.