Differences in Network Functional Connectivity in Response to Sub-Symptomatic Exercise Between Elite Adult Athletes after Sport-Related Concussion and Healthy Matched Controls: A Pilot Study.

Resting-state electroencephalography (rsEEG) has developed as a method to explore functional network alterations related to sport-related concussion (SRC). Although exercise is an integral part of an athlete's return to sport (RTS) protocol, our understanding of the effects of exercise on (impaired) brain network activity in elite adult athletes is limited. However, this information may be beneficial to inform recovery and RTS progressions.

Multidisciplinary Limb Salvage Service Reduces Major Amputations in Diabetic Foot Infections.

Background: Diabetic foot infections (DFIs) can lead to limb loss and mortality. To improve patient care at a safety-net teaching hospital, we created a multidisciplinary limb salvage service (LSS).

Methods: We recruited a cohort prospectively and compared it to a historical control group.

Source connectivity patterns in the default mode network differ between elderly golf-novices and non-golfers.

Learning to play golf has high demands on attention and therefore may counteract age-related changes of functional brain networks. This cross-sectional study compared source connectivity in the Default Mode Network (DMN) between elderly golf novices and non-golfers. Four-minute resting-state electroencephalography (128 channels) from 22 elderly people (mean age 67 ± 4.

Fitness, performance, and cardiac autonomic responses to exercise in people with epilepsy.

People with epilepsy (PWE) are less fit and have an increased risk of sudden cardiac death. Imbalances within the autonomic nervous system (ANS) are believed to mediate some of those effects. However, results are mostly derived from patients whose seizures are refractory to medical therapy.

Learning to play golf for elderly people with subjective memory complaints: feasibility of a single-blinded randomized pilot trial.

Background: Subjective Memory Complaints (SMC) in elderly people due to preclinical Alzheimer's Disease may be associated with dysregulation of the Kynurenine Pathway (KP), with an increase in neurotoxic metabolites that affect cognition. Golf is a challenging sport with high demands on motor, sensory, and cognitive abilities, which might bear the potential to attenuate the pathological changes of preclinical AD. This trial investigated the feasibility of learning to play golf for elderly with cognitive problems and its effects on cognitive functions and the KP.

A Novel Approach to Limb Salvage: Healing Transmetatarsal Amputations without a Viable Plantar Flap.

Background: The lack of a viable plantar flap in patients undergoing transmetatarsal amputation has been considered an indication for below-knee amputation (BKA). In an effort to reduce limb loss in this patient population, we sought to review our experience with transmetatarsal amputation salvage in patients with an open, guillotine transmetatarsal amputation. We hypothesized that performing a transmetatarsal amputation without a viable flap would extend time of independent ambulation and improve limb salvage.

The impact of intracranial pressure monitoring on mortality after severe traumatic brain injury.

Background: The effect of intracranial pressure (ICP) monitoring on mortality after severe traumatic brain injury (sTBI) remains unclear. We hypothesized that ICP monitoring would not be associated with improved survival in patients with sTBI.

Methods: A retrospective analysis was performed on sTBI patients, defined as admission Glasgow Coma Scale score of 8 or less with intracranial hemorrhage.

General Surgery Residents can Be a Reliable Resource in the Evaluation of Residency Applications.

Objective: Surgical residents' ability to screen general surgery (GS) applicants has not been previously investigated. The objective of this study was to compare surgical residents' evaluation of Electronic Residency Application Service (ERAS) applicants to that of faculty using a standardized assessment instrument.

Design: A prospective analysis of ERAS applications using a standardized assessment tool.

The impact of a massive transfusion protocol on outcomes among patients with abdominal aortic injuries.

Background: Injuries of the abdominal aorta are uncommon and associated with a high mortality. The purpose of this study was to examine the impact of an institutional massive transfusion protocol (MTP) on outcomes in patients with injuries of the abdominal aorta.

Methods: A 12.

The Effect of Platelet and Desmopressin Administration on Early Radiographic Progression of Traumatic Intracranial Hemorrhage.

Limited data exist regarding the use of hemostatic adjuncts on the progression of traumatic intracranial hemorrhage (tICH). The objective of this study was to examine the impact of platelet transfusion and desmopressin (DDAVP) administration on hemorrhage progression following tICH. We hypothesized that platelet and DDAVP administration would not result in decreased early hemorrhagic progression.

Surgical malpractice in California: res judicata.

Medical negligence claims are of increasing concern to surgeons. Although noneconomic damage awards in California are limited by the Medical Injury Compensation Reform Act (MICRA) law to $250,000, the total amount of such settlements can increase significantly based on claims for economic damages. We reviewed negligence litigation involving California surgeons to determine outcomes and monetary awards through retrospective review of surgical malpractice cases published in a legal journal.

Effect of marijuana use on outcomes in traumatic brain injury.

Traumatic brain injury (TBI) is associated with significant morbidity and mortality. Several studies have demonstrated neuroprotective effects of cannabinoids. The objective of this study was to establish a relationship between the presence of a positive toxicology screen for tetrahydrocannabinol (THC) and mortality after TBI.

Abdominal hollow viscus injuries are associated with spine and neurologic infections after penetrating spinal cord injuries.

Penetrating spinal cord injuries are rare but potentially devastating injuries that are associated with significant morbidity. The objective of this study was to assess the impact of abdominal hollow viscus injuries (HVIs) on neurologic and spinal infectious complications in patients sustaining penetrating spinal cord injuries. We performed a 13-year retrospective review of a Level I trauma center database.

Trends in organ donor management: 2002 to 2012.

Background: Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of hormone replacement therapy (HRT) has been accompanied by improved outcomes over time.

Study Design: Using the Organ Procurement and Transplant Network donor database, all brain-dead donors procured from July 1, 2001 to June 30, 2012 were studied.

Flat or fat? Inferior vena cava ratio is a marker for occult shock in trauma patients.

Background: Identification of occult shock (OS) or hypoperfusion is critical in the initial management of trauma patients. Analysis of inferior vena cava (IVC) ratio on computed tomography (CT) scan has shown promise in predicting intravascular volume. We hypothesized that a flat IVC is a predictor of OS and associated with worse outcomes in major trauma patients.

A comparison of rural versus urban trauma care.

Objective: We compared the survival of trauma patients in urban versus rural settings after the implementation of a novel rural non-trauma center alternative care model called the Model Rural Trauma Project (MRTP).

Materials And Methods: We conducted an observational cohort study of all trauma patients brought to eight rural northern California hospitals and two southern California urban trauma centers over a one-year period (1995-1996). Trauma patients with an injury severity score (ISS) of >10 were included in the study.

Insurance status predicts survival for trauma patients undergoing urgent intervention.

Background: The purpose of this study was to investigate the relationship between insurance status and outcomes for trauma patients presenting without vital signs undergoing urgent intervention.

Materials And Methods: The National Trauma Data Bank was queried for patients presenting with a systolic blood pressure equal to zero and a Glasgow Coma Scale score of three ("clinically dead"), who underwent urgent thoracotomy and-or laparotomy (UTL). Insured patients were compared with uninsured (INS [-]) patients.

The impact of age on mortality in patients in extremis undergoing urgent intervention.

Trauma patients admitted without vital signs have little hope of survival even with extreme interventions. We performed this study to determine the effect of age on survival in patients in extremis undergoing urgent thoracotomy. The National Trauma Database was searched for patients presenting without a systolic blood pressure (0), a Glasgow Coma Scale score less than 8, and underwent an urgent thoracotomy.

The effect of arginine vasopressin on organ donor procurement and lung function.

Background: Hormone replacement therapy (HRT) is becoming more common when managing brain-dead donors. Arginine vasopressin (AVP) is associated with benefits but is not consistently used. We hypothesize that AVP is associated with the maintenance of lung function and successful recovery in donors and enhanced lung graft performance in recipients.

Penetrating cardiac injury and the significance of chest computed tomography findings.

In rare circumstances, hemodynamically stable patients can harbor serious penetrating cardiac injuries. We hypothesized that chest computed tomography (CCT) is potentially useful in evaluation. The records of all patients admitted to our center with wounds to the precordium or who sustained a hemothorax or pneumothorax after penetrating torso injuries over a 48-month period were reviewed.

Ventilator-associated pneumonia in severe traumatic brain injury: the clinical significance of admission chest computed tomography findings.

Background: Ventilator-associated pneumonia (VAP) in severe traumatic brain injury (STBI) is a significant morbidity. Bilateral dependent consolidation (BDC) can be seen on admission chest computed tomography (CCT) in STBI. We hypothesize that this finding may be associated with VAP.

Arginine vasopressin significantly increases the rate of successful organ procurement in potential donors.

Background: Hormone replacement therapy increases the number and quality of grafts recovered from brain-dead organ donors. Arginine vasopressin (AVP) has also been shown to have beneficial effects. The aim of this study was to determine the effect of AVP on recovery rates.