Publications by authors named "Chibueze Nwaiwu"
Article Synopsis
- A systematic review was conducted to investigate racial disparities in outcomes of surgical treatment for thyroid cancer, focusing on data from various studies.
- The review included 12 studies involving 7,221 patients, where a large majority were White (67%), with significant representation from Black (22%), Hispanic (7%), and Asian (3%) patients.
- Results indicated that Black and Hispanic patients had a higher incidence of extrathyroidal extension compared to White patients, while recurrence rates were similar across racial groups, suggesting a need for further investigation into these disparities in thyroid cancer outcomes.
Article Synopsis
- Researchers investigated how machine learning algorithms can predict complications after colectomy surgery for colonic neoplasia, aiming to enhance accuracy compared to traditional statistical methods.
- The study used data from the National Inpatient Sample database (2003-2017) and included 14,935 adult patients who underwent elective colectomy, analyzing outcomes such as anastomotic leaks and inpatient mortality.
- Among the machine learning models tested—decision tree, random forest, and artificial neural networks—the neural network performed best in predicting complications, achieving high accuracy with area under the receiver operating characteristic curve scores ranging from 0.84 to 0.93 for various outcomes.
Background: When viewed under near-infrared light, indocyanine green (ICG) signal for kidney perfusion can be utilized in partial nephrectomy. Laser speckle contrast imaging (LSCI) uses coherent light to detect perfusion during real-time laparoscopic surgery.
Materials And Methods: Laser speckle contrast imaging or ActivSight, an imaging sensor adapter, was used during laparoscopy of an anesthetized porcine kidney model.
Article Synopsis
- Real-time tissue perfusion measurement using Laser Speckle Contrast Imaging can enhance surgical decision-making by revealing ischemic changes in the intestines due to blood flow obstruction.
- In a study with porcine models, the technique effectively distinguished between well-perfused and ischemic bowel segments under various occlusion scenarios.
- Results showed a strong correlation between perfusion measurements and blood pressure changes, demonstrating that Laser Speckle could be used to assess and compare perfusion in different intestinal anastomosis techniques.
Background: Acute Appendicitis (AA), one of the most common surgical emergencies, is usually managed operatively. There is a paucity of data addressing how HIV/AIDS affects management of acute uncomplicated appendicitis.
Methods: A retrospective review of HIV/AIDS positive (HPos) versus negative (HNeg) patients with acute, uncomplicated appendicitis over a 19-year period.
Article Synopsis
- Peripheral artery disease (PAD) outcomes vary based on social factors like insurance status, particularly in those who are dual-eligible for both Medicare and Medicaid.
- A systematic review of six articles highlights that dual-eligible patients generally face higher comorbidities, more severe PAD symptoms, and worse treatment outcomes, including mortality rates.
- More research is needed to better understand the link between dual eligibility and PAD, emphasizing the importance of early detection to enhance disease prevention and health equity for these patients.
Article Synopsis
- Real-time intraoperative perfusion assessment using Laser Speckle Contrast Imaging (LSCI) could potentially minimize anastomotic leaks in surgeries by providing a dye-free visualization of blood flow in the intestines.
- The ActivSight™ system, which can use both LSCI and indocyanine green imaging (ICG), was tested on porcine models to evaluate its effectiveness in quantifying intestinal perfusion under various experimental conditions.
- Results showed that LSCI accurately differentiated between healthy and ischemic bowel regions, with quantification correlating well to blood pressure and the distance from ischemic areas, suggesting it offers a more objective assessment of bowel perfusion than traditional visual methods.
Introduction: Protective devices such as seat belts and helmets save lives. Most studies only address one aspect of the injury profile - compliance or mortality - not the entire spectrum of trauma care, and little attention is paid to racial differences in the use or impact of protective devices.
Methods: Patients with blunt mechanisms where using protective devices would be expected were included and were divided into utilizing (P) vs not utilizing protection (Non-P).
Objective: To determine if laser speckle contrast imaging (LSCI) mitigates variations and subjectivity in the use and interpretation of indocyanine green (ICG) fluorescence in the current visualization paradigm of real-time intraoperative tissue blood flow/perfusion in clinically relevant scenarios.
Methods: De novo laparoscopic imaging form-factor detecting real-time blood flow using LSCI and blood volume by near-infrared fluorescence (NIRF) of ICG was compared to ICG NIRF alone, for dye-less real-time visualization of tissue blood flow/perfusion. Experienced surgeons examined LSCI and ICG in segmentally devascularized intestine, partial gastrectomy, and the renal hilum across six porcine models.
Article Synopsis
- Laser speckle contrast imaging (LSCI) is a technology used in robotic-assisted and laparoscopic surgeries to measure real-time tissue blood flow without the need for dye, offering advantages over traditional imaging methods like indocyanine green (ICG).
- A study involving 67 patients assessed the effectiveness and usability of a new device that combines LSCI and ICG during various surgical procedures, revealing that both methods performed comparably in detecting perfusion.
- Results showed no adverse effects and high usability ratings for surgeons, indicating that LSCI can be safely and effectively integrated into robot-assisted surgeries alongside laparoscopic techniques.
Article Synopsis
- This study looks at how insurance status, particularly for dual-eligible beneficiaries (those with both Medicare and Medicaid), affects outcomes for patients hospitalized due to hemorrhagic strokes, drawing on a decade's worth of data.* -
- Among the analyzed 410,621 patients, dual-eligible individuals tended to be older (average age 73) and had higher rates of in-hospital mortality and complications compared to those with Medicaid or private insurance.* -
- The results indicated dual-eligibles had significantly increased odds of complications and lower chances of favorable discharge outcomes compared to other patient groups, highlighting their vulnerability in emergency healthcare situations.*
Objective: Peripheral arterial disease (PAD) is a prevalent and debilitating disease that can be effectively treated by surgical revascularization. However, Medicare-Medicaid dual-eligible patients have experienced worse long-term outcomes, notably higher rates of amputation and mortality, relative to other insurance groups. In the present study, we investigated how insurance status can perpetuate health disparities in PAD outcomes.
View Article and Find Full Text PDFPeople experiencing homelessness are particularly vulnerable when diagnosed with pancreatic cancer. Patients with lower socioeconomic status have worse outcomes from pancreatic cancer as the result of disparities in access to treatment and barriers to navigation of the health care system. Patients with lower socioeconomic status, or who are vulnerably housed, are less likely to receive surgical treatment even when it is recommended by National Comprehensive Cancer Network guidelines.
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- The ethical considerations surrounding the use of kidneys with solid renal masses (SRMs) in transplantation are becoming increasingly relevant, particularly as the life expectancy of transplant patients improves and more SRMs are found in donors.
- A 60-year-old woman received a deceased-donor kidney transplant after a long wait, and although initial imaging showed no issues, a later CT scan revealed a previously unnoticed 2.4-cm oncocytoma in the graft.
- The tumor was monitored closely over five years with no need for surgical intervention due to its benign nature, and the patient continued to receive standard immunosuppressive therapy without complications.
An e-learning tutorial was developed to cover the basic aspects of acute burns management. The aim of this study was to provide objective educational evidence supporting the role of an e-learning on acute burns management ("basic burns management" or BBM) when compared with traditional teaching methods when introduced in different medical school settings around the world. A multicenter randomized controlled trial was conducted at the University of Pittsburgh, Peninsula College of Medicine and Dentistry, and St.
View Article and Find Full Text PDFBackground: The studies enumerating the risk of HIV transmission to health care workers (HCWs) as 0.3% after percutaneous exposure to HIV-positive blood, and 0.09% after a mucous membrane exposure, are weakened by dated literature.
View Article and Find Full Text PDFBackground: Hepatitis C virus (HCV) transmission to health care personnel (HCP) after exposure to a HCV-positive source has been reported to occur at an average rate of 1.8% (range, 0%-10%). We aimed to determine the seroconversion rate after exposure to HCV-contaminated body fluid in a major U.
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