Background: Hepatocellular carcinoma (HCC) is the second most lethal malignancy worldwide. There has been virtually no change in the survivability of HCC in spite of improvement in therapies. Surgery is considered the ideal first, curative intervention, however most patients present in advanced stages with unresectable disease.
View Article and Find Full Text PDFBackground: Digital patient engagement platforms are designed to improve the efficacy of the perioperative surgical home, but the currently available solutions have shown low patient and provider adoption. The purpose of this study was to evaluate the effectiveness of a text-messaging (Short Message Service [SMS]) bot with respect to patient engagement following joint replacement procedures in a randomized clinical trial.
Methods: One hundred and fifty-nine patients (83 patients in the control group and 76 patients in the intervention group) were enrolled in a randomized controlled trial comparing the effectiveness of an SMS bot (intervention group) with the traditional perioperative education process (control group) in patients undergoing primary total knee or hip arthroplasty.
We present a case of an iatrogenic rectothecal fistula in a 34-year-old man who underwent repair of a congenital anterior sacral meningocele, intraoperatively complicated by rectal perforation. Postoperatively, the patient developed symptoms of meningitis prompting concern for the cerebrospinal fluid leak. Subsequent workup with computed tomography (CT) and magnetic resonance imaging demonstrated a postoperative pseudomeningocele and fistulization with an abdominal fluid collection.
View Article and Find Full Text PDFOrthopedic surgeons are tasked with treating complex patients while employing critical surgical skills, clinical knowledge, and new technologies. The constant inundation of information, coupled with hours in the hospital setting, provides unique perspectives on various aspects of how health care is delivered, thereby creating a milieu ripe for innovation. The rigors of an orthopedic career make it challenging for physicians to translate an idea into a great product.
View Article and Find Full Text PDFBackground: Deficiencies in medical student knowledge in musculoskeletal medicine have been well documented. To address these deficiencies, numerous curricular changes at our institution were instituted. The objective of this study was to determine whether medical students in their preclinical years benefit from early exposure to musculoskeletal medicine when compared to students exposed to musculoskeletal medicine just prior to completion of their preclinical curriculum.
View Article and Find Full Text PDFCurr Probl Diagn Radiol
September 2018
Multiple guidelines and legal precedents have established the radiologist's duty to inform clinicians directly of critical findings, or findings that will greatly impact patient health in a timely manner [1]. While the number one cause for radiology malpractice cases is misdiagnosis, the literature shows a growing portion of lawsuits surrounding breakdowns in communication between radiologists and ordering providers [2,3]. As such, a review of guidelines related to the communication of imaging results is warranted.
View Article and Find Full Text PDFCurr Probl Diagn Radiol
November 2017
In the last century, rapidly advancing technological innovations have become essential components of modern healthcare, increasing the frequency and necessity of interactions between physicians and industry. These interactions have the potential to bias objectivity and should be approached carefully. A recent JACR article by Harvey et al, highlighted 2014 CMS data, which reported that only 4% of radiologists had interactions with industry, coming in second lowest amongst all 19 reported specialties.
View Article and Find Full Text PDFSurgical excision of orbital cavernous venous malformations located in the orbital apex is challenging due to difficulty obtaining surgical exposure and higher risk of morbidity. Intralesional bevacizumab injection has been utilized for the treatment of choroidal and intracranial cavernous venous malformations. A 52-year-old woman with an orbital apical mass consistent with a cavernous venous malformation causing decreased visual acuity, diminished color vision, and visual field loss was treated with intralesional bevacizumab injected under direct surgical visualization.
View Article and Find Full Text PDFWe present a case of a solitary neurofibroma involving the right posterior shoulder of a 69-year-old man with degeneration into a massive, malignant peripheral nerve sheath tumor measuring more than 3 times the average reported size. The radiographic, magnetic resonance imaging, and computed tomographic features are compared with the gross appearance and pathology.
View Article and Find Full Text PDFStudy Design: Prospective single-cohort observational study.
Objectives: To compare cage settling rates after extreme lateral interbody fusion (XLIF) across various implant sizes and fixation types. Secondary objectives were to detect factors associated with cage settling and correlation with clinical and radiographical improvement.
The aim of this review was to describe quality of life (QoL) questionnaires relevant to interventional radiology. Interventional radiologists perform a large number of palliative procedures. The effect of these therapies on QoL is important.
View Article and Find Full Text PDFWe present a case of well-differentiated liposarcoma (WDL) involving the right proximal arm and axilla in a 66-year-old Filipino male. The patient first noticed the lesion 18 years ago, and it subsequently slowly progressed in size. MR and CT imaging interpreted the lesion as likely being a WDL, a diagnosis that was confirmed by histology.
View Article and Find Full Text PDFStudy Design: Retrospective cohort series.
Objective: Characterize average iatrogenic radiation dose to a cohort of children with thoracic insufficiency syndrome (TIS) during assessment and treatment at a single center with vertically expandable prosthetic titanium rib.
Summary Of Background Data: Children with TIS undergo extensive evaluations to characterize their deformity.
Background: Preoperative simulation warm-up has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized that a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors.
Study Design: In a 2-center randomized trial, 51 residents and experienced minimally invasive surgery faculty in General Surgery, Urology, and Gynecology underwent a validated robotic surgery proficiency curriculum on a VR robotic simulator and on the da Vinci surgical robot (Intuitive Surgical Inc).