Publications by authors named "Douglas Johnston"

Article Synopsis
  • First branchial cleft anomalies are rare issues in the head and neck area that some kids are born with, and there's not much info on how to classify or treat them properly.
  • * Expert doctors worked together to come up with better ways to identify and manage these anomalies using a method called the Delphi method.
  • * They created a new classification system and treatment guidelines to help doctors give better care to kids with these conditions.
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  • A group of heart surgeons and doctors met to talk about how to improve a special type of heart surgery called minimally invasive cardiac surgery (MICS).
  • They want to make sure the surgery uses smaller cuts to make recovery easier for patients while still achieving good results.
  • They believe that to get the best results from MICS, there should be three key parts: smaller surgical cuts, proper care of the heart during surgery, and a program called Enhanced Recovery After Surgery (ERAS) that helps patients heal better afterward.
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  • Recent advances in understanding pericardial diseases and the use of multimodal imaging have significantly improved the diagnosis and treatment approaches.
  • Pericardiectomy is advised for serious cases like chronic constrictive pericarditis and requires a team of specialists for the best patient outcomes.
  • Performing radical pericardiectomy at high-volume medical centers with skilled staff enhances the likelihood of a successful surgery and recovery.
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Purpose: The most common indications for total thyroidectomy (TT) in children are malignancy and thyrotoxicosis due to Graves' disease (GD). However, the incidence of patients with GD among patients undergoing TT is unknown. This study aims to examine trends in pediatric TT.

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  • Patients increasingly prefer bioprosthetic valves for aortic valve replacement (AVR) to avoid anticoagulation, but the impact of patient-prosthesis mismatch (PPM) on valve durability remains under-studied.
  • A study evaluated 2,100 patients who underwent surgical AVR with the Magna bioprosthesis, revealing that smaller valve sizes correlated with poorer survival but not higher rates of reintervention.
  • Overall, reintervention rates after 15 years were low, but higher initial mean gradients at implant were linked to increased late reinterventions.
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Objective: Anterior mitral anular calcification, particularly in radiation heart disease, and previous valve replacement with destroyed intervalvular fibrosa are challenging for prosthesis sizing and placement. The Commando procedure with intervalvular fibrosa reconstruction permits double-valve replacement in these challenging conditions. We referenced outcomes after Commando procedures to standard double-valve replacements.

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  • Berotralstat is an oral medication used for the prevention of hereditary angioedema in patients aged 12 and older, evaluated in a Phase III trial called APeX-J in Japan.
  • The trial had three parts: the first part compared different doses of berotralstat to a placebo, the second allowed for continuation of treatment, and the third involved all patients receiving berotralstat over an extended period, focusing on safety and effectiveness.
  • Results showed that most patients reported side effects, but they were generally mild, and patients on the 150 mg dose experienced significant reductions in attack rates and improved quality of life.
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Introduction: We examined the association of socioeconomic status as defined by median household income quartile (MHIQ) with mortality and readmission patterns following open repair of acute type A aortic dissection (ATAAD) in a nationally representative registry.

Methods: Adults who underwent open repair of ATAAD were selected using the US Nationwide Readmissions Database and stratified by MHIQ. Patients were selected based on diagnostic and procedural codes.

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Background: The management of aortic stenosis has evolved to stratification by age as reflected in recent societal guidelines. We evaluated age-stratified surgical aortic valve replacement (SAVR) trends and outcomes in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) from The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Methods: This cohort included adults (≥18 years) undergoing SAVR for severe aortic stenosis between July 2011 and December 2022.

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Background: Berotralstat is a first-line, once-daily oral plasma kallikrein inhibitor approved for prophylaxis of hereditary angioedema (HAE) attacks in patients 12 years or older.

Objective: This analysis examined the safety and effectiveness of long-term prophylaxis with berotralstat.

Methods: APeX-2 was a phase 3, parallel-group, multicenter trial in patients with HAE caused by C1-inhibitor deficiency (NCT03485911).

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Introduction: Type A Aortic Dissection (TAAD) is a surgical emergency with a time-dependent rate of mortality. We hypothesized that a direct-to-operating room (DOR) transfer program for patients with TAAD would reduce time to intervention.

Methods: A DOR program was started at an urban tertiary care hospital in February 2020.

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Objectives: To investigate long-term outcomes, imaging, and pathologic findings in pediatric patients who underwent superficial parotidectomy for recalcitrant juvenile recurrent parotitis (JRP).

Methods: Records for 20 children (23 parotidectomies; 9 females, 11 males; age at surgery of 8.6 ± 3.

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Objective: The study objective was to determine the effect of sinutubular junction stabilization on long-term outcomes of bicuspid aortic valve repair.

Methods: From January 1998 to January 2020, 419 patients underwent bicuspid aortic valve repair with ascending aorta replacement and 421 without (bicuspid aortic valve repair alone). Propensity score matching (97 pairs) was used to compare outcomes.

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Background: Violence is a critical problem in the emergency department (ED) and patients experiencing mental health crises are at greater violence risk; however, tools appropriate for assessing violence risk in the ED are limited. Our goal was to evaluate the utility of the Fordham Risk Screening Tool (FRST) in reliability assessing violence risk in adult ED patients with acute mental health crises through evaluation of test characteristics compared to a reference standard.

Methods: We evaluated performance of the FRST when used with a convenience sample of ED patients undergoing acute psychiatric evaluation.

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Background: Patients with pure native aortic regurgitation (AR) have been excluded from transcatheter aortic valve replacement (TAVR) trials. We sought to examine midterm outcomes with TAVR in AR compared with surgical AVR (SAVR) in a contemporary cohort.

Methods: Medicare beneficiaries who underwent elective TAVR or SAVR for pure AR from 2016 to 2019 were identified.

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Background: The implications of left ventricular remodeling and dysfunction before and after aortic valve replacement (AVR) for mixed aortic valve disease (MAVD) are not well understood. This study aims to evaluate the impact of AVR on left ventricular (LV) systolic function in MAVD, and determine the prognostic value of postoperative LV global longitudinal strain (LV-GLS) and LV ejection fraction (LVEF).

Methods: We retrospectively assessed 489 consecutive patients with MAVD (defined as at least moderate aortic stenosis and at least moderate aortic regurgitation) and baseline LVEF ≥50%, who underwent AVR between February 2003 and August 2018.

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Objectives: Porcelain aorta complicates aortic valve replacement and is an indication for transcatheter approaches. No study has compared surgical and transcatheter valve replacement in the setting of porcelain aorta. We characterize porcelain aorta patients undergoing aortic valve replacement and the association of aortic calcification and outcomes.

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Objectives: Guidelines suggest aortic valve replacement (AVR) for low-risk asymptomatic patients. Indications for transcatheter AVR now include low-risk patients, making it imperative to understand state-of-the-art surgical AVR (SAVR) in this population. Therefore, we compared SAVR outcomes in low-risk patients with those expected from Society of Thoracic Surgeons (STS) models and assessed their intermediate-term survival.

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Background We assessed the Ozaki procedure, aortic valve reconstruction using autologous pericardium, with respect to its learning curve, hemodynamic performance, and durability compared with a stented bioprosthesis. Methods and Results From January 2007 to January 2016, 776 patients underwent an Ozaki procedure at Toho University Ohashi Medical Center. Learning curves, aortic regurgitation (AR), and peak gradient, assessed by serial echocardiograms, valve rereplacement, and survival were investigated.

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Background: Hashimoto's thyroiditis (HT) affects 1-2 % of the pediatric population. In adults with HT, thyroidectomy is considered challenging and prone to postoperative complications due to the chronic inflammatory process. However, the complications of thyroidectomy among children with HT have not been established.

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Surgical treatment of aneurysmal distal congenital coronary artery fistulas depends on size and anatomy. From 2008 to 2021, we applied a new surgical technique in 7 adult patients: proximal and distal fistula closure, opening of aneurysmal artery, and revascularization of branches rising from the fistula under cardiopulmonary bypass and cardiac arrest. ().

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Objective: To identify variables that are associated with poor compliance to thyroid hormone replacement therapy in children after total thyroidectomy.

Method: A retrospective cohort study of children who underwent total thyroidectomy by high-volume pediatric otolaryngologists between 1/2014 and 9/2021. Postoperative poor compliance was characterized by at least three separate measurements of high TSH levels not associated with radioactive iodine treatment.

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