Increase in trauma volume as compared to emergency department volume during the COVID-19 pandemic.

Background: During the months between April through June 2020 when we experienced the largest number of COVID-19 patients in our hospital, the volume of patients in the Emergency Department (ED) was decreased by more than 30%. In contrast to most early reports we did not notice a decrease in trauma volume during this time period.

Materials And Methods: We compared trauma patients presenting to our Level III Trauma Center, between April 2019 through June 2019 to those presenting from April 2020 through June 2020, the initial surge in COVID-19 patients.

A 22-year history of treating intentional falls from the Golden Gate Bridge at Marin Health Medical Center.

Background: The historical mortality rate after falling from the Golden Gate Bridge has been approximately 98%. We report on 14 recent survivors treated at Marin Health Medical Center.

Methods: We retrospectively reviewed the 22-year experience of treating patients after Golden Gate Bridge falls.

Helmet Usage Reduces Serious Head Injury Without Decreasing Concussion After Bicycle Riders Crash.

Background: The importance of bicycle helmets in reducing injuries is unclear. Our center receives a disproportionate number of bicycle crash victims. We sought to evaluate the types of injuries observed and the role of helmets in reducing head injuries.

Increased risk of vascular thrombosis in pediatric liver transplant recipients with thrombophilia.

Background: Pediatric patients who undergo liver transplantation are at higher risk of developing vascular complications when compared to adult liver transplant recipients. The consequences of hepatic artery thrombosis (HAT) or portal vein thrombosis (PVT) can cause significant morbidity and mortality. We examined pediatric liver transplant recipients who developed vascular thrombosis and the presence of thrombophilia.

The cost of resident education.

Background: Patients cared for by surgeons with resident coverage have an increase in cost versus those patients cared for by surgeons without resident coverage, despite no significant difference in complications. We evaluated the reasons for the disparate cost.

Methods: In a single institutional analysis, patients received their care from a group of eight surgeons, four with and four without resident coverage.

Laparoscopic ventral hernia repair is safer than open repair: analysis of the NSQIP data.

Introduction: Previous single institutional studies have demonstrated fewer complications in laparoscopic ventral hernia repair (LVHR) compared to open ventral hernia repair (OVHR). We questioned whether or not these data were supported in large cross-sectional studies.

Materials And Methods: We evaluated the National Surgical Quality Improvement Program (NSQIP) database comparing all LVHR versus primary OVHR for patients from 2005 to 2006.

Resident versus no resident: a single institutional study on operative complications, mortality, and cost.

Background: Previous studies have demonstrated an increase in surgical morbidity, mortality, duration of stay, and costs in teaching hospitals. These studies are confounded by many variables. Controlling for these variables, we studied the effect of surgical residents on these outcomes during rotations with non-academic-based teaching faculty at a teaching hospital.

Validation of a screening protocol for identifying low-risk candidates with type 1 diabetes mellitus for kidney with or without pancreas transplantation.

Background: Certain clinical risk factors are associated with significant coronary artery disease in kidney transplant candidates with diabetes mellitus. We sought to validate the use of a clinical algorithm in predicting post-transplantation mortality in patients with type 1 diabetes. We also examined the prevalence of significant coronary lesions in high-risk transplant candidates.

Renal vascular response to static handgrip exercise: sympathetic vs. autoregulatory control.

Static exercise causes activation of the sympathetic nervous system, which results in increased blood pressure (BP) and renal vascular resistance (RVR). The question arises as to whether renal vasoconstriction that occurs during static exercise is due to sympathetic activation and/or related to a pressure-dependent renal autoregulatory mechanism. To address this issue, we monitored renal blood flow velocity (RBV) responses to two different handgrip (HG) exercise paradigms in 7 kidney transplant recipients (RTX) and 11 age-matched healthy control subjects.

Excellent outcome in infants and small children with thrombophilias undergoing kidney transplantation.

One of the most common causes of early graft failure in children undergoing renal transplantation is vascular thrombosis. Numerous risk factors for graft thrombosis have been previously described. Children with various types of thrombophilias such as protein C, protein S and factor V Leiden deficiencies are at an increased risk for vascular thrombosis.

Dual-kidney transplantation with organs from expanded criteria donors: a long-term follow-up.

Background: Since 1995, dual-kidney transplantation using organs from marginal donors has been used at our center to expand the organ donor pool and decrease the waiting time for deceased donor kidney transplantation. This approach has allowed for a shorter waiting period without compromising outcome in the early posttransplant period. We now have 8-year follow-up in the first recipients.

Randomized trial of tacrolimus + mycophenolate mofetil or azathioprine versus cyclosporine + mycophenolate mofetil after cadaveric kidney transplantation: results at three years.

Methods: Two hundred twenty-three recipients of first cadaveric kidney allografts were randomized to receive tacrolimus (TAC) + mycophenolate mofetil (MMF), TAC + azathioprine (AZA), or cyclosporine (Neoral; CsA) + MMF. All regimens contained corticosteroids, and antibody induction was used only in patients who experienced delayed graft function (DGF). Patients were followed-up for 3 years.

Prospective, randomized, multi-center trial of antibody induction therapy in simultaneous pancreas-kidney transplantation.

A randomized, multicenter, prospective study was conducted at 18 pancreas transplant centers in the United States to determine the role of induction therapy in simultaneous pancreas-kidney (SPK) transplantation. One hundred and 74 recipients were enrolled: 87 recipients each in the induction and noninduction treatment arms. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and corticosteroids.

Dual-kidney transplants: long-term results.

Background: Dual-kidney transplantation, where two usually aged adult kidneys are placed into an adult recipient, is one way to help alleviate the continuing disparity between the number of patients on the kidney transplant waiting list and those who receive kidney transplants each year. The Dual Kidney Registry was developed to analyze donor and recipient data and outcomes at several centers.

Methods: Two hundred eighty-seven patients who have undergone transplantation since 1994 have been entered into the relational database.

Maintenance and recovery stages of postischemic acute renal failure in humans.

Postischemic injury in 38 recipients of 7-day-old cadaveric renal allografts was classified into sustained (n = 15) or recovering (n = 23) acute renal failure (ARF) according to the prevailing inulin clearance. Recipients of long-standing allografts that functioned optimally (n = 16) and living transplant donors undergoing nephrectomy (n = 10) served as functional and structural controls, respectively. A combination of physiological and morphometric techniques were used to evaluate glomerular filtration rate and its determinants 1-3 h after reperfusion and again on day 7 to elucidate the mechanism for persistent hypofiltration in ARF that is sustained.