Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations.

Purpose: Acute hand infections (AHIs) remain a challenge for hand surgeons and represent a condition for which clinical outcomes are considerably affected by social barriers. We previously described the looped Penrose drainage technique, where a drain is sutured to itself in a loop and the outflow tract of egress is maintained, thus obviating the need for large incisions, wound closure, or repeat packing, thereby reducing the follow-up burden. In the face of escalating numbers of socioeconomically vulnerable patients, especially in urban settings, we aimed to characterize the clinical features and outcomes of this technique in an urban population of patients with AHI.

Probabilistic nested model selection in pharmacokinetic analysis of DCE-MRI data in animal model of cerebral tumor.

Best current practice in the analysis of dynamic contrast enhanced (DCE)-MRI is to employ a voxel-by-voxel model selection from a hierarchy of nested models. This nested model selection (NMS) assumes that the observed time-trace of contrast-agent (CA) concentration within a voxel, corresponds to a singular physiologically nested model. However, admixtures of different models may exist within a voxel's CA time-trace.

Onlay Resorbable Biosynthetic versus Underlay Biologic Mesh Ventral Hernia Repair in Contaminated Fields.

Introduction: Abdominal wall reconstruction (AWR) with ventral hernia repair (VHR) in the setting of contamination poses unique and controversial challenges. The purpose of this study was to examine the efficacy of onlay resorbable biosynthetic mesh against underlay biologic mesh in contaminated VHR with AWR.

Methods: A single-center retrospective review from 2015 to 2021 was performed examining subjects who underwent VHR with AWR in contaminated fields (Centers for Disease Control wound class II-IV).

Word of the Wise: A Propensity-Matched Comparative Analysis of Breast Reduction Incision Patterns on Clinical Outcomes and Quality of Life.

Introduction: Breast reduction surgery addresses both functional complaints and aesthetic concerns. Two commonly used incision patterns in the US are the Wise and vertical patterns, but there are limited data comparing their clinical and quality of life (QoL) outcomes. This study evaluates and compares these outcomes between the two techniques.

Multimodal Pilot Evaluation of a Hyaluronic Acid Infraorbital Filler Using Precise, Multipositional, 3-Dimensional Imaging Quantification, Patient-Reported Outcomes, and Anatomic Cadaveric Assessments.

Background: Despite the high demand of filler in the infraorbital area, there remains debate on injection practices, precise anatomical placement, and hyaluronic acid (HA) filler behavior.

Objectives: We aimed to contribute to the clinical and anatomic understanding of infraorbital HA injection through a prospective patient injection study in combination with a cadaveric analysis.

Methods: Patients were injected with Volbella XC (JUVÉDERM, Allergan Aesthetics, an AbbVie Company, Irvine, CA) into the tear trough region by a single experienced aesthetic plastic surgeon.

A Longitudinal Evaluation of Collaboration in Plastic Surgery Clinical Research.

Background: Few dedicated, funded clinical research fellowship positions exist in plastic surgery. This study provides insights from an established clinical research fellowship, highlighting its educational impact and confirming the impact of positive institutional support and a collaborative-first approach.

Methods: All research fellows within the program from 2008 to 2020 were examined during their year of employment and subsequent 2 years.

Marijuana and Its Implications in Breast Reduction Surgery Outcomes and Quality of Life: A Matched Analysis.

Background: With marijuana use on the rise, its influence on surgical outcomes, particularly for breast reduction, warrants investigation. This study aims to clarify marijuana's effects on breast reduction surgery outcomes, given its limited research focus despite potential perioperative implications.

Methods: A retrospective review was conducted from 2016 to 2022 of patients with/without marijuana use undergoing breast reduction.

Influence of polysubstance use on the health-related quality of life among people who inject drugs undergoing opioid agonist treatment following treatment for hepatitis c virus.

Background: Treating hepatitis C virus (HCV) in people who inject drugs (PWID) has been associated with increased health-related quality of life (HRQOL). Polysubstance use (PSU) is common among PWID, but no studies have investigated PSU influence on PWID's HRQOL HCV treatment.

Methods: Participants included 150 PWID receiving HCV treatment at opioid agonist treatment clinics in Bronx, NY.

Implementing an obstetric sepsis bundle in a large academic hospital system.

For the purposes of this review, obstetric sepsis refers to sepsis (from all causes, including non-obstetric such as pneumonia) in pregnant or postpartum patients, which was previously described as maternal sepsis. Obstetric sepsis poses a significant threat to pregnant, birthing, and postpartum individuals, contributing prominently to maternal mortality and morbidity despite being largely preventable. In response to identified gaps in sepsis management, particularly the lack of specific protocols tailored to obstetric populations, New York-Presbyterian undertook a system-wide initiative to implement a comprehensive sepsis bundle.

"I Didn't Have to Worry about It": Patient and Family Experiences with Health System Involvement in Notifying Relatives of Genetic Test Results.

Introduction: In the USA, patients who undergo genetic testing for hereditary cancer risk are responsible for informing relatives about their genetic test results, but many relatives never find out they might be at risk. A health system-mediated relative notification program might help fill this gap, but questions remain about the acceptability of this approach.

Methods: We analyzed qualitative data from a single-arm, nonrandomized, mixed-methods study to understand how patients and families experienced a new health system-mediated relative notification program.

Reevaluation of Recipient Vessel Selection in Breast Free Flap Reconstruction.

Background: Current consensus has established the internal mammary vessels (IMV) over the thoracodorsal vessels (TDV) as the preferred recipients for microvascular breast reconstruction due to their superior flow rates and long-established outcomes. Yet, there are occurrences where the IMVs are not reliable and may subsequently prompt intraoperative decision-making. Several options exist, including the contralateral IMVs, thoracoacromial vessels, and TDVs.

Leveraging Multi-Sectoral Partnership for Colorectal Cancer Education and Screening in the African American Community: A Protocol and Preliminary Results.

Colorectal cancer (CRC) awareness and screening rates are still low in African Americans (AAs), especially for those who do not have regular access to health care. We established a multi-sector community partnership between academia, health system, cancer advocacy, and local county treasurer's office (CTO), to test a pilot CRC screening intervention using a tailored educational brochure and fecal immunochemical test (FIT). Participants were recruited at a local CTO in an urban midwestern region.

Open versus robotic retromuscular ventral hernia repair: outcomes of the ORREO prospective randomized controlled trial.

Background: Robotic retromuscular ventral hernia repair (rRMVHR) potentially combines the best features of open and minimally invasive VHR: myofascial release with abdominal wall reconstruction (AWR) with the lower wound morbidity of laparoscopic VHR. Proliferation of this technique has outpaced the data supporting this claim. We report 2-year outcomes of the first randomized controlled trial of oRMVHR vs rRMVHR.

Effects of Prolonged Proton-Pump Inhibitor Use on Renal Dysfunction and Bone Fragility: A Retrospective Study.

Background: Proton-pump inhibitor (PPI) use for management of gastroesophageal reflux disease (GERD) consists of a short-duration trial, according to guidelines. Long-term usage is appropriate under certain indications. Literature has increasingly documented an adverse effect profile of PPIs, including kidney disease and bone fragility.

Remote Patient Monitoring Is Associated with Improved Outcomes in Hypertension: A Large, Retrospective, Cohort Analysis.

Hypertension (HTN) is a chronic condition that requires careful monitoring and management. Blood pressure readings in the clinic and self-reported blood pressure readings are often too intermittent to allow for careful management. Remote patient monitoring is a solution that may have positive impacts on HTN management.

Reprint of: Efficacy and safety of apixaban compared to warfarin for nonvalvular atrial fibrillation in end-stage renal disease on hemodialysis.

Background: This study compared the efficacy and safety of apixaban and warfarin in patients with nonvalvular atrial fibrillation (NVAF) and end-stage renal disease (ESRD) on hemodialysis (HD). Apixaban decreased incidence of stroke and bleeding compared with warfarin in major clinical trials that excluded patients with severe renal dysfunction. Apixaban is no longer contraindicated in patients with ESRD on HD with NVAF based on pharmacokinetic studies.

Development of an Enhanced Recovery After Surgery Program in Ventral Hernia.

Background: Enhanced Recovery After Surgery (ERAS) programs have spread after initial success in colorectal surgery decreasing length of stay (LOS) and decreasing opioid consumption. Adoption of ERAS specifically for ventral hernia patients remains in evolution. This study presents the development and implementation of an ERAS pathway for ventral hernia.

Heterogeneous Mechanical Stress and Interstitial Fluid Flow Predictions Derived from DCE-MRI for Rat U251N Orthotopic Gliomas.

Mechanical stress and fluid flow influence glioma cell phenotype in vitro, but measuring these quantities in vivo continues to be challenging. The purpose of this study was to predict these quantities in vivo, thus providing insight into glioma physiology and potential mechanical biomarkers that may improve glioma detection, diagnosis, and treatment. Image-based finite element models of human U251N orthotopic glioma in athymic rats were developed to predict structural stress and interstitial flow in and around each animal's tumor.

Unveiling the Need to Improve Personalized Applicant Tools: A Critical Evaluation of the Reliability of the Texas STAR database in Predicting Match Success for Plastic Surgery Applicants.

Objectives: Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool.

Design, Setting, And Participants: A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models.

Probabilistic Nested Model Selection in Pharmacokinetic Analysis of DCE-MRI Data in Animal Model of Cerebral Tumor.

Purpose: Best current practice in the analysis of dynamic contrast enhanced (DCE)-MRI is to employ a voxel-by-voxel model selection from a hierarchy of nested models. This nested model selection (NMS) assumes that the observed time-trace of contrast-agent (CA) concentration within a voxel, corresponds to a singular physiologically nested model. However, admixtures of different models may exist within a voxel's CA time-trace.

Balancing the Scales: Caution in Reduction Mammaplasty Recommendations for Obesity Class III Patients.

Introduction: The prevalence of obesity has risen worldwide, posing a problem to surgeons as obesity is a well-known risk factor for surgical outcomes. While prior studies have suggested performing reduction mammaplasty (RM) in patients with obesity, the variance in outcomes and quality of life (QoL) for obesity classes are ill-defined. We investigated whether obesity classes should be considered for RM by examining the surgical outcomes and QoL across different weight classes, aiming to pinpoint when outcomes become less favorable.

Outcomes and Quality of Life After Resorbable Synthetic Ventral Hernia Repair in Contaminated Fields.

Introduction: The ideal mesh type for hernia repair in a contaminated field remains controversial. Data regarding outcomes beyond 1 year and the impact on quality of life (QoL) are unknown. This study aims to evaluate the long-term surgical outcomes and patient-reported outcomes (PROs) after contaminated repair with poly-4-hydroxybutyrate (P4HB) mesh.

Efficacy and safety of apixaban compared to warfarin for nonvalvular atrial fibrillation in end-stage renal disease on hemodialysis.

Background: This study compared the efficacy and safety of apixaban and warfarin in patients with nonvalvular atrial fibrillation (NVAF) and end-stage renal disease (ESRD) on hemodialysis (HD). Apixaban decreased incidence of stroke and bleeding compared with warfarin in major clinical trials that excluded patients with severe renal dysfunction. Apixaban is no longer contraindicated in patients with ESRD on HD with NVAF based on pharmacokinetic studies.