Publications by authors named "Georgi Mladenov"
Background: The United States (US) has one of the highest rates of gunshot-related incidents in the world. Gunshot wounds to the head (GSWH) in the pediatric population are also common, with high morbidity and mortality rates.
Methods: We performed a retrospective study to analyze if there was a notable change in trends in pediatric GSWH at our Level 1 Pediatric Trauma Center due to the COVID-19 pandemic.
Introduction: Hepatic angioembolization is highly effective for hemorrhage control in hemodynamically stable patients with traumatic liver injuries and contrast extravasation. However, there is a paucity of data regarding the specific location of angioembolization within the hepatic arterial vasculature and its implications on patient outcomes.
Methods: A post-hoc analysis of a multicenter prospective observational study across 23 centers was performed.
Background: Prior studies evaluating observation versus angioembolization (AE) for blunt liver injuries (BLT) with contrast extravasation (CE) on computed tomography imaging have yielded inconsistent conclusions, primarily due to limitations in single-center and/or retrospective study design. Therefore, this multicenter study aims to compare an observation versus AE-first approach for BLT, hypothesizing decreased liver-related complications (LRCs) with observation.
Methods: We conducted a post hoc analysis of a multicenter, prospective observational study (2019-2021) across 23 centers.
Article Synopsis
- High-grade liver injuries with extravasation (HGLI + Extrav) carry significant risks, and the study evaluated whether an observation-first strategy (OBS) is safe compared to initial angiography (IR).
- Of 59 patients, 39% were treated with OBS and 61% with IR, with patients initially managed by IR experiencing a higher rate of surgery (13.9% vs. 0%).
- Despite the increased rate of operations for IR patients, there were no significant differences in liver-related complications or mortality, indicating that OBS may be a suitable approach for selectively managing HGLI + Extrav patients.
Article Synopsis
- Necrotizing enterocolitis (NEC) is a major surgical emergency in preterm infants, and despite decades of research, more investigations are needed on its causes and treatments.
- * This paper discusses the primary animal models used for studying NEC—rats, mice, and piglets—along with their advantages and disadvantages.
- * Additionally, it explores other lesser-used animal models that have provided valuable insights into NEC and emphasizes the importance of selecting the right model for effective research.
Article Synopsis
- Lowe syndrome is a rare genetic disorder caused by mutations in the OCRL1 gene, leading to issues primarily in the eyes, brain, and kidneys, with a prevalence of about 1 in 500,000 people.
- A 9-year-old boy with Lowe syndrome was found to have multiple epidermal cysts in the perianal region, which is an uncommon manifestation of the condition, and underwent successful excision without complications.
- This case highlights the need for awareness of epidermal cysts as a potential diagnosis in Lowe syndrome patients, especially when presented with unusual symptoms like perianal masses, which could initially raise concerns for more serious conditions.
Introduction: The management of liver injuries in hemodynamically stable patients is variable and includes primary treatment strategies of observation (OBS), angiography (interventional radiology [IR]) with angioembolization (AE), or operative intervention (OR). We aimed to evaluate the management of patients with liver injuries with active extravasation on computed tomography (CT) imaging, hypothesizing that AE will have more complications without improving outcomes compared with OBS.
Methods: This is a prospective, multicenter, observational study.
Aims: Design to develop an artificial intelligence (AI) algorithm to accurately predict the pulmonary artery pressure (PAP) waveform using non-invasive signal inputs.
Methods And Results: We randomly sampled training, validation, and testing datasets from a waveform database containing 180 patients with pulmonary atrial catheters (PACs) placed for PAP waves collection. The waveform database consisted of six hemodynamic parameters from bedside monitoring machines, including PAP, artery blood pressure (ABP), central venous pressure (CVP), respiration waveform (RESP), photoplethysmogram (PPG), and electrocardiogram (ECG).
Purpose: There is mounting evidence that surgical patients with COVID-19 have higher morbidity and mortality than patients without COVID-19. Infection is prevalent amongst the trauma population, but any effect of COVID-19 on trauma patients is unknown. We aimed to evaluate the effect of COVID-19 on a trauma population, hypothesizing increased mortality and pulmonary complications for COVID-19-positive (COVID) trauma patients compared to propensity-matched COVID-19-negative (non-COVID) patients.
View Article and Find Full Text PDF