Diagnostic accuracy for detecting atrial fibrillation using a novel machine learning algorithm in a blood pressure monitor.

Background: Early detection of atrial fibrillation (AF) is key for preventing strokes. Blood pressure monitors (BPMs) with built-in AF screening features have the potential for early detection at home. Recently, 2 BPMs (HEM-7371T1-AZ and HEM-7372T1-AZAZ, Omron Healthcare Co.

Is cardiac resynchronization therapy for right ventricular failure in pulmonary arterial hypertension of benefit?

Pulmonary arterial hypertension is a manifestation of a group of disorders leading to pulmonary vascular remodeling and increased pulmonary pressures. The right ventricular (RV) response to chronic pressure overload consists of myocardial remodeling, which is in many ways similar to that seen in left ventricular (LV) failure. Maladaptive myocardial remodeling often leads to intraventricular and interventricular dyssychrony, an observation that has led to cardiac resynchronization therapy (CRT) for LV failure.

Sleep apnea syndrome is significantly underdiagnosed in bariatric surgical patients.

Background: Devastating morbidity and mortality can result when patients with undiagnosed sleep apnea syndrome (SAS) undergo bariatric surgery. We evaluated the prevalence of SAS and its rate of nondiagnosis in bariatric patients at a university hospital.

Methods: The demographic, anthropomorphic, and co-morbidity data were collected from 1368 patients evaluated for bariatric surgery.

Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass.

Background: Previous outcome research in bariatric surgery has been unable to document quantitative changes in co-morbidities associated with obesity owing to a lack of a standardized instrument to grade the severity. We report a detailed description of the early resolution of the metabolic syndrome using our novel scheme for assessing co-morbidities. This study was performed at a tertiary care university hospital.

Depression is associated with increased severity of co-morbidities in bariatric surgical candidates.

Background: Depression is prevalent among bariatric surgical patients, and previous studies have suggested a link between depression and quality of life. Our objective was to examine the relationship between depression and other co-morbidities of obesity at a university hospital in the United States.

Methods: Data were collected from 1368 consecutive patients evaluated for bariatric surgery.

3-D telestration: a teaching tool for robotic surgery.

Background: Telestration is an important teaching tool in minimally invasive surgery (MIS). While robotic surgery offers the added benefit of three-dimensional (3-D) visualization, telestration technology does not currently exist for this modality. This project aimed to develop a video algorithm to accurately translate a mentor's two-dimensional (2-D) telestration into a 3-D telestration in the da Vinci visual field.

Switching robotic surgical systems does not impact surgical performance.

Background: Robotic surgery is heavily dependent on the availability of, and innovation in, technology. As new robotic systems become available, it will be important to identify the impact of emerging technology on clinical outcomes in robotic surgery.

Materials And Methods: A total of 140 laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures have been performed with robotic assistance (80 with Zeus and 60 with da Vinci).

Is routine cholecystectomy indicated for asymptomatic cholelithiasis in patients undergoing gastric bypass?

Background: The purpose of this study was to evaluate the natural history of patients undergoing Roux-en-Y gastric bypass (RYGBP) with known asymptomatic cholelithiasis in whom prophylactic cholecystectomy was not performed at the time of surgery.

Methods: The records of 144 consecutive patients from a single year experience in RYGBP surgery at the University of California, Davis Medical Center were reviewed. Patients undergoing RYGBP were routinely screened for cholelithiasis by ultrasound.

Weight loss before gastric bypass: feasibility and effect on postoperative weight loss and weight loss maintenance.

Background: This study was performed at a tertiary care university hospital. We hypothesized that weight loss before laparoscopic Roux-en-Y gastric bypass (LRYGB) is feasible, does not diminish the expected postoperative weight loss, and might enhance overall weight loss and maintenance.

Methods: A population of 351 consecutive patients, who had undergone LRYGB, was divided into 4 groups depending on the percentage of body weight loss achieved before surgery (group 1, none or gain; group 2, <5%; group 3, 5-10%; and group 4, >10%).

The utility of routine postoperative upper GI series following laparoscopic gastric bypass.

Background: Routine upper gastrointestinal (UGI) studies following laparoscopic Roux-en-Y gastric bypass (LRYGBP) have the potential advantage of early identification of anastomotic complications. The aim of our study was to evaluate the efficacy of routine postoperative UGI and its relationship to clinical outcomes.

Methods: Over a three-year period, 516 patients underwent LRYGBP followed by routine postoperative UGI studies.

Teaching robotic surgery: a stepwise approach.

Background: After an initial institutional experience with 50 robot-assisted laparoscopic Roux-en-Y gastric bypass procedures, a curriculum was developed for fellowship training in robotic surgery.

Methods: Thirty consecutive robotic gastric bypasses were performed using the Zeus robotic surgical system to fashion a two-layer gastrojejunostomy. For teaching purposes, performance of the anastomosis was divided into three discrete tasks.

Reasons for delayed discharge of trauma patients.

Background: In the trauma population, increased length of stay is associated with age, comorbidities, and injury severity. We hypothesized that a significant contributor to a delay in length of stay was unrelated to these variables.

Materials And Methods: All trauma patients admitted for > 48 h with acute injury from 7/1/2000 to 9/30/2000 were evaluated daily for discharge readiness.