Fortification of Preservation Solution With Nitroprusside Does Not Alter Lung Allograft Survival in Clinical Human Lung Transplantation.

Nitric oxide improves gas exchange following primary lung allograft dysfunction. Nitroprusside, a potent nitric oxide donor, has reduced reperfusion injury and improved oxygenation in experimental lung transplantation. We sought to study the effect on lung allograft outcomes of fortifying the preservation solution with nitroprusside.

Effect of Obesity on Component Alignment in Total Knee Arthroplasty.

Background: Obesity is routinely cited as a negative predictive factor for outcomes after total knee arthroplasty (TKA), but the direct mechanism responsible for this relationship has not been described. One possible explanation is a propensity for component malalignment in obese patients that is attributable to difficulty with surgical exposure.

Methods: This study evaluated the effect of obesity on TKA component alignment in 251 primary TKAs during a 12-month period at a single center in 2009.

The Effects of a Hospitalist Comanagement Model for Joint Arthroplasty Patients in a Teaching Facility.

Background: The goal of this study was to compare postoperative medical comanagement of total hip arthroplasty and total knee arthroplasty patients using a hospitalist (H) and nonhospitalist (NH) model at a single teaching institution to determine the clinical and economic impact of the hospitalist comanagement.

Methods: We retrospectively reviewed the records of 1656 patients who received hospitalist comanagement with 1319 patients who did not. The NH and H cohorts were compared at baseline via chi-square test for the American Society of Anesthesiologists classification, the t test for age, and the Wilcoxon test for the unadjusted Charlson Comorbidity Index score and the age-adjusted Charlson Comorbidity Index score.

Financial Analysis of Treating Periprosthetic Joint Infections at a Tertiary Referral Center.

Background: Periprosthetic joint infection (PJI) is a significant challenge to the orthopedic surgeon, patient, hospital, and insurance provider. Our study compares the financial information of self-originating and referral 2-stage revision hip and knee surgeries at our tertiary referral center for hip or knee PJI over the last 4 years.

Methods: We performed an in-house retrospective financial review of all patients who underwent 2-stage revision hip or knee arthroplasty for infection between January 2008 and August 2013, comparing self-originating and referral cases.

The Financial Impact of a Multidisciplinary Preoperative Risk Stratification Program for Joint Arthroplasty.

This study's purpose was to assess the impact of a preoperative risk stratification program on joint arthroplasty outcomes at a single institution. We hypothesized that by using a standardized preoperative risk stratification center we would see better outcomes and decreased costs. The triage cohort (T) included 1498 patients assessed at a standardized risk stratification center, and the non-triage cohort (NT) included 1100 patients who did not utilize the center.

Comparison of limb-length discrepancy after THA: with and without computer navigation.

Limb-length discrepancy following total hip arthroplasty (THA) is often cited as a reason for patient dissatisfaction and for hip instability. Various intraoperative techniques have been described to help restore normal limb length after THA. The purpose of this study was to assess whether a computer-navigated surgical technique would help restore limb-length equality following THA.

Can private, non-university-affiliated cardiothoracic training programs provide sufficient surgical experience in cardiac tumors?

Surgical case volumes in non-university-affiliated cardiothoracic surgery training programs in the US have been extensively studied by the Residency Review Committee (RRC) for thoracic surgery. The RRC has established that these programs offer a broad experience in common cardiothoracic procedures such as myocardial revascularization, valvular surgery, and cardiopulmonary transplantation. However, resident exposure to other important but less common cardiac surgical conditions in these programs remains unanswered.

Massive osteolysis due to failure of a unipolar endoprosthesis.

Unipolar endoprostheses are commonly used for the treatment of displaced femoral neck fractures in the elderly. Failure due to polyethylene wear, which has been well documented in bipolar endoprostheses, is not a commonly reported problem with unipolar prostheses. We present 2 cases of a particular unipolar design that failed due to polyethylene wear.

Revascularization in severe ventricular dysfunction (15% < OR = LVEF < OR = 30%): a comparison of bypass grafting and percutaneous intervention.

Background: We sought to determine the optimal approach to revascularization of patients with severe left ventricular (LV) dysfunction.

Methods: We conducted a single-center observational study of 117 consecutive patients who had severe LV dysfunction (15% < OR = LV ejection fraction < OR = 30%) and underwent either coronary artery bypass grafting (CABG, n = 69) or percutaneous revascularization (n = 48) between 1992 and 1997.

Results: The CABG group was younger (62 versus 67 years, p = 0.

A history of the diagnosis and treatment of venous thrombosis and pulmonary embolism.

The history of venous thrombosis and pulmonary embolism echoes the naes of Harvey, Virchow, Margagni, Lannec, Trendelenberg, Ochsner DeBakey, Murray and many other famous figures in medicine. Through anatomical observation, physiologic experimentation, and laboratory or clinical investigation, they individually and collectively contributed to our current knowledge and approach to the treatment of these common and often life-threatening maladies. This article chronicles the important historical milestones in the understanding and development of current surgical and medical management of thromboembolic disease.

Ventricular Septal Defect Masquerading as Severe Tricuspid Regurgitation: A Case Report and Literature Review.

Two-dimensional echocardiography (2-D) is a useful technique for noninvasive evaluation cardiac structure, function, and hemodynamics; however, multiple factors may limit the technical adequacy of the 2-D examination. In this article, we present the case of a ventricular septal defect to right atrial shunt, which was misinterpreted as severe tricuspid regurgitation secondary to severe pulmonary hypertension, despite the absence of right ventricular enlargement or hypertrophy. A transesophageal echocardiography (TEE) examination was performed to explain the discrepancy between the 2-D and Doppler findings, the results of which are discussed, along with a review of the literature.