J Thorac Cardiovasc Surg
November 2024
Background: Chatbot use has developed a presence in medicine and surgery and has been proposed to help guide clinical decision making. However, the accuracy of information provided by artificial intelligence (AI) platforms has been called into question. We evaluated the performance of 4 popular chatbots on a board-style examination and compared results with a group of board-certified thoracic surgeons.
View Article and Find Full Text PDFBronchopulmonary sequestration presents rarely in adults and less frequently with an aneurysmal aberrant feeding artery. Treatment of bronchopulmonary sequestration generally involves lung resection with vascular ligation; however, aneurysmal disease increases the risk of intra- and postoperative hemorrhage and often necessitates more extensive surgery for vascular control. A 39-year-old female patient with a history of prior abdominal surgery presented with sudden onset epigastric and back pain.
View Article and Find Full Text PDFBackground: Chatbot use in medicine is growing, and concerns have been raised regarding their accuracy. This study assessed the performance of 4 different chatbots in managing thoracic surgical clinical scenarios.
Methods: Topic domains were identified and clinical scenarios were developed within each domain.
In the last 60 years, health care has evolved due to many trends including the introduction of third-party payers, a progressively aging society, advancing technology, emerging recognition of social issues of race/gender/poverty, the relative decline in the physician workforce, rising health care costs, ongoing consolidation of health care entities, and the corporatization of health care delivery. This has led to problems in health care delivery with respect to cost, quality, and access. Many medical leaders feel it is now the duty of the physician to go beyond the classic patient-doctor clinical responsibility and work to advocate for their patients and society regarding economic, financial, educational, and social issues.
View Article and Find Full Text PDFAnti-reflux procedures have become a mainstay in managing gastroesophageal reflux disease (GERD) and hiatal hernia. Unfortunately, post-operative events such as breakdown of the wrap, downward slippage, or transdiaphragmatic herniation of an intact wrap cause these procedures to fail and create complications such as recurrent hiatal hernia and reflux dysphagia, regurgitation, and obstruction requiring revision surgery. We discuss a case of a rotational retro-esophageal herniation of the gastric body through a Nissen fundoplication presenting as obstruction, dysphagia, and regurgitation, highlighting the peculiar nature of this presentation and the ease of misdiagnosis given its rarity.
View Article and Find Full Text PDFThe National Emphysema Treatment Trial compared medical treatment of severe pulmonary emphysema with lung-volume-reduction surgery in a multiinstitutional randomized prospective fashion. Two decades later, this trial remains one of the key sources of information we have on the treatment of advanced emphysematous lung disease. The trial demonstrated the short- and long-term effectiveness of surgical intervention as well as the need for strict patient selection and preoperative workup.
View Article and Find Full Text PDFThoracic injury is common in high-energy and low-energy trauma, and is associated with significant morbidity and mortality. Evaluation requires a systematic approach prioritizing airway, respiration, and circulation. Chest injuries have the potential to progress rapidly and require prompt procedural intervention.
View Article and Find Full Text PDFBackground: There is debate regarding the appropriate use of transanal endoscopic microsurgery for rectal cancer.
Objective: This study analyzed our single-center experience with transanal endoscopic microsurgery for early rectal cancer.
Design: Medical charts of patients who underwent transanal endoscopic microsurgery were reviewed to determine lesion characteristics, as well as operative and treatment characteristics.
Background: A novel potential approach for lung transplantation could be to utilize xenogeneic decellularized pig lung scaffolds that are recellularized with human lung cells. However, pig tissues express several immunogenic proteins, notably galactosylated cell surface glycoproteins resulting from alpha 1,3 galactosyltransferase (α-gal) activity, that could conceivably prevent effective use. Use of lungs from α-gal knock out (α-gal KO) pigs presents a potential alternative and thus comparative de- and recellularization of wild-type and α-gal KO pig lungs was assessed.
View Article and Find Full Text PDFThe world of medicine is in a state of flux with major and substantive changes in its educational model. Students, residents, and junior attendings can no longer rely entirely on experiential development through clinical immersion. Instead, to attain similar levels of knowledge, technique, and situational comfort, there must be innovations in medical education that take advantage of the experience of mentors.
View Article and Find Full Text PDFAcellular scaffolds from complex whole organs such as lung are being increasingly studied for ex vivo organ generation and for in vitro studies of cell-extracellular matrix interactions. We have established effective methods for efficient de and recellularization of large animal and human lungs including techniques which allow multiple small segments (∼ 1-3 cm(3)) to be excised that retain 3-dimensional lung structure. Coupled with the use of a synthetic pleural coating, cells can be selectively physiologically inoculated via preserved vascular and airway conduits.
View Article and Find Full Text PDFBackground: Relatively little is known or understood about the nature of complications that occur during a surgical procedure. Definitions, classification, and documentation are substantive challenges to comprehensive event capture. We hypothesized that our prospective complication database (ie, Surgical Activity Tracking System) would supplement traditional sources of intraoperative complication reporting.
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