Publications by authors named "Kerry Breen"

Article Synopsis
  • Pancreas divisum (PD) is a common birth defect of the pancreas, but the genetic factors behind it are still unclear, prompting a genome-wide study to find potential genetic links.
  • Researchers analyzed data from 13,940 participants, identifying a significant genetic locus on chromosome 3q29 associated with PD, specifically linked to two genes related to cellular functions.
  • The study not only established a genetic link to PD but also identified potential regulatory genes that might influence pancreatic development, which could aid in better understanding and treating related pancreatic conditions.
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Unlabelled: Prospective, multicenter, single-arm study of antimicrobial-coated, noncrosslinked, acellular porcine dermal matrix (AC-PDM) in a cohort involving all centers for disease control and prevention wound classes in ventral/incisional midline hernia repair (VIHR).

Materials And Methods: Seventy-five patients (mean age 58.6±12.

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Background: Opioid overprescription in trauma contributes to the opioid epidemic through diversion of unused pills. Through our study, we sought to do the following: (1) understand the variation in opioid prescription after injury and its relationship to patient and/or clinical variables, and (2) study the relationship between opioid prescribing and long-term pain and analgesic use.

Method: Trauma patients with an injury severity score ≥9 admitted to 3 level 1 trauma centers were screened for chronic pain and analgesic use 6 to 12 months postinjury.

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Background: Socioeconomic status (SES) is defined as a total measure of an individual's economic or social position in relation to others. Income and educational level are often used as quantifiable objective measures of SES but are inherently limited. Perceived SES (p-SES), refers to an individual's perception of their own SES.

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Purpose: Enteral nutrition is associated with improved outcomes in acute pancreatitis (AP), but previous studies have not focused on critically-ill patients. Our purpose was to determine the association between nutritional support and infectious complications in ICU-admitted patients with AP.

Methods: A retrospective analysis of patients with AP admitted in ICUs of 127 US hospitals from the eICU Collaborative were included.

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Background: In military combat settings, noncompressible closed cavity exsanguination is the leading cause of potentially survivable deaths, with no effective treatment available at point of injury. The aim of this study was to assess whether an expanding foam based on hydrophobically modified chitosan (hm-chitosan) may be used as a locally injectable hemostatic agent for the treatment of noncompressible bleeding in a swine model.

Methods: A closed-cavity, grade V hepato-portal injury was created in all animals resulting in massive noncoagulopathic, noncompressible bleeding.

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Introduction: Intraoperative deaths (IODs) are rare but catastrophic. We systematically analyzed IODs to identify clinical and patient safety patterns.

Methods: IODs in a large academic center between 2015 and 2019 were included.

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Background: Several studies have demonstrated that low-molecular weight heparin (LMWH) is superior to unfractionated heparin (UFH) in trauma patients. The superiority of either one has not been established for the elderly. In this study, we compared LMWH to UFH in elderly trauma patients.

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Importance: The familial aspect of acute appendicitis (AA) has been proposed, but its hereditary basis remains undetermined.

Objective: To identify genomic variants associated with AA.

Design, Setting, And Participants: This genome-wide association study, conducted from June 21, 2019, to February 4, 2020, used a multi-institutional biobank to retrospectively identify patients with AA across 8 single-nucleotide variation (SNV) genotyping batches.

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Article Synopsis
  • Abdominal wall thickness (AWT) is proposed as a more reliable predictor for surgical site infections (SSI) than body mass index (BMI) in patients undergoing emergency colon surgeries.
  • A study analyzing data from 236 patients found that a higher AWT significantly correlated with increased SSI rates, while BMI alone did not show a strong statistical relationship.
  • The findings suggest that incorporating AWT measurements in preoperative evaluations may improve wound management and outcomes in emergency surgeries.
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Background: Bedside experience and studies of critically ill patients with coronavirus disease 2019 (COVID-19) indicate COVID-19 to be a devastating multisystem disease. We aim to describe the incidence, associated variables, and outcomes of rhabdomyolysis in critically ill COVID-19 patients.

Materials And Methods: Data for all critically ill adult patients (≥18 years old) admitted to the ICU at a large academic medical center with confirmed COVID-19 between March 13, 2020 and April 18, 2020 were prospectively collected.

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Background: Prehospital tourniquet (PHT) utilization has increased in response to mass casualty events. We aimed to describe the incidence, therapeutic effectiveness, and morbidity associated with tourniquet placement in all patients treated with PHT application.

Methods: A retrospective observational cohort study was performed to evaluate all adults with a PHT who presented at two Level I trauma centers between January 2015 and December 2019.

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Background: We sought to describe characteristics, multisystem outcomes, and predictors of mortality of the critically ill COVID-19 patients in the largest hospital in Massachusetts.

Methods: This is a prospective cohort study. All patients admitted to the intensive care unit (ICU) with reverse-transcriptase-polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 infection between March 14, 2020, and April 28, 2020, were included; hospital and multisystem outcomes were evaluated.

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Background: Emergency departments (EDs) at level 1 trauma centers are often overcrowded and deny ED-to-ED transfers from lower-tiered centers. Lack of access to timely level 1 care is associated with increased mortality. We evaluated the feasibility of a direct admission (DA) protocol as a method to increase timely access to a level 1 trauma center during periods of ED overcrowding.

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Background: The Emergency Surgery Score (ESS) has been previously validated as a reliable tool to predict postoperative outcomes in emergency general surgery (EGS). The purpose of this study is to assess the differential performance of the ESS in specific EGS procedures.

Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was retrospectively analyzed for patients undergoing EGS between 2007 and 2017.

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Article Synopsis
  • Psychoactive drug use (PDU) affects up to 40% of trauma patients and is linked to higher in-hospital complications, but its long-term impact is not well understood.
  • A study evaluated trauma patients 6 to 12 months after injury to assess the long-term effects of PDU on functional, mental, and psychosocial outcomes, using a structured phone interview.
  • Results from 571 patients showed that those with PDU were generally younger, had more severe injuries, lower educational attainment, and were more prone to chronic pain and mental health disorders post-injury.
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Background: Trauma patients are at a significant risk of venous thromboembolism (VTE), with lower extremity fractures (LEF) being independent risk factors. Use of direct oral anticoagusants (DOACs) for VTE prophylaxis is effective in elective orthopedic surgery, but currently not approved for trauma patients. The primary objective of this study was to compare the effectiveness and safety of thromboprophylaxis of DOACs with low-molecular-weight heparin (LMWH) in trauma patients sustaining LEF.

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Hypotension is a known risk factor for poor neurologic outcomes after traumatic brain injury (TBI). Current guidelines suggest that higher systolic blood pressure (SBP) thresholds likely confer a mortality benefit. However, there is no consensus on the ideal perfusion pressure among different age groups (i.

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Background: Decision making regarding the optimal timing for initiating thromboprophylaxis in patients with blunt abdominal solid organ injuries (BSOIs) remains ill-defined, with no guidelines defining optimal timing. In this study, we aimed to evaluate the relationship of the timing of thromboprophylaxis with thromboembolic and bleeding complications in the setting of BSOIs.

Methods: A retrospective analysis of the Trauma Quality Improvement Program database was performed between 2013 and 2016.

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This study examined records of 2566 consecutive COVID-19 patients at five Massachusetts hospitals and sought to predict level-of-care requirements based on clinical and laboratory data. Several classification methods were applied and compared against standard pneumonia severity scores. The need for hospitalization, ICU care, and mechanical ventilation were predicted with a validation accuracy of 88%, 87%, and 86%, respectively.

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