The association of Medicaid expansion and parathyroidectomy for benign disease: Insurance status remains an important factor in access to high-volume centers.

Background: Medicaid expansion has been associated with improved access to surgical care at high-volume centers. Its impact on parathyroidectomy, however, is unclear. We evaluated the association between Medicaid expansion and parathyroidectomy at high- and low-volume centers.

Reoperation Rates After Initial Thyroid Lobectomy for Patients with Thyroid Cancer: A National Cohort Study.

The 2015 American Thyroid Association (ATA) guidelines recommended thyroid lobectomy (TL) as an alternative to total thyroidectomy (TT) for the surgical treatment of low-risk differentiated thyroid cancer. Increasing use of TL has since been reported despite concerns for an increased risk of disease recurrence and need for reoperation. This study sought to compare reoperation rates among patients who underwent initial TL or TT for malignancy, characterize trends at centers based on operative volume, and examine factors associated with reoperation.

Which Ultrasound Characteristics Predict Lymphatic Spread of Papillary Thyroid Cancer?

Introduction: The 2015 American Thyroid Association guidelines recommend lymph node mapping US in patients with definitive cytological evidence of thyroid cancer. Suspicious lymph node features on imaging including enlarged size (>1 cm in any dimension), architectural distortion, loss of fatty hilum, and microcalcifications often prompt evaluation with fine needle aspiration. There is no universally agreed upon model for determining which ultrasound characteristics most strongly correlate with metastatic disease.

Association of Medicaid expansion with access to thyroidectomy for benign disease at high-volume centers.

Background: Insurance-based disparities in access to thyroidectomy are well established. Patients undergoing thyroidectomy by high-volume surgeons have fewer complications and better postoperative outcomes. The aim of this study was to evaluate the association of Medicaid expansion with access to high-volume centers for thyroidectomy for benign disease.

Operative trends for pancreatic and hepatic malignancies during the COVID-19 pandemic.

Background: The COVID-19 pandemic disrupted routine health care, including many elective and non-cancer operations in the United States. Most hepato-pancreato-biliary malignancy patients require outpatient imaging, tissue sampling, and staging, and many undergo neoadjuvant therapy before operative intervention. The aims of this study were to evaluate the effect of the COVID-19 pandemic on hepato-pancreato-biliary oncologic operations and to determine whether trends in neoadjuvant therapy were altered by the pandemic.

Malpractice litigation after thyroid surgery: What factors favor surgeons?

Background: Litigation impacts physicians financially, reputationally, and professionally. Although thyroid surgery has favorable patient outcomes, litigation persists. We aimed to characterize malpractice claims after thyroidectomy and investigate which factors favor physicians.

Does Hospital Operative Volume Influence the Outcomes of Patients After Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis?

Background: For some cancer operations, center volume is associated with improved patient outcomes. Whether this association is true for cytoreductive surgery/heated intraperitoneal chemotherapy (CRS/HIPEC) is unclear. Given the rapidly expanding use of CRS/HIPEC, the aim of this analysis was to determine whether a volume-outcome relationship exists for this strategy.

COVID-19 Effect on Surgery for Gastrointestinal Malignancies: Have Operative Volumes Recovered?

Background: COVID-19 disrupted elective operations, cancer screening, and routine medical care while simultaneously overwhelming hospital staff and supplies. Operations for gastrointestinal (GI) malignancies rely on endoscopic screening, staging, and neoadjuvant therapy (NAT), each of which was disrupted by the pandemic. The aim was to evaluate the effect of the COVID-19 pandemic on the US national rates of gastrointestinal oncologic operations.

Effects of the COVID-19 pandemic on endocrine operations in the United States.

Background: The COVID-19 pandemic disrupted the United States (US) healthcare system. Endocrine operations are predominantly elective and were likely affected. Therefore, our aim was to determine the effect of the pandemic on endocrine operations.

The Impact of Surgical Boot Camp on Medical Student Confidence and Imposter Syndrome.

Introduction: Transitioning from medical student to surgical intern is accompanied by increased responsibility, stress, and clinical burden. This environment lends itself to imposter syndrome (IS), a psychological condition grounded in self-doubt causing fear of being discovered as fraud despite adequate abilities. We hypothesized a 2-week surgical boot camp for fourth year medical students would improve confidence in technical skills/knowledge and IS.

Association of Medicaid expansion of the Affordable Care Act with operations for benign endocrine surgical disease.

•Background: The Affordable Care Act's Medicaid expansion increased insurance coverage and access to care for endocrine cancers, though impact on benign endocrine disease is unknown. •Methods: Patients undergoing operations for benign thyroid, parathyroid, and adrenal disease were collected from the Vizient® Clinical Data Base from 2009 to 2016 and grouped by state Medicaid expansion status in January 2014. Insurance coverage was analyzed by difference-in-differences analysis, and logistic regression evaluated odds of operation by insurance status.

Assessment of the ANDE 6C Rapid DNA system and investigative biochip for the processing of calcified and muscle tissue.

The ANDE 6C Rapid DNA system could offer a potential alternative for the processing of calcified and soft tissue samples, often encountered in mass disaster scenarios. While originally designed for single source buccal swabs, interest in the performance of these instruments when using other types of single source samples continues to grow. To enhance the recovery of otherwise lesser quality samples, the manufacturer developed the investigative biochip, an alternative to the NDIS approved Arrestee biochip for reference sample buccal swabs.

Practical recommendations for the safe use of gadolinium in magnetic resonance imaging: a Delphi expert panel study.

Objective: To assess the practical aspects of the use of various gadolinium-based contrast agents (GBCAs) by radiologists.

Materials And Methods: Ten experienced radiologists from different regions of Brazil participated in a Delphi panel querying their use of various GBCAs, including linear and macrocyclic classes (1.0 and 0.

Assessing the impact of using conventional swabs on the ANDE 6C arrestee biochip.

Rapid DNA technology will provide law enforcement booking personnel the ability to process and query reference samples obtained from qualifying arrestees against unsolved crimes of special concern in real-time, potentially enhancing the speed of an investigation. The technology could also be utilized within the laboratory setting to expedite the processing of reference samples submitted with a case. Validation studies have found that when used with reference samples, the ANDE 6C Rapid DNA technology generates successful profiles that are concordant to orthogonal system generated data ∼85 % of the time.

The health of communities living in proximity of geothermal plants generating heat and electricity: A review.

Since the 1990s, in areas with natural geothermal manifestations studies on the association between exposure to pollutants and health effect have become increasingly relevant. These emissions consist of water vapor mixed with carbon dioxide, hydrogen sulfide (HS), methane and, to a lesser extent, rare gases and trace elements in volatile forms. Considering the indications of the World Health Organization and the growth in the use of geothermal energy for energy production, this review aims to report studies exploring the health status of the populations living in areas where geothermal energy is used to produce heat and electricity.

Using S. cerevisiae as a Model System to Investigate V. cholerae VopX-Host Cell Protein Interactions and Phenotypes.

Most pathogenic, non-O1/non-O139 serogroup Vibrio cholerae strains cause diarrheal disease in the absence of cholera toxin. Instead, many use Type 3 Secretion System (T3SS) mediated mechanisms to disrupt host cell homeostasis. We identified a T3SS effector protein, VopX, which is translocated into mammalian cells during in vitro co-culture.

Analysis of non-typeable Haemophilous influenzae VapC1 mutations reveals structural features required for toxicity and flexibility in the active site.

Bacteria have evolved mechanisms that allow them to survive in the face of a variety of stresses including nutrient deprivation, antibiotic challenge and engulfment by predator cells. A switch to dormancy represents one strategy that reduces energy utilization and can render cells resistant to compounds that kill growing bacteria. These persister cells pose a problem during treatment of infections with antibiotics, and dormancy mechanisms may contribute to latent infections.

Abdominal manifestations of lymphoma: spectrum of imaging features.

Non-Hodgkin and Hodgkin lymphomas frequently involve many structures in the abdomen and pelvis. Extranodal disease is more common with Non-Hodgkin's lymphoma than with Hodgkin's lymphoma. Though it may be part of a systemic lymphoma, single onset of nodal lymphoma is not rare.

Brain magnetic resonance imaging findings in young patients with hepatosplenic schistosomiasis mansoni without overt symptoms.

The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9-25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.

Immunogenicity and safety of 1 vs 2 doses of quadrivalent meningococcal conjugate vaccine in youth infected with human immunodeficiency virus.

Objective: To compare the immunogenicity of 1 vs 2 doses of meningococcal polysaccharide conjugate vaccine (MCV4) in youth infected with human immunodeficiency virus (HIV).

Study Design: P1065 was a phase I/II immunogenicity and safety trial of MCV4 in 324 youth infected with HIV performed at 27 sites of the International Maternal Pediatric Adolescent AIDS Clinical Trials Group network in the US. At entry subjects received 1 dose of MCV4.

Safety and immunogenicity of quadrivalent meningococcal conjugate vaccine in 2- to 10-year-old human immunodeficiency virus-infected children.

Background: Human immunodeficiency virus (HIV)-infected children are at increased risk of meningococcal infection and poor response to quadrivalent meningococcal conjugate vaccine (MCV4), but MCV4 has not been studied in preadolescent HIV-infected children.

Methods: The P1065 trial enrolled 2- to 10-year-old HIV-infected children with CD4 ≥ 25% to receive MCV4 at entry and at week 24. Rates of response (≥ 4-fold increase in rabbit serum bactericidal antibody) against each meningococcal serogroup (A, C, Y, W-135), geometric mean titers, and rates of seroprotection (rabbit serum bactericidal antibody titer ≥ 1:128) were determined from sera obtained at entry and weeks 4, 24, 28, and 72.

Imaging of gossypibomas: pictorial review.

Objective: Textiloma and gossypiboma are terms used to describe a mass of cotton matrix that is left behind in a body cavity during an operation. This is an uncommon surgical complication. Gossypibomas are most frequently discovered in the abdomen.

Imaging of gossypibomas: self-assessment module.

The educational objectives of this self-assessment module are for the participants to exercise, self-assess, and improve their understanding of the most important features of gossypibomas and the role of imaging in the diagnosis of these masses.

Schistosomiasis of the liver.

Schistosomiasis is an infection of trematodes, Schistosoma, causing periportal fibrosis and liver cirrhosis due to deposition of eggs in the small portal venules. In schistosomiasis caused by S. mansoni, sonography shows echogenic thickening or fibrotic band along the portal veins.