A 3-dimensional ultrasound study of local anesthetic spread during lateral popliteal nerve block: what is the ideal end point for needle tip position?

Background And Objectives: Recent clinical trials suggest that subfascial (sometimes termed subepineural) injections result in faster block onset and success compared with conventional techniques. This prospective, randomized, observer-blinded study measured and compared the 3-dimensional spread pattern and volume of perineural local anesthetic (LA) in contact with the sciatic nerve after subfascial versus extrafascial lateral popliteal injections.

Methods: Sixty patients were randomly assigned to either the subfascial or the extrafascial injection group.

Inflammation, organomegaly, and muscle wasting despite hyperphagia in a mouse model of burn cachexia.

Background: Burn injury results in a chronic inflammatory, hypermetabolic, and hypercatabolic state persisting long after initial injury and wound healing. Burn survivors experience a profound and prolonged loss of lean body mass, fat mass, and bone mineral density, associated with significant morbidity and reduced quality of life. Understanding the mechanisms responsible is essential for developing therapies.

Obesity and weight loss at presentation of lung cancer are associated with opposite effects on survival.

Background: Lung cancer is the second most common neoplasm and the leading cause of cancer deaths in the United States. In cancer, weight loss and obesity are associated with reduced survival. However, the effect of obesity or weight loss at presentation on lung cancer survival has not been well studied.

Evidence-based medicine and its role in plastic surgery.

In an era in which evidence-based medicine (EBM) has become an intricate aspect of the practice and advancement of the field of medicine, plastic surgery must aim to sustain its role as a pioneer division. It is critical that plastic surgeons understand the significance of EBM and, more importantly, its application to everyday practice. We aimed to review a comprehensive systemic approach to gather high-quality data that help support clinical decision making and assist in determining best available treatment.

Unique Aspects of the Elderly Surgical Population: An Anesthesiologist's Perspective.

Increasing life expectancies paired with age-related comorbidities have resulted in the continued growth of the elderly surgical population. In this group, age-associated changes and decreased physiological reserve impede the body's ability to maintain homeostasis during times of physiological stress, with a subsequent decrease in physiological reserve. This can lead to age-related physiological and cognitive dysfunction resulting in perioperative complications.

Improved survival with lymph node sampling in Wilms tumor.

Objective: We sought to determine the impact of number of lymph nodes examined on survival for Wilms tumor (WT).

Methods: Data from the Surveillance, Epidemiology, and End Results and Florida Cancer Data System were queried for patients < 20 years of age with WT.

Results: Of 1805 WT patients, 1340 had lymph node (LN) data available following surgery.

Incidence and outcomes of extremity soft-tissue sarcomas in children.

Background: We studied the outcomes of pediatric extremity tumors on a population scale.

Methods: The Surveillance, Epidemiology, and End Results database (1973-2006) was queried for all patients under 20 y of age.

Results: Overall, 1175 patients were identified.

Pediatric non-Wilms renal tumors: subtypes, survival, and prognostic indicators.

Background: To determine the outcomes and predictors of survival for pediatric non-Wilms renal tumors (NWRT).

Methods: The SEER database (1973-2005) was queried for all patients < 20 y of age.

Results: Overall, 349 cases of NWRT were identified.

Do all patients with carcinoma of the esophagus benefit from treatment at teaching facilities?

Background: We sought to determine whether patients with esophageal carcinoma benefit from regionalization of care.

Methods: The Florida Cancer Data System (FCDS) and the Agency for Health Care Administration data sets (1998-2002) were merged and queried.

Results: A total of 5,041 patients (87.

Do racial or socioeconomic disparities exist in lung cancer treatment?

Background: Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer.

Methods: The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998-2002.

Results: A total 76,086 of lung cancer patients were identified.

Survival effects of adjuvant chemoradiotherapy after resection for pancreatic carcinoma.

Background: The survival benefit of adjuvant chemotherapy alone or chemoradiotherapy in patients with pancreatic cancer who have undergone surgical resection remains unclear.

Objective: To identify the additional benefit of adjuvant therapy by retrospectively examining a large population-based registry of patients who underwent definitive surgical resection for pancreatic adenocarcinoma.

Design And Setting: The Florida cancer registry and state inpatient and outpatient hospital data records were queried for pancreatic adenocarcinoma diagnosed between 1998 and 2002.

Are patients of low socioeconomic status receiving suboptimal management for pancreatic adenocarcinoma?

Background: The objective of this study was to define the effects of socioeconomic status (SES) and other demographic variables on outcomes for patients with pancreatic adenocarcinoma.

Methods: Florida cancer registry and inpatient hospital data were queried for pancreatic adenocarcinoma diagnosed from 1998 to 2002.

Results: In total, 16,104 patients were identified.

Pediatric solid tumors and second malignancies: characteristics and survival outcomes.

Background: To examine the incidence, characteristics, and outcomes for second malignancies following the diagnosis of a primary solid tumor in pediatric patients.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried from 1973 to 2005, excluding recurrences, in patients <20 y.

Results: A total of 31,685 cases of pediatric solid malignancies were identified.

Disappearance of racial disparities in gastrointestinal stromal tumor outcomes.

Background: The purpose of this study was to determine the effects of race, socioeconomic status, and demographic and clinical variables on the outcomes of gastrointestinal stromal tumors (GISTs).

Study Design: The Surveillance, Epidemiology, and End Results (SEER) database was queried for GIST and other intestinal mesenchymal tumors from 1992 to 2005.

Results: A total of 3,795 patients with mesenchymal tumors were identified.

Pediatric FAST and elevated liver transaminases: An effective screening tool in blunt abdominal trauma.

Background: The current standard for the evaluation of children with blunt abdominal trauma (BAT) consists of physical examination, screening lab values, and computed tomography (CT) scan. We sought to determine if the focused assessment with sonography for trauma (FAST) combined with elevated liver transaminases (AST/ALT) could be used as a screening tool for intra-abdominal injury (IAI) in pediatric patients with BAT.

Methods: Registry data at a level 1 trauma center was retrospectively reviewed from 1991-2007.

Survival disparities among African American women with invasive bladder cancer in Florida.

Background: The authors sought to understand the effect of patient sex, race, and socioeconomic status (SES) on outcomes for bladder cancer.

Method: The Florida Cancer Data System and the Agency for Health Care Administration data sets (1998-2003) were merged and queried. Survival outcomes for patients with bladder cancer were compared between different races, ethnicities, and community poverty levels.

Pediatric intestinal foregut and small bowel solid tumors: a review of 105 cases.

Background: The outcomes of pediatric intestinal foregut and small bowel solid tumors have never been studied on a population scale.

Materials And Methods: The Surveillance, Epidemiology, and End Results database (1973-2005) was queried for all patients under 20 y of age.

Results: A total of 105 cases of pediatric intestinal foregut and small bowel solid tumors were identified.

African-American and low-socioeconomic status patients have a worse prognosis for invasive ductal and lobular breast carcinoma: do screening criteria need to change?

Background: Determine the effect of race, socioeconomic status (SES) and other demographic variables on outcomes of patients with invasive ductal and lobular breast cancer.

Study Design: Florida cancer registry and inpatient hospital data were queried for patients diagnosed with invasive breast cancer from 1998 to 2002.

Results: A total of 63,472 patients with breast cancer were identified.

Primary solid tumors of the colon and rectum in the pediatric patient: a review of 270 cases.

Objective: To study the outcomes of solid tumors of the colon and rectum in pediatric patients.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973-2005) was queried for patients less than 20 y of age.

Results: Overall, 270 patients with malignant tumors of the lower gastrointestinal tract were identified.

A comprehensive evaluation of outcomes for inflammatory breast cancer.

Objective: Inflammatory breast cancer (IBC) remains the breast malignancy with the worst prognosis. We sought to determine the effects of race, socioeconomic status and treatment on outcomes for women with IBC. Study design The Florida cancer registry, inpatient and ambulatory data were queried for patients diagnosed from 1998 to 2002.

Will patients benefit from regionalization of gynecologic cancer care?

Objective: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma.

Methods: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000.