Pediatric Facial Burn Reconstruction.

Contrary to prior pediatric burn treatment philosophies, we now know that early burn excision and grafting for non life-threatening burns can compromise future reconstruction. Extensive scar excision should be minimized and scar rehabilitation maximized, as secondary iatrogenic deformities can become even more difficult to fix. Scar remodeling with local tissue rearrangement can relieve tension and soften scars over time.

Reasons for multiple biologic and targeted synthetic DMARD switching and characteristics of treatment refractory rheumatoid arthritis.

Objective: Switching biologic and targeted synthetic DMARD (b/tsDMARD) medications occurs commonly in RA patients, however data are limited on the reasons for these changes. The objective of the study was to identify and categorize reasons for b/tsDMARD switching and investigate characteristics associated with treatment refractory RA.

Methods: In a multi-hospital RA electronic health record (EHR) cohort, we identified RA patients prescribed ≥1 b/tsDMARD between 2001 and 2017.

Analysis of Reapplicants to Ophthalmology Residency: Factors Associated with Successful Matching.

Background: Ophthalmology residency programs are highly competitive and each year there are many unmatched reapplicants who must make time-sensitive decisions on how to prepare for their reapplication. Our analysis of reapplication factors will be the first evidence-based guide to reapplying ophthalmology.

Objective: To determine the components of a reapplicants application that contribute and that do not contribute to ophthalmology residency match success.

Qualitative Analysis of Interviews and Focus Groups Exploring Factors Contributing to Adherence to GnRH Agonists in Men with Prostate Cancer.

Objectives: Side effects from the prolonged use of gonadotropin-releasing hormone (GnRH) agonists may lead to nonadherence to the treatment in men with advanced prostate cancer (PCa). We investigated the reasons contributing to nonadherence to GnRH agonists through interviews with men with PCa and focus groups with their health care professionals.

Data Sources: The three stages of the study were validation of themes, interviews with men on GnRH agonists, and focus groups with oncology specialists and clinical nurse specialists.

Mechanics of neural tube morphogenesis.

The neural tube is an important model system of morphogenesis representing the developmental module of out-of-plane epithelial deformation. As the embryonic precursor of the central nervous system, the neural tube also holds keys to many defects and diseases. Recent advances begin to reveal how genetic, cellular and environmental mechanisms work in concert to ensure correct neural tube shape.

The cancer risk according to three subtypes of ANCA-associated vasculitis: A propensity score-matched analysis of a nationwide study.

Objective: It remains unknown whether cancer risk differs among the three subtypes of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and what the cancer risk factors are. We conducted a nationwide study in Korea to evaluate the risk of cancer in patients with AAV and to identify the risk factors for cancer.

Methods: We analyzed the Health Insurance Review and Assessment database of Korea and identified 1982 patients diagnosed with AAV between January 1, 2007 and December 31, 2017.

Frozen Elephant Trunk for Aortic Arch Reconstruction is Associated with Reduced Mortality as Compared to Conventional Techniques.

To examine the perioperative outcomes following aortic arch repair using frozen elephant trunk (FET) vs conventional elephant trunk (ET) techniques. Between 2002 and 2018, 390 patients underwent aortic repair with elephant trunk reconstruction at 9 centers: 172 patients received a FET (mean age: 65+/-13 years, 30% female, 37% aortic dissection) and 218 patients received an ET (mean age: 63+/-13 years, 37% female, 43% aortic dissection). Outcomes of interest included in-hospital mortality; stroke; and spinal cord injury (SCI).

Ultra-Widefield Imaging for Evaluation of the Myopic Eye.

: Ultra-widefield (UWF) imaging of the myopic eye. : Myopes, and particularly high and pathologic myopes, present a unique challenge in fundoscopic imaging. Critical pathology is often located in the anteriormost portion of the retina, variations in posterior segment contour are difficult to capture in two-dimensional images, and extremes in axial length make simply focusing imaging devices difficult.

Changes in the Foveal Avascular Zone Area and Retinal Vessel Density after Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration.

Purpose: To investigate changes in the foveal avascular zone (FAZ) area and retinal vessel density (VD) in the macula of patients receiving multiple anti-vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration (N-AMD).

Methods: This study included 54 eyes of 54 treatment-naïve N-AMD patients. Thirty-three eyes were treated with intravitreal aflibercept injections, and 21 eyes were treated with intravitreal ranibizumab injections.

Novel Suture Technique for Slide Tracheoplasty for the Treatment of Long-Segment Tracheal Stenosis.

Long-segment tracheal stenosis is a rare, life-threatening condition. Slide tracheoplasty is the surgical treatment of choice but is associated with significant morbidity and mortality. We examined our institutional outcomes utilizing a running, everting horizontal mattress suture technique.

History of Cardiothoracic Surgery at Washington University in Saint Louis.

The Division of Cardiothoracic Surgery at Washington University evolved a century ago to address what many considered to be the last surgical frontier, diseases of the chest. In addition, as one of the first training programs in thoracic surgery, Washington University has been responsible for educating more thoracic surgeons than nearly any other program in the world. Beginning with Evarts A.

Clinical Importance of Intraoperative Cephalic Vein Distensibility as a Predictor of Radiocephalic Arteriovenous Fistula Maturation.

Radiocephalic arteriovenous fistula (RCAVF) is the preferred vascular access, but the maturation failure rate is high. Poor vein distensibility is the main cause of maturation failure. There have been several studies regarding vein distensibility, but vein dilation protocol and the cut-off value predicting maturation failure were inconsistent.

Challenges in interventional radiology: the pregnant patient.

A pregnant patient presenting to interventional radiology (IR) has a different set of needs from any other patient requiring a procedure. Often, the patient's care can be in direct conflict with the growth and development of the fetus, whether it be optimal fluoroscopic imaging, adequate sedation of the mother, or the timing of the needed procedure. Despite the additional risks and complexities associated with pregnancy, IR procedures can be performed safely for the pregnant patient with knowledge of the special and general needs of the pregnant patient, use of acceptable medications and procedures likely to be encountered during pregnancy, in addition to strategies to protect the patient and her fetus from the hazards of radiation.

Genotype and clinical care correlations in craniosynostosis: findings from a cohort of 630 Australian and New Zealand patients.

Craniosynostosis is one of the most common craniofacial disorders encountered in clinical genetics practice, with an overall incidence of 1 in 2,500. Between 30% and 70% of syndromic craniosynostoses are caused by mutations in hotspots in the fibroblast growth factor receptor (FGFR) genes or in the TWIST1 gene with the difference in detection rates likely to be related to different study populations within craniofacial centers. Here we present results from molecular testing of an Australia and New Zealand cohort of 630 individuals with a diagnosis of craniosynostosis.

Racial and ethnic disparities in infant mortality.

Racial and ethnic disparities in infant mortality in the United States seem to defy all attempts at elimination. Despite national priorities to eliminate these disparities, black infants are 2.5 times more likely to die in infancy compared with non-Hispanic white infants.

Prophylactic antibiotic guidelines in modern interventional radiology practice.

Modern interventional radiology practice is continuously evolving. Developments include increases in the number of central venous catheter placements and tumor treatments (uterine fibroid therapy, radio- and chemoembolization of liver tumor, percutaneous radiofrequency and cryoablation), and new procedures such as abdominal aortic aneurysm stent-graft repair, vertebroplasty, kyphoplasty, and varicose vein therapies. There have also been recent advancements in standard biliary and urinary drainage procedures, percutaneous gastrointestinal feeding tube placement, and transjugular intrahepatic portosystemic shunts.

The aortic arch and ascending aorta: are they within the endovascular realm?

Aneurysms involving the ascending aorta and arch have been historically treated with open surgical techniques requiring cardiopulmonary bypass and, in cases involving the aortic arch, utilizing deep hypothermic circulatory arrest. The reported rates of mortality range from 0% to 16.5% for surgery addressing ascending aorta and arch pathology, and stroke rates of 2% to 18%.

Molecular genetic analysis of cytoskeletal proteins in development and implications for the membrane skeleton.

The membrane skeleton of nonerythroid cells may be involved in a variety of processes, including the formation and maintenance of specific membrane-cytoskeletal domains. Although much has been learned about the ultrastructure and protein chemistry of the membrane skeleton, there are few direct tests of the in vivo functions of the constituent proteins of the membrane skeleton. Recent advances in molecular genetic analysis provide techniques for studying the membrane skeleton and its components in vivo.