Publications by authors named "Taleen MacArthur"

Article Synopsis
  • A 42-year-old man with DiGeorge syndrome and congenital heart issues had a large pseudoaneurysm in his descending aorta, complicating his medical history that included two previous bypass surgeries during childhood.
  • The pseudoaneurysm measured 7.4 cm and the left subclavian artery was abnormally connected to it.
  • The patient underwent a hybrid surgical procedure that involved a bypass from the left common carotid artery to the subclavian artery, followed by a specialized endovascular repair of the aortic aneurysm.
View Article and Find Full Text PDF

Purpose: Our objectives were to compare overall survival (OS) and pulmonary relapse between patients with metastatic Ewing sarcoma (EWS) at diagnosis who achieve rapid complete response (RCR) and those with residual pulmonary nodules after induction chemotherapy (non-RCR).

Patients And Methods: This retrospective cohort study included children under 20 years with metastatic EWS treated from 2007 to 2020 at 19 institutions in the Pediatric Surgical Oncology Research Collaborative. Chi-square tests were conducted for differences among groups.

View Article and Find Full Text PDF
Article Synopsis
  • Inorganic polyphosphate (polyP) is a substance that promotes blood clotting, and the study evaluated the effects of polyP inhibitors (MPI 8 and UHRA-8) on thrombin generation in trauma patients compared to healthy controls.
  • Results indicated that trauma patients had higher baseline thrombin levels than controls, and treatment with MPI 8 prolonged key measures of thrombin generation in both groups.
  • Overall, the findings suggest that inhibiting polyP reduces thrombin generation, but this effect is less pronounced in trauma patients, indicating polyP plays a significant role in enhancing thrombin production after trauma.
View Article and Find Full Text PDF

Intercostal patch aneurysms after open thoracoabdominal aneurysm repair represent a challenging pathology, with highly variable patient anatomy and spinal cord ischemia risk. We present a case of a 51-year-old man with a large symptomatic "bucket-handle" loop graft intercostal patch aneurysm, which was treated with endovascular exclusion with concurrent parallel intercostal stent grafting. This case highlights specialized endovascular techniques to treat intercostal patch aneurysms and the necessity of meticulous operative case planning in both open and endovascular thoracoabdominal aneurysm repair.

View Article and Find Full Text PDF
Article Synopsis
  • This study investigates the effects of high ratio fresh frozen plasma (FFP) to red blood cell (RBC) transfusions in children experiencing shock due to trauma, aiming to clarify their outcomes compared to low ratio transfusions.
  • An analysis of data from 135 injured children showed that while more severe injuries were present in the high ratio group, there was no significant difference in mortality rates or extended hospital stays between those receiving high and low ratios of FFP/RBC.
  • The findings indicate that high ratio FFP/RBC transfusion does not lead to worse outcomes, highlighting variability in massive transfusion protocols across different medical institutions.
View Article and Find Full Text PDF

Introduction: Neutrophil extracellular traps (NETs) contribute to trauma-induced coagulopathy. We aimed to develop a murine multiple-injury model that induces thrombo-inflammatory response, that is, NETosis and accelerated thrombin generation.

Methods: Wild-type male mice (n = 10, aged 8-12 weeks) underwent multiple injuries (gastrocnemius crush, femur fracture, and laparotomy) and were compared with an uninjured control group (n = 10).

View Article and Find Full Text PDF

Unlabelled: The coronavirus disease 2019 (COVID-19) pandemic provoked rapid changes in clinical practice to accommodate mandated restrictions within healthcare delivery. This study reviewed patient-reported experiences and clinical outcomes after implementation of a same-day discharge protocol after mastectomy with immediate alloplastic breast reconstruction compared with our historical overnight stay protocol.

Methods: This is a retrospective single-institution study of consecutive patients who underwent mastectomy and immediate alloplastic reconstruction between July 2019 and November 2020.

View Article and Find Full Text PDF

Low- and middle-income countries (LMICs) have adopted procedural skill simulation, with researchers increasingly investigating simulation efforts in resource-strained settings. We aim to summarize the current state of procedural skill simulation research in LMICs focusing on methodology, clinical area, types of outcomes and cost, cost-effectiveness, and overall sustainability. We performed a comprehensive literature review of original articles that assessed procedural skill simulation from database inception until April 2022.

View Article and Find Full Text PDF

Objective: Racial and gender biases exist within academic surgery; bias negatively impacts patient care, reimbursement, student training, and staff retention. Few studies have investigated the potential for bias in surgical fellowship recruitment. We aimed to compare the racial and gender diversity at our hepatopancreatobiliary (HPB) surgery fellowship program to nationwide standards.

View Article and Find Full Text PDF
Article Synopsis
  • This study analyzed injured children to compare those with severe traumatic brain injury (sTBI) to those without, focusing on clinical and resuscitation differences.
  • Results revealed that children with sTBI had lower initial hemoglobin levels, higher injury severity, and required more intensive medical support, including ventilation and ICU care.
  • It was found that sTBI patients received more resuscitation fluids, and those getting crystalloid boluses had longer hospital stays and more complications compared to those who didn’t.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates thrombin generation kinetics in pediatric (ages 0-17) and young adult (YA, ages 18-21) trauma patients to understand variations based on clinical characteristics and injury types.
  • Plasma samples were collected from patients upon arrival at the emergency department, and key thrombin metrics were analyzed and compared between the two age groups using statistical methods.
  • Results reveal that pediatric patients requiring surgery or transfusion have significantly shorter thrombin generation initiation times compared to those who do not require these interventions, and YA patients with traumatic brain injury show higher thrombin potential.
View Article and Find Full Text PDF
Article Synopsis
  • - The study examined how having guidelines for chemoprophylaxis affects the incidence of venous thromboembolism (VTE) in pediatric trauma patients, given the lack of previous data in this area.
  • - Researchers reviewed data from 45,202 injured children across 10 trauma centers over nine years, comparing those with and without chemoprophylaxis guidelines.
  • - While the presence of guidelines correlated with lower VTE rates, the actual impact was confounded by patient risk factors; many who developed VTE were not indicated for treatment based on these guidelines.
View Article and Find Full Text PDF

Objective: To determine differences in plasma sex hormone levels in male and female coronavirus disease 2019 (COVID-19) patients and healthy volunteers (HVs) because cell entry of severe acute respiratory syndrome coronavirus 2 occurs via the angiotensin-converting enzyme 2 receptor which is downregulated by 17β-estradiol.

Patients And Methods: Citrated plasma samples were collected from 101 patients with COVID-19 upon presentation to the emergency department and from 40 HVs between November 1, 2020, and May 30, 2021. Plasma 17β-estradiol and 5α-dihydrotestosterone (DHT) levels were measured using enzyme-linked immunosorbent assay (pg/mL).

View Article and Find Full Text PDF
Article Synopsis
  • Management of small lymph nodes in pediatric cancer patients is complicated due to their location and size; this study explores using TC 99m MAA for localization.
  • A review of 10 pediatric cases showed this technique was effective in identifying and removing both palpable and non-palpable lymph nodes during surgery from 2017 to 2021.
  • The use of TC 99m MAA facilitated better disease management and staging, with 90% of patients experiencing changes in treatment based on biopsy results.
View Article and Find Full Text PDF

Introduction: Little is known regarding peripheral blood mononuclear cell telomere length (PBMC-TL) and response to traumatic injury. The objective of this study was to characterize the role of PBMC-TL in coagulation and clinical outcomes after injury. Methods: Plasma and buffy coats were prospectively collected from trauma patients and healthy volunteers.

View Article and Find Full Text PDF

Lynch syndrome is an autosomal dominant condition caused by a heterozygous variation in one of the DNA mismatch repair (MMR) genes that pre-disposes individuals to early onset colorectal cancers and other malignancies. Lynch syndrome is generally considered an adult-onset disorder, with malignancy rarely manifesting in childhood. Colorectal cancer is extremely rare in children, but hereditary syndromes including Lynch syndrome are an important cause.

View Article and Find Full Text PDF

Introduction: Neutrophil extracellular traps (NETs) trigger thrombin generation. We aimed to characterize the effects of deoxyribonuclease (DNAse) on NET components (cell-free DNA [cfDNA] and histones) and thrombin generation after trauma. Methods: Citrated plasma samples were collected from trauma patients and healthy volunteers.

View Article and Find Full Text PDF

Background: Pulmonary nodules that are deep within lung parenchyma and/or small in size can be challenging to localize for biopsy. This study describes current trends in performance of image-guided localization techniques for pulmonary nodules in pediatric patients.

Methods: A retrospective review was performed on patients < 21 years of age undergoing localization of pulmonary nodules at 15 institutions.

View Article and Find Full Text PDF

Background: Early-onset gastric cancer (EOGC, age ≤ 60 years at diagnosis) now comprises >30% of new gastric cancers in the United States. It is hypothesized that chronic acid suppression with proton-pump inhibitors (PPIs) may promote tumorigenesis, while other medications including statins, nonsteroidal anti-inflammatory drugs (NSAIDs), metformin, and cyclooxygenase-2 (COX-2) inhibitors have been proposed as protective. We aimed to assess for an association between use of the aforementioned commonly prescribed medications and EOGC development.

View Article and Find Full Text PDF

Background: COVID-19-associated coagulopathy is incompletely understood.

Objectives: To characterize thrombin generation, Von Willebrand Factor (VWF), neutrophil extracellular traps (NETs), and their role in COVID-19 risk stratification in the emergency department (ED).

Patients/methods: Plasma samples from 67 ED COVID-19 patients were compared to 38 healthy volunteers (HVs).

View Article and Find Full Text PDF

Objective: The virtual interview season has challenged general surgery residency programs to recruit applicants through the loss of visiting clerkships, tours, and time with residents. Webinars, increased informal resident and faculty sessions, and live-narrated video tours are potential solutions. This study aimed to assess the effectiveness of these elements in virtually showcasing a residency program during the virtual interview season.

View Article and Find Full Text PDF