Can Surgeons Reliably Identify Non-cirrhotic Liver Disease During Laparoscopic Bariatric Surgery?

Introduction: Identification of liver disease during bariatric operations is an important task given the patients risk for occult fatty liver disease. Surgeon's accuracy of assessing for liver disease during an operation is poorly understood. The objective was to measure surgeons' performance on intra-operative visual assessment of the liver in a simulated environment.

Longitudinal study evaluating post-ICU syndrome differences between acute care surgery and trauma SICU survivors.

Background: Post-intensive care unit (ICU) syndrome (PICS) occurs at an exorbitant rate in surgical ICU (SICU) survivors. It remains unknown if critical illness due to trauma versus acute care surgery (ACS) may represent different pathophysiologic entities. In this longitudinal study, we determined if admission criteria in a cohort of trauma and ACS patients were associated with differences in the occurrence of PICS.

Readmissions after emergent incisional ventral hernia repair: a retrospective review of the nationwide readmissions database.

Emergent ventral hernia repair (eVHR) is associated with significant morbidity, yet there is no consensus regarding optimal surgical approach. We hypothesized that eVHR with synthetic mesh would have a higher readmission rate compared to primary eVHR or biologic mesh repair. Retrospective analysis of the Nationwide Readmissions Database (NRD) was conducted for patient entries between 2016 and 2018.

The Third Delay in General Surgical Care in a Regional Referral Hospital in Soroti, Uganda.

Background: Building capacity for surgical care in low-and-middle-income countries is essential for the improvement of global health and economic growth. This study assesses in-hospital delays of surgical services at Soroti Regional Referral Hospital (SRRH), a tertiary healthcare facility in Soroti, Uganda.

Methods: A prospective general surgical database at SRRH was analyzed.

Computed tomography angiography is associated with low added utility for detecting clinically relevant vascular injuries among patients with extremity trauma.

Background: Extremity CT angiography (CTA) is frequently used to assess for vascular injury among patients with extremity trauma. The injured extremity index (IEI), defined as the ratio of systolic occlusion pressure between injured and uninjured extremities, has been implemented to screen patients being considered for CTA. Physical examination together with IEI is extremely sensitive for significant extremity vascular injury.

Common Injury Patterns from Standing Motorized Scooter Crashes.

Purpose Of Review: With the rising popularity of standing motorized scooters in major cities in the United States, many hospitals are experiencing a surge of traumatic injuries associated with this new mode of transportation. The impact and characteristics of injuries associated with standing motorized scooters are evolving, and safety regulations for the riders are poorly defined. There is a need for a review for healthcare providers and policy makers on this topic.

The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic-An interrupted time-series analysis.

Background: The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses.

Emergency Transfusions.

Successful emergency transfusions require early recognition and activation of resources to minimize treatment delays. The initial goals should focus on replacement of blood in a balanced fashion. There is an ongoing debate regarding the best approach to transfusions, with some advocating for resuscitation with a fixed ratio of blood products and others preferring to use viscoelastic assays to guide transfusions.

Decreasing Accuracy of the eFAST Examination-Another Challenge Due to Morbid Obesity.

The extended focused assessment with sonography for trauma (eFAST) ultrasound examination is an essential step in the initial assessment of trauma patients. Its accuracy depends on the ability to acquire high-quality ultrasound images, and we hypothesized that increasing BMI was associated with increased odds for incorrect eFAST. All adult blunt trauma activations at a high-volume urban trauma center in 2016 that underwent eFAST and CT chest, abdomen, and pelvis were included (n = 446).

Vital Statistics: Estimating Injury Mortality in Kigali, Rwanda.

Background: Globally, injury deaths largely occur in low- and middle-income countries. No estimates of injury associated mortality exist in Rwanda. This study aimed to describe the patterns of injury-related deaths in Kigali, Rwanda using existing data sources.

Management of long-standing partially torn and flipped laser in situ keratomileusis flaps.

Unlabelled: We describe 2 cases of traumatized and torn laser in situ keratomileusis (LASIK) flaps, partially flipped anteriorly or posteriorly, fixed for 8 months or 4 months, and accompanied by epithelial ingrowth. The 2 patients had had uneventful bilateral LASIK 6 years and 1 year before the trauma. In Case 1, the anteriorly flipped flap was removed with transepithelial phototherapeutic keratectomy.

Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993-2012): 20-year systematic review.

Objective: To assess the extent to which people with diabetes in low- and middle-income countries (LMIC) of Asia and the Middle East met evidence-based care recommendations through a systematic review of published literature.

Methods: Electronic searches of Medline and Embase were carried out for studies assessing quality of care among people with diabetes in Asia and the Middle East between 1993 and 2012. Benchmarking against American Diabetes Association guidelines, we reported level and proportions meeting recommended risk factor control (glycated hemoglobin [HbA1c], blood pressure, and low density lipoprotein-cholesterol [LDL]) and preventive care processes across different settings.

Cataract subtype risk factors identified from the Korea National Health and Nutrition Examination survey 2008-2010.

Background: To assess the socio-demographic and health-related risk factors associated with cataract subtypes in Korea.

Methods: A total of 11,591 participants (aged ≥40 years) were selected from the Korean National Health and Nutrition Examination Survey between 2008 and 2010. The Korean Ophthalmologic Society conducted detailed ophthalmologic examinations on these participants based on the Lens Opacity Classification System III.

Are recommended standards for diabetes care met in Central and South America? A systematic review.

Aims: We evaluated quality of diabetes care in low- and middle-income countries (LMIC) of Central and South America by documenting the ability to meet the guideline-recommended targets. We also identified barriers to achieving goals of treatment and characteristics of successful programs.

Methods: We searched the National Library of Medicine and Embase databases to systematically compile literature that reported on guideline-recommended processes of care (annual foot, eye, urine examinations, and regular blood glucose testing) and risk factor control (glycemic, blood pressure, and lipid levels) among people with diabetes since 1980.

Prevalence of granular corneal dystrophy type 2 (Avellino corneal dystrophy) in the Korean population.

Purpose: This study investigates the prevalence of granular corneal dystrophy type 2 (GCD2; Avellino corneal dystrophy) in the Korean population.

Methods: GCD2 homozygotes were identified through a collaboration of Korean referral centers for corneal disease. The genetic status of the patients and their immediate families were verified by DNA analysis.

Exacerbation of granular corneal dystrophy type II (Avellino corneal dystrophy) after LASEK.

Purpose: To report cases of granular corneal dystrophy type II (Avellino corneal dystrophy) that were exacerbated by uncomplicated laser epithelial keratomileusis (LASEK) for myopia.

Methods: Eight patients (15 eyes) with granular corneal dystrophy type II who underwent LASEK were examined by DNA sequencing, slit-lamp microscopy, and confocal microscopy.

Results: The number and density of the opacities increased after LASEK.

Effects of corneal neovascularization on the manifestations of Avellino corneal dystrophy (granular corneal dystrophy type II).

Purpose: To evaluate the corneal deposits of Avellino corneal dystrophy (ACD) in patients with corneal neovascularization from pterygium or phthisis bulbi as a way of understanding the pathogenesis of ACD.

Methods: Five patients with ACD with pterygium, 10 patients with ACD (age >50 years) without pterygium, 1 patient with ACD with phthisis bulbi with corneal neovascularization, and 1 patient with ACD with phthisis bulbi without corneal neovascularization were examined. The corneal deposits of all patients were assessed by slit-lamp examination and reviewed with biomicroscopic photographs.

Exacerbation of Avellino corneal dystrophy after LASIK in North America.

Purpose: To report the first case of Avellino corneal dystrophy exacerbation after LASIK in a white or North American patient.

Methods: Case report and literature review.

Results: A 25-year-old white female developed progressive corneal opacities after LASIK.

Avellino corneal dystrophy exacerbated after LASIK: scanning electron microscopic findings.

Purpose: To evaluate the ultrastructure of the cornea of Avellino corneal dystrophy (ACD) exacerbated by LASIK.

Methods: Three ACD patients with exacerbation of granular corneal deposits after LASIK underwent surgical removal of the corneal flap. The corneal flap was processed for scanning electron microscopy (SEM).