Use of Suboptimal Great Saphenous Vein in Lower Extremity Bypass Yields Favorable Amputation-Free Survival.

Objective: Historically, studies have identified a great saphenous vein (GSV) diameter of at least 3.0 mm for optimal durability following lower extremity bypass. With the recent publication of BEST-CLI and BASIL-2 studies, we sought to compare patency and post-operative complications utilizing GSV conduit of <3.

Seizure Cycle app: A feasibility study.

Background And Objective: Catamenial seizure exacerbation (CSE) is challenging to track given unreliable patient reports. This highlights the need for improved recognition of CSE. In this study, we discuss the feasibility of using the Seizure Cycle app for that purpose.

Continuation of anticoagulation through ambulatory phlebectomy does not impact postoperative bleeding risk.

Objectives: Chronic anticoagulation for atrial fibrillation, a history of venous thromboembolism, and after heart valve replacement is often stopped or bridged for surgery. Our institutional practice is to continue anticoagulation through ambulatory phlebectomy (AP) procedures. As such, we aimed to compare postprocedure bleeding and major adverse events in patients on anticoagulation who received AP compared with patients not on anticoagulation.

Therapeutic Antithrombotic Agent Use and Bleeding Risk in Retrobulbar Anesthesia for Outpatient Ophthalmic Surgery.

Background and objective Retrobulbar block is commonly used for providing effective anesthesia and akinesia for ophthalmic surgery. It can, however, lead to sight-threatening retrobulbar hemorrhage in very rare cases. The aim of this study was to evaluate retrobulbar block quality, to determine the prevalence of retrobulbar hemorrhage associated with these blocks, and to assess whether the use of antithrombotic agents in patients undergoing retrobulbar block for ophthalmic surgery was associated with retrobulbar hemorrhage.

Continuous Serratus Anterior Versus Erector Spinae Plane Block Catheters for Postoperative Pain Management Following Video-Assisted Thoracoscopic Surgery: A Retrospective Study.

Introduction: Optimal pain management following video-assisted thoracoscopic surgery (VATS) is key to promoting efficient recovery while minimizing the incidence of postoperative complications. Regional anesthesia can help achieve greater pain control, fostering enhanced recovery and increased patient satisfaction, though debate remains over the most effective technique for VATS. This study sought to compare the analgesic efficacy of two continuous regional anesthetic techniques commonly used for VATS, the serratus anterior plane block (SAPB or CSAPB) and the erector spinae plane block (ESPB or CESPB).

Association of a Novel Electronic Form for Preoperative Cardiac Risk Assessment With Reduction in Cardiac Consultations and Testing: Retrospective Cohort Study.

Background: Preoperative cardiac risk assessment is an integral part of preoperative evaluation; however, there is significant variation among providers, leading to inappropriate referrals for cardiology consultation or excessive low-value cardiac testing. We implemented a novel electronic medical record (EMR) form in our preoperative clinics to decrease variation.

Objective: This study aimed to investigate the impact of the EMR form on the preoperative utilization of cardiology consultation and cardiac diagnostic testing (echocardiograms, stress tests, and cardiac catheterization) and evaluate postoperative outcomes.

Patient Reported Barriers for Participation in Supervised Exercise Therapy for Symptomatic Peripheral Artery Disease.

Background: Supervised exercise therapy (SET) provides clinical benefit for patients suffering from intermittent claudication due to peripheral artery disease (PAD). However, enrollment in programs when offered remains low. We sought to identify patient-reported barriers to enrollment in SET as part of a prospective quality improvement program.

Multimodal approach utilising a weight management programme prior to bariatric surgery in patients with BMI ≥50 kg/m: A propensity score matching retrospective cohort study.

We evaluated preoperative weight loss and days from initial consult to surgery in patients with BMI ≥50 kg/m who were and were not enrolled in medical weight management (MWM) prior to laparoscopic sleeve gastrectomy. We retrospectively identified patients with BMI ≥50 kg/m who had primary sleeve gastrectomy between 2014 and 2019 at two bariatric surgery centres in our healthcare system. Patients presenting after 2017 that received preoperative MWM (n = 28) were compared to a historical cohort of non-MWM patients (n = 118) presenting prior to programme initiation in 2017 on preoperative percent total body weight loss (%TBWL) and days from initial consult to surgery.

Rectus Sheath Block Improves Patient Recovery Following Open Aortic Surgery.

Background: Postoperative pain management remains a barrier to recovery following aortic surgery. Although epidural catheters help in adjunctive pain management, less is known about the use of rectus sheath blocks. We compared patient recovery following open abdominal aortic surgery (OAS) with and without adjunctive rectus block.

Incidence of Hiatal Hernia Repair During Primary Bariatric Surgery Conversion: an Analysis of the 2020 MBSAQIP Database.

The rate of hiatal hernia (HH) repair during conversion bariatric surgery is largely unknown. We sought to determine this rate in 12,788 patients undergoing conversion surgery using the 2020 participant use file of the MBSAQIP database. Concurrent HH repair was performed in 24.

Frequency of Parathyroid Hormone Assessment in the Evaluation of Hypercalcemia. A Comparison Between Patients With and Without a History of Malignancy in a 20-year Dataset of 20,954 Patients.

Background: The purpose of this study was to evaluate whether a prior diagnosis of malignancy affected the assessment of parathyroid hormone (PTH) in hypercalcemic patients and whether the rate of this assessment changed over time.

Methods: A retrospective cohort study was designed that included adult patients with hypercalcemia with and without a history of malignancy between January 1, 2000 and December 31, 2019 in the Marshfield Clinic Health System (MCHS). The overall and annual rates of PTH assessment in each group was determined.

Evaluation of Diagnostic Workup and Etiology of Hypercalcemia of Malignancy in a Cohort of 167 551 Patients Over 20 Years.

Context: Hypercalcemia of malignancy (HCM) has not been studied in a fashion to determine all possible mechanisms of hypercalcemia in any given patient.

Objective: The 2 objectives were to assess the completeness of evaluation and to determine the distribution of etiologies of HCM in a contemporary cohort of patients.

Methods: A retrospective analysis was performed of patients with cancer who developed hypercalcemia over 20 years at a single health system.

A review of breast cancer pathology reports in Nigeria.

Background: Diagnosis and treatment of cancer rely heavily on imaging, histopathology and molecular information. Incomplete or missing tumour information can hinder the delivery of high-quality care in oncology practice, especially in resource-limited countries. To evaluate the completeness of histopathology reporting in a real-world setting and identify areas for future cancer care delivery research efforts, we retrospectively analysed reports from patients diagnosed with breast cancer who received care at a high-volume oncology department at a hospital in Lagos, Nigeria.

Modified Docetaxel, Cisplatin, and Fluorouracil (mDCF) as a Neoadjuvant Chemotherapy for Non-metastatic Esophageal Cancer (nMEC).

Perioperative chemotherapy can potentially downstage esophageal cancer, reducing the risk of early systemic dissemination. One recommended neoadjuvant regimen for managing gastroesophageal junction and esophageal cancer is docetaxel, cisplatin, and 5-fluorouracil (DCF). To address the high toxicity profile of DCF, modifications in dosages and treatment intervals have been studied.

Randomized Trial of VasoStat Versus TR Band Following Radial Artery Access for Catheterization Procedures.

Purpose: VasoStat (VS; Forge Medical) is a recently developed radial artery compression device (RCD) producing focused puncture-site pressure. We compared time to hemostasis and patient experience with VS vs balloon compression with the TR Band (Terumo) in a randomized, prospective trial among subjects undergoing radial catheterization procedures with same-day discharge.

Methods: Forty subjects without prior radial access undergoing elective coronary and/or endovascular diagnostic or interventional procedures were randomized to VS or TR Band.

Cost-effectiveness of Dabigatran Compared With Rivaroxaban for Prevention of Stroke and Systemic Embolism in Patients With Atrial Fibrillation in China.

Purpose: In China, dabigatran and rivaroxaban are the only approved non-vitamin K antagonist oral anticoagulants for the treatment of atrial fibrillation (AF). The goal of this article was to assess the cost-effectiveness of dabigatran versus rivaroxaban for the prevention of stroke and systemic embolism in Chinese patients with AF from the perspective of the Chinese health care system.

Methods: A Markov model was constructed to estimate the cost-effectiveness of dabigatran versus rivaroxaban.

Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination.

A fully integrated Obstetric Mental Health Clinic (OBMHC) was established in 2007 in the rural northwest United States to address perinatal depression. The purpose of this mixed methods study was to examine depression outcomes in women receiving outpatient psychiatric services between 2007 and 2017 at a fully integrated OBMHC and to explore patient and obstetric team perceptions of OBMHC experiences. A retrospective database study was employed; depression was measured at baseline and follow-up visits using the Edinburgh Postnatal Depression Scale.

The Stepped-Wedge Trial Design: Paving the Way for Cancer Care Delivery Research.

Cancer care delivery research (CCDR) is an emerging field that investigates ways to optimally provide care for patients within complex health-care systems. Novel research designs are essential to efficiently study CCDR research questions. A stepped-wedge trial (SWT) is one such pragmatic design and is similar to a parallel randomized controlled trial (RCT).

Assessment of sexually transmitted disease/HIV risk among young African Americans: comparison of self-perceived and epidemiological risks utilizing ecodevelopmental theory.

Background: Recent advances in understanding the developmental processes associated with adolescents warrant new thinking and systematic application of key concepts of risk and protective processes. This study examined the association between epidemiological and self-perceived risks of contracting sexually transmitted diseases (STDs)/HIV among young African Americans (AAs) and the multilevel factors identified using ecodevelopmental theory.

Methods: A retrospective cross-sectional study was conducted on wave 1 data from the National Longitudinal Study of Adolescent Health comprising 1,619 AA youth aged 14-18 years.

HIV-related sexual decisions made by African-American adolescents living in different family structures: study from an ecodevelopmental perspective.

Purpose: The purpose of this study was to explore the association between the dynamics of family structure and sexual behaviors of African-American adolescents using the ecodevelopmental theory.

Methods: This study stratified data from 1,617 African-American adolescents of the Add Health Wave I respondents with an identified family composition. It examined the associations between family structure, parenting function, and adolescents' sexual decision-making: age of first sexual intercourse, sexual initiation before age 16, and using a condom during the first and last sexual intercourse.

Modeling ecodevelopmental context of sexually transmitted disease/HIV risk and protective behaviors among African-American adolescents.

Risk and protective processes are integrated developmental processes that directly or indirectly affect behavioral outcomes. A better understanding of these processes is needed, in order to gauge their contribution to sexual risk behaviors. This retrospective cross-sectional study modeled the ecodevelopmental chain of relationships to examine the social contexts of African-American (AA) adolescents associated with sexually transmitted disease (STD)- and HIV-risk behaviors.