Clinical Application of Mathematical Long Bone Ratios to Calculate Appropriate Donor Limb Lengths in Bilateral Upper Limb Transplantation.

Limited methods exist to aid in deciding the appropriate donor limb lengths in bilateral upper limb amputees qualifying for vascularized composite allotransplantation. We hypothesized mathematical equations could be created using long bone length ratios, and applied to radiographs, to approximate the patient's limb length prior to amputation. A data set of 30 skeletons' unilateral upper limb long bones measured using osteometric board and calipers was used.

Noise Reduction in the Neonatal Intensive Care Unit: A Quality Improvement Initiative.

Exogenous noise has deleterious effects on the developing fetus and infant. The aim of this quality improvement project was to lower the mean ambient noise level within a level IV neonatal intensive care unit (NICU) by 10% from the baseline in one year. Multiple noise reduction strategies were tested through Plan-Do-Study-Act cycles based on the Institute for Healthcare Improvement model for improvement.

Impact of Urologist Density and County Rurality on the Practice of Retroperitoneal Lymph Node Dissection and Cancer-Specific Death in Patients with Nonseminomatous Germ Cell Tumors.

Purpose: To investigate the impact of rural status and urologist density on the practice of retroperitoneal lymph node dissection (RPLND) and cancer-specific death (CSD) in patients with nonseminomatous germ cell tumor (NSGCT).

Methods: Urologist density was determined from 2014 to 2015 Area Health Resource File data, and rural residence was determined using the 2003 Rural-Urban Continuum Codes. All cases of NSGCT within Surveillance, Epidemiology and End Results (SEER) 18 with known county code were used for analysis (n = 9473).

Does early orchidopexy improve fertility?

Cryptorchidism or undescended testis (UDT) is a common problem in the pediatric male population. While spontaneous testicular descent occurs in the majority of cases, orchidopexy is the definitive treatment in those with remaining cryptorchid testis. A long established sequela to cryptorchidism is reduced fertility in the adult male and recent guidelines have advocated for earlier orchidopexy as studies have shown improvement in fertility rates when surgery is performed before one year of age.