Cholesteatoma Causing a Horizontal Semicircular Canal Fistula.

Horizontal canal fistulas are not uncommon in patients with cholesteatoma. Patients with canal wall down cavities and exposed horizontal canal fistulas develop significant dizziness with wind or suction exposure. Obliteration of mastoid cavities in patients with exposed fistulas can be challenging.

Investigating a Substance Abuse Screening in a Trauma Setting.

Introduction: Drug and alcohol consumption are often associated with trauma-related injuries. Various studies have been conducted which have shown the benefits of screening and brief intervention (SBI) tools for alcohol consumption. Despite their success, there are few SBI tools utilized for substance use and minimal reports of computerized versions.

The DEPARTS Score: A Novel Tool for Predicting Discharge Disposition in Geriatric Trauma Patients.

Background: Geriatric trauma patients (GTPs) represent a high-risk population for needing post-acute care, such as skilled nursing facilities (SNFs) and long-term acute care hospitals (LTACs), due to a combination of traumatic injuries and baseline functional health. As there is currently no well-established tool for predicting these needs, we aimed to create a scoring tool that predicts disposition to SNFs/LTACs in GTPs.

Methods: The adult 2017 Trauma Quality Improvement Program database was divided at random into two equal sized sets (derivation and validation sets) of GTPs >65 years old.

Perceived Discrimination, Retention, and Diabetes Risk Among American Indians and Alaska Natives in a Diabetes Lifestyle Intervention.

To examine the association of perceived discrimination with participant retention and diabetes risk among American Indians and Alaska Natives. Data were drawn from the Special Diabetes Program for Indians-Diabetes Prevention Demonstration Project ( = 2553). Perceived discrimination was significantly and negatively associated with short-term and long-term retention and diabetes risk without adjusting.

Improved Perceptions of Education and Wellness Among General Surgery Residents and Faculty After the Implementation of Outpatient Scribes.

Background: Recent studies have revealed a high rate of burnout among general surgery (GS) residents. Efforts to design and implement interventions to mitigate fatigue in surgical trainees are critical. Our aim was to assess the educational and wellness impact of outpatient scribe utilization at an academic GS residency program.

Adjuvant pembrolizumab in genomically selected high-risk patients with muscle-invasive bladder cancer.

Introduction: Patients with muscle-invasive urothelial bladder cancer post neoadjuvant cisplatin-based chemotherapy with pathologic advanced disease (ypT3, ypT4, ypN+) at radical cystectomy have a significantly worse five-year overall survival. There is currently no preferred adjuvant therapy to reduce risk of cancer recurrence in this high-risk patient cohort and surveillance remains the standard-of-care.

Case Report: We present a case series of two patients who received cisplatin-based neoadjuvant chemotherapy and had pathologic node-positive urothelial carcinoma at the time of radical cystectomy.

No Difference in Morbidity or Mortality Between Octogenarians and Other Geriatric Burn Trauma Patients.

Background: Geriatric burn trauma patients (age ≥65 years) have a 5-fold higher mortality rate than younger adults. With the population of the US aging, the number of elderly burn and trauma patients is expected to increase. A past study using the National Burn Repository revealed a linear increase in mortality for those >65 years old.

Cryopreservation: An Overview of Principles and Cell-Specific Considerations.

The origins of low-temperature tissue storage research date back to the late 1800s. Over half a century later, osmotic stress was revealed to be a main contributor to cell death during cryopreservation. Consequently, the addition of cryoprotective agents (CPAs) such as dimethyl sulfoxide (DMSO), glycerol (GLY), ethylene glycol (EG), or propylene glycol (PG), although toxic to cells at high concentrations, was identified as a necessary step to protect against rampant cell death during cryopreservation.

Regional, Racial, and Mortality Disparities Associated With Neurosurgeon Staffing at Level I Trauma Centers.

Background: Traumatic brain injury (TBI) occurs in approximately 30% of trauma patients. Because neurosurgeons hold expertise in treating TBI, increased neurosurgical staffing may improve patient outcomes. We hypothesized that TBI patients treated at level I trauma centers (L1TCs) with ≥3 neurosurgeons have a decreased risk of mortality vs.

Exhalation Delivery Systems for Application of Intranasal Corticosteroids.

Background: Chronic rhinosinusitis (CRS) is a common sinonasal disorder which results in significant inflammation in the nasal cavity and paranasal sinuses. Topical nasal steroids play an important role in the treatment of CRS. Exhalation delivery system with fluticasone (EDS-FLU) utilizes a patient's forced exhalation to power the delivery of topical steroids to deeper areas of the nasal cavity and paranasal sinuses most affected by CRS.

Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region.

Objectives: Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States.

Methods: The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.

What's Fair in Child Welfare? Parent Knowledge, Attitudes, and Experiences.

Parents play a critical role in the progression and outcomes of juvenile dependency (child welfare court) cases. Yet, very little is known about these parents' knowledge, attitudes, and experiences. We examined legal understanding and attitudes among 201 parents involved in ongoing dependency cases in California and Florida via semi-structured, in-person interviews.

Food insecurity and healthcare access, utilization, and quality among middle and later life adults in California.

This study examined the association between food insecurity status and healthcare access, utilization, and quality among adults aged 55 years and older. Data collected between 2011 and 2016 for the California Health Interview Survey were used. The sample included 72,212 individuals who were divided into three groups: food secure (FS), low food security (L-FS), and very low food security (VL-FS).

Preferences of Type 1 Diabetic Patients on Devices for Islet Transplantation.

Transplantation of pancreatic islets within a biomaterial device is currently under investigation in clinical trials for the treatment of patients with type 1 diabetes (T1D). Patients' preferences on such implants could guide the designs of next-generation implantable devices; however, such information is not currently available. We surveyed the preferences of 482 patients with T1D on the size, shape, visibility, and transplantation site of islet containing implants.

Islet Transplantation in the Lung via Endoscopic Aerosolization: Investigation of Feasibility, Islet Cluster Cell Vitality, and Structural Integrity.

Aerosolized drug delivery has recently attracted much attention as a possible new tool for the delivery of complex nanoparticles. This study aims to investigate whether catheter-based aerosolization of islets via endobronchial systems is a feasible option in islet transplantation. Besides investigating the feasibility of islet aerosolization, we also examined cluster cell vitality and structural integrity of the islets following aerosolization.

Sustainable Cleft Care: A Comprehensive Model Based on the Global Smile Foundation Experience.

Introduction: Clefts of the lip and palate are leading congenital facial anomalies. Underserved patients with these facial differences lack access to medical care, surgical expertise, prenatal care, or psychological support. Moreover, the disease results in significant economic strains on patients and their families.

Impact of Cirrhosis on Morbidity and Mortality After Spinal Fusion.

Study Design: Retrospective large database study.

Objective: To determine the impact of cirrhosis on perioperative outcomes and resource utilization in elective spinal fusion surgery.

Methods: Elective spinal fusion hospitalizations in patients with and without cirrhosis were identified using ICD-9-CM codes between the years of 2009 and 2011 using the Nationwide Inpatient Sample database.

Positive Encounters as a Buffer: Pain and Sleep Disturbances in Older Adults' Everyday Lives.

To test whether older adults' pain was bidirectionally associated with nighttime sleep disturbances and whether daily positive encounters attenuated these associations. Participants ( = 292, = 73.71 years old) from the indicated pain and positive encounters with close partners (e.

Heterogeneity in the Effects of Food Vouchers on Nutrition Among Low-Income Adults: A Quantile Regression Analysis.

Purpose: To determine whether baseline fruit and vegetable (FV) intake or other predictors are associated with response to food vouchers (change in FV intake) among low-income adults.

Design: Secondary analysis of a randomized, 2 x 2-factorial, community-based trial.

Setting: San Francisco, California.

Saphenous Nerve Somatosensory-Evoked Potentials Monitoring During Lateral Interbody Fusion.

Study Design.: Retrospective cohort study.

Objectives: To clinically evaluate saphenous nerve somatosensory-evoked potentials (SSEPs) as a reliable and predictable way to detect upper lumbar plexus injury intraoperatively during lateral lumbar trans-psoas interbody fusion (LLIF).

Penetrating Abdominal Aortic Injury: Comparison of ACS-Verified Level-I and II Trauma Centers.

Objectives: Penetrating abdominal aortic injury (PAAI) is a highly acute injury requiring prompt surgical management. When compared to surgeons at level-II trauma centers, surgeons at level-I trauma centers are more likely to take in-house call, and may more often be available within 15 minutes of patient arrival. Thus, we hypothesized that level-I trauma centers would have a lower mortality rate than level-II trauma centers in patients with PAAI.

Evoked Potentials During Peripheral Stimulation Confirm Electrode Location in Thalamic Subnuclei in Children With Secondary Dystonia.

Deep brain stimulation is an elective surgical intervention that improves the function and quality of life in children with dystonia and other movement disorders. Both basal ganglia and thalamic nuclei have been found to be relevant targets for treatment of dystonia in children, including the ventral intermediate nucleus of the thalamus, in which stimulation can control dystonic spasms. Electrophysiological confirmation of correct electrode location within the ventralis intermediate nucleus is thus important for the success of the surgical outcome.

Testosterone Associations With Parents' Child Abuse Risk and At-Risk Parenting: A Multimethod Longitudinal Examination.

The current investigation considered salivary testosterone as a potential biomarker of physical child abuse risk. Parents enrolled in a prospective, longitudinal, multimethod study beginning prenatally provided saliva when their toddlers were 18 months old. Mothers and fathers self-reported on their empathy, frustration tolerance, and child abuse risk, as well as completing analog tasks of frustration intolerance and child abuse risk and participating in structured parent-child interactions.

Metastatic penile squamous cell carcinoma with dramatic response to combined checkpoint blockade with ipilimumab and nivolumab.

Introduction: Prognosis for patients with lymph node positive or metastatic penile squamous cell carcinoma remains poor. Chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP regimen) is recommended as a first-line option in this cohort of patients. No standard preferred subsequent-line therapy exists for patients with relapsed or refractory penile carcinoma following TIP chemotherapy.

Racial Disparities in Adult Blunt Trauma Patients With Acute Respiratory Distress Syndrome.

Objective: Study incidence and mortality for blunt trauma patients developing acute respiratory distress syndrome (ARDS) across race and insurance.

Design: The National Trauma Data Bank (2007-2015) was queried for blunt trauma patients age 16. Covariates (age 65, injury severity score [ISS] 25, traumatic brain injury, lung injury, pneumonia, severe sepsis, hypotension on admission, and blood transfusion) were included in a multivariable logistic regression analysis.