Patient-Initiated Communication After Parotidectomy.

Objectives: We sought to study the incidence of patient-initiated communication after parotidectomy, identify patient and surgical factors associated with patient-initiated communication, and evaluate trends and possible areas for improvement.

Methods: A retrospective cohort study of patients who underwent parotidectomy without combined procedures from 2018 to 2022 in a single tertiary-care institution was performed. We reviewed all patient communications documented within the electronic medical record within 30 days of discharge.

An International, Expert-Based Delphi Consensus Document on Controversial Issues about TransCarotid Artery Revascularization (TCAR).

Background: Transcarotid artery revascularization (TCAR) has emerged as an alternative therapeutic modality to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS) for the management of patients with carotid artery stenosis. However, certain issues regarding the indications and contraindications of TCAR remain unanswered or unresolved. The aim of this international, expert-based Delphi consensus document was to attempt to provide some guidance on these topics.

Variation in Mpox Vaccine Coverage in the United States: Influence of Political Orientation and Public Health Resources.

During the 2022-2023 mpox outbreak in the United States, the federal government distributed mpox vaccines to individual states. Significant variation in vaccine coverage was noted across states. State-level factors associated with higher vaccine coverage were Democratic political orientation, higher public health spending, higher proportion of at-risk population, and higher mpox cases.

Using disruptive innovation to design endoscopic ligators for resource-challenged health settings.

Background: Commercial single-use endoscopic multiband ligators, used for esophageal variceal band ligation (EVL), are prohibitively expensive. To enable greater access to EVL, we used disruptive innovation to develop a novel endoscopic multiband ligator.

Methods: We designed and tested a prototype handle 'ENDOhandle' using computer-aided design modeling and exported a cap, trigger cord and latex to form a functional banding unit.

Programming Chatbots Using Natural Language: Generating Cervical Spine MRI Impressions.

Purpose: The utility of machine learning, specifically large language models (LLMs), in the medical field has gained considerable attention. However, there is a scarcity of studies that focus on the application of LLMs in generating custom subspecialty radiology impressions. The primary objective of this study is to evaluate and compare the performance of multiple LLMs in generating specialized, accurate, and clinically useful radiology impressions for degenerative cervical spine MRI reports.

Thyroid Cancer Incidence During 2020 to 2021 COVID-19 Variant Waves.

Importance: How rates of thyroid cancer diagnosis were affected by the emergence of COVID-19 variants during the 2020 to 2021 era of the pandemic has not been described.

Objective: To estimate the total number of undiagnosed cases of thyroid cancer, by histologic type, during the first 2 years of the COVID-19 pandemic (2020 and 2021) by comparing observed to expected incidence and to test for changes in size of cancer at incidence during the same period compared to prior years.

Design, Setting, And Participants: This longitudinal study analyzed trends in thyroid cancer diagnoses from 2016 to 2021 among US adults using data from the Surveillance, Epidemiology, and End Results 22 (SEER-22) program database.

Comparing fluorescent contrast agents for fluorescence guided surgery using 3-D cryo-imaging.

Fluorescence cryo-imaging is a high-resolution optical imaging technique that produces 3-D whole-body biodistributions of fluorescent molecules within an animal specimen. To accomplish this, animal specimens are administered a fluorescent molecule or reporter and are frozen to be autonomously sectioned and imaged at a temperature of -20°C or below. Thus, to apply this technique effectively, administered fluorescent molecules should be relatively invariant to low temperature conditions for cryo-imaging and ideally the fluorescence intensity should be stable and consistent in both physiological and cryo-imaging conditions.

Lung-Kidney Axis in Cystic Fibrosis: Early Urinary Markers of Kidney Injury Correlate with Neutrophil Activation and Worse Lung Function.

Background: Adult people with cystic fibrosis (PwCF) have a higher risk of end-stage kidney disease than the general population. The nature and mechanism of kidney disease in CF are unknown. This study quantifies urinary kidney injury markers and examines the hypothesis that neutrophil activation and lung infection are associated with early kidney injury in CF.

Teamwork in Clinical Medicine.

Clinical teams are at the heart of healthcare value. Teamwork requires an appreciation of the unique geniuses of each team member as well as an understanding of team dynamics and larger organizational challenges. Effective teams leverage each member's unique talents within a culture of shared humility, service, and dedication.

Racial Differences in Adoption and Outcomes of Transcarotid Artery Revascularization among High-Risk Adults with Carotid Artery Stenosis.

Background: Differential access to new technologies may contribute to racial disparities in surgical outcomes but has not been well-studied in the treatment of carotid artery stenosis. We examined race-based differences in adoption and outcomes of transcarotid artery revascularization (TCAR) among high-risk non-Hispanic (NH) Black and NH white adults undergoing carotid revascularization.

Methods: We conducted a retrospective analysis of TCAR, transfemoral carotid artery stenting (TF-CAS), and carotid endarterectomy (CEA) procedures performed for carotid artery stenosis from January 2015 to July 2023 in the Vascular Quality Initiative.

Multivariable modeling: A retrospective cohort study exploring the impact of socioeconomic status and distance to a rural academic center on all-cause preterm delivery.

Objective: Hospital-based labor and delivery units are closing at increasing rates in the rural US, significantly impacting maternal and newborn health. The objective of this study to determine if rurality-measured as distance from the hospital-and socioeconomic status-measured as insurance payor-impact both spontaneous and medically indicated preterm birth incidence at a single rural academic institution.

Methods: This was a retrospective cohort study using electronic medical records of patients with singleton pregnancies delivering at a single rural academic institution between 2016-2018.

Revascularization in a Time After CORAL.

Revascularization of renal artery stenosis became less common following randomized controlled trials that failed to demonstrate benefit in low-risk patients. An 88-year-old patient with recurrent acute pulmonary edema and progressive kidney disease in the setting of high-grade renal artery stenosis, a phenotype excluded from these trials, underwent revascularization.