The 95% Effective Duration of Music for Anxiolysis Before Elective Cesarean Delivery.

Background: Music can be used in the perioperative period as a nonpharmacological intervention to reduce anxiety, but how long it should be played to be effective is unknown. The goal of this study was to determine the 95% effective duration (ED95) of music of different subtypes for anxiolysis in parturients awaiting elective cesarean delivery. It was hypothesized that the overall ED95 would be <15 minutes and similar between music groups.

SPECT/CT with Tc-DTPA in a Patient with Persistent Complex Pneumothorax after Endobronchial Valve Placement.

Ventilation-perfusion SPECT with or without CT using technetium 99m (Tc)-diethylenetriaminepentaacetic acid (DTPA) has been used to identify patterns typical of cardiopulmonary diseases, such as pulmonary embolism, pneumonia, heart failure, and obstructive lung disease. This case demonstrates the utility of a ventilation scan with SPECT/CT using Tc-DTPA for investigating the cause of a persistent complex pneumothorax in a patient with severe chronic obstructive pulmonary disease who recently underwent endobronchial valve placement. CT-Spectral Imaging (Multienergy), SPECT/CT, Thorax, Lung © RSNA, 2024.

Safety and Early Results for Off-Label Use of Intranasal Calcitonin for Treatment of Nondisplaced Acromial and Scapular Spine Stress Fractures After Reverse Total Shoulder Arthroplasty.

Immobilization for acromial and scapular spine stress AU4fractures (AF/SSF) after reverse total shoulder arthroplasty (RSA) is associated with patient dissatisfaction. Our study reports the effects and safety of intranasal calcitonin alongside sling immobilization on pain and function in the treatment of AF/SSF after RSA. The treatment was regimented calcitonin (salmon) 200 unit/actuation nasal spray (1 spray/day) for 6 weeks with sling immobilization for 4 weeks.

The Keystone Perforator Island Flap: Review of Utility and Versatile Clinical Applications.

Background: The keystone perforator island flap (KPIF) was described almost a decade ago. However, this flap has only recently been recognized for its advantages in various clinical applications in plastic surgery. A better understanding of the versatility of KPIFs can help promote the widespread adoption of this technique for complex wounds in various anatomical regions.

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.

Reimbursement Trends in Reduction Mammoplasty: A Single-Center Analysis of Insurance Reimbursements From 2012 to 2021.

Background: Medicare reimbursement for plastic surgery procedures increased by 2% while inflation increased by 19% in the past decade. Given increasing national breast reduction case volume and the negative impact decreased reimbursements have on surgeon well-being, we sought to evaluate actual surgeon reimbursements for bilateral breast reduction over a decade.

Methods: A retrospective review was performed including all identifiable breast reduction procedures (Current Procedure Terminology 19318) performed at a tertiary academic hospital between October 2011 and September 2021 (fiscal year 2012-2021).

Clinical Reasoning: Adult Patient Presenting With Spine Pain Following a Motor Vehicle Accident.

A 52-year-old woman with a complex medical history, including a history of consanguinity, developed refractory uncontrollable spine pain after a motor vehicle accident 2 years before presentation. There were no well-defined findings on clinical examination. She was found to have mildly elevated serum creatine phosphokinase levels, and spine imaging revealed fatty replacement and atrophy affecting predominantly lumbar paraspinal muscles.

Critical Appraisal of the Quality of Publications in Hepatobiliary and Pancreatic Surgery Research Using the American College of Surgeons NSQIP Database.

Background: The use of the American College of Surgeons (ACS) NSQIP has increased in hepatobiliary and pancreatic surgery (HPB) research as it provides access to high-quality surgical outcome data on a national scale. Using the ACS NSQIP database, this study examined the methodologic reporting of HPB publications.

Study Design: Web of Science core collection (all editions) was queried for all HPB studies using the ACS NSQIP database published between 2004 and 2022.

Impella 5.5 Support Beyond 50 Days as Bridge to Heart Transplant in End-Stage Heart Failure Patients.

Prolonged mechanical circulatory support (MCS) for severe left ventricular dysfunction in cardiogenic shock as a bridge to heart transplantation (HTx) generally requires a surgical procedure. Typically, a surgically implanted temporary extracorporeal left ventricular assist device (LVAD) is chosen because of superior flow and durability compared with a percutaneously delivered endovascular LVAD (pVAD). However, compared with its predecessors, the Impella 5.

A Decade Later-Progress and Next Steps for Pediatric Simulation Research.

A decade ago, at the time of formation of the International Network for Pediatric Simulation-based Innovation, Research, and Education, the group embarked on a consensus building exercise. The goal was to forecast the facilitators and barriers to growth and maturity of science in the field of pediatric simulation-based research. This exercise produced 6 domains critical to progress in the field: (1) prioritization, (2) research methodology and outcomes, (3) academic collaboration, (4) integration/implementation/sustainability, (5) technology, and (6) resources/support/advocacy.

High occurrence of postintensive care syndrome identified in surgical ICU survivors after implementation of a multidisciplinary clinic.

Background: Postintensive care syndrome (PICS) has been identified in a large proportion of medical intensive care unit survivors; however, the occurrence surgical intensive care unit (SICU) survivors is unknown. We implemented a multidisciplinary critical care outpatient clinic (CCOC) to identify the occurrence of PICS in SICU survivors.

Methods: Seventy acute care surgery and trauma patients, 18 years or older, who remained in the SICU for 72 hours or longer at a Level I trauma center were seen in CCOC at 2 weeks, 12 weeks, and 24 weeks after hospital discharge.

The relationship between mast cell activation syndrome, postural tachycardia syndrome, and Ehlers-Danlos syndrome.

Postural tachycardia syndrome (POTS), hypermobile Ehlers-Danlos syndrome (EDS), and mast cell activation syndrome (MCAS) can occur in the same patient. In this study, we investigated the relationship among these three syndromes. To establish the relationship of MCAS in patients diagnosed with POTS and hypermobile EDS as well as characterize the demographics of the patients affected by these syndromes.

Readmission following surgical stabilization of rib fractures: Analysis of incidence, cost, and risk factors using the Nationwide Readmissions Database.

Background: Surgical stabilization of rib fractures (SSRF) has become increasingly common for the treatment of traumatic rib fractures; however, little is known about related postoperative readmissions. The aims of this study were to determine the rate and cost of readmissions and to identify patient, hospital, and injury characteristics that are associated with risk of readmission in patients who underwent SSRF. The null hypotheses were that readmissions following rib fixation were rare and unrelated to the SSRF complications.

Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Clinical Update.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently recognized malignancy of T-lymphocytes that is linked to certain types of textured breast implants. Although rare, the increasing awareness of the disease is resulting in more case reports and heightened anxiety in patients with textured breast implants. This review aims to summarize the available BIA-ALCL data, including the existing theories of etiopathogenesis, the diagnostic work-up for BIA-ALCL patients, BIA-ALCL treatment recommendations, the epidemiologic challenges, and the current opinions surrounding the use of textured breast implants.

Patch Testing With an Extended Metal Allergen Series at the Massachusetts General Hospital (2006-2017).

Background: Reports of patch test data with an extended metal series that includes rare metals are limited.

Objective: The aims of the study were to analyze and report patch testing results from an extended metal series, examine associations with sex and age, and highlight concomitant metal reactions.

Methods: This study is a retrospective review of 150 patients referred for suspected metal allergy from January 1, 2007, to December 31, 2016.

Lateralization and Decreased Neck-Shaft Angle Reduces Scapular Notching and Heterotopic Ossification.

Background: Lateralization of the glenosphere in reverse shoulder arthroplasty likely mitigates scapular notching; however, there is a paucity of data evaluating the effect of heterotopic ossification (HO) at the inferior aspect of the glenoid neck.

Methods: We retrospectively reviewed 107 consecutive reverse shoulder arthroplasty patients between April 2013 and April 2016. During the study period, the surgeon switched from a 2.

Patch Testing Results From the Massachusetts General Hospital Contact Dermatitis Clinic, 2007-2016.

Background: Patch testing is the criterion standard for diagnosis of allergic contact dermatitis (ACD).

Objective: The aim of the study was to report the trends of patch testing results with the standard series at Massachusetts General Hospital from January 1, 2007, to December 31, 2016, compared with previous data from 1998 to 2006 and from 1990 to 2006 and those reported by the North American Contact Dermatitis Group.

Methods: Data were collected and analyzed from retrospective chart reviews, focusing on 50 allergens in our standard series.

Three Different Databases, Three Different Complication Rates for Knee and Hip Arthroplasty: Comparing the National Inpatient Sample, National Hospital Discharge Survey, and National Surgical Quality Improvement Program, 2006 to 2010.

Background: National databases are increasingly used to research complication rates, risk factors, and the role of comorbidities. Three commonly used databases are the Healthcare Cost and Utilization Program's National Inpatient Sample (NIS), the National Hospital Discharge Survey (NHDS), and the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Despite many publications, the accuracy of results from these databases remains unclear.