Blunt Cerebrovascular Injury: Are We Overscreening Low-Mechanism Trauma?

Background And Purpose: Screening patients with trauma for blunt cerebrovascular injury with neck CTA is a common practice, but there remains disagreement regarding which patients should be screened. We reviewed adult blunt cerebrovascular injury data from a level 1 trauma center to investigate whether screening is warranted in low-mechanism trauma.

Materials And Methods: We reviewed all neck CTAs performed on adult trauma patients in the emergency department during the 2019 calendar year.

Nonaccidental Pediatric Trauma: Which Traditional Clues Predict Abuse?

Objectives: The objective of this study is to determine which of the child abuse clues quoted in the literature predict nonaccidental trauma (NAT): history incongruent with injuries found on examination or imaging, old injuries present, history of trauma denied by caregivers, multiple fractures present, changing history, fractures of varied duration, metaphyseal fracture, ear bruise, neck bruise, different history (second historian), and metaphyseal fracture.

Methods: This is a 4-year retrospective study of all suspected NAT cases referred to our medical center. In addition to the index visit, medical records were searched for visits before the index visit with patient historical or physical findings that might have suggested NAT but were not investigated.

Comparing Outcomes in the Therapeutic and Prophylactic Breast for Bilateral Mastectomy With Implant-Based Breast Reconstruction.

Background: Increasingly patients with unilateral breast cancer elect to undergo bilateral mastectomy with subsequent reconstruction. Studies have aimed to better identify the risks associated with performing mastectomy on the noncancerous breast. Our study aims to identify differences in complications between therapeutic and prophylactic mastectomy in patients undergoing implant-based breast reconstruction.

Factors Influencing Patient Preferences for Phototherapy: A Survey Study.

There is limited literature regarding patient preferences for phototherapy. Patients may consider different forms of phototherapy depending on a multitude of factors important to them, including safety, cost, efficacy, insurance issues, and convenience. This study aimed to determine which form of phototherapy-in-office UVB, at-home UVB, home tanning, salon tanning, and sunbathing-was preferred by survey participants and the reasons for their preferences.

Interstitial Granulomatous Dermatitis as an Adverse Reaction to Vedolizumab.

A 61-year-old woman with a medical history of ulcerative colitis (UC) developed an erythematous, mildly pruritic, maculopapular rash that was histologically consistent with reactive granulomatous dermatitis (RGD) with interstitial granulomatous dermatitis (IGD)-type features 1 week after vedolizumab infusion. Awareness of this complication is key to enhanced recognition and appropriate management as use of this medication becomes more prevalent.

Views and Beliefs of Vitiligo Patients in Online Discussion Forums: A Qualitative Study.

Individuals with chronic illnesses turn to online communities to engage in asynchronous peer-to-peer exchanges to better understand and manage their disease. Messages and advice exchanged by online users with vitiligo are not well characterized. We conducted a qualitative study to explore the content exchanged by individuals with vitiligo in online forums.

Low-Dose Eptifibatide for Tandem Occlusion in Stroke: Safety and Carotid Artery Patency.

Background And Purpose: Maintaining carotid patency and avoiding symptomatic intracranial hemorrhage are competing concerns in tandem occlusions. This study provides data regarding the safety and efficacy of eptifibatide in stroke from tandem occlusion of the extracranial carotid artery and the intracranial carotid or middle cerebral artery.

Materials And Methods: This is a retrospective analysis of 58 consecutive patients who received low-dose eptifibatide (135-mcg/kg bolus, 1-mcg/kg/min infusion) during treatment of tandem occlusions.

Reperfusion repercussions: A review of the metabolic derangements following resuscitative endovascular balloon occlusion of the aorta.

Background: Current resuscitative endovascular balloon occlusion of the aorta (REBOA) literature focuses on improving outcomes through careful patient selection, diligent catheter placement, and expeditious definitive hemorrhage control. However, the detection and treatment of post-REBOA ischemia-reperfusion injury (IRI) remains an area for potential improvement. Herein, we provide a review of the metabolic derangements that we have encountered while managing post-REBOA IRI in past swine experiments.

The Effect of Resident Involvement in Pelvic Prolapse Surgery: A Retrospective Study From a Nationwide Inpatient Sample.

Objective: The primary aim of this study was to assess the effect of resident involvement on perioperative complication rates in pelvic organ prolapse surgery using the National Surgical Quality Improvement database.

Methods: All pelvic organ prolapse operations from 2006 to 2012 were identified and dichotomized by resident participation. Preoperative characteristics and 30-day perioperative outcomes were compared using χ and Student t test.

Venovenous extracorporeal life support improves survival in adult trauma patients with acute hypoxemic respiratory failure: a multicenter retrospective cohort study.

Background: Venovenous extracorporeal life support (VV ECLS) has been reported in adult trauma patients with severe respiratory failure; however, ECLS is not available in many trauma centers, few trauma surgeons have experience initiating ECLS and managing ECLS patients, and there is currently little evidence supporting its use in severely injured patients. This study seeks to determine if VV ECLS improves survival in such patients.

Methods: Data from two American College of Surgeons-verified Level 1 trauma centers, which maintain detailed records of patients with acute hypoxemic respiratory failure (AHRF), were evaluated retrospectively.