6,985 results match your criteria: "Jefferson University Hospital[Affiliation]"

Background: One of the barriers to counseling patients for shoulder arthroplasty (TSA) is the anticipated pain after surgery. This can be contrasted with the common perception of arthroscopic rotator cuff repair (RCR) surgery being less painful because of the less invasive nature of the procedure. We conducted a prospective study comparing postoperative pain levels and narcotic consumption after TSA to those after RCR.

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Asymptomatic carotid stenosis (ACS) carries a 4.7% risk of ipsilateral stroke if left untreated. Carotid endarterectomy (CEA) is a surgical intervention that has demonstrated efficacy in reducing stroke risk among symptomatic elderly.

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Ergonomics in Facial Plastic and Reconstructive Surgery: A Clinical Evaluation.

Laryngoscope

October 2024

Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.

Objectives: Surgeons experience a risk for physical strain and injury secondary to physical demands in the workplace. To minimize injury and maximize career longevity, physicians should be aware of ergonomics pitfalls and postural correction methods. This study investigates ergonomic trends in Facial Plastic and Reconstructive Surgery (FPRS) clinic by quantifying surgeons' and trainees' cervicothoracic spine posture.

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Objectives: Though there is extensive research on recovery and outcomes of proximal joint fractures, such as hip and knee, there is a paucity of such research in foot and ankle fractures and a lack of uniform data on the incidence of venous thromboembolism (VTE). This is a retrospective cohort study that seeks to investigate the incidence of VTE following surgically versus conservatively treated foot and ankle fractures METHODS: This study included all adult-patient hospitalizations with International Classification of Disease 10th Revision diagnosis codes related to closed foot and ankle fractures as a primary diagnosis in the National Inpatient Sample, an administrative database part of the Healthcare Cost and Utilization Project, for a total of 209,595 cases. Multivariate binary logistic regression was performed to determine the effect of age, gender, past medical history of venous thromboembolism (PMHVTE), Charlson Comorbidity Index, race, surgery, and transfusion of red cell products on the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).

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Article Synopsis
  • - The study investigated the safety and feasibility of a new spinal electrical stimulation technology called RISES, which allows real-time adjustments to stimulation settings while collecting various data.
  • - Four participants with spinal cord injuries (SCIs) were tested, and results showed no serious adverse effects, with stable skin integrity, vital signs, and pain levels; however, fatigue increased post-stimulation.
  • - The trial compared open-loop and closed-loop stimulation methods, finding that while open-loop sessions had longer stimulation durations, there were no significant differences in setup time or other health measures between the two methods.
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Ketamine plus midazolam compared to midazolam infusion for the management of refractory status epilepticus.

Clin Neurol Neurosurg

November 2024

Department of Neurology, Thomas Jefferson University Hospital, 901 Walnut Street 4th Floor, Philadelphia, PA 19107, USA. Electronic address:

Article Synopsis
  • The study aimed to evaluate the effectiveness of using ketamine along with midazolam for treating refractory and super-refractory status epilepticus compared to using midazolam alone.
  • Researchers analyzed data from a neurointensive care unit, identifying two groups of patients: one receiving only midazolam (MDZ cohort) and the other receiving a combination of midazolam and ketamine (Ket+MDZ cohort).
  • Results indicated that while the overall time from midazolam start to seizure end was similar for both groups, the Ket+MDZ cohort experienced a significantly shorter time from the start of ketamine infusion to seizure end, suggesting that ketamine may enhance treatment efficacy.
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  • The study aimed to determine if additional doses of the COVID-19 vaccine correlate with fewer COVID-19-like symptoms six weeks after infection among health care workers.
  • A total of 2478 participants were enrolled, with 57% confirmed cases of COVID-19; symptoms like fatigue and sleep difficulties were common, especially in those infected.
  • Results indicated that those who received extra vaccine doses after their primary series experienced significantly lower odds of symptoms at six weeks post-infection compared to those who did not get boosted.
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The Role of Medicaid Expansion on the Receipt of Adjuvant Chemotherapy in Patients With Lung Cancer.

Clin Lung Cancer

September 2024

Department of Surgery, Division of Esophageal and Thoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, 19107. Electronic address:

Article Synopsis
  • The study aimed to analyze how Medicaid expansion impacted the receipt of adjuvant chemotherapy among eligible cancer patients using a national database.
  • Researchers reviewed data from nearly 10,000 patients treated in states that expanded Medicaid, finding a significant increase in chemotherapy receipt post-expansion (70.2% vs. 62.3%).
  • The results suggest that Medicaid expansion improved access to care and potentially led to better survival outcomes for patients receiving adjuvant therapy.
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Study Objective: To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs.

Methods: We established a prospective, multicenter, observational registry involving adult critically ill patients in whom focused TEE was performed for evaluation of out-of-hospital cardiac arrest (OHCA), inhospital cardiac arrest, evaluation of undifferentiated shock, hemodynamic monitoring, and/or procedural guidance in the ED, ICU, or operating room setting. The primary objective of the current investigation was to evaluate the clinical influence and safety of focused, point-of-care TEE in critically ill patients.

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Ventricular wall rupture is associated with poor outcomes subsequent to an acute myocardial infarction. We describe a case of postmyocardial infarction apical wall rupture following percutaneous coronary intervention. Our case emphasizes the importance of swift evaluation, diagnosis, and management to enhance survival in individuals confronting this critical condition.

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Nephrolithiasis (kidney stones) is a frequently occurring urologic condition resulting in significant patient morbidity and healthcare costs. Despite the higher prevalence of metabolic risk factors for nephrolithiasis among Black women, there have been few epidemiologic studies of kidney stones focusing on this group. We describe demographic and health characteristics, diagnostics, and metabolic profiles of US Black women with self-reported kidney stones.

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Background And Aims: Co-axial plastic double pigtail stents (DPSs) are commonly placed through lumen apposing metal stents (LAMS) in patients with pancreatic fluid collections (PFCs) to decrease the risk of adverse events. In this meta-analysis, we have compared the outcomes of LAMS plus co-axial DPS versus LAMS alone in patients with PFCs.

Methods: We reviewed several databases to identify the studies that compared outcomes of LAMS with DPS to LAMS without DPS in the treatment of PFCs.

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Article Synopsis
  • Cardiogenic shock (CS) is a serious condition that can lead to severe complications, and this study looked at how changes in hemodynamic (blood flow-related) measurements correlate with patient outcomes in those suffering from heart failure or heart attack.
  • Researchers analyzed data from over 2,200 patients to compare the hemodynamic profiles at the start and end of hospitalization, finding that mortality rates were higher in patients with acute myocardial infarction compared to those with heart failure.
  • The study revealed that improvements in various hemodynamic and metabolic factors during hospitalization, such as lower blood pressure and better cardiac output, were linked to increased survival rates in both groups of patients.
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  • The combination of xylazine and illicit fentanyl leads to serious soft tissue injuries, including deep tissue necrosis, due to its impact on tissue toxicity.
  • Xylazine, although a non-opioid tranquilizer, enhances the euphoric effects of fentanyl, increasing the risk of abuse and dependence.
  • The rise in xylazine-adulterated opioids, particularly in cities like Philadelphia, necessitates a multidisciplinary approach in managing the resulting wounds, emphasizing the roles of hand and reconstructive surgeons.
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  • - Hypertension is a leading cause of heart disease and death globally, and low-dose combination therapy using amlodipine, telmisartan, and chlorthalidone shows promise for safe and effective management according to a systematic review.
  • - The review analyzed randomized controlled trials (RCTs) to assess the effectiveness of this combination therapy, focusing on changes in blood pressure and adverse effects, finding three RCTs that met quality standards.
  • - Results indicated significant improvements in blood pressure control and a low risk of serious side effects; however, variations in dosages and control groups suggest further research is necessary to fully understand the long-term outcomes and factors influencing treatment responses.
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Atypical Presentation and Postoperative Management of Vagal Nerve Tumors.

Ann Otol Rhinol Laryngol

December 2024

Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Article Synopsis
  • The study focuses on managing tumors involving the vagus nerve, which often don't show obvious symptoms. It highlights various clinical cases and the unique challenges in treatment.
  • Five patients with different presentations of vagal nerve tumors underwent surgery, with four experiencing symptom resolution post-operation.
  • The findings suggest that innovative approaches, like ligating blood supply to certain tumors instead of complete removal, can effectively alleviate symptoms while preserving nerve function.
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Background: Arteriovenous malformations (AVMs) are uncommon cerebral lesions that can cause significant neurological complications. Surgical resection is the gold standard for treatment, but endovascular embolization and stereotactic radiosurgery (SRS) are viable alternatives.

Objective: To compare the outcomes of endovascular embolization versus SRS in the treatment of AVMs with Spetzler-Martin grades I-III.

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Article Synopsis
  • There has been a growing number of cervical fusion surgeries in the U.S., but there's a lack of research on how well surgeons follow evidence-based medicine (EBM) guidelines, particularly as patients turn to large language models (LLMs) for decision-making assistance.* -
  • An observational study tested four LLMs—Bard, BingAI, ChatGPT-3.5, and ChatGPT-4—against the 2023 North American Spine Society (NASS) cervical fusion guidelines, and found that none fully adhered, with only ChatGPT-4 and Bing Chat achieving 60% compliance.* -
  • The findings suggest a need for better training of LLMs on clinical guidelines and highlight the necessity of
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Increasing Caudal Block Utilization to Promote Opioid Stewardship in the NICU Population: A Quality Improvement Project.

J Pediatr Surg

September 2024

Department of Surgery, Nemours Children's Health, Wilmington, DE, USA; Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address:

Background: Regional anesthetic techniques are safe and effective in reducing pain and the need for opioid analgesia but may be underutilized in neonatal intensive care unit (NICU) patients. We developed an opioid stewardship pathway aimed at reducing the use of opioid analgesia in neonates by increasing caudal block utilization from a baseline of 50%-90% within 18 months.

Methods: We used control charts to track intra-operative opioid utilization in morphine milligram equivalents per kilogram (MME/kg) and immediate post-operative extubation rates.

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Minimal mathematical model for glycation of albumin.

Clin Biochem

December 2024

Siemens Healthcare Diagnostics, Inc., Tarrytown, NY, USA.

Background: Glycated albumin (GA) is often described as a reflection of glucose exposure over the past 2-4 weeks. We examined the scale of the operative interval for changes in %GA from the perspective of a theoretical model for GA formation, by simulating the time course of changes in %GA after changes in glucose.

Methods: Probability of survival of albumin (A) was according to first-order elimination based on t of 17 days.

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Microbiome is an endocrine organ that refers to both the complicated biological system of microbial species that colonize our bodies and their genomes and surroundings. Recent studies confirm the connection between the microbiome and eye diseases, which are involved in the pathogenesis of eye diseases, including age-related macular disorders, diabetic retinopathy, glaucoma, retinitis pigmentosa, dry eye, and uveitis. The aim of this review is to investigate the microbiome in relation to eye health.

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Article Synopsis
  • Brain metastasis from prostate adenocarcinoma (PCa) is uncommon but often leads to a poor prognosis, necessitating an assessment of its clinical and histopathological features for better diagnosis.
  • A study reviewed 21 cases from the past 20 years, discovering that the average age for brain metastasis presentation was 70, with diverse types and locations of lesions.
  • The research highlighted various histological patterns in tumor cells, including cribriform and papillary structures, and noted that nearly half of the cases displayed necrosis, indicating the need for thorough evaluation to improve diagnostic accuracy.
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