Combined Upper-Lower Extremities Fractures in the Elderly.

Age-related bone loss is believed to increase the risk of traumatic fragility fractures in both men and women. We aimed to determine the risk factors associated with simultaneous fractures in the upper-lower extremities. This retrospective study utilized the ACS-TQIP database from 2017 to 2019 to identify patients with respective fractures caused by ground-level falls.

Age-Related Outcomes in Le Fort Fractures.

This study aims to provide patient characteristics and short-term clinical outcomes of Le Fort fractures. Using the National Surgical Quality Improvement Program database from 2016 to 2019, cases involving Le Fort fractures on initial encounters were reviewed. 130 cases from 3293 facial fractures were identified.

Effect of the COVID-19 pandemic on the epidemiological trends and outcomes of gastrointestinal bleeding: a nationwide study.

The COVID-19 pandemic altered healthcare delivery in the United States. This study examined the effect of the COVID-19 pandemic on the epidemiological trends and outcomes of gastrointestinal bleeding. We compared the admission rate, in-hospital mortality rate, and mean length of hospital stay between 2019 and 2020 to estimate the pandemic effect.

Impact of cardiac and noncardiac cirrhosis on coronary revascularization outcomes from the National Inpatient Sample, 2016 to 2018.

Data on coronary revascularization in patients with cirrhosis are scarce because it is often deferred in the setting of significant comorbidities and coagulopathies. It is unknown whether patients with cardiac cirrhosis have a worse prognosis. The National Inpatient Sample was surveyed to identify patients who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) from 2016 to 2018.

The Dilemma Behind Negative Troponin: A Case Report.

Acute coronary syndrome remains the primary cause of mortality and morbidity in the United States. Cardiac ischemia is a consequence of an imbalance between oxygen demand and supply. The sensitivity of troponin is above 99% in diagnosing cardiac injury; rare exceptions can occur, however.

The American Association for the Surgery of Trauma Organ Injury Scale is Associated With Cystoscopic and Percutaneous Urologic Procedures in Renal Injuries.

Background: The American Association for the Surgery of Trauma Organ Injury Scale for the kidney was created in 1989. It has been validated to various outcomes including operations. It was updated in 2018 to better predict endourologic interventions, but this change has not been validated.

Validating the American Association for the Surgery of Trauma Pancreas Injury Grade Using Trauma Quality Improvement Program Data.

The American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) for the pancreas was created in 1990. Our aim was to validate the ability of the AAST-OIS pancreas grade to predict adjuncts to operative management, including endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous drain placement. We analyzed the Trauma Quality Improvement Program (TQIP) database from 2017 to 2019, including all patients with a pancreas injury.

Factor Xa inhibitors versus vitamin K antagonist in morbidly obese patients with venous thromboembolism: a systematic review and meta-analysis.

Introduction: Guidelines have endorsed non-vitamin K antagonist oral anticoagulants (NOACs), consisting of factor Xa inhibitors (xabans) and direct thrombin inhibitors, as the first line of treatment in venous thromboembolism (VTE) and atrial fibrillation. However, morbidly obese patients were under-represented in landmark trials of NOACs. Therefore, this study aimed to systematically review and perform a meta-analysis of studies on xabans versus vitamin K antagonist (VKA) in this high-risk population with VTE.

Does a time threshold exist for bladder repair after which outcomes worsen? A Trauma Quality Improvement Program study.

Background: The appropriate timing of surgical intervention for bladder injuries is not well-defined. The effect of time to surgery on the outcomes of patients with a bladder injury was assessed using data from the Trauma Quality Improvement Program.

Methods: Patients with dominant or isolated bladder injuries who underwent surgical repair from 2017 to 2019 were studied.

TeleEMS: An EMS Telemedicine Pilot Program Barriers to Implementation.

Introduction: In response to the COVID-19 pandemic, emergency medical services (EMS) and hospitals recognized the need for innovative programs addressing 9-1-1 utilization and ambulance transport to provide patient-centered, safe, cost-effective care. The ET3 (Emergency Triage, Treatment, and Transport) model provides flexibility and new payments to ambulance care teams for Medicare beneficiaries for alternate strategies of care. This includes providing treatment in place through telehealth after a 9-1-1 call and ambulance response.

Trends and Outcomes of Transcatheter Aortic Valve Implantation in Patients With Peripheral Arterial Disease: Insights From the National Readmissions Database.

Due to shared risk factors, many patients with severe aortic stenosis (AS) also have concomitant peripheral arterial disease (PAD). The readmission rates and long term clinical outcomes of these patients following transcatheter aortic valve implantation (TAVI) in a large sample has not been well defined. The National Readmissions Database (NRD) (2015-2019) was used to identify patients undergoing TAVI.

Impact of COVID-19 on Patients Hospitalized with ST-Segment Elevation Myocardial Infarction in the United States during the Early Pandemic: An Analysis of Outcomes, Care Delivery, and Racial Disparities in Mortality.

The COVID-19 pandemic has impacted healthcare delivery to patients with ST-segment elevation myocardial infarction (STEMI). The aim of our retrospective study was to determine the effect of COVID-19 on inpatient STEMI outcomes and to investigate changes in cardiac care delivery during 2020. We utilized the National Inpatient Sample database to examine inpatient mortality and cardiac procedures among STEMI patients with and without COVID-19.

Trends and Disparities in Outcomes of Infection Hospitalizations in the United States: A Ten-Year Joinpoint Trend Analysis.

Background: infection (CDI) is the most frequently reported nosocomial infection. This study aimed to describe epidemiological trends, sex, race, and economic disparities in clinical and mortality outcomes among CDI hospitalizations over a decade.

Methods: We queried Nationwide Inpatient Sample databases from 2010 to 2019, identified hospitalizations with CDI, and obtained the incidence and admission rate of CDI per 100,000 adult hospitalizations each year.

Needs and Gaps in Resident Trainee Education, Clinical Patient Care, and Clinical Research in Cosmetic Dermatology: Position Statement of the Association of Academic Cosmetic Dermatology.

Cosmetic dermatology is a key subspecialty of academic dermatology. As such, academic centers are expected to demonstrate excellence in the teaching of cosmetic dermatology skills to trainees, the clinical delivery of cosmetic dermatology services to patients, and the performance of clinical research that advances knowledge and uncovers new therapies in cosmetic dermatology. The Association of Academic Cosmetic Dermatology (AACD), a newly formed medical professional society, includes as its principal aims the support of all of these areas.

Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction.

The superiority of angiotensin receptor-neprilysin inhibitor (ARNI) over angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin receptor blocker (ARB) has not been reassessed after the publication of recent trials that did not find clinical benefits. Therefore, we performed an updated network meta-analysis comparing the efficacy and safety of ARNI, ACE-I, ARB, and placebo in heart failure with reduced ejection fraction. We included randomized clinical trials that compared ARNI, ARB, ACE-I, and placebo in heart failure with reduced ejection fraction.

The Association of Academic Cosmetic Dermatology: improving cosmetic dermatology education through collaboration, research, and advocacy.

Cosmetic and laser procedures are increasingly popular among patients and are skills in which dermatologists are regarded as well trained. Most dermatology residents intend to incorporate cosmetic procedures into their practice and prefer to learn such procedures during residency through direct patient care. However, there are notable challenges in optimizing how residents are trained in cosmetic and laser dermatology.

Two Cases of Heterotopic Pancreas of the Small Bowel Incidentally Found During Laparoscopic Bariatric Surgery.

Background: We present two cases of incidentally found heterotopic pancreas during laparoscopic bariatric surgery. Heterotopic pancreas is a rare congenital anomaly where pancreatic tissue is located outside of the pancreas. These lesions may be encountered incidentally during surgery, which raise unexpected management questions.

A decade of hospitalizations for hyperthyroidism in the US.

The goal of this study was to examine healthcare burden, hospitalizations, mortality, and healthcare cost utilization from hyperthyroidism to further our understanding of the effect of changes in thyroid disease management over the past decade. This was a retrospective longitudinal trends study involving hospitalizations for hyperthyroidism in the US from 2008 to 2018. We trended crude hospitalization rate, estimated incidence of hospitalizations, trends in inpatient mortality rate, mean length of hospital stay, and mean total hospital cost of patients with hyperthyroidism.

Plasmapheresis in hypertriglyceridemia-induced acute pancreatitis.

The study involved hospitalizations with a diagnosis of hypertriglyceridemia-induced acute pancreatitis (HTGAP). This cohort was grouped into plasmapheresis and nonplasmapheresis groups using ICD-10 codes (6A550Z3 and 6A551Z3). Information was obtained on inpatient mortality, length of stay, total hospital charges, as well as the occurrence of comorbid systemic immune response syndrome, sepsis, septic shock, acute respiratory failure, acute respiratory distress syndrome, kidney failure, hypocalcemia, and need for transfusion of blood products.