7,269 results match your criteria: "MedStar Washington Hospital Center; Department of Surgery[Affiliation]"

Burn injury in obesity: Examination of the Burn Care Quality Platform's (BCQP) available data on obese patients to determine burn-related outcomes.

Burns

September 2024

The Burn Center, MedStar Washington Hospital Center, Washington DC, United States; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington DC, United States; Department of Plastic Surgery, Georgetown University School of Medicine, Washington DC, United States. Electronic address:

Introduction: Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes.

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Metabolic Alkalosis.

Adv Kidney Dis Health

November 2024

MedStar Georgetown University Hospital, Division of Nephrology, Washington, DC.

Metabolic alkalosis is one of the four cardinal acid-base disorders and perhaps the least well understood by students. Taking a mechanistic approach to etiologies and management can be very helpful in such cases. Particularly, one should focus on the factors that generate the alkalosis (source of fluid loss and composition, less commonly alkali administration) and the factors (extracellular fluid volume status, hormonal systems) that maintain the abnormality.

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We examined the social and emotional challenges (SEC) of young children and the mental health of their caregivers in areas affected by armed conflict and displacement in Colombia. Anxiety, depression, and PTSD symptoms were assessed in 1,133 caregivers. Caregivers also reported on the SEC of their children aged 21-53 months.

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Longitudinal Goal Attainment With Repeat Injections of AbobotulinumtoxinA in Adults With Lower Limb Spasticity: Results From a Prospective Observational Study.

Arch Phys Med Rehabil

November 2024

Department of PM&R, Centro de Medicina de Reabilitaçãode Alcoitão, Serviço de Reabilitação de adultos 3, Estoril, Portugal.

Objective: To assess longitudinal goal attainment with repeat abobotulinumtoxinA (AboBoNT-A) injections for lower limb spasticity (LLS) over 16 months.

Design: Prospective, longitudinal, international, multicenter, observational study (NCT04050527).

Setting: Specialist neurorehabilitation centers.

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Introduction: Individual-level social risk factors have a significant impact on health. Social risks can be documented in the electronic health record using ICD-10 diagnosis codes (the "Z codes"). This study aims to summarize the literature on using Z codes to document social risks.

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UNICORN With a Self-Expanding Valve to Treat a Degenerated Balloon-Expandable Valve.

JACC Cardiovasc Interv

November 2024

Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. Electronic address:

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Objective: To evaluate the safety and tolerability of ubrogepant for the acute treatment of migraine in participants taking atogepant for the preventive treatment of episodic migraine (EM).

Background: Atogepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist approved for the preventive treatment of migraine in adults and ubrogepant is an oral CGRP receptor antagonist approved for the acute treatment of migraine in adults, with or without aura. The safety and tolerability of the concomitant use of ubrogepant and atogepant have not been previously evaluated in a clinical setting.

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Purpose: This study evaluates patient-reported outcomes among patients who underwent medial collateral ligament (MCL) reconstruction with suture-augmented semitendinosus autograft (SASA).

Methods: Patients who underwent SASA MCL reconstruction between 2017 and 2022 participated in preoperative and postoperative surveys for patient-reported outcomes: Visual Analog Pain Scale (VAS), Knee Injury and Osteoarthritis Outcomes Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Single Assessment Numeric Evaluation (SANE), Marx Activity Rating Scale (MARS), and Veterans Rand 12 (VR-12). Paired t-tests were performed to compare preoperative and postoperative scores.

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Managing Recurrent Urinary Tract Infections After Spinal Cord Injury: Practical Approaches and Emerging Concepts.

Phys Med Rehabil Clin N Am

February 2025

MedStar National Rehabilitation Hospital, Washington, DC, USA; Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC, USA.

The majority of individuals with neurogenic lower urinary tract dysfunction will have complicated urinary tract infections (UTIs) that will qualify as recurrent. Existing inconsistencies and challenges contribute to its subjective diagnosis. Thus, there is a pressing need for a reconceptualization of our understanding of UTI, accompanied by a paradigm shift in diagnosis and treatment approaches.

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Thriving Through Adaptation: Adaptive Sports after Spinal Cord Injury.

Phys Med Rehabil Clin N Am

February 2025

Spinal Cord Injury Program, Shepherd Center, 2020 Peachtree Road Northwest, Atlanta, GA 30309, USA.

This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment considerations, and recommendations on how to determine sport appropriateness for a person with spinal cord injury will be provided. The authors emphasize through appropriate medical management and consideration of level of disability, functional performance, psychological readiness, and individual preference, a health care provider can play a valuable role in connecting individuals with spinal cord injury to adaptive sports and recreation.

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In healthy adults different language abilities-sentence processing versus emotional prosody-are supported by the left (LH) versus the right hemisphere (RH), respectively. However, after LH stroke in infancy, RH regions often support both abilities with normal outcomes. This finding raises an important question: How does the functional map of RH regions change to support both emotional prosody and also typically left-lateralized language functions after an early LH stroke? Does sentence processing simply become reflected into RH frontotemporal regions and overlap with emotional prosody processing? Or do these functions overlap less than would be expected with simple mirroring? In the current work we used task fMRI to examine precisely how sentence processing and emotional prosody processing are both organized in the intact RH of individuals who suffered a large LH perinatal arterial ischemic stroke (LHPS participants).

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Background: To evaluate the benefit-risk assessment of atogepant and calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) vs. placebo based on the number needed to treat (NNT) and the number needed to harm (NNH) in a blended episodic migraine and chronic migraine (EM + CM) population.

Methods: The NNT was calculated based on achievement of a ≥ 50% reduction in mean monthly migraine days (MMDs) from baseline across 12 weeks.

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Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.

N Engl J Med

November 2024

From Cleveland Clinic, Cleveland (O.M.W., W.I.S., K.W.); St. Bernards Medical Center and Arrhythmia Research Group, Jonesboro, AR (D.G.N.); the Cardiology Department, European Georges Pompidou Hospital, Paris (E.M.); Cardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt am Main (B.S.), Catholic Hospital, Sankt Johann Nepomuk, Erfurt (H.E.), and Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin (C.S.) - all in Germany; Iowa Heart Center, West Des Moines (T.H.); Ascension St. Vincent's Medical Center, Jacksonville, FL (S.O.); UPMC Pinnacle, Harrisburg, PA (C.P.); Vanderbilt University, Nashville (A.K.); Phoenix Cardiovascular Research Group, Phoenix AZ (A.S.); South Denver Cardiology, Littleton, CO (S.S.); Grandview Medical Center, Birmingham, AL (J. Osorio); Heart House-Cooper University, Camden, NJ (G.M.); Lindner Center for Research and Education at Christ Hospital, Cincinnati (M.G.); Emory University, Medicine, Atlanta (D.B.D.); St. Vincent Heart Center of Indiana, Indianapolis (J. Olson); the Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (J.E.N.-K.); St. Antonius Hospital, Nieuwegein, the Netherlands (L.V.A.B.); the Population Health Research Institute, Hamilton, ON, Canada (J.S.H.); Brisbane AF Clinic, Greenslopes Private Hospital, Brisbane, QLD, Australia (K.P.P.); Medstar Health Research Institute, Medstar Washington Hospital Center, Washington, DC (F.M.A.); Boston Scientific, Marlborough, MA (K.R., T.C., B.S.S., K.M.S.); and Cardiac Electrophysiology, Mount Sinai Fuster Heart Hospital School of Medicine, New York (V.Y.R.).

Background: Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking.

Methods: We conducted an international randomized trial involving 1600 patients with atrial fibrillation who had an elevated score (≥2 in men and ≥3 in women) on the CHADS-VASc scale (range, 0 to 9, with higher scores indicating a greater risk of stroke) and who underwent catheter ablation.

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A Novel Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort.

Orthop J Sports Med

November 2024

Luminis Health Orthopedics, Pasadena, Maryland, USA.

Background: As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights.

Purpose: To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure.

Study Design: Cohort study; Level of evidence, 3.

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Redo-TAVI with the SAPIEN 3 valve in degenerated calcified CoreValve/Evolut explants.

EuroIntervention

November 2024

Cardiovascular Translational Lab, Centre for Heart Lung Innovation, University of British Columbia and Providence Health Care, St. Paul's Hospital, Vancouver, Canada.

Article Synopsis
  • Redo-transcatheter aortic valve implantation (TAVI) is often needed for failed aortic valves, specifically examining SAPIEN 3 (S3) valves in degenerated CoreValve/Evolut (CV/EV) valves, which is not fully understood.
  • The study assessed the performance of S3 valves following implantation in calcified CV/EV valves through various hydrodynamic tests, measuring factors like mean gradient, effective orifice area, and leaflet behaviors.
  • Results indicated that S3 valves generally performed well, showing decreased mean gradient and acceptable effective orifice area, but issues like underexpansion, leaflet pinwheeling, and calcium protrusion were noted, highlighting the need for further research on long
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Guidelines regarding the optimal use and timing of anti-Mullerian hormone (AMH) screening in childhood cancer survivors to evaluate for the risk of premature ovarian insufficiency or reduced fertility potential are lacking. We conducted a systematic review of the current evidence supporting AMH screening of female childhood cancer survivors with the overall objective to identify gaps in the literature needing further study, to allow for future data-driven recommendations. Search terms included "cancer, fertility, and anti-Mullerian hormone.

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Cardiac surgery is associated with significant postoperative pain that can affect patients' recovery and quality of life. Optimal analgesia after cardiac surgery can be challenging due to patients' coexisting morbidities and frequently observed adverse effects when opioids are used to treat postoperative pain. In this current era of enhanced recovery and fast track extubation, the use of multimodal analgesia for pain management after cardiac surgery is expanding.

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Lower Risk of Death and Kidney Failure Associated with Higher Target (vs. Below-Target) Doses of RAS Inhibitors in Octogenarians with HFrEF.

Am J Med

November 2024

Department of Medicine, George Washington University, Washington, DC; Department of Medicine, Westchester Medical Center, Valhalla, NY; Department of Medicine, Georgetown University, Washington, DC. Electronic address:

Background: Renin-angiotensin system inhibitors (RASIs) at higher target doses reduce the risk of death in patients with heart failure with reduced ejection fraction (HFrEF). Less is known about their effectiveness in octogenarians, the examination of which was the objective of this study.

Methods: Of 32,964 Veterans ≥80 years with HFrEF (ejection fraction ≤40%) receiving RASIs, 6655 received target-dose.

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Bladder exstrophy in adulthood: A narrative review of transitional health.

J Pediatr Urol

November 2024

Department of Urology, School of Medicine, University of California San Francisco, 400 Parnassus Ave, San Francisco, CA, 94143, USA; Department of Surgery, San Francisco Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA, 94121, USA.

Background: Exstrophy-epispadias complex (EEC) classically presents as bladder exstrophy (BE) and requires lifetime urologic care. As men and women with BE age, there is an often difficult period of transition to adulthood in terms of addressing urologic and general health challenges. BE can lead to many urinary and sexual health issues as these patients age, which is often made more complex given their past surgical history and anatomy.

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Aortic aneurysms represent the 15 leading cause of death in men and women over 55 years of age. Where historically these lesions were all addressed via an open approach, endovascular aortic repair has entirely altered the way that surgeons approach aortic lesions. Although it was initially employed for patients who were poor surgical candidates, endovascular repair is now standard for abdominal aortic aneurysms and aneurysms in the descending thoracic aorta.

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Article Synopsis
  • * A total of 2.1% of patients (n=138) experienced dislocations, primarily within the first 90 days post-surgery, with different treatment approaches for dislocation including closed reduction, open reduction, revision arthroplasty, or benign neglect.
  • * Among those treated with closed reduction, only 31% were successfully resolved without further intervention, while many either required revision surgery or experienced recurrent dislocations, highlighting the complexity of managing these postoperative complications.
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Feasibility of Obtaining Patient-Reported Outcome Measures in a High-Volume Multidisciplinary Surgical Limb Salvage Center.

J Am Podiatr Med Assoc

November 2024

*Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC. Dr. Sayyed is now with SIU Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield IL.

Background: Completion of patient-reported outcome measures (PROMs) is labor-intensive but paramount in improving patient-centered care, allowing for advancement of techniques and scrutinization of outcomes. We report the feasibility of PROM collection and reporting for patients seen in a high-volume, multidisciplinary, tertiary limb salvage center to determine pain and functionality outcomes.

Methods: The center received grant funding resources for large-scale PROM collection.

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