A Readmission Risk Assessment Tool Is Not Predictive of 90-Day Readmission After Total Joint Arthroplasty at an Urban Tertiary Referral Hospital.

Introduction: Readmission within 90 days of total joint arthroplasty (TJA) via an emergency department (ED) encounter represents a significant economic burden to the healthcare system. We aimed to determine the utility of a previously described readmission risk assessment tool (RRAT) in predicting readmission after presentation to the ED within 90 days of primary TJA.

Methods: At a single academic tertiary referral medical center, a retrospective chart review was used to collect demographic data, surgery type, medical history, reason for presentation in the ED, and ED disposition for the 1,576 patients who underwent TJA between April 1, 2016, and December 31, 2018.

Health system-wide access to generative artificial intelligence: the New York University Langone Health experience.

Objectives: The study aimed to assess the usage and impact of a private and secure instance of a generative artificial intelligence (GenAI) application in a large academic health center. The goal was to understand how employees interact with this technology and the influence on their perception of skill and work performance.

Materials And Methods: New York University Langone Health (NYULH) established a secure, private, and managed Azure OpenAI service (GenAI Studio) and granted widespread access to employees.

Early diagnostics and interventional glaucoma.

The glaucoma treatment paradigm is starting to change from a more reactive approach that relies on topical medications to a more proactive approach that leverages procedural interventions. This evolution toward interventional glaucoma has been enabled by a growing array of lower-risk minimally invasive procedures such as laser trabeculoplasty, minimally invasive glaucoma surgery, and procedural pharmaceuticals. A common feature of these glaucoma interventions-as with all glaucoma interventions-is the need for early, prompt, and accurate diagnosis.

Race- associated molecular differences in uterine serous carcinoma.

Purpose: Endometrial cancer (EMCA) is the most common gynecologic malignancy, and new diagnoses are increasing in the United States. Black patients are more likely to present with advanced stage, be diagnosed with high-risk uterine serous carcinoma (USC) and die of their cancer.

Methods: Patients with endometrial adenocarcinoma who received tumor FoundationOne CDx testing at our institution between January 2017 and August 2022 were identified.

Taking action to achieve health equity and eliminate healthcare disparities within acute care surgery.

Addressing disparities is crucial for enhancing population health, ensuring health security, and fostering resilient health systems. Disparities in acute care surgery (trauma, emergency general surgery, and surgical critical care) have been well documented and the magnitude of inequities demand an intentional, organized, and effective response. As part of its commitment to achieve high-quality, equitable care in all aspects of acute care surgery, the American Association for the Surgery of Trauma convened an expert panel at its eigty-second annual meeting in September 2023 to discuss how to take action to work towards health equity in acute care surgery practice.

Unraveling the Clinical Complexity of Thyrotoxic Periodic Paralysis: A Case Report.

Thyrotoxic periodic paralysis (TPP) is a clinical condition characterized by hypokalemia, muscle paralysis, and hyperthyroidism. TPP can be challenging to diagnose due to its low disease prevalence and the similarity of paralysis to other common conditions. Through this case report, we highlight the importance of considering hyperthyroidism as a cause of recurrent attacks of muscle paralysis, particularly in the setting of other signs of hyperthyroidism.

Robotic Removal of Spilled Gallstones After Laparoscopic Cholecystectomy: Resolving Chronic Abdominal Pain Using New Technology.

Spilled gallstones during laparoscopic cholecystectomy can potentially lead to serious complications in patients. We present a case of a patient with gallstone spillage during cholecystectomy who was found years later to have gallstones stuck in a difficult location, requiring robotic surgery. A robotic approach allows for greater visual angles compared to conventional laparoscopy.

Effect of a behavioral nudge on adoption of an electronic health record-agnostic pulmonary embolism risk prediction tool: a pilot cluster nonrandomized controlled trial.

Objective: Our objective was to determine the feasibility and preliminary efficacy of a behavioral nudge on adoption of a clinical decision support (CDS) tool.

Materials And Methods: We conducted a pilot cluster nonrandomized controlled trial in 2 Emergency Departments (EDs) at a large academic healthcare system in the New York metropolitan area. We tested 2 versions of a CDS tool for pulmonary embolism (PE) risk assessment developed on a web-based electronic health record-agnostic platform.

Outcomes Following the Use of Extracellular Matrix Cartilage Allograft for the Management of Osteochondral Lesions of the Talus: A Systematic Review.

Extracellular matrix cartilage allograft (EMCA) is a novel biological strategy utilized to augment the repair of osteochondral lesions of the talus (OLTs). However, there is no consensus on the precise role and outcomes following its use in the treatment of OLTs. The purpose of this systematic review was to evaluate the clinical and radiological outcomes following the use of EMCA for the treatment of OLT.

Anatomical correlates for the newly discovered meningeal layer in the existing literature: A systematic review.

The existence of a previously unrecognized subarachnoid lymphatic-like membrane (SLYM) was reported in a recent study. SLYM is described as an intermediate leptomeningeal layer between the arachnoid and pia mater in mouse and human brains, which divides the subarachnoid space (SAS) into two functional compartments. Being a macroscopic structure, having missed detection in previous studies is surprising.

Soft tissue coverage for IIIB fractures: from timing to coverage options.

Open tibia fractures are the most common open long bone injury. Most of these injuries involve a high-energy mechanism. Many standards for management have been created to provide guidance and a baseline for quality.

Atraumatic Idiopathic Compartment Syndrome Requiring Emergent Fasciotomy: A Case Report and Literature Review.

A 42-year-old male with no past medical history presented to an emergency room with increasing pain and swelling of his left lower extremity over 48 hours with no preceding trauma. A computed tomography scan demonstrated a hematoma (20 cm × 4 cm × 10 cm) present within the gastrocnemius-soleus complex. Acute compartment syndrome (ACS) was diagnosed clinically, confirmed intraoperatively with an arterial line transducer, and treated with emergent fasciotomy.

A review of air pollution as a driver of cardiovascular disease risk across the diabetes spectrum.

The prevalence of diabetes is estimated to reach almost 630 million cases worldwide by the year 2045; of current and projected cases, over 90% are type 2 diabetes. Air pollution exposure has been implicated in the onset and progression of diabetes. Increased exposure to fine particulate matter air pollution (PM) is associated with increases in blood glucose and glycated hemoglobin (HbA1c) across the glycemic spectrum, including normoglycemia, prediabetes, and all forms of diabetes.

Quality measures in pre-liver transplant care by the Practice Metrics Committee of the American Association for the Study of Liver Diseases.

The liver transplantation (LT) evaluation and waitlisting process is subject to variations in care that can impede quality. The American Association for the Study of Liver Diseases (AASLD) Practice Metrics Committee (PMC) developed quality measures and patient-reported experience measures along the continuum of pre-LT care to reduce care variation and guide patient-centered care. Following a systematic literature review, candidate pre-LT measures were grouped into 4 phases of care: referral, evaluation and waitlisting, waitlist management, and organ acceptance.

Intestinal Spirochetosis: To Treat or Not to Treat.

Spirochete colonization of the gastrointestinal tract is a poorly understood phenomenon presenting with varying signs and symptoms. Due to the lack of a unified approach and its varying presentations, the management decision for intestinal spirochetosis (IS) has always been challenging. While metronidazole is the commonly preferred antimicrobial treatment, it remains unclear if therapeutic intervention is indicated for everyone, especially asymptomatic patients.

Sleep-Related Problems and Pediatric Anxiety Disorders.

Sleep-related problems are highly prevalent among childhood and adolescent anxiety disorders. The objective of this review was to summarize the relevant clinical research literature as it pertains to the nature of the association between sleep-related problems and youth anxiety, developmental factors relevant to this association, and intervention efforts to target comorbid sleep challenges and anxiety. Limitations of the literature and future directions are discussed.

Delineating spatial cell-cell interactions in the solid tumour microenvironment through the lens of highly multiplexed imaging.

The growth and metastasis of solid tumours is known to be facilitated by the tumour microenvironment (TME), which is composed of a highly diverse collection of cell types that interact and communicate with one another extensively. Many of these interactions involve the immune cell population within the TME, referred to as the tumour immune microenvironment (TIME). These non-cell autonomous interactions exert substantial influence over cell behaviour and contribute to the reprogramming of immune and stromal cells into numerous pro-tumourigenic phenotypes.

Hospitalization and Housing: A Qualitative Study Exploring the Perspectives of Hospitalized Patients Experiencing Housing Insecurity.

Although housing insecurity has clear negative impacts on health, little is known about how it impacts patients' experience of hospitalization. In this qualitative study, we interviewed 22 hospitalized patients experiencing housing insecurity. The following three major themes emerged: 1) adverse social and environmental factors directly contribute to hospitalization, 2) lack of tailored care during hospitalization leaves patients unprepared for discharge, and 3) patients have difficulty recuperating after a hospital stay, leading to the risk of rehospitalization.