476 results match your criteria: "St Mary's Medical Center[Affiliation]"

Context.—: Morphologic evaluation of peripheral blood smears provides valuable information to diagnose and manage a variety of hematologic disorders.

Objective.

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Background And Purpose: Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.

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Patients are at risk of experiencing medication errors during each transition of care (TOC), which can result in adverse drug events and readmissions. Implementing a pharmacist-led TOC service can optimize medication safety and patient outcomes by identifying and correcting medication discrepancies prior to hospital discharge. A pharmacist-led TOC service at a tertiary care center expanded services to review medications at discharge for all enrolled hospitalized patients, but data collection and review had yet to be performed.

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Context.—: The aim of the study was to determine the impact of peripheral blood (PB) smear review by a pathologist when requested by a technologist or provider to measure the rate of pathologist-detected clinically relevant findings.

Objective.

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Background: Surgery for knee flexion contractures in patients with arthrogryposis multiplex congenital (AMC) have achieved extension to redirect the arc of motion and improve ambulation but has not demonstrated maintained increases in total range of motion (ROM). This study aimed to review the clinical outcomes of combined posterior knee release, proximal femoral shortening, and nerve decompression in patients with arthrogryposis.

Methods: A retrospective chart and radiographic review were performed on patients with AMC who underwent treatment for knee flexion deformities ≥30 degrees.

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Gallbladder disease, one of the most common diseases in the United States, ranges from symptomatic gallstones to severe systemic infections from cholangitis. Little research is available on how often patients undergoing emergent cholecystectomy also have bacteremia. We hypothesized that blood cultures would be performed rarely in patients undergoing emergent cholecystectomy, and that positive cultures would be associated with worse outcomes.

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Background: There are limited studies examining local control (LC) and overall survival (OS) following stereotactic ablative radiation therapy (SABR) for adolescent and young adult (AYA) populations/histologies with local recurrences or metastatic disease.

Methods: The RSSearch® Patient Registry, an international SABR registry, was evaluated for AYA patients treated with SABR. AYA patients with adult histologies/primaries were excluded.

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Article Synopsis
  • - This study investigates the incidence of delayed intracranial hemorrhage (ICH) in older patients (65+) who suffered head trauma and were on anticoagulant medications, noting that delayed ICH rates post-injury range widely in existing literature.
  • - Conducted across two emergency departments with 3,425 enrolled patients, the findings showed a very low incidence of delayed ICH at 0.4%, and no significant difference in rates between patients on anticoagulants and those not on them.
  • - The results suggest that delayed ICH is uncommon in this population, which could influence clinical decision-making and management strategies for geriatric patients with blunt head trauma.
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Risk factors for infection in severe open tibial shaft fractures.

Injury

November 2024

Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address:

Objective: To evaluate risk factors for infection in severe open tibial shaft fractures.

Methods: A secondary analysis of a multicenter prospective study investigated internal versus external fixation of severe open tibia fractures at 20 US Level I trauma centers. Adult patients, aged <65 years, with a Gustilo-Anderson Type IIIB or severe IIIA metaphyseal or diaphyseal tibia fracture were included.

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This case report highlights a rare but significant complication of blunt trauma requiring preperitoneal packing and illustrates the intricate relationship between trauma surgery and urological emergencies. Testicular torsion is an acute urological emergency necessitating prompt surgical intervention to salvage testicular function. While commonly associated with intrinsic factors such as the "bell-clapper" deformity, extrinsic factors such as trauma and postoperative complications can also precipitate this condition.

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Background: For the vast majority of displaced femoral neck fractures in older patients, cemented femoral fixation is indicated because it is associated with a lower risk of periprosthetic fracture than cementless fixation. Nevertheless, cementless fixation continues to be utilized with high frequency for hip fractures in the United States. It is therefore helpful to understand the performance of individual cementless brands and models.

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Introduction: Pediatric firearm injury prevention research in younger age groups is limited. This study evaluated a large multicenter cohort of younger children with firearm injuries, focusing on injury patterns and surgical resource utilization.

Methods: Children ≤15 y old sustaining firearm injuries between 2016 and 2021 and treated at 10 pediatric trauma centers in Florida were included.

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Article Synopsis
  • - Groove pancreatitis (GP) is a rare type of chronic pancreatitis primarily affecting middle-aged men, with risk factors including excessive alcohol use, smoking, and pancreatic issues, leading to symptoms like severe abdominal pain and jaundice.
  • - Diagnosing GP is difficult due to its symptoms overlapping with other conditions, which can result in delayed treatment and increased health risks.
  • - The potential use of artificial intelligence in diagnostic imaging could help differentiate GP from pancreatic cancers, improving diagnosis and patient outcomes, as discussed in a comprehensive review of GP's causes, symptoms, and treatment options.
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Article Synopsis
  • The Surgical Infection Society (SIS) has updated its evidence-based guidelines for managing intra-abdominal infections (IAI) after a systematic review of literature from 2016 to February 2024.
  • This update includes new recommendations and revisions based on rigorous evaluations of evidence using the GRADE system, which ranks the strength and quality of recommendations.
  • Key topics covered involve antimicrobial agent selection, treatment timing and methods, pathogen-specific treatments, and the implementation of antimicrobial stewardship programs in hospitals.
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Although percutaneous coronary intervention (PCI) has radically transformed the scope of treating coronary artery disease with stenting, stent thrombosis (STh) remains a feared complication. Very late STh, a rare complication after PCI, refers to STh occurring greater than one year after post-stent implantation. An even rarer phenomenon, "very" very late stent thrombosis (VVLST), is described in the literature as STh occurring more than five years post-stent implantation.

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The Florida Geriatric Head Trauma CT Clinical Decision Rule.

J Am Geriatr Soc

September 2024

Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.

Background: Several clinical decision rules have been devised to guide head computed tomography (CT) use in patients with minor head injuries, but none have been validated in patients 65 years or older. We aimed to derive and validate a head injury clinical decision rule for older adults.

Methods: We conducted a secondary analysis of an existing dataset of consecutive emergency department (ED) patients >65 years old with blunt head trauma.

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Scanning the aged to minimize missed injury: An Eastern Association for the Surgery of Trauma multicenter study.

J Trauma Acute Care Surg

January 2025

From the Department of Surgery (V.P.H., S.K.K., J.O., J.A.C.), MetroHealth Medical Center; Department of Surgery (S.K.K.), University Hospitals Cleveland Medical Center; Departments of Surgery (V.P.H.), and Population and Quantitative Health Sciences (V.P.H.), Case Western Reserve University School of Medicine; Biostatistics and Data Sciences Group (H.H.), Population Health and Equity Research Institute, MetroHealth Medical Center, Cleveland, Ohio; Department of Surgery (A.R., S.S.S., T.H.T.), Crozer-Chester Medical Center, Upland; Department of Surgery (C.A.B., A.M., B.F.D.), Reading Hospital, West Reading, Pennsylvania; Department of Surgery (G.A.B., P.P., T.B.S.P.), NYU Langone Hospital-Long Island, Mineola, New York; Department of Surgery (S.M., T.C., J.B.), Conemaugh Memorial Medical Center, Johnstown, Pennsylvania; Trauma Administration (L.E.J., J.M.W., C.S.N.), Ascension St. Vincent Hospital, Indianapolis, Indiana; Department of Surgery (P.O.U., K.T., C.P.), WakeMed Health and Hospitals, Raleigh, North Carolina; Department of Surgery (J.M.V., T.J.C., E.J.K.), Creighton University Medical Center - Bergan Mercy, Omaha, Nebraska; Department of Surgery (L.M.K., S.M.M., D.A.), Yale School of Medicine, New Haven, Connecticut; Department of Surgery (C.M., N.D., R.B.), Spartanburg Medical Center, Spartanburg, South Carolina; Department of Surgery (A.E., S.D., E.V.), OhioHealth Grant Medical Center, Columbus, Ohio; Department of Surgery (M.C.W., J.K.D., E.W.), Loma Linda University Medical Center, Loma Linda, California; Department of Trauma and Acute Care Surgery (M.L.M., B.P., K.H.), Kettering Health Main Campus, Kettering, Ohio; Department of Surgery (T.E., J.W.), Cooper University Hospital, Camden, New Jersey; Department of Surgery (J.H., K.L.), Ascension Via Christi Saint Francis, Wichita, Kansas; Department of Trauma Surgery (K.P.C., M.L.H.), Essentia Health-St. Mary's Medical Center; Essentia Institute of Rural Health (M.L.H.), Essentia Health, Duluth, Minnesota; Department of Surgery (J.N., E.T.-L.), University of California, Irvine Medical Center, Orange; and Department of Surgery (J.C., C.J.H.), Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California.

Background: Despite the high incidence of blunt trauma in older adults, there is a lack of evidence-based guidance for computed tomography (CT) imaging in this population. We aimed to identify an algorithm to guide use of a pan-scan (head/cervical spine [C-spine]/torso) or a selective scan (head/C-spine ± torso). We hypothesized that a patient's initial history and examination could be used to guide imaging.

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Background: In patients with severe traumatic brain injury (TBI), clinicians must balance preventing venous thromboembolism (VTE) with the risk of intracranial hemorrhagic expansion (ICHE). We hypothesized that low molecular weight heparin (LMWH) would not increase risk of ICHE or VTE as compared to unfractionated heparin (UH) in patients with severe TBI.

Methods: Patients ≥ 18 years of age with isolated severe TBI (AIS ≥ 3), admitted to 24 level I and II trauma centers between January 1, 2014 to December 31, 2020 and who received subcutaneous UH and LMWH injections for chemical venous thromboembolism prophylaxis (VTEP) were included.

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To close or not to close? Wound management in emergent colorectal surgery, an EAST multicenter prospective cohort study.

J Trauma Acute Care Surg

July 2024

From the Anne Arundel Medical Center and Doctors Community Medical Center (C.B.F., S.R., R.A., J.R.K., J.T.), Luminis Health, Annapolis, Maryland; Cooper University Hospital (N.B., E.M.K.), Camden, New Jersey; Maine Medical Center (D.C.C., C.R.F.), Portland, Maine; Yale New Haven Hospital (B.B., A.A.M.), New Haven, Connecticut; Crozer Chester Medical Center (S.S., A.R.), Upland; Hospital of the University of Pennsylvania (G.A.B., J.L.P.), Philadelphia, Pennsylvania; University of Texas Southwestern Medical Center (D.B.), Dallas, Texas; Loma Linda University Medical Center (D.S., N.W.), Loma Linda, California; Jackson Memorial Hospital (J.L., B.N.), University of Miami, Miami, Florida; St. Mary's Medical Center (F.A., L.A.T.), Florida Atlantic University, West Palm Beach, Florida; University of California at Irvine Health (J.N., M.M.), Orange; Zuckerberg San Francisco General Hospital (R.T., S.B.K.), UCSF, San Francisco, California; Medical City Plano (M.C.), Envision Health, Plano, Texas; OhioHealth Grant Medical Center (M.K., K.S.), Columbus, Ohio; and Texas Tech University Health Science Center (A.P.S.), Lubbock, Texas.

Background: This study aimed to determine the clinical impact of wound management technique on surgical site infection (SSI), hospital length of stay (LOS), and mortality in emergent colorectal surgery.

Methods: A prospective observational study (2021-2023) of urgent or emergent colorectal surgery patients at 15 institutions was conducted. Pediatric patients and traumatic colorectal injuries were excluded.

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Posttraumatic cubitus varus is a multiplanar deformity that results from an improperly reduced supracondylar humerus fracture. The prevention of posttraumatic cubitus varus hinges on the stable restoration of all 3 columns of the distal humerus while avoiding malrotation. The collapse of any column leads to varying degrees of deformity in the coronal, sagittal, and/or axial plane.

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3D printing and modeling has continued to grow in popularity over the past decade because the technology has matured and become more affordable and widely available. The main indications for nonbiological reconstruction of large bone defects are principally those patients where the candidate is unlikely to be successful if reconstructed by other means. Bespoke, custom, patient-specific implants can be designed to very effectively address bone loss, incorporating design elements that are particular to the needs of any given unique clinical condition.

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Introduction: Distal femur fractures are difficult to successfully treat due to high rates of nonunion. Obesity is an independent prognostic risk factor for nonunion. Advances in finite element analyses (FEAs) have allowed researchers to better understand the performance and behavior of constructs at the bone-implant interface under a variety of conditions.

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