Incidence of Thrombocytopenia With Different Continuous Renal Replacement Systems and Modalities in a Cardiac Intensive Care Unit.

Thrombocytopenia is due to multifactorial causes in critically ill patients. One etiology is continuous renal replacement therapy (CRRT); however, it is unknown if different modalities impact the incidence. To compare the incidence of thrombocytopenia with the NxStage CRRT system using continuous venovenous hemodialysis (CVVHD) compared to the Prismaflex system using continuous venovenous hemodiafiltration (CVVHDF).

Cytokine signatures in post-endoscopic retrograde cholangiopancreatography pancreatitis: a pilot study.

Background: Following endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) is the most common complication. The host's innate immune response to periprocedural pancreatic injury is the hallmark of its pathogenesis. Investigating cytokine signatures associated with PEP and its risk factors can guide understanding of PEP immunopathogenesis.

Worry and rumination elicit similar neural representations: neuroimaging evidence for repetitive negative thinking.

Repetitive negative thinking (RNT) captures shared cognitive and emotional features of content-specific cognition, including future-focused worry and past-focused rumination. The degree to which these distinct but related processes recruit overlapping neural structures is undetermined, because most neuroscientific studies only examine worry or rumination in isolation. To address this, we developed a paradigm to elicit idiographic worries and ruminations during an fMRI scan in 39 young adults with a range of trait RNT scores.

Trainee experience in virtual reality simulation in orbital surgery.

Purpose: To demonstrate the role of Virtual Reality (VR) in orbital surgery as an educational tool for surgical trainees.

Methods: A single-center prospective study was conducted from February 2021 to April 2023. Pre-operative magnetic resonance imaging and computed tomography scans were used to create patient-specific VR models of the orbit using ImmersiveTouch Software.

Variation in Cost Centers Following Gastrointestinal Cancer Surgery.

Introduction: Despite cost-standardization efforts, significant variations in hospital costs persist in insurance claims. We sought to identify and quantify factors driving cost variability at hospital and cost center levels following a complex gastrointestinal surgical procedure.

Methods: Individuals who underwent pancreatectomy (PA), colectomy (CO), and proctectomy (PR) were identified from the Surveillance, Epidemiology, and End Results database.

FIT as a Comparator for Evaluating the Effectiveness of New Non-invasive CRC Screening Test.

Randomized Controlled Trials (RCT) demonstrated that guaiac-based fecal occult blood test (gFOBT), sigmoidoscopy, or colonoscopy are effective at reducing colorectal cancer (CRC) risk and mortality. Even if the impact of fecal immunochemical test (FIT) has not been evaluated within population-based RCT with mortality as the outcome, the results of comparative analyses with gFOBT provide strong indirect evidence of its effectiveness. Extensive information is also available on sensitivity and specificity of FIT, compared with gFOBT.

Productivity Benchmarking and Burnout in Psychosocial Oncology: Creating a Sustainable Care Model.

Objective: Psychosocial oncology specialists in academic medical centers are at risk for burnout as they deliver a wide range of clinical, research, educational, and administrative services in high demand work environments. No national productivity benchmarks exist for this specialty. This study examines factors contributing to burnout among academic psychosocial oncology psychologists (PSOP), presents viable productivity standards, and a sustainable care model to mitigate burnout.

Interobserver Agreement in Dysplasia Grading of Intraductal Papillary Mucinous Neoplasms: Performance of Kyoto Guidelines and Optimization of Endomicroscopy Biomarkers through Pathology Reclassification.

Background And Aims: Interobserver agreement (IOA) among pancreaticobiliary (PB) pathologists in evaluating high-grade dysplasia and/or invasive carcinoma (HGD-IC) of IPMNs remains understudied. EUS-guided needle-based confocal endomicroscopy (nCLE) can evaluate papillary architecture in branch-duct (BD)-IPMNs. We assessed IOA among PB pathologists in classifying dysplasia in resected IPMNs and compared the performance of the Kyoto guidelines' high-risk stigmata (HRS) and pre-surgical EUS-nCLE against reclassified pathology.

An update to the American Radium Society's appropriate use criteria of lower grade gliomas: Integration of IDH inhibitors.

The ARS brain committee recommends that vorasidenib may be appropriate for recurrent or residual IDH-mutant grade 2 oligodendroglioma or astrocytoma. Vorasidenib is usually not appropriate for completely resected grade 2 oligodendroglioma or astrocytoma, any grade 3 oligodendroglioma or astrocytoma, or combined with radiotherapy and/or chemotherapy for any grade 2-3 glioma.

Arrhythmia Challenges in Cardio-Oncology: High-Risk Therapies, Management, and Anticoagulation.

Cardiovascular disease and cancer are the leading cause of mortality in the United States. In 2021, there were 695,547 and 605,213 deaths due to heart disease and cancer, respectively. With novel oncologic and cardiac therapies, survival has improved leading to increased life-expectancy albeit with chronic illness burden.

Open or Closed? Management of Skin Incisions After Emergency General Surgery Laparotomies.

Introduction: We sought to determine if there was a relationship between skin management and surgical site infections (SSIs) among patients undergoing a laparotomy for emergency general surgery (EGS). We hypothesize that skin closure technique is not associated with SSI.

Methods: We performed a retrospective review of adult patients (>18 y) who underwent an exploratory laparotomy for EGS conditions within 6 h of surgical consultation from 2015 to 2019.

Laparoscopic Cecostomy Placement for Antegrade Enema Access in the Pediatric Population.

Aim: Use of the appendix for an antegrade continence enema (ACE) is not always possible. Various methods exist for creating cecostomy tubes, including percutaneous, endoscopic, or surgical placement. We describe our laparoscopic cecostomy technique and review short- and long-term outcomes.

Cardiopulmonary Exercise Testing in Research.

Cardiopulmonary exercise testing is an active research area in patients with unexplained dyspnea, heart failure, and pulmonary hypertension. Focus has centered on the use of novel hemodynamic parameters to further characterize these disease states, influence therapeutics, and determine prognosis. Translational research focuses on the underlying cardiopulmonary physiology to more precisely quantify the effect of pulmonary vascular disease on the right ventricle and pulmonary function/hemodynamics.

Ex Vivo Lung Perfusion in Donation after Cardiac and Brain Death Donation.

Background: Allografts from donation after circulatory death (DCD) or brain death donors may be evaluated by ex vivo lung perfusion (EVLP) to assess quality for transplantation. We sought to determine the association of donor type with transplantation outcomes at a national level.

Methods: The United Network for Organ Sharing database was queried for lung transplant recipients, which were stratified into: DCD EVLP, brain death EVLP, standard DCD and standard brain death, followed by an unadjusted analysis.

Open versus minimally invasive hepatic and pancreatic surgery: 1-year costs, healthcare utilization and days of work lost.

Background: Utilization of minimally invasive surgery (MIS) has become increasingly popular due to its potential benefits such as earlier recovery and reduced morbidity. We sought to characterize differences in 1-year healthcare costs and missed workdays among patients undergoing MIS and open surgery for a hepatic or pancreatic indication.

Methods: Data on patients who underwent hepatic and pancreatic resection were obtained from the IBM Marketscan database.

Clinical trial enrollment during first course of gynecologic cancer treatment and survival.

Objective: Among gynecologic cancer patients, it is unclear whether participation in clinical trials impacts survival outcomes. In addition, given the known racial and ethnic disparities in gynecologic cancer trial enrollment, it is important to assess whether clinical trial enrollment is similarly related to overall survival among racial and ethnic minorities. Therefore, we examined associations between clinical trial enrollment and overall survival and potential effect modification by race/ethnicity and cancer site among gynecologic cancer patients.

Variation in lymph node assessment after pancreatic cancer resection: Patient, surgeon, pathologist, or hospital?

Background: We sought to define individual contributions at the patient, surgeon, pathologist, and hospital levels on lymph node assessment after pancreatic cancer resection.

Methods: SEER-Medicare beneficiaries who underwent pancreatic cancer resection were identified. Multi-level multivariable regression was performed to assess the proportion of variance explained by patient, surgeon, pathologist, and hospitals on lymph node assessment (≥12 versus <12).