Multiple Gas-Containing Renal Stones: A Case Report.

BACKGROUND Emphysematous urinary tract infections are rare and serious conditions that are often multifactorial in etiology and may be associated with the presence of renal stones. Diagnosis can be made by finding gas within the renal collecting system or parenchyma. However, the radiographic finding of gas within a renal stone is rare and little has been published to describe the significance of this finding, its promoting factors, and management.

Fostering Collaborative Practice Through Interprofessional Education.

Background And Objectives: Health care leaders use interprofessional collaborative practice as a strategy to improve health outcomes, and they have stressed its importance in the education of primary care medical providers to apply public health concepts like the social determinants of health and community collaborations. Interprofessional education (IPE) prepares students from different professions for collaborative practice as they enter the health workforce by developing core competencies. Understanding the importance of IPE is vital toward improving person and client-centered care and population health outcomes.

Patient reported outcomes and decision regret scores in redo-paraesophageal hernia repair.

Introduction: Recurrent paraesophageal hernia (PEH) repair presents significant technical challenges, with limited data weighing the benefit to the operative risk. This study aims to describe our experience with recurrent PEH repair, including long-term surgical and patient reported outcomes (PROs).

Methods: We conducted a retrospective review of recurrent PEH repairs from June 2018-March 2023 using our institutional database.

Diet and Survival in Black Women With Epithelial Ovarian Cancer.

Importance: Ovarian cancer survival among Black women is the lowest across all racial and ethnic groups. Poor dietary quality also disproportionately affects Black populations, but its association with ovarian cancer survival in this population remains largely unknown.

Objective: To examine associations between dietary patterns and survival among Black women diagnosed with epithelial ovarian cancer (EOC).

The role of multiple mediation with contextual neighborhood measures in ovarian cancer survival.

Background: Mediation by multiple agents can affect the relation between neighborhood deprivation and segregation indices and ovarian cancer survival. In this paper, we examine a variety of potential clinical mediators in the association between deprivation indices (DIs) and segregation indices (SIs) with all-cause survival among women with ovarian cancer in the African American Cancer Epidemiology Study (AACES).

Methods: We use novel Bayesian multiple mediation structural models to assess the joint role of mediators (stage at diagnosis, histology, diagnostic delay) combined with the DIs and SIs (Yost, ADI, Kolak's URB, ICE-income) and a set of confounders with survival.

Management of Traumatic Diaphragmatic Injuries.

Diaphragm injuries are rarely seen injuries in trauma patients and are difficult to diagnose. With improving technology, computed tomography has become more reliable, but with increasing rates of non-operative management of both penetrating and blunt trauma, the rate of missed diaphragmatic injury has increased. The long-term complications of missed injury include bowel obstruction and perforation, which can carry a mortality rate as high as 85%.

Thoracotomy Resuscitation of a Patient Who Sustained Blunt Force Trauma with a pH of 6.7 on Admission and Ultra Massive Transfusion of 42 Units of Blood.

Extreme acidosis is a life-threatening physiological state that thwarts resuscitative actions and most frequently ends in mortality. This report describes a case of a successful resuscitation in a patient who presented without vital signs, agonal respirations, dilated, unresponsive pupils, and an initial pH of 6.7.

Delayed vs Early Admission to Intensive Care: A Retrospective Review of Outcomes and Clinical Indicators of Deterioration Following Trauma.

Unplanned admission to an intensive care unit (ICU) is a trauma quality improvement indicator associated with increased morbidity, mortality, and hospital resource usage. We identified demographics, injuries, and other clinical factors between early ICU admission, <72 hrs after admission (EAd), and delayed admission, >72 hrs (DelAd) from a medical/surgical floor. 146 trauma patients admitted to ICU at a level 1 trauma center from January 2020 to March 2023 met inclusion criteria and were divided into EAd and DelAd.

Incidence and Risk Factors for ICU-Associated Delirium in the Alert Geriatric Trauma Population.

Background: This study analyzed the overall incidence of delirium, comorbid conditions, injury patterns, and pharmacological risk factors for the development of delirium in an alert, geriatric trauma population.

Methods: IRB-approved, prospective, consecutive cohort series at two Southeastern Level 1 trauma centers from June 11 to August 15, 2023. Delirium was assessed using the Confusion Assessment Method (CAM) score.

Coronary Artery Calcification and Risk of Cardiac Complication in Geriatric Trauma Population.

Background: Better means of identifying patients with increased cardiac complication (CC) risk is needed. Coronary artery calcification (CAC) is reported on routine chest CT scans. We assessed the correlation of CAC and CCs in the geriatric trauma population.

The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.

Background: Deprivation indices are often used to adjust for socio-economic disparities in health studies. Their role has been partially evaluated for certain population-level cancer outcomes, but examination of their role in ovarian cancer is limited. In this study, we evaluated a range of well-recognized deprivation indices in relation to cancer survival in a cohort of self-identified Black women diagnosed with ovarian cancer.

Association of inflammation-related exposures and ovarian cancer survival in a multi-site cohort study of Black women.

Background: An association was observed between an inflammation-related risk score (IRRS) and worse overall survival (OS) among a cohort of mostly White women with invasive epithelial ovarian cancer (EOC). Herein, we evaluated the association between the IRRS and OS among Black women with EOC, a population with higher frequencies of pro-inflammatory exposures and worse survival.

Methods: The analysis included 592 Black women diagnosed with EOC from the African American Cancer Epidemiology Study (AACES).

Optimizing Transitions of Care and Enhancing Surgical Education on Acute Care Surgery: A Multi-Institutional Survey Study.

Objective: Critically ill and injured patients are routinely managed on the Trauma and Acute Care Surgery (ACS) service and receive care from numerous residents during hospital admission. The Clinical Learning Environment Review (CLER) program established by the ACGME identified variability in resident transitions of care (TC) while observing quality care and patient safety concerns. The aim of our multi-institutional study was to review surgical trainees' impressions of a specialty-specific handoff format in order to optimize patient care and enhance surgical education on the ACS service.

Deprivation and segregation in ovarian cancer survival among African American women: a mediation analysis.

Purpose: Deprivation and segregation indices are often examined as possible explanations for observed health disparities in population-based studies. In this study, we assessed the role of recognized deprivation and segregation indices specifically as they affect survival in a cohort of self-identified Black women diagnosed with ovarian cancer who enrolled in the African American Cancer Epidemiology Study.

Methods: Mediation analysis was used to examine the direct and indirect effects between deprivation or segregation and overall survival via a Bayesian structural equation model with Gibbs variable selection.

Obstructive Sleep Apnea as a Predictor of Inducible Atrial Flutter During Pulmonary Vein Isolation in Patients With Atrial Fibrillation: Clinical Significance and Follow-Up Outcomes.

Background: Atrial fibrillation (AF) and atrial flutter (AFL) often coexist in patients and may lead to severe symptoms and complications. Despite their coexistence, prophylactic cavotricuspid isthmus (CTI) ablation has failed to reduce the incidence of recurrent AF or new onset AFL. In contrast, the presence of inducible AFL during pulmonary vein isolation (PVI) has been shown to be predictive of symptomatic AFL during follow-up.

Survival of epithelial ovarian cancer in Black women: a society to cell approach in the African American cancer epidemiology study (AACES).

Purpose: The causes for the survival disparity among Black women with epithelial ovarian cancer (EOC) are likely multi-factorial. Here we describe the African American Cancer Epidemiology Study (AACES), the largest cohort of Black women with EOC.

Methods: AACES phase 2 (enrolled 2020 onward) is a multi-site, population-based study focused on overall survival (OS) of EOC.

Left atrial thrombus after placement of watchman device.

Atrial fibrillation is an irregular rhythm with increased risk of morbidityand mortality. Commonly due to thromboembolism at the left atrialappendage. Guideline therapy for atrial fibrillation is anticoagulation.

Utilization of risk assessment tools in management of PAH: A PAH provider survey.

Pulmonary arterial hypertension (PAH) is a chronically progressive fatal disease. A goal-oriented approach to achieve low risk status has been associated with improved survival. A variety of risk stratification tools are available, but use is low.

Psychosocial factors associated with genetic testing status among African American women with ovarian cancer: Results from the African American Cancer Epidemiology Study.

Background: Racial disparities in the uptake of cancer genetic services are well documented among African American (AA) women. Understanding the multiple social and psychological factors that can influence the uptake of genetic testing among AA women is needed.

Methods: Data came from 270 AA women diagnosed with ovarian cancer and participating in a population-based, case-control study of ovarian cancer who were asked about genetic testing.

Cohesive Round Implants and the Risk of Implant Flipping.

Unlabelled: Fifth-generation, round, form-stable implants have a higher cohesive gel, a higher fill volume, and distinct anterior and posterior profiles. Due to these implant features, anterior-posterior (AP) flipping of round, form-stable implants is discernible, but little is known of this complication of implant reconstruction.

Methods: Patients who underwent skin- or nipple-sparing mastectomy followed by direct-to-implant reconstruction with round, cohesive, smooth implants were included in this retrospective study.

Administering DVT Prophylaxis Sooner Than 48 Hours Does Not Increase Failure of Nonoperative Management of High-Grade (Grades III-V) Splenic Injuries.

Splenic injuries are mostly treated with nonoperative management (NOM) with observation to monitor for continued hemorrhage and holding early chemical DVT prophylaxis to reduce the risk of NOM failure. Eberle et al demonstrated chemoprophylaxis prior to 72 hours didn't increase failure rate of NOM. We chose to extrapolate this finding and compare outcomes in high-grade splenic injuries (HGSI) with chemoprophylaxis before and after 48 hours.