Impact of cerebrovascular accidents on lung transplant survival.

Background: Cerebrovascular accidents (CVA) are a source of postoperative morbidity. Existing data on CVA after lung transplantation (LT) are limited. We aimed to evaluate the impact of CVA on LT survival.

The Ponseti Method for the Treatment of Clubfeet Associated With Down Syndrome: A Single-institution 18-year Experience.

Background: Although the Ponseti method has been used with great success in a variety of nonidiopathic clubfoot deformities, the efficacy of this treatment in clubfeet associated with Down syndrome remains unreported. The purpose of this study is, therefore, to compare treatment characteristics and outcomes of clubfoot patients with Down syndrome to those with idiopathic clubfoot treated with the Ponseti method.

Methods: An Institutional Review Board-approved, retrospective review of prospectively gathered data were performed at a single pediatric hospital over an 18-year period.

Implementation of a Medication Reconciliation Risk Stratification Tool Integrated within an electronic health record: A Case Series of Three Academic Medical Centers.

Medication errors during transitions of care are common, dangerous and costly. Medication reconciliation can help mitigate this risk, but it is a complex and time-consuming process when performed properly. Increasingly, pharmacy staff have been engaged to help improve medication reconciliation.

Craniofacial Fibrous Dysplasia of the Skull Assisted by Virtual Surgical Planning.

Craniofacial fibrous dysplasia (FD) involves thickening of the skull and facial bones, causing asymmetry and distortion of overlying soft tissues. Surgical contouring is often performed with rotary bur or osteotome, with the goal of matching contralateral unaffected anatomy. This is made technically challenging by having no direct visualization of contralateral structures, and the desire to control depth of resection to match the contour of the unaffected side.

ECHS1 deficiency and its biochemical and clinical phenotype.

ECHS1 gene encodes a mitochondrial enzyme, short-chain enoyl-CoA hydratase (SCEH). SCEH is involved in fatty acid oxidation ([Sharpe and McKenzie (2018); Mitochondrial fatty acid oxidation disorders associated with short-chain enoyl-CoA hydratase (ECHS1) deficiency, 7: 46]) and valine catabolism ([Fong and Schulz (1977); Purification and properties of pig heart crotonase and the presence of short chain and long chain enoyl coenzyme A hydratases in pig and guinea pig tissues, 252: 542-547]; [Wanders et al. (2012); Enzymology of the branched-chain amino acid oxidation disorders: The valine pathway, 35: 5-12]), and the dysfunction of SCEH leads to a severe Leigh or Leigh-like Syndrome phenotype in patients ([Haack et al.

Acing the Fundamentals of Radiology: An Online Series for Medical Students and Interns.

Purpose: The current undergraduate radiology education predominantly integrates radiology with other disciplines during preclerkship years and is often taught by nonradiologists. Early exposure to radiology and profound understanding of scientific fundamentals of imaging modalities and techniques are essential for a better understanding and interest in the specialty. Furthermore, the COVID-19 pandemic-related impact on in-person medical education aggravated the need for alternative virtual teaching initiatives to provide essential knowledge to medical students.

Value in acute care surgery, part 2: Defining and measuring quality outcomes.

The prior article in this series delved into measuring cost in acute care surgery, and this subsequent work explains in detail how quality is measured. Specifically, objective quality is based on outcome measures, both from administrative and clinical registry databases from a multitude of sources. Risk stratification is key in comparing similar populations across diseases and procedures.

A review of COVID-19's impact on modern medical systems from a health organization management perspective.

The novel SARS-CoV-2 (COVID-19) disrupted many facets of the healthcare industry throughout the pandemic and has likely permanently altered modern healthcare delivery. It has been shown that existing healthcare infrastructure influenced national responses to COVID-19, but the current implications and resultant sequelae of the pandemic on the organizational framework of healthcare remains largely unknown. This paper aims to review how aspects of contemporary medical systems - the physical environment of care delivery, global healthcare supply chains, workforce structures, information and communication systems, scientific collaboration, as well as policy frameworks - evolved in the initial response to the COVID-19 pandemic.

Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series.

Introduction: Radical cystectomy (RC) and radical nephroureterectomy (RNU) are commonly performed in urological oncology. Concurrent disease in the upper tract and bladder is rare, so performing both procedures in the same setting is uncommon. Here, we report the perioperative and oncological outcomes of a single-institution series of concurrent RC+RNU.

Lateral Cuneiform Ossification and Tibialis Anterior Tendon Width in Children Ages 3 to 6: Implications for Interference Screw Fixation of Tibialis Anterior Tendon Transfers in Children.

Background: While the transfer of the tibialis anterior tendon (TAT) to the lateral cuneiform (LC) following serial casting has been used for nearly 60 years to treat relapsed clubfoot deformity, modern methods of tendon fixation remain largely unstudied. Interference screw fixation represents an alternative strategy that obviates concerns of plantar foot skin pressure-induced necrosis and proper tendon tensioning associated with button suspensory fixation. A better understanding of LC morphology in young children is a necessary first step in assessing the viability of this fixation technique.

Self-Reported Cannabis Use Is Not Associated With Increased Opioid Use or Costs After Hip Arthroscopy.

Purpose: Our purpose is to determine the difference in cost, opioid use, and complication rates following hip arthroscopy with or without perioperative cannabis use.

Methods: Data were collected from a large commercial insurance database (PearlDiver) between the years 2010 and 2019. Patients who underwent hip arthroscopy with reported cannabis use were identified using Common Procedural Terminology codes and the appropriate International Classification of Diseases codes.

Guideline based eligibility for primary prevention statin therapy - Insights from the North India ST-elevation myocardial infarction registry (NORIN-STEMI).

Background: Current risk scores to estimate atherosclerotic cardiovascular disease (ASCVD) risk and allocate statins in at-risk persons have largely been developed in Western populations; their applicability in India is uncertain.

Objective: To assess eligibility for primary prevention statin therapy using the 2018 U.S Multisociety Guideline and other contemporary cholesterol guidelines in patients presenting with ST-elevation myocardial infarction (STEMI) in the North India STEMI (NORIN-STEMI) registry.

Revision of the AAST grading scale for acute cholecystitis with comparison to physiologic measures of severity.

Background: Grading systems for acute cholecystitis are essential to compare outcomes, improve quality, and advance research. The American Association for the Surgery of Trauma (AAST) grading system for acute cholecystitis was only moderately discriminant when predicting multiple outcomes and underperformed the Tokyo guidelines and Parkland grade. We hypothesized that through additional expert consensus, the predictive capacity of the AAST anatomic grading system could be improved.

Longitudinal composite 3D faces and facial growth trends in children 6-11 years of age using 3D cephalometric surface imaging.

Background: Normative craniofacial anthropometry provides clinically important reference values used in the treatment of craniofacial conditions. Few objective datasets of normative data exist for children.

Aim: To establish normative data regarding craniofacial morphology changes with growth in children.

Nutcracker syndrome: diagnosis and therapy.

Nutcracker syndrome (NCS) is an extrinsic compression of the left renal vein (LRV) by the superior mesenteric artery (SMA) anteriorly and aorta posteriorly resulting in renal vascular congestion manifesting as hematuria, proteinuria, orthostatic hypotension, pain, or even renal dysfunction. Long-standing venous compression can encourage collateral drainage pathways through gonadal and pelvic veins, which may explain reported symptom and syndrome overlap with pelvic congestion syndrome. Diagnosis can be challenging and variable, frequently involving a combination of ultrasound Doppler, cross-sectional, and invasive imaging.

Predictors of long-term mortality in octogenarian veterans following inguinal hernia repair.

Background: While elective inguinal hernia repair (IHR) in octogenarians carries a low 30-day mortality rate, long-term outcomes are uncharted. If on average, veteran octogenarians are expected to succumb to pre-existing cardiopulmonary disease within a year of diagnosis, watchful waiting might be advisable. This study interrogated long-term mortality and its predictors following elective IHR in veteran octogenarians.

Maternal Smoking and Congenital Heart Defects, National Birth Defects Prevention Study, 1997-2011.

Objectives: To assess associations between maternal smoking and congenital heart defects (CHDs) in offspring.

Study Design: We performed a retrospective case-control study using data for cases of CHD (n = 8339) and nonmalformed controls (n = 11 020) from all years (1997-2011) of the National Birth Defects Prevention Study. Maternal self-reported smoking 1 month before through 3 months after conception was evaluated as a binary (none, any) and categorical (light, medium, heavy) exposure.

Amyloidosis and 30-Day Outcomes Among Patients With Heart Failure: A Nationwide Readmissions Database Study.

Background: The burden of amyloidosis among hospitalized patients is increasing over time. However, amyloidosis remains an underdiagnosed cause of heart failure (HF) hospitalization among older adults.

Objectives: We investigated the prevalence and prognostic implications of amyloidosis among patients hospitalized with HF.

Mechanical Complications in ST-Elevation Myocardial Infarction (STEMI) Based on Different Reperfusion Strategies.

Contemporary trends of mechanical complications like papillary muscle rupture (PMR), ventricular septal defect/rupture (VSR), and free wall rupture (FWR) in ST-elevation m'yocardial infarction (STEMI), especially in the era of primary percutaneous coronary interventions (PPCI) has not been definitively investigated. We utilized the National Inpatient Sample (NIS) database from years 2003 to 2017 using International Classification of Disease 9th and 10th revision (ICD-9 and ICD-10) codes to identify STEMI patients undergoing PPCI, fibrinolysis alone, and fibrinolysis with subsequent PCI. We identified those developing in-hospital PMR /VSD / FWR.

Scholarly Productivity and Rank in Academic Hospital Medicine.

Despite the rapid growth of academic hospital medicine, scholarly productivity remains poorly characterized. In this cross-sectional study, distribution of academic rank and scholarly output of academic hospital medicine faculty are described. We extracted data for 1,554 hospitalists on faculty at the top 25 internal medicine residency programs.