Optimizing direct RT-LAMP to detect transmissible SARS-CoV-2 from primary nasopharyngeal swab samples.

SARS-CoV-2 testing is crucial to controlling the spread of this virus, yet shortages of nucleic acid extraction supplies and other key reagents have hindered the response to COVID-19 in the US. Several groups have described loop-mediated isothermal amplification (LAMP) assays for SARS-CoV-2, including testing directly from nasopharyngeal swabs and eliminating the need for reagents in short supply. Frequent surveillance of individuals attending work or school is currently unavailable to most people but will likely be necessary to reduce the ~50% of transmission that occurs when individuals are nonsymptomatic.

Retroperitoneal Exposure of the Anterior Lumbar Spine.

Background: Anterior lumbar spine procedures such as anterior lumbar interbody fusion (ALIF) are used commonly to treat multiple pathologies, including pseudoarthrosis and degenerative disk disease. It is generally a safe and effective procedure, but an anterior approach to the lumbar spine requires critical navigation of the surgical window to avoid delicate structures. An operative technique should maximize the exposure without an increased risk of iatrogenic injury.

Comparison of Decompression versus Decompression and Fusion for Lumbar Synovial Cysts and Predictive Factors for Cyst Recurrence.

Background: The management of lumbar synovial cysts (LSC) has been a controversial topic for many years. Whereas many authors label LSC as markers of instability and thus necessitating fusion, others suggest that decompression alone without fusion is a viable initial treatment option. Our objective was to clarify outcomes in patients undergoing decompression alone and decompression with fusion for symptomatic LSC and identify factors for cyst recurrence.

Intercostal nerve cryoablation is associated with lower hospital cost during minimally invasive Nuss procedure for pectus excavatum.

Unlabelled: Minimally invasive repair of pectus excavatum (Nuss procedure) is associated with significant pain, and efforts to control pain impact resource utilization. Bilateral thoracic intercostal nerve cryoablation has been proposed as a novel technique to improve post-operative pain control, though the impact on hospital cost is unknown.

Methods: We conducted a retrospective study of patients undergoing a Nuss procedure from 2016 to 2019.

Lower Extremity Kinematic and Kinetic Asymmetries during Running.

Purpose: The primary aims of this investigation were to describe the magnitude of asymmetries of common variables during running among healthy athletes and to determine if sex and speed influence magnitudes of asymmetry.

Methods: This study analyzed routinely collected running gait data on healthy Division I collegiate athletes. All athletes had no history of lower extremity surgery, no lower extremity injuries for 3 months before testing, and running data available at 2.

Reducing cost and waste in pediatric laparoscopic procedures.

Background: In 2017 the healthcare cost in the United States accounted for 17.9% of the Gross Domestic Product (GDP). Furthermore, healthcare facilities produce more than 4 billion pounds of waste annually.

Utilization and Results of Repeat SARS-CoV-2 RT-PCR Testing in a Presumptive Low Prevalence Population.

Introduction: Early reports have raised concerns regarding the clinical sensitivity of nasopharyngeal SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing for patients with COVID-19 symptoms, which has led to requests for repeat testing at our institution. However, to our knowledge, there are no reports to date of the utilization or results of repeat testing to help guide this practice.

Methods: The authors searched the institutional laboratory information system for consecutive patients who were tested for SARS-CoV-2 by RT-PCR of a nasopharyngeal specimen over a 1-month period.

Current Trends in Prepectoral Breast Reconstruction: A Survey of American Society of Plastic Surgeons Members.

Unlabelled: Prepectoral implant-based breast reconstruction has recently gained increasing popularity, but there are limited data regarding national trends in the use of this technique. Our aim was to determine practice patterns related to prepectoral breast reconstruction among plastic surgeons, as well as to identify perceived advantages and disadvantages of this technique.

Methods: A 16-question electronic survey tool was distributed to 2535 members of the American Society of Plastic Surgeons.

Sentinel lymph node biopsy is associated with increased cost in higher risk thin melanoma.

Introduction: National Comprehensive Cancer Network guidelines recommend that sentinel lymph node biopsy (SLNB) be discussed with patients with thin melanoma at higher risk for lymph node metastasis (T1b or T1a with positive deep margins, lymphovascular invasion, or high mitotic index). We examined the association between SLNB and resource utilization in this cohort.

Methods: We conducted a retrospective cohort study of patients that underwent wide local excision for higher risk thin melanomas from 2009 to 2018 at a tertiary care center.

Molecular Assays to Determine Optimal Duration of Adjuvant Endocrine Therapy in Breast Cancer.

Hormone receptor (HR) positive breast cancer has a high propensity for late recurrences that might be prevented with longer durations of endocrine therapy (ET). However, trials evaluating extended adjuvant ET have produced somewhat conflicting results. Additionally, ET is associated with not only day to day side effects that can impact quality of life, but more detrimental effects that can cause significant morbidity.

Continued Prescribing of Periprocedural Codeine and Tramadol to Children after a Black Box Warning.

Background: Codeine and tramadol are commonly used analgesics in surgery. In 2013, the Food and Drug Administration (FDA) issued a contraindication to the use of codeine in tonsillectomy and adenoidectomy patients aged below 18 y. This warning was expanded in April 2017 to include tramadol and all children aged below 12 y.

The international system for reporting serous fluid cytopathology-diagnostic categories and clinical management.

Introduction: Effusions can develop inside serous cavities in several pathologic states, both neoplastic and non-neoplastic. They are easy to drain and can provide useful diagnostic information. However, the reported diagnostic efficacy of these specimens has not been uniform across different laboratories.

An Unusual Case of Actinomucor elegans: A Challenging Diagnosis.

BACKGROUND Actinomucor elegans is an unusual cause of mucormycosis and can be difficult to identify by conventional methods. Mucormycosis has a very high mortality rate, especially among immunocompromised individuals. Due to the morbid and progressive nature of opportunistic fungal infections, early diagnosis is paramount for effective disease management.

Operative Delay in Adults with Appendicitis: Time is Money.

Background: Evidence suggests that operative delay of up to 24 h is not associated with adverse outcomes among patients undergoing emergent appendectomy. However, the fiscal implication of operative delay is not well described in adults. We sought to examine the effect of delayed appendectomy on clinical outcomes and hospital cost.

A Prospective, Multicenter Study to Assess the Safety and Efficacy of Translingual Neurostimulation Plus Physical Therapy for the Treatment of a Chronic Balance Deficit Due to Mild-to-Moderate Traumatic Brain Injury.

Objectives: Translingual neurostimulation (TLNS) studies indicate improved outcomes in neurodegenerative disease or spinal cord injury patients. This study was designed to assess the safety and efficacy of TLNS plus targeted physical therapy (PT) in people with a chronic balance deficit after mild-to-moderate traumatic brain injury (mmTBI).

Materials And Methods: This international, multicenter, randomized study enrolled 122 participants with a chronic balance deficit who had undergone PT following an mmTBI and had plateaued in recovery.