1,470 results match your criteria: "Wellesley Hospital[Affiliation]"

Three patients with abnormal uterine bleeding underwent uncomplicated minimally invasive total hysterectomy with routine cystoscopy. At time of cystoscopy, the patients had unexpected findings of bladder masses and postoperatively were expeditiously referred to urology. Final pathology for all revealed low-grade urologic carcinoma.

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Impact of a Deep Learning Model for Predicting Mammographic Breast Density in Routine Clinical Practice.

J Am Coll Radiol

September 2022

Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Boston, Massachusetts; Chief, Division of Breast Imaging, Massachusetts General Hospital, Boston, Massachusetts.

Objective: Legislation in 38 states requires patient notification of dense mammographic breast tissue because increased density is a marker of breast cancer risk and can limit mammographic sensitivity. Because radiologist density assessments vary widely, our objective was to implement and measure the impact of a deep learning (DL) model on mammographic breast density assessments in clinical practice.

Methods: This institutional review board-approved prospective study identified consecutive screening mammograms performed across three clinical sites over two periods: 2017 period (January 1, 2017, through September 30, 2017) and 2019 period (January 1, 2019, through September 30, 2019).

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Article Synopsis
  • The study assessed the impact of the COVID-19 pandemic on infection rates related to total joint arthroplasty (TJA), comparing data from three years before the pandemic to the year 2020.
  • Despite evaluating a total of over 20,000 TJA patients, the study found no significant differences in the rates of peri-prosthetic joint infections (PJI) and superficial surgical site infections (SSI) between the pre-pandemic and pandemic cohorts.
  • The findings suggest that while there were no major changes in infection rates, ongoing adherence to hygiene practices and safety measures is crucial during such health crises.
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Deep Learning Algorithms Improve the Detection of Subtle Lisfranc Malalignments on Weightbearing Radiographs.

Foot Ankle Int

August 2022

Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.

Background: Detection of Lisfranc malalignment leading to the instability of the joint, particularly in subtle cases, has been a concern for foot and ankle care providers. X-ray radiographs are the mainstay in the diagnosis of these injuries; thus, improving the performance of clinicians in interpreting radiographs can noticeably affect the quality of health care in these patients. Here we assessed the performance of deep learning algorithms on weightbearing radiographs for detection of Lisfranc joint malalignment in patients with Lisfranc instability.

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Study Design: Retrospective review.

Objectives: Cannabis is an antinociceptive which has been evaluated as a possible adjunct or substitute for opioid use in the treatment of acute pain. The aim of this study was to evaluate the association between preoperative cannabis usage and consumption of opioids for postoperative analgesia.

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Short-Term Risk Factors for Subtalar Arthrodesis After Primary Tibiotalar Arthrodesis.

J Foot Ankle Surg

December 2022

Massachusetts General Hospital and Newton-Wellesley Hospital, Harvard Medical School, Boston, MA; Newton-Wellesley Hospital, Newton, MA.

While adjacent joint arthritis is a recognized long-term downside of primary tibiotalar arthrodesis (TTA), few studies have identified risk factors for early subtalar arthrodesis (STA) after TTA. This study aims to identify the risk factors for STA within the first few years following TTA. All patients older than 18 years undergoing TTA between 2008 and 2016 were identified retrospectively.

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Isolated injuries to the lateral ankle ligaments have no direct effect on syndesmotic stability.

Knee Surg Sports Traumatol Arthrosc

November 2022

Foot and Ankle Research and Innovation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Purpose: This study aim was to detect the impact of lateral ankle ligaments injury on syndesmotic laxity when evaluated arthroscopically in a cadaveric model. The null hypothesis was that lateral ankle ligament injury does not affect the stability of syndesmosis.

Methods: Sixteen fresh-frozen above-knee amputated cadaveric specimens were divided into two groups of eight specimens that underwent arthroscopic evaluation of the distal tibiofibular joint.

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Emerging evidence suggests that "leanness" and good metabolic health markers may predict larger increases in LDL cholesterol (LDL-C) in response to carbohydrate restriction. Specifically, a recent cohort study demonstrated an inverse association between BMI and LDL-C change among individuals on carbohydrate-restricted diets and identified a subgroup of "Lean Mass Hyper-Responders" (LMHR) who exhibit exceptional increases in LDL-C, in the context of low triglycerides and high HDL-C. We present the case of one subject, LM, who adopted a ketogenic diet for management of ulcerative colitis.

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Linking Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form and PROMIS Physical Function.

J Am Acad Orthop Surg

August 2022

From the Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (Heng and Collins), Harvard Medical School, Boston, MA (Heng, Chen, Bedair, O'Brien, and Sisodia), Massachusetts General Physicians Organization, Boston, MA (Heng and Sisodia), Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (Stern), the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine (Tang, Schalet, Franklin, and Cella), the Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA (Chen), the Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Boston, MA (Bedair), the Department of Orthopaedic Surgery, MGB Salem Hospital, Salem, MA (O'Brien), and the Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA (Sisodia).

Introduction: Linking scores on patient-reported outcome measures can enable data aggregation for research, clinical care, and quality. We aimed to link scores on the Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) and the Patient-reported Outcomes Measurement Information System Physical Function (PROMIS PF).

Methods: A retrospective study was conducted from 2017 to 2020 evaluating patients with hip osteoarthritis who received routine clinical care from an orthopaedic surgeon.

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Importance: Bacterial and viral causes of acute respiratory illness (ARI) are difficult to clinically distinguish, resulting in the inappropriate use of antibacterial therapy. The use of a host gene expression-based test that is able to discriminate bacterial from viral infection in less than 1 hour may improve care and antimicrobial stewardship.

Objective: To validate the host response bacterial/viral (HR-B/V) test and assess its ability to accurately differentiate bacterial from viral infection among patients with ARI.

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There is a need to reliably render urolithiasis patients completely stone free with minimal morbidity. We report on the initial safety and feasibility with steerable ureteroscopic renal evacuation (SURE) in a prospective study using basket extraction as a comparison. A pilot randomized controlled study was conducted comparing SURE with basket extraction postlaser lithotripsy.

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Background: Major League Baseball (MLB) players are at risk for metacarpal fractures; however, little is known regarding the impact of these injuries on future performance. The purpose of this study was to determine whether MLB players who sustain metacarpal fractures demonstrate decreased performance on return to competition in comparison to the performance of control-matched peers.

Methods: Data for MLB position players with metacarpal fractures incurred over 17 seasons were obtained from injury reports, press releases, and player profiles.

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Background: Utilization of total joint arthroplasty (TJA) by minorities is disproportionately low compared to Whites. Contributing factors include poorer outcomes, lower expectations, and decreased access to care. This study aimed to evaluate if race and income were predictive of preoperative patient-reported outcome measures (PROMs) and the likelihood of achieving the minimal clinically important difference (MCID) following TJA.

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Purpose: Code status orders impact clinical outcomes as well as patients' and surrogates' experiences. This is the first multicenter cohort examining code status orders of ICU patients with COVID-19 reported to date.

Materials And Methods: This is a retrospective cohort study including adult patients who tested positive for SARS-CoV-2 and were admitted to the ICU at three hospitals in Massachusetts from March 11, 2020 - May 31, 2020.

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Lisfranc injury: Refined diagnostic methodology using weightbearing and non-weightbearing radiographs.

Injury

June 2022

Foot and Ankle Research and Innovation Lab, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Foot & Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Newton-Wellesley Hospital, Boston, MA; Harvard Medical School, Boston, MA, USA.

Background: To compare diagnostic parameters for Lisfranc instability on WB and NWB radiographs and to assess the inter-observer reliability of a standardized diagnostic protocol.

Patients And Methods: Patients who had undergone surgical treatment for subtle, purely ligamentous Lisfranc injury with both WB and NWB post-injury, pre-surgery films (n = 26) were included in this multicentre, retrospective comparative study. Also included was a control group (n = 26) of patients with isolated fifth metatarsal avulsion fractures who similarly had both WB and NWB films.

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Linking the KOOS-PS to PROMIS Physical Function in Knee Patients Evaluated for Surgery.

J Am Acad Orthop Surg

March 2022

From the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (Tang, Schalet, Franklin, and Cella), the Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (Heng, Bedair, and O'Brien), the Harvard Medical School, Boston, MA (Heng, Lange, Bedair, O'Brien, and Sisodia), the Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA (Lange), the Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Boston, MA (Bedair), the Department of Orthopaedic Surgery, North Shore Medical Center, Salem, MA (O'Brien), the Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA (Sisodia), and the Massachusetts General Physicians Organization, Boston, MA (Heng, Sisodia).

Introduction: The Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-form and the Patient-Reported Outcomes Measurement Information System Physical Function are widely used patient-reported outcome measures in orthopaedic practice and research. It would be helpful for clinicians and researchers to compare scores obtained on one instrument with those collected on another. To achieve this goal, this study conducted a linking analysis and computed a crosswalk table between these two scales.

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Comparison of Several Combinations of Suture Tape Reinforcement and Suture Button Constructs for Fixation of Unstable Syndesmosis.

J Am Acad Orthop Surg

May 2022

From the Foot & Ankle Research and Innovation Laboratory, Massachusetts General Hospital, Harvard Medical School, Weston, MA (Schermann, Ogawa, Lubberts, Taylor, Waryasz, DiGiovanni, and Guss), the Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel (Schermann and Khoury), the Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan (Ogawa), the Foot & Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA (Lubberts, Waryasz, DiGiovanni, and Guss), and the Newton-Wellesley Hospital, Harvard Medical School, Newton, MA (DiGiovanni).

Introduction: The purpose of this study was to arthroscopically evaluate syndesmotic stability after fixation with several combinations of suture buttons (SBs) and suture tape reinforcement in a completely unstable cadaver model.

Methods: Fifteen cadaver above-knee specimens underwent sequential ligament transection and fixation to create six experimental models: (1) intact model, (2) after complete disruption of the syndesmotic ligaments, and after repair with either suture tape reinforcement (3), suture tape reinforcement with a single SB (4), suture tape reinforcement with two diverging SBs (5), or two diverging SBs alone (6). Instability measurements included anterior and posterior tibiofibular spaces measured arthroscopically under 100 N coronal stress, tibiofibular anteroposterior and posteroanterior translation in sagittal plane measured arthroscopically under sagittal stress of 100 N, and anterior tibiofibular space measured directly with a caliper under external rotation torque of 7.

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Inherited Patients Taking Opioids for Chronic Pain - Considerations for Primary Care.

N Engl J Med

February 2022

From the San Francisco Department of Public Health and the University of California, San Francisco - both in San Francisco (P.O.C.); and Tufts University School of Medicine, Boston, and the Department of Anesthesiology, Newton-Wellesley Hospital, Newton - both in Massachusetts (A.M.B.).

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Impact of body mass index on opioid consumption in lumbar spine fusion surgery.

N Am Spine Soc J

June 2021

Department of Orthopaedic Surgery, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, United States.

Background: in the United States from 1999 to 2000 through 2017-2018, the prevalence of obesity increased from 30.5 to 42.4%, while the prevalence of severe obesity nearly doubled.

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Background: Morbidly obese (body mass index [BMI] >40 kg/m) patients undergoing total joint arthroplasty (TJA) are at high risk for postoperative venous thromboembolism (VTE); however, there is debate surrounding the optimal pharmacologic agent for prevention of VTE after TJA in this patient subset. Current guidelines recommend against direct-acting oral anticoagulants (DOACs) in patients of BMI >40 kg/m due to low quality evidence justifying their use. We evaluated whether patients of BMI >40 kg/m undergoing primary unilateral TJA would have increased risk of postoperative VTE if prescribed DOACs compared to non-DOAC agents such as aspirin.

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Endometrial cytokines in patients with and without endometriosis evaluated for infertility.

Fertil Steril

March 2022

Biological Engineering Department; Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts. Electronic address:

Objective: To evaluate whether endometrial molecular profiles distinguish subsets of patients according to clinical characteristics, and to infer dysregulated immune networks, by measuring cytokines, chemokines, and growth factors in endometrial biopsy specimens from a cohort of infertile women with a high incidence of endometriosis.

Design: Prospective cohort study.

Setting: Department of Gynecology at a university hospital.

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Objective: Low-energy (LE) images of contrast-enhanced mammography (CEM) have been shown to be noninferior to digital mammography. However, our experience is that LE images are superior to 2D mammography. Our purpose was to compare cancer appearance on LE to 2D images.

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The updated Integrated Framework for Clinical Decision Making responds to changes in evidence, policy, and practice since the publication of the first version in 2008. The original framework was proposed for persons with neurological health conditions, whereas the revised framework applies to persons with any health condition across the lifespan. In addition, the revised framework (1) updates patient-centered concepts with shared clinical decision-making; (2) frames the episode of care around the patient's goals for participation; (3) explicitly describes the role of movement science; (4) reconciles movement science and International Classification of Function language, illustrating the importance of each perspective to patient care; (5) provides a process for movement analysis of tasks; and (6) integrates the movement system into patient management.

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