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  Trends in the Abscopal Effect After Radiation to Spinal Metastases: A Systematic Review

  Adam Robin, Mohamed Macki, Mohamed Fakih, Jaafar Elmenini, Sharath Kumar Anand, and Ian Lee

  While the abscopal effect has been previously described, the phenomenon has been poorly defined with spinal metastases. This article is unique in that we present the first systematic review of the abscopal effect after radiation therapy to metastatic spinal cancer, especially since the spinal column represents one of the most common metastatic locations. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the Enhancing the... Read More

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  Improvement in VAS and ASES Scores After Arthroscopic Latarjet

  Paul Rodenhouse and Shariff Bishai

  Introduction: Shoulder dislocations are the most common dislocation among the major joints. Instability due to a dislocation can be a difficult problem causing significant morbidity among sufferers. Soft-tissue procedures while successful for labral pathology have shown high failure rates in cases of bony deficiency, humeral avulsion of the glenohumeral ligaments, contact sports, and revision of previous soft tissue reconstructions. Coracoid transfer to address anterior shoulder instability, first proposed by... Read More

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  IV iron: Opportunities for Clinical Optimization of Women with Iron Deficiency Anemia

  Haleema Saeed, Ghadear Shukr, and Roopina Sangha

  Objective: Iron deficiency anemia is seen commonly in women of reproductive age and particularly during pregnancy. Current treatment practice with oral iron supplementation is associated with gastrointestinal side effects leading to poor compliance. Intravenous dextran is an effective alternative that is underutilized which can lead to better clinical outcomes, reduced risk of blood transfusion as well as improved quality of life. Our objective was to study improvement inquality of... Read More

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  Mepivacaine Spinal Anesthesia Facilitates Shorter Length of Stay and Fewer Urinary Complications in Total Hip Arthroplasty Compared to Bupivacaine

  Jonathan Shaw, Chad Mahan, Justin Jabara, and Jason J. Davis

  Background: The purpose of this study was to compare the shorter-acting spinal anesthetic mepivacaine versus bupivacaine in total hip arthroplasty (THA). Methods: We retrospectively reviewed a prospectively collected database from a single surgeon’s contemporary cohort of 312 consecutive patients undergoing primary THA. Primary outcomes were urinary retention, length of stay (LOS), neuraxial complications, pain control, and opioid consumption. Statistical analysis with univariate logistic regression was performed followed by a... Read More

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  Vessel Ligation in Transoral Robotic Surgery: Survey of the American Head and Neck Society

  Mohammad K. Shukairy, Tamer Ghanem, and Amy M Williams

  Objectives: Hemorrhage after transoral robotic surgery (TORS) surgery ranges from minor self-limited bleeding to lethal complications. To decrease risk, several publications have suggested ligation of the external carotid artery or its branches, even though statistically it has not been shown to be effective. The current study anonymously surveyed members of American Head and Neck Society (AHNS) on how they manage vessel ligation in TORS for oncological indications to better... Read More

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  Pregnancy of unknown location in a cohort of patients treated with methotrexate

  Ghadear Shukr, Omar Zwain, Sanjana Kulkarni, and David Eisenstein

  Introduction: To determine the prevalence of pregnancy of unknown location (PUL) in patients treated with Methotrexate (MTX) for nonsurgical diagnosis of ectopic pregnancy (EP). To determine the b-HCG treatment outcomes. Methods: Retrospective cohort study of patients who received MTX for treatment of EP over a 10-year period in an urban-based healthcare system. Wilcox test was used for statistical analysis. Results: A total of 150 pregnancies were identified as treated... Read More

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  A Retrospective Review of 93 Cases of Cellular Dermatofibromas

  Rasnik Singh, Samantha L Schneider, Dana Siegel, Marsha Chaffins, and Pranita V Rambhatla

  Cellular dermatofibromas (CDF) are an uncommon variant of benign fibrous histiocytomas with propensity to recur and rarely metastasize as well as demonstrating histologic similarities to more dangerous lesions. The aim of this present study was to further describe the presentation and outcome of the cellular variant of benign fibrous histiocytomas so that it can be diagnosed and treated appropriately. A retrospective chart review was performed on all patients seen... Read More

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  Use of simplified claustrophobia questionnaire in predicting adherence to positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) patients

  Prajan Subedi, George Samuel, Jovica Veljanovski, Kenneth Moss, Beth McLellan, Philip Cheng, David Gessert, Maria Tovar, Meeta Singh, Christopher L. Drake, and Luisa Bazan

  TITLE: Use of simplified claustrophobia questionnaire in predicting adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. Introduction: Claustrophobia could affect adherence to CPAP in sleep apnea patients. High score in a claustrophobia questionnaire containing 12 restriction and 14 suffocation items was associated to poor CPAP adherence in previous research. The restriction and suffocation items were equivalent on predicting CPAP adherence which allowed to limit... Read More

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  Trends in Cerebral Large Vessel Occlusions: The "Clustering" of Strokes at Henry Ford Health System

  Rizwan A Tahir, Travis Hamilton, Ayesha Ahmad, Horia Marin, and Maximillian K Kole

  Introduction: Several studies have examined trends of ischemic stroke and its association with medical, environmental, meteorological, social and economic factors in micropopulations. We investigated these factors and their association with large vessel occlusions (LVOs) that underwent mechanical thrombectomy at a certified comprehensive stroke center.

  Methods: A retrospective analysis was conducted of LVOs which underwent mechanical thrombectomy for reperfusion during a four-year period (2015-2018) to determine if a "clustering" phenomenon... Read More

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  The Efficacy Of BE-FAST In Identifying Strokes

  Henry Tan, Adam Alexander, Anu Gopalan, Caroline Hannon, Satheesh Gunaga, Jared Patel, and Dylan Bergeon

  Introduction: By 2030, it is estimated that stroke will become the leading cause of adult disability in our country, afflicting 1 in 25 Americans. Prompt identification of stroke is essential because primary interventions such as tPA and thrombectomies, which may reduce long-term functional deficits, are extremely time sensitive. Given this, early identification through stroke screening scales such as the FAST (Face, Arms, Speech, Time) exam was developed, which have... Read More

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  Risk Factors for Postoperative Opioid Use in Arthroscopic Labrum Surgery

  Kevin Taylor, Toufic Jildeh, Lafi S Khalil, Joseph S Tramer, Laith Hasan, Kelechi R. Okoroha, and Vasilios Moutzouros

  Background: Arthroscopic shoulder labral surgery is a commonly performed outpatient procedure in which narcotic medications can be used to manage postoperative pain. The purpose of this study was to determine the correlation between preoperative and postoperative opioid use in patients undergoing arthroscopic shoulder labral surgery. Additionally, we aimed to identify patient risk factors associated with increased postoperative opioid use following their labral surgery.

  Methods: A retrospective review of all... Read More

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  Robotic-Assisted Versus Open Techniques for Living Donor Kidney Transplant Recipients: A Comparison Using Propensity Score Analysis

  Francis Tinney Jr., Joel Stracke, Mohamed Safwan, Tracci McEvoy, Lauren E. Malinzak, Dean Kim, Shunji Nagai, and Atsushi Yoshida

  Background: Following the rapid advancements in minimally invasive urology, living donor robotic-assisted kidney transplantation (RAKT) has developed into a feasible alternative to open kidney transplantation (OKT). The procedure has been performed in multiple international programs, but a relative dearth of experience exists in the US. In this investigation, we compare RAKT to OKT using a propensity score analysis, to elucidate the safety and feasibility of RAKT as a suitable... Read More

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  Preoperative PROMIS Scores Predict Postoperative Improvements Following Rotator Cuff Repair

  Joseph S Tramer, Sreten Franovic, Noah A. Kuhlmann, Caleb Gulledge, Vasilios Moutzouros, Stephanie J. Muh, and Eric C Makhni

  Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) has emerged as a valid and efficient means of collecting patient outcomes in patients with rotator cuff tear. The purpose of this study was to examine the role of pre-operative PROMIS computer adaptive test (CAT) scores in predicting post-operative PROMIS CAT scores as well as likelihood of achieving minimal clinically important difference (MCID) following rotator cuff repair. We hypothesize that pre-operative... Read More

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  Impact on Antimicrobial Utilization in the Emergency Department of a Point of Care Polymerase Chain Reaction Compared to Antigen Testing for Influenza

  Jonathan Williams, Nicholas J Mercuro, Amit Vahia, Hira Rizvi, Mujtaba Hameed, Pallavi Bhargava, Odaliz Abreu-Lanfranco, Linoj Samuel, and George J. Alangaden

  Background: Due to poor sensitivity, the FDA mandated that rapid influenza antigen (IAT) must be phased out by 2018. At our institution, an on-site rapid influenza PCR (PCR) was implemented in emergency departments (ED) at the start of the 2016-2017 influenza season. The purpose of this study was to examine the impact of influenza PCR testing on antimicrobial utilization in the ED. Methods: This multicenter quasiexperimental study included adults... Read More

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  Factors Affecting Healing in the Treatment of Hidradenitis Suppuritiva

  Andrew Worden, Daniel Yoho, Ihab Saab, and Aamir Siddiqui

  Background: Hidradenitis suppurativa (HS) is a chronic and debilitating condition which causes recurrent painful nodules. Patients often progress to develop subdermal abscesses, chronic induration, and suppurative draining sinus tracts. HS causes significant debility and morbidity in patients’ body image, and overall quality of life. Despite this, there is typically a 5-­14 year delay in diagnosis from symptom onset. Treatment of HS depends on disease stage, goals of care, access... Read More

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  Intravenous and Oral Tranexamic Acid are Equivalent at Reducing Blood Loss in Thoracolumbar Spinal Fusion: A Prospective Randomized Trial Phase 2

  Charles C. Yu, Omar M Kadri, Allen Kadado, Jacob Pawloski, Morenikeji Buraimoh, Stephen Bartol, and Gregory Graziano

  Intravenous and oral tranexamic acid are equivalent at reducing blood loss in thoracolumbar spinal fusion: a prospective randomized trial.

  Discussion and Conclusion: Patients treated with IV and PO TXA experienced the same perioperative blood loss after spinal fusions. Given its lower cost, PO TXA represents an excellent alternative to IV TXA in patients undergoing elective posterior thoracolumbar fusion and may improve healthcare cost-efficiency in the studied population.

  Results: 91... Read More

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  Improving Sun Protection

  Raheel Zubair, Indermeet Kohli, Alexis B. Lyons, Amanda F. Nahhas, Taylor L. Braunberger, Mohsen Moktari, Eduardo Ruvolo, Henry W. Lim, and Iltefat H. Hamzavi

  Introduction: Visible light (VL) has been demonstrated to cause dark and sustained pigmentation lasting weeks. This has implications for pigment disorders including postinflammatory hyperpigmentation and melasma. The FDA defines sunscreens as broad spectrum if they absorb light between 290nm and 370nm, but this range may be inadequate to prevent VL-induced pigmentation. In this study, an antioxidant product was tested for its ability to mitigate VL-induced pigmentation. Methods: A total... Read More