This case study focuses on the Highland Hospital Records, a highly requested collection of hospital administrative records. During this case study, we outline our institutional considerations as a HIPAA covered entity, how we processed the collection...
Gonzalez-Guarda; Interventions Addressing Systemic Racism in the US: A Scoping Review; MEDLINE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science Core Collection, and Scopus
Background: Sepsis is a life-threatening response to infection that results in significant morbidity and mortality in children. International standardized guidelines have been developed by organizations such as the Surviving Sepsis Campaign to improve...
Background
It is well known that health related social needs (HRSN) impact long-term health outcomes including quality and length of life. Our study sought to examine the relationship between HRSN burden and emergency department (ED) and urgent care...
Background: Postmenopausal bleeding (PMB) is the most common initial presentation of endometrial cancer. The American College of Obstetrics and Gynecology recommends evaluation of PMB with transvaginal ultrasound (TVUS) to determine the endometrial...
Summary
Background
The dural puncture epidural technique (DPE) is a modification of the combined spinal epidural technique (CSE). Data comparing the two techniques are limited. We performed this randomised study to compare the quality of labour...
Background and Hypothesis
Cutaneous wound healing is a complex process that is typically characterized by significant inflammation and fibrosis, culminating in the formation of a scar. Improper wound healing can lead to complications, including...
Background: Single ventricle disease (SVD) is a subtype of congenital heart disease that frequently requires early staged surgical intervention for survival. It is well known that syndromic causes of SVD are associated with worse outcomes. However, the...
Background: Cartilage damage is challenging to treat due to its limited self-healing capacity caused by its avascular and aneural nature. However, 3D tissue engineering approaches that utilize biomaterials, additives, and cells offer a promising...
Background: The burden of Acute Myocardial Infarction (AMI) is growing in sub-Saharan Africa. In Tanzania, uptake of diagnostic testing and evidence-based therapy for AMI is suboptimal. We aimed to describe current gaps in evidence-based AMI care in a...
Background
Historically, the burden of myocardial infarction (MI) in sub-Saharan African nations has been limited, mostly due to the overwhelming impact of communicable diseases on early death. However, with improved access to treatment of...
Background: Despite improvements, patients with advanced cancer often do not receive goal-concordant care at the end of life (EOL). Challenges with prognostication contribute to delays ACP conversations and result in more aggressive care, gaps in...
Background: There are numerous risk factors that affect breast cancer (BC) incidence and mortality, including, but not limited to, age, race, income, insurance status, reproductive patterns, breast density, and germline genetic mutations. Approximately...
Background
Goals of care (GOC) discussions during advanced serious illness and end-of-life (EOL) care are critical. Institutions are increasingly tracking the frequency and timing of GOC documentation, but large-scale content assessments have been...
Background BRAF mutations are common in melanoma, with more than 50% harboring activating BRAF mutations. Though BRAF inhibitors are highly efficacious for nearly half of patients with this BRAF-mutant melanoma, many developing secondary resistance...
Background: Vestibular neuritis and labyrinthitis (VNL) are common causes of vertigo and dizziness. While multiple treatment strategies have been proposed, no established consensus for the optimal way to manage VNL exists. Moreover, no research has...
Background
Long acting injectable (LAI) preexposure prophylaxis (PrEP) has the potential to increase PrEP uptake and adherence. However, the majority of studies investigating opinions about LAI PrEP were theoretical, done prior to its approval. It is...
Background: New childhood cancer diagnoses require timely, multi-specialty care coordination, imposing considerable burdens for families. To better understand these challenges and optimize care delivery, this study aims to 1) track the trajectory of...
Background
A previous exploratory analysis of surveillance data at our large academic medical center identified higher CLABSI rates among non-Hispanic Black patients compared to White patients. In the context of a growing understanding of the...
Background: Human migration patterns have been shown to significantly influence the HIV epidemic. Throughout American history, marginalized populations have demonstrated how migration can function as a liberatory tool, as seen in the 20th century’s...
Background: Current guidelines recommend exploratory laparotomy for pediatric patients with abdominal firearm injuries. Recent research in adults suggests that laparoscopy may be preferable in selected populations. This study compared clinical outcomes...
Objective: This study evaluated predictors of surgical staging with lymphadenectomy (LA) and prescription of adjuvant therapy in a cohort of patients with clinical stage I ovarian cancer.
Methods: This retrospective cohort study assessed surgical...
Laser interstitial thermal therapy (LITT) is an emerging modality for hyperthermic ablation of brain tumors. Hyperthermia-induced tumor coagulative necrosis may serve as a source of neoantigen for T-cell priming and a subsequent anti-tumor immune...
Background: While hematopoietic stem cell transplantation (HSCT) is an effective treatment for hematological malignancies, it is associated with several potential complications. Recent studies have associated beta-blocker (BB) use in critical care...
Background: Mild cognitive impairment (MCI) is currently a clinical diagnosis characterized by decline in memory and daily cognitive function from baseline. Exploratory studies using optical coherence tomography angiography have reported alterations in...
Background: A primary focus of regenerative medicine is to understand the cellular mechanisms
governing tissue regeneration across various species. Mammals generally possess a restricted
regenerative capacity compared to species like zebrafish or...
Introduction: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To...
Background: Gliomas are the most common malignant primary brain tumor. Genomic characterization is necessary for diagnosis and treatment decisions, for which the brain is biopsied and can lead to delays in care, morbidity, and mortality. Here, we...
Background: Hypergranulation tissue (HGT) is recognized as a common complication after vaginoplasty, however it is not well represented in the literature. Silver nitrate is a common, first-line treatment for HGT. In this study, we examine silver...
Background:
Deterioration of children's mental health during the pandemic resulted in the declaration of a national emergency. High rates of psychotropic prescribing among children within the foster care system has been a target of federal and state...
BACKGROUND: The purpose of this study was to systematically review complications arising from intramedullary nailing (IMN) of proximal and humeral shaft fractures. This study hypothesized that there would be a low rate of complications and revision...
Background: Pulmonary artery stenosis, neoaortic dilatation, and neoaortic valve insufficiency are among the most frequent complications of the arterial switch operation (ASO) for repair of dextro-transposition of the great arteries (d-TGA). It remains...
Objectives: Endothelial colony-forming cells (ECFCs) in circulating blood represent an attractive cell source for cellularizing engineered valve scaffolds that may function as living valve replacements with durability and growth potential. In other...
Background: Surgery is the standard of care for early-stage non-small cell lung cancer (NSCLC), with stereotactic body radiotherapy (SBRT) reserved for patients who are not surgical candidates or decline surgery. The role of SBRT for medically operable...
Background: Thoracic aortic pathology most commonly reviewed at our institution includes aortic aneurysms, acute dissection and acute aortitis, all which are associated with distinct histologic and morphologic features. Spatial transcriptomics enables...
Objective:
Compare differences in demographics, comorbidities, and ED visits or hospitalizations in Black versus White AIBD patients evaluated and treated at Duke Dermatology between 2012-2021.
Background:
Previous cross-sectional studies of...
Low back pain (LBP) is a prevalent musculoskeletal condition, but little is known about the characteristics of individuals transitioning from acute to chronic states. This transition can significantly reduce quality of life. The BACk Study aims to...
Chart reviews of 36 NSIP patients were conducted to determine if there is a significant difference in Xe MRI membrane high percent (MHP) signal between NSIP patients with severe outcomes vs non-severe outcomes. The results indicate there is a...
This project is a systematic review of Nigerian neurosurgical literature published between 1962-2023 that analyzes the prevalence, management, and outcomes of hydrocephalus in Nigeria with a focus on pediatrics.
A retrospective mid term study that was a continuation of a short term study that looks at the efficacy of proximal endoscopic hamstring repair to assess patient satisfaction and outcomes.
Background: Red blood cells (RBCs), in addition to carrying oxygen, generate and export vasoregulatory mediators as a function of their metabolic context. S- nitrosothiol (SNO) is exported to effect hypoxic vasodilation, a fundamental vascular reflex...
Background: The Liver Imaging Reporting and Data System (LI-RADS) does not consider factors extrinsic to the observation of interest, such as concurrent LR-5 observations.
Purpose: To evaluate whether the presence of a concurrent LR-5 observation is...
Background: In infants with neurological symptoms, ischemic stroke and bacterial meningitis are possible. To rule out meningitis, clinicians often perform a lumbar puncture. However, there is minimal research describing the cerebrospinal fluid (CSF) of...
Objective: Previous nontechnical skills simulation curricula in surgery have largely focused on teaching communication skills or empathy in isolation from technical skills, with feedback from one rater perspective. We aimed to develop and pilot an...
Objective: Different staging systems have been developed to assess the severity of laryngotracheal stenosis (LTS). In this study, we assess the effects of stenotic length based on the McCaffrey staging system and constriction in cross-sectional area...
There is increasing recognition of the importance of medical student wellbeing. The purpose of this study was to determine the characteristics that are associated with lower wellness in medical students.
An anonymous, IRB-approved survey was...
Objective:
Cesarean hysterectomy for placenta accreta spectrum (PAS) is associated with increased risk of post-partum hemorrhage and severe maternal morbidity (SMM). The current literature lacks large multicenter studies of cesarean hysterectomy for...
Evaluation of pain often relies on subjective patient reported outcomes (PROs) such as the Brief Pain Inventory. Supplementing such measures with objective endpoints can provide a deeper assessment of acute and chronic pain. In the present study, we...
Purpose
To determine the impact of race, socioeconomic deprivation, and insurance status on imaging surveillance adherence in a 5-year period after index diagnosis and surgical resection of a bone or soft tissue sarcoma at a single, large academic...
Background and objective: Human milk oligosaccharides (HMOs) are carbohydrates abundant in human breast milk. Their composition varies widely among women, and prior research has identified numerous factors contributing to this variation. However, the...
Background: The distribution of amyotrophic lateral sclerosis (ALS) across the world appears to be uneven, which may in part be explained by environmental factors. β-methylamino-L-alanine (BMAA), a neurotoxin produced by cyanobacteria, and...
Background: Conduction system pacing (CSP), often accomplished with lumenless pacing leads, is increasingly employed to achieve physiologic ventricular activation. Extraction of CSP leads has raised concerns about damage to the conduction system, lead...
Caused by the parasite Trypanosoma cruzi, Chagas disease is one of the most neglected tropical diseases in the world and poses a significant burden to the estimated eight million people living with disease. As primary infection is largely asymptomatic,...
Objective: Cardiac Allograft Vasculopathy (CAV), a process of vascular damage accelerated by antibody-mediated rejection (AMR), is the leading cause of cardiac transplant failure. Proteasome inhibitors (PIs) are utilized to treat AMR; however,...
Background:
The artificial urinary sphincter (AUS) is considered the gold standard in the surgical management of stress urinary incontinence, particularly for male patients. The AUS is a fluid-filled hydraulic system comprised of a urethral cuff, a...
Hypothesis:
We sought to evaluate whether surgical excision of major peripheral nerve neuromas (MPN) would reduce the use of opioids in patients with preoperative opioid use. Secondarily, we sought to determine whether additional surgical...
Background: The utility of sentinel lymph node biopsy (SLNB) in older patients remains controversial. Advancements in HER2-directed therapy have revolutionized disease response rates and prognosis, supporting efforts to reevaluate the utility of SLNB....
Introduction: Efforts to expand the lung transplant (LTx) donor pool have led to increased use of lungs from donors after circulatory death (DCD), with evidence demonstrating outcomes comparable to those from donors after brain death (DBD). Although...
Background: Malnutrition is a significant driver of mortality in cancer patients – with estimates that between 10-20% of cancer patients die due to the consequences of malnutrition rather than due to the tumor itself. Patients with head and neck cancer...
Background: Glenoid bone loss remains one of the most significant risk factors for recurrent instability following surgical management of glenohumeral instability. Controversy exists regarding the optimal procedure for reconstructing glenoid bone loss...
Web resource for the Medical Center Library & Archives Newsletter (February 2024, Issue 411). All archived website data from this newsletter is hosted and stored by the Internet Archive, which was captured by Archive-It's Brozzler Crawler. The...
Background: In patients with acute pulmonary embolism (PE), early risk stratification is essential in order to determine effective therapeutic management. Right ventricle to left ventricle (RV/LV) ratio measurement is a strong predictor of clinical...
Introduction: We assessed adherence to ACOG guidelines for antihypertensive medication initiation or titration among pregnant chronic hypertensive patients with blood pressure (BP) > 140/90 and patient characteristics associated with...
BACKGROUND: The purpose of this study is to compare the outcomes of reverse total shoulder arthroplasty (RTSA) in elderly patients with proximal humerus fractures (PHFs) who underwent early RTSA versus those who underwent delayed RTSA.
METHODS: A...
INTRODUCTION: In the context of value-based care, the influence of racial and socioeconomic factors on hip fracture outcomes remains underexplored. This study investigates the impact of the area deprivation index (ADI) on readmission rates and costs...
Funding Acknowledgement: This study was supported by a grant from the Orthopaedic Research and Education Foundation
Background: The glenohumeral joint is the most frequently dislocated joint in the human body, and recurrent instability is common with...
Background: Plasma and cerebrospinal fluid (CSF) levels of p-tau181 have been associated with Alzheimer’s disease (AD). The retina and vitreous have shown measurable quantities of phosphorylated tau 181 (p-tau181). The aqueous humor, which can be...
Background
The state hospital at Goldsboro opened in 1880 as North Carolina’s first institution to serve the Black mentally ill, and was the second such institution to open in the American South. And while there is a growing historiography on asylums...
Background:
One of the most challenging groups of patients seen by neurologists today are those experiencing convulsive, seizure-like episodes – but in whom no abnormal neurologic activity is found. Psychogenic non-epileptic seizures sit at the...
Background:
Multiple sclerosis (MS) is more prevalent in female patients and is frequently diagnosed during reproductive years. Patients with multiple sclerosis (PwMS) have a decreased risk of relapse during pregnancy and this risk increases...
ABSTRACT
Background: Osteocutaneous fibula free flaps (FFFs) are a fundamental component of reconstructive surgery in the head and neck region, particularly following traumatic injuries or oncologic resections. Despite their utility, FFFs are...
Background: This study describes the illness burden in the first year of life for children with single-ventricle heart disease, using the metric of days alive and out of hospital to characterize morbidity and mortality.
Methods: This is a...
Background. Persons with rheumatoid arthritis (RA) have increased risk of cardiometabolic disease. The Supervised Weight loss and Exercise Training for Rheumatoid Arthritis (SWET-RA) trial demonstrated improved RA cardiometabolic risk with a weight...
Background: While exercising underwater, divers experience increased ventilatory load which can predispose them to respiratory muscle fatigue and hypercapnia. Hypercapnic ventilatory response (HCVR) is a highly variable measure of the physiological...
Background: Alternating hemiplegia of childhood (AHC) is a rare condition most frequently caused by mutations in ATP1A3, encoding for the alpha-3 subunit of Na+/K+-ATPase, and D801N is the most common variant. Individuals with ATP1A3-D801N have shorter...
Background: Cardiac amyloidosis (CA) is associated with high rates of intrinsic conduction disease. Patients with CA and cardiac implantable electronic devices (CIED) have demonstrated an eventual reliance on ventricular pacing, regardless of initial...
Background: Laboratory rats are used as the standard animal model for studying liver transplantation (LT) due to their size facilitating microsurgery and easy handling, genome similarity to humans, and post-LT immune responses being similar to that of...
Background: Shame is a powerful emotional reaction to a global negative self-evaluation. Prior research has characterized shame’s destructive nature in medical learners and highlighted its potential to catalyze meaningful learning, growth, and identity...
Introduction: In the U.S., patients of Black race and Hispanic ethnicity have lower survival from out-of-hospital cardiac arrest (OHCA) when they are not witnessed by 9-1-1 responders than White patients. Whether these racial and ethnic differences...
Objective.
Interventional Radiologists’ involvement in percutaneous osseous interventions is increasing, however, postprocedural instructions related to weightbearing are often not given. The purpose of this study was to describe the implications of...
OBJECTIVE: To evaluate the effect of surgical case sequencing on patient flow delays considering downstream hospital resources.
BACKGROUND: Operating Rooms (OR) are often constrained by downstream resources, which affect patient flow and surgeon...
Background: Current osteoporosis screening guidelines recommend bone mineral density (BMD) testing following fragility fractures. Despite the existence of such guidelines, previous studies have demonstrated that rates of osteoporosis screening remain...
Background & Hypothesis: Demand for pediatric heart transplants exceeds the supply of available organs, resulting in an average waiting time of six months and significant waitlist mortality. The use of donor hearts after circulatory death (DCD)...
Background: Ocular surface squamous neoplasia (OSSN) is a potentially vision-threatening malignancy and may be difficult to diagnose as it often appears similar to other lesions such as pterygium and pingueculae. Ocular surface images are easy to...
BACKGROUND: Slings with abduction pillows are used by surgeons in the postoperative rehabilitation protocol for arthroscopic rotator cuff repair (ARCR); however, there is a lack of evidence demonstrating superior outcomes. The purpose of this study is...
Background: While cardiometabolic disease (CMD) is the number one cause of death for women in the US, age at CMD onset is 10-20 years after that of men. This stark difference in CMD incidence is attributed to menopausal estrogen withdrawal. Along with...
Background: Clinically significant depressive disturbances occur in 40-50% of patients with Parkinson’s Disease (PD) and often precede the onset of any measurable motor symptoms. Cross-sectional studies indicate a majority of those affected experience...
Background: Hispanic patients exhibit a wide range of skin colors and represent one of the fastest growing populations in the United States. However, most cutaneous squamous cell carcinoma (cSCC) treatment and follow-up guidelines are based on studies...
Introduction: Spine surgery and the recovery process are both physically and mentally demanding for patients. Sociodemographic disparities impact access to spine surgery and post-operative outcomes, with low-income, older, and non-White patients...
Background:
Robeson County is a rural community in North Carolina with the lowest life expectancy in North Carolina. While many risk factors contribute to these poor health outcomes, there is limited data on the comorbidities and outcomes related to...
Background: Persons living with HIV (PLWH) have approximately double the risk of cardiovascular disease (CVD) compared to those without HIV. Despite Tanzania’s impressive strides in expanding access to HIV testing, one in five PLWH in Tanzania are...
Introduction: A low level of social connectedness is a risk factor and a warning sign for suicide, and it is particularly relevant to understanding suicide in veteran populations. Data from psychological autopsies may provide insights into changes in...
Background: This study identified demographic factors and other characteristics of people experiencing homelessness (PEH) associated with an increased likelihood of being rehoused upon discharge from a transitional care program. Despite homelessness...