Radiation Exposure to the Eye with Mini C-arm Use During Hand Surgery

Introduction: Fluoroscopic radiation exposure is a potential occupational health risk to the Hand Surgeon, given operator proximity and the relative lack of eye shielding. The association of eye radiation exposure and the early development of cataracts have been previously reported. Mini C-arm fluoroscopy is commonly utilized during routine Hand Surgery. At present, the amount of radiation exposure to the eye, associated with the routine use of mini C-arm fluoroscopy, is unknown, thus warranting further investigation. The purpose of this study is to test the hypothesis that eye radiation exposure, sustained during routine mini C-arm use, does not exceed that of previously reported critical radiation dosages to the eye

Obesity and Overweight Prevalence Among Adolescents With Disabilities

IntroductionWe examined overweight and obesity prevalence among adolescents with disabilities by disability type (physical vs cognitive) and demographic factors (sex, age, race/ethnicity).MethodsParents (N = 662) of adolescents aged 12 to 18 years with disabilities from 49 states responded to an online survey from September 2008 through March 2009.ResultsPrevalence of obesity among adolescents with physical and cognitive disabilities (17.5%) was significantly higher compared with that among adolescents without disabilities (13.0%). Obesity prevalence was higher among males, 18-year-olds, and youths with cognitive disabilities than among females, younger adolescents, and youths with physical disabilities.ConclusionThe higher prevalence of obesity among youths with disabilities compared with nondisabled youths, particularly in certain subgroups, requires further examination in future surveillance research

Acute CD47 Blockade During Ischemic Myocardial Reperfusion Enhances Phagocytosis-Associated Cardiac Repair

Our data suggest that, after a myocardial infarction, integrin-associated protein CD47 on cardiac myocytes is elevated. In culture, increased CD47 on the surface of dying cardiomyocytes impairs phagocytic removal by immune cell macrophages. After myocardial ischemia and reperfusion, acute CD47 inhibition with blocking antibodies enhanced dead myocyte clearance by cardiac phagocytes and also improved the resolution of cardiac inflammation, reduced infarct size, and preserved cardiac contractile function. Early targeting of CD47 in the myocardium after reperfusion may be a new strategy to enhance wound repair in the ischemic heart

Giant mediastinal lymphocele after esophagectomy successfully treated with thoracic duct embolization

A 64-year old man had developed a giant mediastinal lymphocele after undergoing esophagectomy for the treatment of esophageal squamous cell carcinoma. The thoracic duct was embolized with six micro-coils, followed by embolization using a 1:3 mixture of N-butyl-2-cyanoacrylate (Histoacryl; B. Braun, Melsungen, Germany) and ethiodized oil. Resolution of the lymphocele was achieved within 5 days after embolization. To the best of our knowledge, ours is the first reported case of thoracic duct embolization for the treatment of mediastinal lymphocele

Human_CVD_All_Years_Top250_Genes.xlsx

This table contains the top-250 genes relevant to Cardiovascular diseases using the method described here: http://dx.doi.org/10.1016/j.jacc.2015.04.072

Abnormal preoperative leukocyte counts and postoperative complications following total shoulder arthroplasty

Background: Total shoulder arthroplasty (TSA) has become the mainstay of treatment for degenerative glenohumeral arthritis, proximal humerus fracture, and rotator cuff arthropathy. The expanding indications for reverse TSA have increased the overall demand for TSA. This necessitates higher quality preoperative testing and risk stratification. White blood cell counts can be obtained from routine preoperative complete blood count testing. The association between abnormal preoperative white blood cell counts and postoperative complications has not been extensively studied. The purpose of this study was to investigate the association between abnormal preoperative leukocyte counts and 30-day postoperative complications following TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015-2020. Patient demographics, comorbidities, surgical characteristics, and 30-day postoperative complication data were collected. Multivariate logistic regression was used to identify postoperative complications associated with preoperative leukopenia and leukocytosis. Results: In this study, 23,341 patients were included: 20,791 (89.1%) were in the normal cohort, 1307 (5.6%) were in the leukopenia cohort, and 1243 (5.3%) were in the leukocytosis cohort. Preoperative leukopenia was significantly associated with higher rates of bleeding transfusions (P = .011), deep vein thrombosis (P = .037), and non–home discharge (P = .041). After controlling for significant patient variables, preoperative leukopenia was independently associated with higher rates of bleeding transfusions (odds ratios [OR] 1.55, 95% confidence intervals [CI] 1.08-2.23; P = .017) and deep vein thrombosis (OR 2.26, 95% CI 1.07-4.78; P = .033). Preoperative leukocytosis was significantly associated with higher rates of pneumonia (P < .001), pulmonary embolism (P = .004), bleeding transfusions (P < .001), sepsis (P = .007), septic shock (P < .001), readmission (P < .001), and non–home discharge (P < .001). After controlling for significant patient variables, preoperative leukocytosis was independently associated with higher rates of pneumonia (OR 2.20, 95% CI 1.30-3.75; P = .004), pulmonary embolism (OR 2.43, 95% CI 1.17-5.04; P = .017), bleeding transfusions (OR 2.00, 95% CI 1.46-2.72; P < .001), sepsis (OR 2.95, 95% CI 1.20-7.25; P = .018), septic shock (OR 4.91, 95% CI 1.38-17.53; P = .014), readmission (OR 1.36, 95% CI 1.03-1.79; P = .030), and non–home discharge (OR 1.61, 95% CI 1.35-1.92; P < .001). Conclusion: Preoperative leukopenia is independently associated with higher rates of deep vein thrombosis within 30 days following TSA. Preoperative leukocytosis is independently associated with higher rates of pneumonia, pulmonary embolism, bleeding transfusion, sepsis, septic shock, readmission, and non–home discharge within 30 days following TSA. Understanding the predictive value of abnormal preoperative lab values will aid in perioperative risk stratification and minimize postoperative complications