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  1. Article ; Online: Commentary: Risk Factors and Neurological Outcomes Associated With Circulatory Shock After Moderate-Severe Traumatic Brain Injury: A TRACK-TBI Study.

    Adenwalla, Ammar / Caruso, James P / Bedros, Nicole / Aoun, Salah G

    Neurosurgery

    2022  Volume 91, Issue 3, Page(s) e83–e84

    MeSH term(s) Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/epidemiology ; Humans ; Risk Factors
    Language English
    Publishing date 2022-06-22
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/neu.0000000000002067
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    Zs.A 1424: Show issues Location:
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  2. Article: Sixth Annual Enhanced Recovery After Surgery Symposium highlights: work in progress or standard care?

    Fair, Lucas / Duggan, Elizabeth / Dellinger, Evan P / Bedros, Nicole / Godawa, Kimberly / Krusinski, Cynthia / Curran, Rachel / Hart, Charlette / Zhu, Alex / Peters, Walter / Fleshman, James / Fichera, Alessandro

    Proceedings (Baylor University. Medical Center)

    2023  Volume 36, Issue 5, Page(s) 651–656

    Abstract: Enhanced Recovery After Surgery (ERAS) protocols have demonstrated effectiveness in accelerating patient recovery and improving outcomes. Since the systemwide implementation of ERAS protocols at Baylor Scott & White Health, an annual multidisciplinary ... ...

    Abstract Enhanced Recovery After Surgery (ERAS) protocols have demonstrated effectiveness in accelerating patient recovery and improving outcomes. Since the systemwide implementation of ERAS protocols at Baylor Scott & White Health, an annual multidisciplinary conference has provided a review of outcomes and advancements in the ERAS program. This meeting, coined the ERAS symposium, allows providers who utilize recovery protocols to collaborate with national and international leaders in the field to improve the clinical care of patients. The sixth annual ERAS symposium was held on February 10, 2023, and provided key presentations that discussed the latest results from ERAS efforts across multiple surgical specialties along with updates in anesthesia, nursing, and nutrition. A summary of those presentations, which included perioperative glycemic control, misconceptions in pain management, and emerging ERAS protocols in different surgical specialties, is provided to document the system progress.
    Language English
    Publishing date 2023-06-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2023.2221112
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  3. Article ; Online: Adapting Compassionate Conversations for Virtual Mediated Communication.

    Rivet, Emily B / Feldman, Moshe / Khandelwal, Sorabh / Anderson, Aaron / Bedros, Nicole / Haynes, Susan / McDonough, Erin / Cholyway, Renee / Lange, Patricia / Edwards, Cherie / Santen, Sally A

    Journal of surgical education

    2023  Volume 80, Issue 9, Page(s) 1296–1301

    Abstract: Objective: The Covid-19 pandemic resulted in a shift in communication of difficult, emotionally charged topics from almost entirely in-person to virtual mediated communication (VMC) methods due to restrictions on visitation for safety. The objective was ...

    Abstract Objective: The Covid-19 pandemic resulted in a shift in communication of difficult, emotionally charged topics from almost entirely in-person to virtual mediated communication (VMC) methods due to restrictions on visitation for safety. The objective was to train residents in VMC and assess performance across multiple specialties and institutions.
    Design: The authors designed a teaching program including asynchronous preparation with videos, case simulation experiences with standardized patients (SPs), and coaching from a trained faculty member. Three topics were included - breaking bad news (BBN), goals of care / health care decision making (GOC), and disclosure of medical error (DOME). A performance evaluation was created and used by the coaches and standardized patients to assess the learners. Trends in performance between simulations and sessions were assessed.
    Setting: Four academic university hospitals - Virginia Commonwealth University Medical Center in Richmond, Virginia, The Ohio State University Wexner Medical Center in Columbus, Ohio, Baylor University Medical Center in Dallas, Texas and The University of Cincinnati in Cincinnati, Ohio- participated.
    Participants: Learners totaled 34 including 21 emergency medicine interns, 9 general surgery interns and 4 medical students entering surgical training. Learner participation was voluntary. Recruitment was done via emails sent by program directors and study coordinators.
    Results: A statistically significant improvement in mean performance on the second compared to the first simulation was observed for teaching communication skills for BBN using VMC. There was also a small but statistically significant mean improvement in performance from the first to the second simulation for the training overall.
    Conclusions: This work suggests that a deliberate practice model can be effective for teaching VMC and that a performance evaluation can be used to measure improvement. Further study is needed to optimize the teaching and evaluation of these skills as well as to define minimal acceptable levels of competency.
    MeSH term(s) Humans ; Internship and Residency ; Pandemics ; COVID-19/epidemiology ; Communication ; Truth Disclosure ; Emergency Medicine ; Physician-Patient Relations
    Language English
    Publishing date 2023-07-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.06.012
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  4. Article ; Online: From chaos to creativity: Designing collaborative communication training for the delivery of bad news.

    Rivet, Emily B / Edwards, Cherie / Bedros, Nicole / Haynes, Susan / Anderson, Aaron / McDonough, Erin / Khandelwal, Sorabh / Cholyway, Renee / Feldman, Moshe / Lange, Patricia

    Surgery

    2022  Volume 172, Issue 5, Page(s) 1323–1329

    Abstract: Background: Before the COVID-19 pandemic, teaching communication skills in health care focused primarily on developing skills during face-to-face conversation. Even experienced clinicians were unprepared for the transition in communication modalities ... ...

    Abstract Background: Before the COVID-19 pandemic, teaching communication skills in health care focused primarily on developing skills during face-to-face conversation. Even experienced clinicians were unprepared for the transition in communication modalities necessitated due to physical distancing requirements and visitation restrictions during the COVID-19 pandemic. We aimed to develop and pilot a comprehensive video-mediated communication training program and test its feasibility in multiple institutional settings and medical disciplines.
    Methods: The education team, consisting of clinician-educators in general surgery and emergency medicine (EM) and faculty specialists in simulation and coaching, created the intervention. Surgery and EM interns in addition to senior medical students applying in these specialties were recruited to participate. Three 90-minute sessions were offered focusing on 3 communication topics that became increasingly complex and challenging: breaking bad news, goals of care discussions, and disclosure of medical error. This was a mixed-methods study using survey and narrative analysis of open comment fields.
    Results: Learner recruitment varied by institution but was successful, and most (75%) learners found the experience to be valuable. All of the participants reported feeling able to lead difficult discussions, either independently or with minimal assistance. Only about half (52%) of the participants reported feeling confident to independently disclose medical error subsequent to the session.
    Conclusion: We found the program to be feasible based on acceptability, demand, the ability to implement, and practicality. Of the 3 communication topics studied, confidence with disclosure of medical error proved to be the most difficult. The optimal length and structure for these programs warrants further investigation.
    MeSH term(s) COVID-19 ; Communication ; Humans ; Internship and Residency ; Pandemics/prevention & control ; Physician-Patient Relations ; Truth Disclosure
    Language English
    Publishing date 2022-08-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2022.06.010
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  5. Article ; Online: Organ Donation and End-of-Life Discussions: A Scripting Template for Supportive Palliative Care.

    Wall, Anji / Polk, Heather / Bedros, Nicole / Casanova, Mark / Trahan, Chad / Clay, Michael / Adams, Bradley L / Niles, Patricia / Testa, Giuliano / Fine, Robert

    Journal of pain and symptom management

    2022  Volume 64, Issue 5, Page(s) e300–e304

    MeSH term(s) Death ; Humans ; Palliative Care ; Terminal Care ; Tissue and Organ Procurement
    Language English
    Publishing date 2022-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639142-4
    ISSN 1873-6513 ; 0885-3924
    ISSN (online) 1873-6513
    ISSN 0885-3924
    DOI 10.1016/j.jpainsymman.2022.08.001
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  6. Article ; Online: Transfusion Guidelines in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of the Currently Available Evidence.

    Montgomery, Eric Y / Barrie, Umaru / Kenfack, Yves J / Edukugho, Derrek / Caruso, James P / Rail, Benjamin / Hicks, William H / Oduguwa, Emmanuella / Pernik, Mark N / Tao, Jonathan / Mofor, Paula / Adeyemo, Emmanuel / Ahmadieh, Tarek Y El / Tamimi, Mazin Al / Bagley, Carlos A / Bedros, Nicole / Aoun, Salah G

    Neurotrauma reports

    2022  Volume 3, Issue 1, Page(s) 554–568

    Abstract: Our study aims to provide a synthesis of the best available evidence on the hemoglobin (hgb) red blood cell (RBC) transfusion thresholds in adult traumatic brain injury (TBI) patients, as well as describing the risk factors and outcomes associated with ... ...

    Abstract Our study aims to provide a synthesis of the best available evidence on the hemoglobin (hgb) red blood cell (RBC) transfusion thresholds in adult traumatic brain injury (TBI) patients, as well as describing the risk factors and outcomes associated with RBC transfusion in this population. A systematic review and meta-analysis was conducted using PubMed, Google Scholar, and Web of Science electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to assess articles discussing RBC transfusion thresholds and describe complications secondary to transfusion in adult TBI patients in the perioperative period. Fifteen articles met search criteria and were reviewed for analysis. Compared to non-transfused, TBI patients who received transfusion tended to be primarily male patients with worse Injury Severity Score (ISS) and Glasgow Coma Scale. Further, the meta-analysis corroborated that transfused TBI patients are older (
    Language English
    Publishing date 2022-12-22
    Publishing country United States
    Document type Journal Article
    ISSN 2689-288X
    ISSN (online) 2689-288X
    DOI 10.1089/neur.2022.0056
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  7. Article ; Online: Anisocoria Correlates With Injury Severity and Outcomes After Blunt Traumatic Brain Injury.

    Nyancho, Daniel / Atem, Folefac D / Venkatachalam, Aardhra M / Barnes, Arianna / Hill, Michelle / Traylor, Jeffrey I / Stutzman, Sonja E / Bedros, Nicole / Aiyagari, Venkatesh / Aoun, Salah G

    The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses

    2021  Volume 53, Issue 6, Page(s) 251–255

    Abstract: Abstract: BACKGROUND: Automated infrared pupillometry (AIP) has been shown to be helpful in the setting of aneurysmal subarachnoid hemorrhage and stroke as an indicator of imminent irreversible brain injury. We postulated that the early detection of ... ...

    Abstract Abstract: BACKGROUND: Automated infrared pupillometry (AIP) has been shown to be helpful in the setting of aneurysmal subarachnoid hemorrhage and stroke as an indicator of imminent irreversible brain injury. We postulated that the early detection of pupillary dysfunction after light stimulation using AIP may be useful in patients with traumatic brain injury (TBI). METHODS: We performed a retrospective review of the Establishing Normative Data for Pupillometer Assessment in Neuroscience Intensive Care database, a prospectively populated multicenter registry of patients who had AIP measurements taken during their intensive care unit admission. The primary eligibility criterion was a diagnosis of blunt TBI. Ordinal logistic modeling was used to explore the association between anisocoria and daily Glasgow Coma Scale scores and discharge modified Rankin Scale scores from the intensive care unit and from the hospital. RESULTS: Among 118 subjects in the who met inclusion, there were 6187 pupillometer readings. Of these, anisocoria in ambient light was present in 12.8%, and that after light stimulation was present in 9.8%. Anisocoria after light stimulation was associated with worse injury severity (odds ratio [OR], 0.26 [95% confidence interval (CI), 0.14-0.46]), lower discharge Glasgow Coma Scale scores (OR, 0.28 [95% CI, 0.17-0.45]), and lower discharge modified Rankin Scale scores (OR, 0.28 [95% CI, 0.17-0.47]). Anisocoria in ambient light showed a similar but weaker association. CONCLUSION: Anisocoria correlates with injury severity and with patient outcomes after blunt TBI. Anisocoria after light stimulation seems to be a stronger predictor than does anisocoria in ambient light. These findings represent continued efforts to understand pupillary changes in the setting of TBI.
    MeSH term(s) Anisocoria/diagnosis ; Anisocoria/etiology ; Brain Injuries, Traumatic/diagnosis ; Glasgow Coma Scale ; Humans ; Prospective Studies ; Retrospective Studies
    Language English
    Publishing date 2021-09-28
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 632790-4
    ISSN 1945-2810 ; 0888-0395
    ISSN (online) 1945-2810
    ISSN 0888-0395
    DOI 10.1097/JNN.0000000000000613
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  8. Article ; Online: Single-site laparoscopic surgery for inflammatory bowel disease.

    Olson, Craig H / Bedros, Nicole / Hakiman, Hekmat / Araghizadeh, Farshid Y

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2014  Volume 18, Issue 2, Page(s) 258–264

    Abstract: Background and objectives: Single-site laparoscopic colorectal surgery has been firmly established; however, few reports addressing this technique in the inflammatory bowel disease population exist.: Methods: We conducted a case-matched retrospective ...

    Abstract Background and objectives: Single-site laparoscopic colorectal surgery has been firmly established; however, few reports addressing this technique in the inflammatory bowel disease population exist.
    Methods: We conducted a case-matched retrospective review of 20 patients who underwent single-site laparoscopic procedures for inflammatory bowel disease compared with 20 matched patients undergoing multiport laparoscopic procedures. Data regarding these patients were tabulated in the following categories: demographic characteristics, operative parameters, and perioperative outcomes.
    Results: A wide range of cases were completed: 9 ileocolic resections, 7 cases of proctocolectomy with end ileostomy or ileal pouch anal anastomosis, 2 cases of proctectomy with ileal pouch anal anastomosis, and 2 total abdominal colectomies with end ileostomy were all matched to equivalent multiport laparoscopic cases. No single-incision cases were converted to multiport laparoscopy, and 2 single-incision cases (10%) were converted to an open approach. For single-incision cases, the mean length of stay was 7.7 days, the mean time to oral intake was 3.3 days, and the mean period of intravenous analgesic use was 5.0 days. There were no statistically significant differences between single-site and multiport cases.
    Conclusions: Single-site laparoscopic surgery is technically feasible in inflammatory bowel disease. The length of stay and period of intravenous analgesic use (in days) appear to be higher than those in comparable series examining outcomes of single-site laparoscopic colorectal surgery, and the outcomes are comparable with those of multiport laparoscopy. This may be because of the nature of inflammatory bowel disease, limiting the benefits of a single-site approach in this population.
    MeSH term(s) Adolescent ; Adult ; Aged ; Anal Canal/surgery ; Anastomosis, Surgical/methods ; Colectomy/methods ; Colonic Pouches ; Female ; Humans ; Inflammatory Bowel Diseases/surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2014-06-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
    DOI 10.4293/108680813X13753907292872
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    Zs.MO 310: Show issues

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  9. Article ; Online: Osteodiskitis of Lumbar Spine Due to Migrated Fractured Inferior Vena Cava Filter.

    Aoun, Salah G / Bedros, Nicole / El Ahmadieh, Tarek Y / Kreck, Jake / Mehta, Nikhil / Al Tamimi, Mazin

    World neurosurgery

    2018  Volume 113, Page(s) 298–303

    Abstract: Background: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement.: Case description: A 36-year-old man presented ... ...

    Abstract Background: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement.
    Case description: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His radiograph, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disk space, and surrounding bony lysis and severe osteodiskitis. He was treated medically with intravenous and then oral antibiotics and improved clinically and radiographically.
    Conclusions: Conservative use of filter devices and early retrieval once their indication expires are paramount to avoid unnecessary complications.
    MeSH term(s) Administration, Intravenous ; Adult ; Anti-Bacterial Agents/administration & dosage ; Discitis/diagnostic imaging ; Discitis/drug therapy ; Discitis/etiology ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Male ; Prosthesis Failure/adverse effects ; Vena Cava Filters/adverse effects
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2018-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2018.02.154
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  10. Article ; Online: Quantitative pupillometry in patients with traumatic brain injury and loss of consciousness: A prospective pilot study.

    Traylor, Jeffrey I / El Ahmadieh, Tarek Y / Bedros, Nicole M / Al Adli, Nadeem / Stutzman, Sonja E / Venkatachalam, Aardhra M / Pernik, Mark N / Collum, C Munro / Douglas, Peter M / Aiyagari, Venkatesh / Bagley, Carlos A / Olson, DaiWai M / Aoun, Salah G

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

    2021  Volume 91, Page(s) 88–92

    Abstract: Objective: Loss of consciousness (LOC) is a hallmark feature in Traumatic Brain Injury (TBI), and a strong predictor of outcomes after TBI. The aim of this study was to describe associations between quantitative infrared pupillometry values and LOC, ... ...

    Abstract Objective: Loss of consciousness (LOC) is a hallmark feature in Traumatic Brain Injury (TBI), and a strong predictor of outcomes after TBI. The aim of this study was to describe associations between quantitative infrared pupillometry values and LOC, intracranial hypertension, and functional outcomes in patients with TBI.
    Methods: We conducted a prospective study of patients evaluated at a Level 1 trauma center between November 2019 and February 2020. Pupillometry values including the Neurological Pupil Index (NPi), constriction velocity (CV), and dilation velocity (DV) were obtained.
    Results: Thirty-six consecutive TBI patients were enrolled. The median (range) age was 48 (range 21-86) years. The mean Glasgow Coma Scale score on arrival was 11.8 (SD = 4.0). DV trichotomized as low (<0.5 mm/s), moderate (0.5-1.0 mm/s), or high (>1.0 mm/s) was significantly associated with LOC (P = .02), and the need for emergent intervention (P < .01). No significant association was observed between LOC and NPi (P = .16); nor between LOC and CV (P = .07).
    Conclusions: Our data suggests that DV, as a discrete variable, is associated with LOC in TBI. Further investigation of the relationship between discrete pupillometric variables and NPi may be valuable to understand the clinical significance of the pupillary light reflex findings in acute TBI.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/diagnostic imaging ; Glasgow Coma Scale ; Humans ; Middle Aged ; Pilot Projects ; Prospective Studies ; Unconsciousness ; Young Adult
    Language English
    Publishing date 2021-07-02
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 1193674-5
    ISSN 1532-2653 ; 0967-5868
    ISSN (online) 1532-2653
    ISSN 0967-5868
    DOI 10.1016/j.jocn.2021.06.044
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