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Article ; Online: Gender-Affirming Surgery Improves Mental Health Outcomes and Decreases Anti-Depressant Use in Patients with Gender Dysphoria.

Kilmer, Lee H / Chou, Jesse / Campbell, Christopher A / DeGeorge, Brent R / Stranix, John T

2024

Abstract: Background: Patients with gender dysphoria face significant health disparities and barriers to care. Transition-related care includes hormonal therapy, mental healthcare, and gender-affirming surgeries. Studies have described favorable surgical outcomes ...

Abstract	Background: Patients with gender dysphoria face significant health disparities and barriers to care. Transition-related care includes hormonal therapy, mental healthcare, and gender-affirming surgeries. Studies have described favorable surgical outcomes and patient satisfaction, however, the degree to which these procedures impact mental health conditions is not fully understood. The purpose of this study was to evaluate the effect of gender-affirming plastic surgery on mental health and substance abuse in the transgender population. Methods: A national insurance claims-based database was used for data collection. Patients with a diagnosis of gender dysphoria were propensity score-matched for the likelihood of undergoing gender-affirming surgery (no surgery being the control cohort), based on comorbidities, age, and sex. Primary outcomes included post-operative antidepressant use and the prevalence of mental health conditions. Results: A total of 3,134 patients with gender dysphoria were included in each cohort. Patients in the surgery group had overall lower rates of mental health conditions, substance abuse, and SSRI/SNRI use. There was an absolute decrease of 8.8% in SSRI or SNRI prescription after gender-affirming plastic surgery (p<0.001), and significant decreases in post-operative depression (7.7%), anxiety (1.6%), suicidal ideation (5.2%) and attempts (2.3%), alcohol abuse (2.1%), and drug abuse (1.9%). Conclusion: Gender-affirming surgery in appropriately selected gender dysphoric patients is associated with decreased postoperative rates of SSRI or SNRI use and improved mental health.
Language	English
Publishing date	2024-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000011325
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Article ; Online: Traditional Neuroma Management Strategies: A Systematic Review.

Chou, Jesse / Liston, Jared M / DeGeorge, Brent R

Annals of plastic surgery

2022 Volume 90, Issue 6S Suppl 4, Page(s) S350–S355

Abstract: Background: In this systematic review, the authors discuss traditional management strategies of neuromas. Surgical management can be described as either passive and ablative or active and reconstructive. Our aim was to evaluate the evidence supporting ... ...

Abstract	Background: In this systematic review, the authors discuss traditional management strategies of neuromas. Surgical management can be described as either passive and ablative or active and reconstructive. Our aim was to evaluate the evidence supporting traditional management strategies in patients affected by neuromas. Methods: The systematic literature search was conducted in PubMed/MEDLINE databases using search terms related to neuromas and their surgical management. Studies involving targeted muscle reinnervation or regenerative peripheral nerve interface were excluded. Two reviewers selected the studies, evaluated their methodological quality, and retrieved data independently. This review was conducted in a manner consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Selected studies were analyzed for pain and functional outcomes. Results: A total of 1064 articles were identified, and 22 studies were selected for review. Passive or ablative modalities for treatment of neuromata include excision of neuroma, excision with implantation into adjacent tissue, nerve caps, vein cap, and relocation nerve grafting. Active or reconstructive modalities that allow for nerve regeneration include hollow tube reconstruction, reconstruction with an allograft, and centrocentral nerve anastomosis. Conclusions: Passive treatment modalities can offer reliable pain relief in appropriately selected patients but do not allow for nerve regeneration. As such active, reconstructive modalities should be used when possible.
MeSH term(s)	Humans ; Neuroma/surgery ; Pain ; Amputation, Surgical ; Neurosurgical Procedures ; Pain Management
Language	English
Publishing date	2022-12-08
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003342
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Article ; Online: Is nerve coaptation associated with improved sensation after microvascular breast reconstruction? A systematic review.

Chou, Jesse / Hyland, Colby J / Kaufman Goldberg, Tal / Broyles, Justin M

Microsurgery

2022 Volume 43, Issue 5, Page(s) 522–528

Abstract: Background: Sensation after autologous breast reconstruction is an increasingly important outcome. Several studies demonstrated improved sensation with flap neurotization but utilized heterogenous measures and follow-up intervals. This review evaluates ... ...

Abstract	Background: Sensation after autologous breast reconstruction is an increasingly important outcome. Several studies demonstrated improved sensation with flap neurotization but utilized heterogenous measures and follow-up intervals. This review evaluates sensory outcomes after neurotization using uniform, objective outcome measurements. Methods: PubMed/Medline and Embase databases were queried for articles published between January 1990 and January 2022. Inclusion criteria included studies with free flap tissue transfer breast reconstruction patients and use of Semmes-Weinstein Monofilaments (SWM) to quantify return of sensation after either neurotization or no neurotization. Reviews, case reports, and studies utilizing implants or pedicled flaps were excluded. Results: Overall, 513 articles were screened. Eleven articles met inclusion criteria for a total of 474 patients. There were 254 non-neurotized patients included as controls (Group A) and 220 neurotized patients (Group B). Mean follow-up time was similar in both groups (22.06 months vs. 22.78 months, p > 0.05). There was no significant difference in age (Group A = 49.97 years vs. Group B = 42.47 years) or BMI (Group A = 25.48 vs. Group B = 25.97) between groups. More patients in group B received radiation therapy (Group B = 32.72% vs. Group A = 20.86%, p > 0.05). Patients that received neurotization had lower mean pressure thresholds (Group A = 38.85 gm/mm Conclusion: Neurotization has been shown to be a safe and feasible option for enhancing return of sensation after breast reconstruction. Future studies with standardized, long-term follow-up will further elucidate the pattern of breast sensation return and the impact of neurotization.
MeSH term(s)	Humans ; Middle Aged ; Mammaplasty/adverse effects ; Sensation/physiology ; Breast/surgery ; Nerve Transfer ; Free Tissue Flaps/surgery
Language	English
Publishing date	2022-10-22
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	605524-2
ISSN	1098-2752 ; 0738-1085
ISSN (online)	1098-2752
ISSN	0738-1085
DOI	10.1002/micr.30979
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Article ; Online: Effectiveness of Liposomal Bupivacaine Transversus Abdominis Plane Block in DIEP Flap Breast Reconstruction: Randomized Controlled Trial.

Park, Rachel H / Chou, Jesse / DeVito, Robert G / Elmer, Aric / Hollenbeck, Scott T / Campbell, Chris A / Stranix, John T

Plastic and reconstructive surgery

2024

Abstract: Background: Transversus Abdominis Plane (TAP) blocks improve pain control and reduce narcotic medication requirements in various surgical procedures. Liposomal bupivacaine may provide more sustained analgesia. This study compares pain related outcomes ... ...

Abstract	Background: Transversus Abdominis Plane (TAP) blocks improve pain control and reduce narcotic medication requirements in various surgical procedures. Liposomal bupivacaine may provide more sustained analgesia. This study compares pain related outcomes between standard bupivacaine and liposomal bupivacaine TAP blocks after autologous breast reconstruction. Methods: Prospective single-center, single-blinded, randomized controlled trial between March 2021 and December 2022. DIEP flap breast reconstruction patients in a standardized Enhanced Recovery After Surgery (ERAS) pathway were randomized to receive intraoperative TAPs with either bupivacaine / epinephrine (control) or liposomal bupivacaine / bupivacaine / epinephrine (experimental). Primary outcome was postoperative narcotic medication requirements, with secondary outcomes of pain scores, length of stay (LOS), and narcotic medication refills. Results: 117 patients met inclusion criteria (59 control, 58 experimental). Patient demographics, comorbidities, breast pathologic variables, surgery laterality and immediate versus delayed reconstruction status were equivalent between groups. Control group had significantly higher average pain scores postoperatively (4.3 vs. 3.6, p=0.004). However, there were no significant differences in mean narcotic use (66.9 MME vs 60.2 MME, p=0.47). Both LOS and postoperative narcotic prescription refills were equivalent between groups (2.1 vs 2.2 days, p = 0.55, 22% vs 17.2%, p=0.52). Conclusion: Addition of liposomal bupivacaine to standard bupivacaine TAP block mixture in a standardized ERAS protocol did not demonstrate a significant reduction in postoperative narcotic requirements after DIEP flap breast reconstruction compared to standard bupivacaine alone. Patient-reported pain scores, however, were lower among liposomal bupivacaine patients after the initial 24 hours postoperatively and consistent with a longer duration of analgesia.
Language	English
Publishing date	2024-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000011326
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Article ; Online: The Mechanism of Cannabichromene and Cannabidiol Alone Versus in Combination in the Alleviation of Arthritis-Related Inflammation.

Grogan, Graham / Stephens, Kristen / Chou, Jesse / Timko, Michael P / Cottler, Patrick / DeGeorge, Brent R

Annals of plastic surgery

2023 Volume 90, Issue 6S Suppl 4, Page(s) S408–S415

Abstract: Background: Patients suffering from arthritis have limited treatment options for nonoperative management. In search of pain relief, patients have been taking over-the-counter cannabinoids. Cannabidiol (CBD) and cannabichromene (CBC) are minor ... ...

Abstract	Background: Patients suffering from arthritis have limited treatment options for nonoperative management. In search of pain relief, patients have been taking over-the-counter cannabinoids. Cannabidiol (CBD) and cannabichromene (CBC) are minor cannabinoids with reported analgesic and anti-inflammatory properties and have been implicated as potential therapeutics for arthritis-related pain. To this end, we utilized a murine model to investigate the effectiveness of and mechanism by which CBC alone, CBD alone, or CBD and CBC in combination may provide a reduction in arthritis-associated inflammation. Methods: Forty-eight mice were included in the study, which were separated into 4 groups: control group (n = 12), treatment with CBD alone (n = 12), treatment with CBC alone (n = 12), and treatment with CBD + CBC (n = 12). We induced inflammation in each mouse utilizing the collagen-induced arthritis model. At scheduled timepoints, mice were clinically assessed for weight gain, swelling, and arthritis severity. In addition, inflammation-associated serum cytokine levels were analyzed for each animal. Results: Thirty-five of 48 mice survived the duration of the study resulting in the following group numbers: control group (n = 8), treatment with CBD alone (n = 9), treatment with CBC alone (n = 9), and treatment with CBD + CBC (n = 9). Animals treated with CBC and CBD + CBC showed significant weight gain between 3 and 5 weeks. Irrespective of treatment, regression analysis comparing all cytokine measurement and physical outcomes found a significant positive correlation between levels of 5 individual cytokines and both arthritis scores and swelling. Animals treated with CBD + CBC showed a significant decrease in swelling between 3 and 5 weeks compared with the control group. Cannabinoid treatment selectively affected the gene expression of eotaxin and lipopolysaccharide-induced CXC chemokine with combined treatment of CBC + CBD. Conclusion: Treatment with cannabinoids resulted in decreased clinical markers of inflammation. Further, the anti-inflammatory effect of CBC and CBD in conjunction was associated with a greater anti-inflammatory effect than either minor cannabinoid alone. Future work will elucidate the possibility of synergistic or entourage effects of minor cannabinoids used in combination for the treatment of arthritis-related pain and inflammation.
MeSH term(s)	Mice ; Animals ; Cannabidiol/therapeutic use ; Cannabidiol/metabolism ; Cannabidiol/pharmacology ; Cannabinoids/therapeutic use ; Cannabinoids/metabolism ; Cannabinoids/pharmacology ; Inflammation/drug therapy ; Inflammation/metabolism ; Arthritis/drug therapy ; Arthritis/etiology ; Pain ; Cytokines
Chemical Substances	cannabichromene (K4497H250W) ; Cannabidiol (19GBJ60SN5) ; Cannabinoids ; Cytokines
Language	English
Publishing date	2023-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003547
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Article ; Online: The Impact of Social Determinants of Health on the Treatment of Distal Radius Fracture.

Grogan, Graham / Stephens, Kristen L / Chou, Jesse / Abdalla, Jasmina / Wagner, Ryan / Peek, Kacy J / Freilich, Aaron M / DeGeorge, Brent R

Hand (New York, N.Y.)

2024 , Page(s) 15589447241233369

Abstract: Background: Disparities in social determinants of health (SDH) have been shown to play an increasingly important role in the equitable delivery of health care. Distal radius fractures (DRFs) are among the most common upper-extremity injuries encountered. ...

Abstract	Background: Disparities in social determinants of health (SDH) have been shown to play an increasingly important role in the equitable delivery of health care. Distal radius fractures (DRFs) are among the most common upper-extremity injuries encountered. This study aims to examine the influence of economic, educational, social, environmental, and healthcare disparities on management of these injuries. Methods: PearlDiver Mariner insurance claims database was analyzed for treatment patterns of DRF in patients aged 18 to 65 years based on the presence or absence of social determinants of health disparities (SDHDs). Outcome variables included the primary mode of management of DRF, including operative versus non-operative, as well as concomitant procedures. Multivariate logistic regression was used to compare fracture management modality in patients with and without SDHDs. Results: Of 161 704 patients identified with DRF, 38.3% had at least 1 reported SDHD. The majority of SDHDs were economic. Patients identified with 1 or more SDHDs had a higher medical comorbidity index. Patients with environmental SDHD were more likely to receive non-operative management. Within any SDHD and economic subgroups, odds of operative management were higher. No relationship was identified between SDHD and concomitant procedures. Conclusions: The presence of environmental disparities in SDH may predispose patients disproportionately to non-operative management. The presence of SDHDs may influence medical decision-making in favor of open reduction and internal fixation in patients with DRF treated operatively. In treating at-risk populations, providers should be aware of the potential for implicit bias associated with SDHDs and prioritize shared decision-making between patients and physicians.
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277325-3
ISSN	1558-9455 ; 1558-9447
ISSN (online)	1558-9455
ISSN	1558-9447
DOI	10.1177/15589447241233369
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Article: Neurodevelopmental outcomes of preterm infants: a recent literature review.

Hee Chung, Estefani / Chou, Jesse / Brown, Kelly A

Translational pediatrics

2020 Volume 9, Issue Suppl 1, Page(s) S3–S8

Abstract: Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, ... ...

Abstract	Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference. Methods: A literature search was conducted through PubMed for articles published between January 2018 and September 2019. Studies that concentrated on preterm infants with relatively uncomplicated NICU courses and without extensive medical interventions were selected. Results: Historically, preterm infants have been found to be at increased risk for the inattentive subtype of attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism spectrum disorder (ASD), avoidant personality, and anti-social personality, when compared to full term infants. However, some studies found that this difference between the two groups decrease as they enter adolescence and adulthood. Preterm infants are at increased risk for language, cognitive, sensory and motor deficits. Greater gestational age (GA) at birth and higher birth weight is associated with a lower risk of developmental delay. Cohort studies focusing on motor development showed that the degree of impairment decreased over time. Adverse childhood experiences (ACEs) have a negative correlation on multiple domains of development. The overall outcome of these infants may be influenced by socioeconomic status (SES), neonatal morbidities, demographics and parental education. Hearing and vision deficits are relatively infrequent among premature infants. A significant risk factor for hearing impairment involves the use of ototoxic agents such as gentamicin and infants with a patent ductus arteriosus (PDA). Conclusions: Preterm infants are at higher risk of adverse neurodevelopmental outcomes when compared to their full-term counter parts. However, in recent years it appears that rates of certain neurologic and developmental conditions are occurring in rates lower than historically noted. Premature individuals with possible developmental or mental health concerns should be identified early on so that interventions can be implemented immediately. Those meeting developmental milestone should continue to be monitored closely as deficits may develop later.
Language	English
Publishing date	2020-02-13
Publishing country	China
Document type	Journal Article
ZDB-ID	2901309-4
ISSN	2224-4344 ; 2224-4344 ; 2224-4336
ISSN (online)	2224-4344
ISSN	2224-4344 ; 2224-4336
DOI	10.21037/tp.2019.09.10
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Article: The Volume-Outcome Relationship and Traveling for Hepatobiliary and Pancreatic Surgery: A Quantitative Analysis of Patient Perspectives.

Chou, Jesse / Somnay, Vishal / Woodwyk, Alyssa / Munene, Gitonga

Cureus

2020 Volume 12, Issue 10, Page(s) e11023

Abstract: Despite the well-established relationship between volume and outcomes, patients continue to have procedures performed at low-volume hospitals. The factors patients use to make the complex decision of where to have hepatopancreaticobiliary (HPB) surgery ... ...

Abstract	Despite the well-established relationship between volume and outcomes, patients continue to have procedures performed at low-volume hospitals. The factors patients use to make the complex decision of where to have hepatopancreaticobiliary (HPB) surgery remain poorly characterized. A novel survey instrument was administered to all patients who had undergone HPB surgery at two university-affiliated community hospitals. 76 patients participated in the study (89% response rate). The majority of patients were unaware of the volume-outcome relationship (58.8%). No demographic factors differed between patients who were or were not aware except for patient research. Physician factors were the most important selection category (64.4%). Only 28.9% of patients were willing to travel more than two hours to have an operation performed at a hospital with a high volume/improved quality. Despite many voices calling for regionalization, patient decision-making factors should be considered before any realistic implementation.
Language	English
Publishing date	2020-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.11023
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Article: Cervical cancer recurrence presenting as abdominal wall mass and accompanying cellulitis.

Chou, Jesse / Strzyzewski, Lauren / Timmers, Caitlin / Hoekstra, Anna

Gynecologic oncology reports

2020 Volume 33, Page(s) 100619

Abstract: Background: Most recurrences of early stage cervical cancer occur in the pelvis or lymphatic system. Distant metastases occur in a minority of patients. Large abdominal wall recurrence presenting as cellulitis and intra-abdominal mass is unusual and ... ...

Abstract	Background: Most recurrences of early stage cervical cancer occur in the pelvis or lymphatic system. Distant metastases occur in a minority of patients. Large abdominal wall recurrence presenting as cellulitis and intra-abdominal mass is unusual and presents diagnostic as well as treatment challenges. Case: A 46-year-old woman with a history of stage 1B1 poorly differentiated squamous cell carcinoma of the cervix 2 years earlier presented with infraumbilical abdominal wall erythema, tenderness and warmth to the touch. She had a subcutaneous mass in that area with associated abdominopelvic pain. Imaging showed a 9.5 × 11 cm lobulated mass in the anterior lower abdominal wall, encompassing the width of the lower rectus muscles also invading the small bowel and the bladder. Superimposed cellulitis led to the symptoms with which she presented. She was treated with intravenous antibiotics, and biopsy of the mass revealed squamous cell carcinoma consistent with her prior cervical cancer. She was treated with neoadjuvant chemotherapy followed by surgical debulking with negative margins and adjuvant chemotherapy. Three months after completing treatment she recurred in the inguinal lymph nodes and restarted multimodality treatment. She was without evidence of disease for the entire 18 months of follow up following treatment to the lymph nodes. Conclusion: Cervical cancer recurrence patterns can be unique. Surveillance for recurrence may also include consideration of these unusual patterns of recurrence.
Language	English
Publishing date	2020-08-03
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2818505-5
ISSN	2352-5789
ISSN	2352-5789
DOI	10.1016/j.gore.2020.100619
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Article ; Online: Is the Isolation of

Chou, Jesse / Knight, Patrick H / Sawyer, Robert G

Surgical infections

2020 Volume 22, Issue 7, Page(s) 675–679

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	APACHE ; Adult ; Cross Infection/drug therapy ; Cross Infection/epidemiology ; Humans ; Intensive Care Units ; Intraabdominal Infections/drug therapy ; Intraabdominal Infections/epidemiology ; Oxazolidinones ; Pseudomonas Infections/drug therapy ; Pseudomonas Infections/epidemiology ; Pseudomonas aeruginosa ; Retrospective Studies
Chemical Substances	Oxazolidinones ; 3-chloro-4,4-dimethyl-2-oxazolidinone (58629-01-9)
Language	English
Publishing date	2020-12-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1440120-4
ISSN	1557-8674 ; 1096-2964
ISSN (online)	1557-8674
ISSN	1096-2964
DOI	10.1089/sur.2020.396
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