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  1. Book ; Online ; E-Book: The acute management of surgical disease

    Zielinski, Martin D. / Guillamondegui, Oscar

    2022  

    Author's details Martin D. Zielinski, Oscar Guillamondegui editors
    Keywords Electronic books
    Language English
    Size 1 Online-Ressource (xviii, 558 Seiten), Illustrationen, Diagramme
    Publisher Springer
    Publishing place Cham
    Publishing country Switzerland
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT021492963
    ISBN 978-3-031-07881-1 ; 9783031078804 ; 3-031-07881-0 ; 3031078802
    DOI 10.1007/978-3-031-07881-1
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Book: Contemporary management of civilian trauma

    Guillamondegui, Oscar D.

    (Surgical clinics of North America ; volume 97, number 5 (October 2017))

    2017  

    Author's details editors Oscar D. Guillamondegui, Bradley M. Dennis
    Series title Surgical clinics of North America ; volume 97, number 5 (October 2017)
    Collection
    Language English
    Size xvi Seiten, Seite 947-1197, Illustrationen
    Publisher Elsevier
    Publishing place Philadelphia, Pennsylvania
    Publishing country United States
    Document type Book
    HBZ-ID HT019501763
    ISBN 978-0-323-54690-4 ; 0-323-54690-0
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    Uk I Zs 75 -97,5- verfügbar in Königswinter Königswinter

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  3. Article ; Online: Invited Commentary.

    Guillamondegui, Oscar

    Journal of the American College of Surgeons

    2021  Volume 232, Issue 4, Page(s) 579

    Language English
    Publishing date 2021-03-26
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2020.12.059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Traumatic Brain Injury Recovery Trajectories in Patients With Disorders of Consciousness.

    Smith, Michael C / Patel, Mayur B / Guillamondegui, Oscar D

    JAMA neurology

    2022  Volume 78, Issue 11, Page(s) 1411

    MeSH term(s) Brain Injuries, Traumatic/complications ; Consciousness ; Consciousness Disorders ; Humans
    Language English
    Publishing date 2022-01-04
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2021.3433
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Incidence of Endoscopic Retrograde Cholangiography after Subtotal Fenestrating and Reconstituting Cholecystectomy.

    Nordness, Mina F / Smith, Michael C / Fogel, Jessa / Guillamondegui, Oscar D / Dennis, Bradley M / Gunter, Oliver L

    Journal of the American College of Surgeons

    2024  

    Abstract: Background: Laparoscopic subtotal cholecystectomy (SC) is used for the difficult cholecystectomy, but published experience with resource utilization for SC is limited. We hypothesized that the need for advanced resources are common after SC.: Study ... ...

    Abstract Background: Laparoscopic subtotal cholecystectomy (SC) is used for the difficult cholecystectomy, but published experience with resource utilization for SC is limited. We hypothesized that the need for advanced resources are common after SC.
    Study design: Retrospective review of laparoscopic cholecystectomies between 2017 and 2021 at a large center. SC cases were identified using a medical record tool. Baseline characteristics were assessed with student's t-test and chi-squared. Primary outcome was ERC within 60-days. Secondary outcomes were reconstituted SC on post-op ERC and length of stay (LOS). Uni- and multivariable logistic regression were used for binary outcomes. Multiple linear regression was used for LOS. Covariates included age, sex, BMI, ASA class.
    Results: A total of 1222 laparoscopic cholecystectomies were performed between 2017 and 2021. Of these, 87 (7%) were SC. Male (p<0.001) and older (p<0.001) patients were more likely to undergo SC. Odds of post-op ERC were higher in the SC group (OR 9.79 95% CI 5.90, 16.23 p<0.001). There was no difference in pre-op ERC (17% vs 21% p=0.38). Reconstituting SC had lower odds of post-op ERC (OR 0.12, 0.023-0.58, p=0.009). LOS was 1.81 times higher in the SC group(p=<0.001). Post-op ERC was not associated with LOS (p=.24).
    Conclusions: We present one of the largest single-center series of SC. SC patients are more likely to be male, older, have higher ASA class, and have increased LOS. SC should be performed when access to ERC and interventional radiology is available. Absent these adjuncts, reconstituting SC decreases the need for early ERC, but long-term outcomes are unknown.
    Language English
    Publishing date 2024-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1097/XCS.0000000000001072
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Decision Support Tool to Judiciously Assign High-Frequency Neurologic Examinations in Traumatic Brain Injury.

    Bryant, Peter / Yengo-Kahn, Aaron / Smith, Candice / Smith, Melissa / Guillamondegui, Oscar

    The Journal of surgical research

    2022  Volume 280, Page(s) 557–566

    Abstract: Introduction: Traumatic brain injury (TBI) management includes serial neurologic examinations to assess for changes dictating neurosurgical interventions. We hypothesized hourly examinations are overassigned. We conducted a decision tree analysis to ... ...

    Abstract Introduction: Traumatic brain injury (TBI) management includes serial neurologic examinations to assess for changes dictating neurosurgical interventions. We hypothesized hourly examinations are overassigned. We conducted a decision tree analysis to determine an algorithm to judiciously assign hourly examinations.
    Methods: A retrospective cohort study of 1022 patients with TBI admitted to a Level 1 trauma center from January 1, 2019, to December 31, 2019, was conducted. Patients with penetrating TBI or immediate or planned interventions and those with nonsurvivable injuries were excluded. Patients were stratified by whether they underwent an unplanned intervention (e.g., craniotomy or invasive intracranial monitoring). Univariate analysis identified factors for inclusion in chi-square automatic interaction detection technique, classifying those at risk for unplanned procedures.
    Results: A total of 830 patients were included, 287 (35%) were assigned hourly (Q1) examinations, and 17 (2%) had unplanned procedures, with 16 of 17 (94%) on Q1 examinations. Patients requiring unplanned procedures were more likely to have mixed intracranial hemorrhage pattern (82% versus 39%; P = 0.001), midline shift (35% versus 14%; P = 0.023), an initial poor neurologic examination (Glasgow Comas Scale ≤8, 77% versus 14%; P < 0.001), and be intubated (88% versus 17%; P < 0.001). Using chi-square automatic interaction detection, the decision tree demonstrated low-risk (2% misclassification) and excellent discrimination (area under the curve = 0.915, 95% confidence interval 0.844-0.986; P < 0.001) of patients at risk of an unplanned procedure. By following the algorithm, 167 fewer patients could have been assigned Q1 examinations, resulting in an estimated 6012 fewer examinations.
    Conclusions: Using a 4-factor algorithm can optimize the assignment of neuro examinations and substantially reduce neuro examination burden without sacrificing patient safety.
    MeSH term(s) Humans ; Retrospective Studies ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/diagnosis ; Glasgow Coma Scale ; Trauma Centers ; Neurologic Examination
    Language English
    Publishing date 2022-09-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2022.07.045
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  7. Article ; Online: Preface.

    Guillamondegui, Oscar D / Dennis, Bradley M

    The Surgical clinics of North America

    2017  Volume 97, Issue 5, Page(s) xv–xvi

    MeSH term(s) Humans ; Wounds and Injuries/surgery
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Introductory Journal Article
    ZDB-ID 215713-5
    ISSN 1558-3171 ; 0039-6109
    ISSN (online) 1558-3171
    ISSN 0039-6109
    DOI 10.1016/j.suc.2017.08.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Analysis of Need for Intervention in Low-Grade Traumatic Splenic Injury.

    Bontrager, Alexandria M / Ewing, John K / Singh, Tanya / Medvecz, Andrew J / Devasahayam, Rebekah J / Smith, Michael C / Guillamondegui, Oscar D

    The American surgeon

    2023  Volume 89, Issue 8, Page(s) 3411–3415

    Abstract: Background: Blunt splenic injuries are common traumatic injuries. Severe injuries may require blood transfusion, procedural, or operative intervention. Conversely, patients with low-grade injuries and normal vital signs frequently do not require ... ...

    Abstract Background: Blunt splenic injuries are common traumatic injuries. Severe injuries may require blood transfusion, procedural, or operative intervention. Conversely, patients with low-grade injuries and normal vital signs frequently do not require intervention. The level and duration of monitoring required to safely manage these patients are unclear. We hypothesize that low-grade splenic trauma has a low rate of intervention and may not require acute hospitalization.
    Methods: This retrospective descriptive analysis included patients admitted to a level I trauma center with low injury burden (injury severity score <15) and The American Association for the Surgery of Trauma (AAST) grade 1 (G1) and 2 (G2) splenic injuries between January 2017 and December 2019 using the Trauma Registry of the American College of Surgeons (TRACS). The primary outcome was the need for any intervention. Secondary outcomes included time to intervention and length of stay.
    Results: 107 patients met inclusion criteria. 87.9% required no intervention . 9.4% required blood products, with a median time to transfusion of 7.4 hours from arrival. All patients receiving blood products had extenuating circumstances such as bleeding from other injuries, anticoagulant use, or medical comorbidities. 2 patients required splenic artery embolization, one presenting with return precautions 9 days post-injury and 1 with significant comorbidities. One patient with concomitant bowel injury required splenectomy.
    Conclusions: Low-grade blunt splenic trauma has a low rate of intervention, which typically occurs within the first 12 hours of presentation. This suggests that outpatient management with return precautions may be appropriate for select patients after a short interval of observation.
    MeSH term(s) Humans ; Retrospective Studies ; Treatment Outcome ; Spleen/injuries ; Splenectomy ; Abdominal Injuries/surgery ; Wounds, Nonpenetrating/surgery ; Injury Severity Score ; Embolization, Therapeutic
    Language English
    Publishing date 2023-03-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348231161707
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Continuous Intrathecal Morphine Infusion for Pain Management in a Polytrauma Patient: A Case Report.

    Boncyk, Christina S / Brennan, Kaitlyn A / Guillamondegui, Oscar / Benson, Clayne

    A&A practice

    2020  Volume 14, Issue 13, Page(s) e01338

    Abstract: Polytrauma patients are at high risk for neurologic complications as a result of the primary mechanism of their trauma and/or delirium caused by subsequent pain, sedatives and analgesic exposure, sleep disturbances, infections, metabolic derangements, ... ...

    Abstract Polytrauma patients are at high risk for neurologic complications as a result of the primary mechanism of their trauma and/or delirium caused by subsequent pain, sedatives and analgesic exposure, sleep disturbances, infections, metabolic derangements, organ dysfunctions, withdrawal syndromes, or other factors. The high prevalence of delirium within trauma intensive care units increases risks for both patients and providers and is associated with worsened patient outcomes. This case report explains the rationale and utilization of continuous intrathecal morphine administration to improve pain control while reducing and eliminating intravenous (IV) analgesics and sedatives to enable wakefulness in a polytrauma patient with refractory agitated delirium.
    MeSH term(s) Humans ; Injections, Spinal ; Morphine/therapeutic use ; Multiple Trauma/complications ; Pain/drug therapy ; Pain Management
    Chemical Substances Morphine (76I7G6D29C)
    Language English
    Publishing date 2020-11-13
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001338
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Artificial intelligence in trauma systems.

    Stonko, David P / Guillamondegui, Oscar D / Fischer, Peter E / Dennis, Bradley M

    Surgery

    2020  Volume 169, Issue 6, Page(s) 1295–1299

    Abstract: Local trauma care and regional trauma systems are data-rich environments that are amenable to machine learning, artificial intelligence, and big-data analysis mechanisms to improve timely access to care, to measure outcomes, and to improve quality of ... ...

    Abstract Local trauma care and regional trauma systems are data-rich environments that are amenable to machine learning, artificial intelligence, and big-data analysis mechanisms to improve timely access to care, to measure outcomes, and to improve quality of care. Pilot work has been done to demonstrate that these methods are useful to predict patient flow at individual centers, so that staffing models can be adapted to match workflow. Artificial intelligence has also been proven useful in the development of regional trauma systems as a tool to determine the optimal location of a new trauma center based on trauma-patient geospatial injury data and to minimize response times across the trauma network. Although the utility of artificial intelligence is apparent and proven in small pilot studies, its operationalization across the broader trauma system and trauma surgery space has been slow because of cost, stakeholder buy-in, and lack of expertise or knowledge of its utility. Nevertheless, as new trauma centers or systems are developed, or existing centers are retooled, machine learning and sophisticated analytics are likely to be important components to help facilitate decision-making in a wide range of areas, from determining bedside nursing and provider ratios to determining where to locate new trauma centers or emergency medical services teams.
    Language English
    Publishing date 2020-09-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2020.07.038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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