Rotator cuff repair: what questions are patients asking online and where are they getting their answers?

Alexander J. Hodakowski,Johnathon R. McCormick,Dhanur Damodar,Matthew R. Cohn,Kyle D. Carey,Nikhil N. Verma,Gregory Nicholson,Grant E Garrigues 대한견주관절학회 2023 대한견주관절의학회지 Vol.26 No.1

Background: This study analyzed questions entered online by rotator cuff patients and determined types and quality of websites providing information at the top of queries. Methods: Three strings related to rotator cuff repair were explored in Google Search. The result pages were manually collected under the “People also ask” function for frequent questions and associated webpages. Questions were categorized using Rothwell’s classification with further topical subcategorization. Webpages were evaluated by Journal of American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty “People also ask” questions were collected with their associated webpages. Based on the Rothwell classification of questions, queries were thematically organized into fact (41.7%), value (31.7%), and policy (26.7%) categories. The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). The average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most common suggested question for rotator cuff repair/surgery was, “Is rotator cuff surgery worth having?,” while the most common suggested question for rotator cuff repair pain was, “What happens if a rotator cuff is not repaired?” Conclusions: The most common questions asked on Google pertaining to rotator cuff repair evaluate management options and relate to the timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding the questions that rotator cuff repair patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes. Level of evidence: IV.

Adult stem cells and tissue engineering strategies for salivary gland regeneration: a review

Chankee Yoo,Jeremy B Vines,Grant Alexander,Kyle Murdock,Patrick Hwang,Ho-Wook Jun 한국생체재료학회 2014 생체재료학회지 Vol.18 No.3

Saliva is an important compound produced by the salivary glands and performs numerous functions. Hyposalivation (dry mouth syndrome) is a deleterious condition often resulting from radiotherapy for patients with head and neck cancer, Sjogren’s Syndrome, or as a side effect of certain medications. Hyposalivation negatively affects speaking, mastication, and swallowing in afflicted patients, greatly reducing their quality of life. Current treatments for this pathology include modifying lifestyle, synthetic saliva supplementation, and the utilization of salivary gland stimulants and sialagogues. However, many of these treatments do not address the underlying issues and others are pervaded by numerous side effects. In order to address the shortcomings related to current treatment modalities, many groups have diverted their attention to utilizing tissue engineering and regenerative medicine approaches. Tissue engineering is defined as the application of life sciences and materials engineering toward the development of tissue substitutes that are capable of mimicking the structure and function of their natural analogues within the body. The general underlying strategy behind the development of tissue engineered organ substitutes is the utilization of a combination of cells, biomaterials, and biochemical cues intended to recreate the natural organ environment. The purpose of this review is to highlight current bioengineering approaches for salivary gland tissue engineering and the adult stem cell sources used for this purpose. Additionally, future considerations in regard to salivary gland tissue engineering strategies are discussed.

Stabilization of Ruthenium(II) Polypyridyl Chromophores on Nanoparticle Metal-Oxide Electrodes in Water by Hydrophobic PMMA Overlayers

Wee, Kyung-Ryang,Brennaman, M. Kyle,Alibabaei, Leila,Farnum, Byron H.,Sherman, Benjamin,Lapides, Alexander M.,Meyer, Thomas J. American Chemical Society 2014 JOURNAL OF THE AMERICAN CHEMICAL SOCIETY - Vol.136 No.39

<P>We describe a poly(methyl methacrylate) (PMMA) dip-coating procedure, which results in surface stabilization of phosphonate and carboxylate derivatives of Ru(II)-polypyridyl complexes surface-bound to mesoporous nanoparticle TiO<SUB>2</SUB> and nanoITO films in aqueous solutions. As shown by contact angle and transmission electron microscopy (TEM) measurements, PMMA oligomers conformally coat the metal-oxide nanoparticles changing the mesoporous films from hydrophilic to hydrophobic. The thickness of the PMMA overlayer on TiO<SUB>2</SUB>–Ru(II) can be controlled by changing the wt % of PMMA in the dipcoating solution. There are insignificant perturbations in electrochemical or spectral properties at thicknesses of up to 2.1 nm with the Ru(III/II) couple remaining electrochemically reversible and <I>E</I><SUB>1/2</SUB> values and current densities nearly unaffected. Surface binding by PMMA overlayers results in stable surface binding even at pH 12 with up to a ∼100-fold enhancement in photostability. As shown by transient absorption measurements, the MLCT excited state(s) of phosphonate derivatized [Ru(bpy)<SUB>2</SUB>((4,4′-(OH)<SUB>2</SUB>PO)<SUB>2</SUB>bpy)]<SUP>2+</SUP> undergo efficient injection and back electron transfer with pH independent kinetics characteristic of the local pH in the initial loading solution.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/jacsat/2014/jacsat.2014.136.issue-39/ja506987a/production/images/medium/ja-2014-06987a_0006.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/ja506987a'>ACS Electronic Supporting Info</A></P>

Percutaneous Dilatational Tracheostomy in a Cardiac Surgical Intensive Care Unit: A Single-Center Experience

Vignesh Vudatha,Yahya Alwatari,George Ibrahim,Tayler Jacobs,Kyle Alexander,Carlos Puig-Gilbert,Walker Julliard,Rachit Dilip Shah 대한심장혈관흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.5

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08–0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.