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748 results on '"de Moya, Marc A"'

203. Bone Anchor Fixation in the Repair of Blunt Traumatic Abdominal Wall Hernias: A Western Trauma Association Multicenter Study

Author

Harrell, Kevin N, Grimes, Arthur D, Gill, Harkanwar, Reynolds, Jessica K, Ueland, Walker R, Sciarretta, Jason D, Todd, Samual R, Trust, Marc D, Ngoue, Marielle, Thomas, Bradley W, Ayuso, Sullivan A, LaRiccia, Aimee, Spalding, Chance M, Collins, Michael J, Collier, Bryan R, Karam, Basil S, de Moya, Marc A, Lieser, Mark J, Chipko, John M, Haan, James M, Lightwine, Kelly L, Cullinane, Daniel C, Falank, Carolyne R, Phillips, Ryan C, Kemp, Michael T, Alam, Hasan B, Udekwu, Pascal O, Sanin, Gloria D, Hildreth, Amy N, Biffl, Walter L, Schaffer, Kathryn B, Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L, and Maxwell, Robert A

Abstract

Background Blunt traumatic abdominal wall hernias (TAWHs) are rare but require a variety of operative techniques to repair including bone anchor fixation (BAF) when tissue tears off bony structures. This study aimed to provide a descriptive analysis of BAF technique for blunt TAWH repair. Bone anchor fixation and no BAF repairs were compared, hypothesizing increased hernia recurrence with BAF repair.Methods A secondary analysis of the WTA blunt TAWH multicenter study was performed including all patients who underwent repair of their TAWH. Patients with BAF were compared to those with no BAF with bivariate analyses.Results 176 patients underwent repair of their TAWH with 41 (23.3%) undergoing BAF. 26 (63.4%) patients had tissue fixed to bone, with 7 of those reinforced with mesh. The remaining 15 (36.6%) patients had bridging mesh anchored to bone. The BAF group had a similar age, sex, body mass index, and injury severity score compared to the no BAF group. The time to repair (1 vs 1 days, P= .158), rate of hernia recurrence (9.8% vs 12.7%, P= .786), and surgical site infection (SSI) (12.5% vs 15.6%, P= .823) were all similar between cohorts.Conclusions This largest series to date found nearly one-quarter of TAWH repairs required BAF. Bone anchor fixation repairs had a similar rate of hernia recurrence and SSI compared to no BAF repairs, suggesting this is a reasonable option for repair of TAWH. However, future prospective studies are needed to compare specific BAF techniques and evaluate long-term outcomes including patient-centered outcomes such as pain and quality of life.

Published
2024
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206. 306

Author

Tainter, Christopher, primary, Seethala, Raghu, additional, Bittner, Edward, additional, Quraishi, Sadeq, additional, Kaafarani, Haytham, additional, Yeh, Daniel, additional, de Moya, Marc, additional, and Lee, Jarone, additional

Published
2015
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208. Antibiotic Regimen after a Total Abdominal Colectomy with Ileostomy for FulminantClostridium difficileColitis: A Multi-Institutional Study

Author

van der Wilden, Gwendolyn M., primary, Subramanian, Melanie P., additional, Chang, Yuchiao, additional, Lottenberg, Lawrence, additional, Sawyer, Robert, additional, Davies, Stephen W., additional, Ferrada, Paula, additional, Han, Jinfeng, additional, Beekley, Alec, additional, Velmahos, George C., additional, and de Moya, Marc A., additional

Published
2015
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211. Prospective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma

Author

Inaba, Kenji, primary, Nosanov, Lauren, additional, Menaker, Jay, additional, Bosarge, Patrick, additional, Williams, Lashonda, additional, Turay, David, additional, Cachecho, Riad, additional, de Moya, Marc, additional, Bukur, Marko, additional, Carl, Jordan, additional, Kobayashi, Leslie, additional, Kaminski, Stephen, additional, Beekley, Alec, additional, Gomez, Mario, additional, and Skiada, Dimitra, additional

Published
2015
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215. The Role of Computed Tomography in the Diagnosis of Necrotizing Soft Tissue Infections.

Author

Martinez, Myriam, Peponis, Thomas, Hage, Aglaia, Yeh, Daniel D., Kaafarani, Haytham M. A., Fagenholz, Peter J., King, David R., de Moya, Marc A., and Velmahos, George C.

Subjects
SOFT tissue infections, COMPUTED tomography, FASCIAE (Anatomy), NECROSIS, INFLAMMATION, DIAGNOSIS
Abstract

Background: The exact role of IV contrast-enhanced computed tomography (CT) in the diagnosis of necrotizing soft tissue infections (NSTIs) has not yet been established. We aimed to explore the role of CT in patients with clinical suspicion of NSTI and assess its sensitivity and specificity for NSTI. Methods: The medical records of patients admitted between 2009 and 2016, who received IV contrast-enhanced CT to rule out NSTI, were reviewed. CT was considered positive in case of: (a) gas in soft tissues, (b) multiple fluid collections, (c) absence or heterogeneity of tissue enhancement by the IV contrast, and (d) significant inflammatory changes under the fascia. NSTI was confirmed only by the presence of necrotic tissue during surgical exploration. NSTI was considered absent if surgical exploration failed to identify necrosis, or if the patient was successfully treated non-operatively. Results: Of the 184 patients, 17 had a positive CT and hence underwent surgical exploration with NSTI being confirmed in 13 of them (76%). Of the 167 patients that had a negative CT, 38 (23%) underwent surgical exploration due to the high clinical suspicion for NSTI and were all found to have non-necrotizing infections; the remaining 129 (77%) were managed non-operatively with successful resolution of symptoms. The sensitivity of CT in identifying NSTI was 100%, the specificity 98%, the positive predictive value 76%, and the negative predictive value 100%. Conclusions: A negative IV contrast-enhanced CT scan can reliably rule out the need for surgical intervention in patients with initial suspicion of NSTI. [ABSTRACT FROM AUTHOR]

Published
2018
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216. Prospective evaluation of a continuous infusion vancomycin dosing nomogram in critically ill patients undergoing continuous venovenous haemofiltration.

Author

Sin, Jonathan H., Newman, Kelly, Elshaboury, Ramy H., Dante Yeh, D., de Moya, Marc A., Lin, Hsin, and Yeh, D Dante

Subjects
VANCOMYCIN, INFUSION therapy, CRITICALLY ill patient care, BLOOD filtration, NOMOGRAPHY (Mathematics), ANTIBIOTICS, CATASTROPHIC illness, KIDNEY failure, BIOTRANSFORMATION (Metabolism), LONGITUDINAL method, GRAM-positive bacterial infections, SPECIALTY hospitals, STATISTICAL models, PREVENTION, THERAPEUTICS
Abstract

Objectives: The most optimal method of attaining therapeutic vancomycin concentrations during continuous venovenous haemofiltration (CVVH) remains unclear. Studies have shown continuous infusion vancomycin (CIV) achieves target concentrations more rapidly and consistently when compared with intermittent infusion. Positive correlations between CVVH intensity and vancomycin clearance (CLvanc) have been noted. This study is the first to evaluate a CIV regimen in patients undergoing CVVH that incorporates weight-based CVVH intensity (mL/kg/h) into the dosing nomogram.Methods: This was a prospective, observational study of patients undergoing CVVH and receiving CIV based on the nomogram. The primary outcome was achievement of a therapeutic vancomycin concentration (15-25 mg/L) at 24 h. Secondary outcomes included the achievement of therapeutic concentrations at 48 and 72 h.Results: The nomogram was analysed in 52 critically ill adults. Vancomycin concentrations were therapeutic in 43/52 patients (82.7%) at 24 h. Of the nine patients who were not therapeutic at 24 h, seven were supratherapeutic and two were subtherapeutic. The mean (SD) concentration was 20.1 (4.2)  mg/L at 24 h, 20.7 (3.7) mg/L at 48 h and 21.9 (3.5)  mg/L at 72 h. Patients with CVVH intensity >20 mL/kg/h experienced higher CLvanc at 24 h compared with patients with CVVH intensity <20 mL/kg/h (3.1 versus 2.6 L/h; P = 0.013).Conclusions: By incorporating CVVH intensity into the CIV dosing nomogram, the majority of patients achieved therapeutic concentrations at 24 h and maintained them within range at 48 and 72 h. Additional studies are required to validate this nomogram before widespread implementation may be considered. [ABSTRACT FROM AUTHOR]

Published
2018
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217. Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

Author

Peponis, Thomas, Bohnen, Jordan D., Sangji, Naveen F., Nandan, Anirudh R., Han, Kelsey, Lee, Jarone, Yeh, D. Dante, de Moya, Marc A., Velmahos, George C., Chang, David C., and Kaafarani, Haytham M.A.

Abstract

Background The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Methods Using the 2011–2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of “emergent,” and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. Results A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. Conclusion The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision-making tool for patient and family counseling, as well as for adequate risk-adjustment in emergent laparotomy quality benchmarking efforts. [ABSTRACT FROM AUTHOR]

Published
2017
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218. Acute care surgery: An evolving paradigm.

Author

Jurkovich, Gregory J., Davis, Kimberly A., Burlew, Clay Cothren, Dente, Christopher J., Galante, Joseph M., IIGoodwin, Joel S., Joseph, Bellal, de Moya, Marc, Becher, Robert D., and Pandit, Viraj

Published
2017
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223. 1044

Author

Lin, Hsin, primary, PIRIYAPATSOM, ANNOP, additional, Schmidt, Ulrich, additional, Bittner, Edward, additional, Pirrone, Massimiliano, additional, De Pascale, Gennaro, additional, de Moya, Marc, additional, and Berra, Lorenzo, additional

Published
2014
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224. 503

Author

Lin, Hsin, primary, Bukovskaya, Yana, additional, de Moya, Marc, additional, and Schmidt, Ulrich, additional

Published
2014
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225. Board #254 - Program Innovation A Perioperative Teamwork Instructor Training Program for Supporting Perioperative Teamwork Training (Submission #10164)

Author

Walzer, Toni, primary, Simon, Robert, additional, Berry, William, additional, Cooper, Jeffrey, additional, de Moya, Marc, additional, Dwyer, Kathy, additional, Hemingway, Maureen, additional, Kissane, Nicole, additional, Nadelberg, Robert, additional, Palaganas, Janice, additional, Pawlowski, John, additional, Phitayakorn, Roy, additional, Raemer, Daniel, additional, and Rudolph, Jenny, additional

Published
2014
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228. Fulminant Clostridium difficile colitis

Author

van der Wilden, Gwendolyn M., primary, Chang, Yuchiao, additional, Cropano, Catrina, additional, Subramanian, Melanie, additional, Schipper, Inger B., additional, Yeh, D. Dante, additional, King, David R., additional, de Moya, Marc A., additional, Fagenholz, Peter J., additional, and Velmahos, George C., additional

Published
2014
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231. Real-time heart rate entropy predicts the need for lifesaving interventions in trauma activation patients

Author

Mejaddam, Ali Y., primary, Birkhan, Oscar A., additional, Sideris, Antonis C., additional, Van der Wilden, Gwendolyn M., additional, Imam, Ayesha M., additional, Hwabejire, John O., additional, Chang, Yuchiao, additional, Velmahos, George C., additional, Fagenholz, Peter J., additional, Yeh, Daniel D., additional, de Moya, Marc A., additional, and King, David Richard, additional

Published
2013
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234. Implementation of 24/7 intensivist presence in the SICU

Author

van der Wilden, Gwendolyn M., primary, Schmidt, Ulrich, additional, Chang, Yuchiao, additional, Bittner, Edward A., additional, Cobb, J. Perren, additional, Velmahos, George C., additional, Alam, Hasan B., additional, de Moya, Marc A., additional, and King, David R., additional

Published
2013
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236. Evaluation of the Infection-Related Ventilator-Associated Events Algorithm for Ventilator-Associated Pneumonia Surveillance in a Trauma Population.

Author

Annop Piriyapatsom, Hsin Lin, Pirrone, Massimiliano, De Pascale, Gennaro, Corona De Lapuerta, Javier, Bittner, Edward A., Schmidt, Ulrich H., De Moya, Marc, and Berra, Lorenzo

Subjects
PNEUMONIA diagnosis, ALGORITHMS, APACHE (Disease classification system), CHI-squared test, CRITICAL care medicine, CROSS infection, FISHER exact test, PROBABILITY theory, PUBLIC health surveillance, STATISTICAL hypothesis testing, WOUNDS & injuries, MECHANICAL ventilators, PREDICTIVE tests, CONTINUING education units, RETROSPECTIVE studies, DATA analysis software, POSITIVE end-expiratory pressure, MANN Whitney U Test
Abstract

BACKGROUND: The Centers for Disease Control and Prevention have recently introduced new ventilator-associated pneumonia (VAP) surveillance on the basis of the infection-related ventilator-associated complication (IVAC) definition. We aim to evaluate the accuracy of this new IVAC algorithm for detecting VAP according to the 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (NHSN) definition as the reference diagnosis (VAP-NHSN) in high-risk trauma patients. METHODS: This retrospective single-center study included all trauma subjects who were admitted to the ICU, required mechanical ventilation for >48 h, and received a blood transfusion. The new IVAC surveillance and the criteria for VAP-NHSN diagnosis were applied. The accuracy of the new IVAC surveillance for detecting VAP-NHSN was determined, and the clinical outcomes were compared between groups. RESULTS: The sensitivity, specificity, and positive and negative predictive values of IVAC for VAP-NSHN identification were 28.12%, 91.45, 58.06%, and 75.14%, respectively. Subjects with IVAC, VAP-NHSN, or both had higher morbidity when compared with those without IVAC and VAP-NHSN. Subjects with IVAC only had lower morbidity compared with those with VAP-NHSN only or those with both IVAC and VAP-NHSN. There was no significant difference in clinical outcomes between subjects with VAP-NHSN only and those with both IVAC and VAP-NHSN. CONCLUSIONS: IVAC criteria had a low accuracy for identifying VAP-NHSN in subjects with high-risk trauma. [ABSTRACT FROM AUTHOR]

Published
2016
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238. Using micropower impulse radar technology to screen for pneumothorax

Author

Van der Wilden, Gwen, primary, Albers, Christof, additional, Haefeli, Peter, additional, Zimmerman, Heinz, additional, Exadaktylos, Aris, additional, Levy, Phillip, additional, Birkham, Oscar, additional, Michailidou, Maria, additional, Sideris, Antonios, additional, Velmahos, George, additional, Alam, Hasan, additional, King, David, additional, Fagenholz, Peter, additional, Yeh, Dante, additional, and de Moya, Marc A., additional

Published
2012
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239. Case 28-2012

Author

de Moya, Marc A., primary, Wong, Johnson T., additional, Kroshinsky, Daniela, additional, Robbins, Gregory K., additional, Shenoy-Bhangle, Anuradha S., additional, and Gimbel, Devon C., additional

Published
2012
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247. Imaging and Resuscitation in Trauma

Author

Exadaktylos, Aristomenis K., primary, de Moya, Marc A., additional, Lecky, Fiona, additional, Driscoll, Peter, additional, Zimmermann, Heinz, additional, Wallis, Lee Alan, additional, and Novelline, Robert A., additional

Published
2011
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