Ambulatory Curriculum Enhancing Education for Modern Resident Learners.

Introduction: Data on the implementation of successful pediatric ambulatory curricula in residency are limited. Although most pediatric residents pursue careers in primary care, the educational focus in residency training sways toward inpatient medicine. Barriers exist to standardized, consistent teaching in the outpatient clinic.

Preexisting anticoagulation is an independent predictor of mortality in geriatric trauma patients - a retrospective cohort study.

Introduction: Preexisting anticoagulation is common among geriatric trauma patients. Geriatric trauma patients have a higher risk of mortality compared to younger patients. We sought to evaluate the association of preexisting anticoagulation with mortality in a group of geriatric trauma patients.

The clinical impact of early detection of ESBL-producing Enterobacterales with PCR-based blood culture assays.

Background: Starting January 4, 2021, our health system core microbiology laboratory changed blood culture identification (BCID) platforms to ePlex BCID from BioFire BCID1 with the additional capability to detect the bla gene of ESBL-producing organisms. Clinical outcomes of ESBL bloodstream infections (BSI) after implementing ePlex BCID were unknown.

Methods: Patients with ESBL BSI were compared pre and postimplementation of ePlex BCID in this 11-hospital retrospective analysis (BioFire BCID1 in 2019 vs ePlex BCID in 2021).

Acute ischemic stroke outcomes in patients with COVID-19: a systematic review and meta-analysis.

Background: Although patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain.

Aims: To determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+).

Methods: We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Pediatric and emergency medicine resident comfort assessing and treating pediatric pain across pediatric age groups.

Assess pediatric and emergency medicine (EM) resident comfort treating and assessing pediatric pain. Pediatric and EM residents at a single institution (SIUH Northwell Health in New York) completed an anonymous survey 6 months into the academic year regarding comfort assessing and treating pediatric pain. A total of 40 (16/24 EM and 24/24 pediatric) residents completed this survey: 20% (8/24) pediatric first year residents, 40% (16/40) pediatric second year and above, 20% (8/40) EM first year and 20% (8/40) EM second year and above.

Characteristics of Suspected COVID-19 Discharged Emergency Department Patients Who Returned During the First Wave.

Introduction: Limited information exists on patients with suspected coronavirus disease 2019 (COVID-19) who return to the emergency department (ED) during the first wave. In this study we aimed to identify predictors of ED return within 72 hours for patients with suspected COVID-19.

Methods: Incorporating data from 14 EDs within an integrated healthcare network in the New York metropolitan region from March 2-April 27, 2020, we analyzed this data on predictors for a return ED visit-including demographics, comorbidities, vital signs, and laboratory results.

Emergency department visits and hospitalizations for pediatric vaso-occlusive pain events during the COVID-19 pandemic.

The coronavirus SARS-CoV-2 (COVID-19) pandemic altered all aspects of life, including healthcare. During the pandemic, social distancing led to decreased transmission of typical viral illnesses, leading to a decrease in these pediatric admissions. Studies have shown that pediatric emergency department (ED) visits and hospitalizations decreased during the pandemic, which may have led to some unmet healthcare needs and delays in treatment.

Urinary Tract Infections in Low Birth Weight Neonates.

Objective: Our objective was to evaluate the incidence of urinary tract infections (UTIs) in low birth weight (LBW) neonates and to evaluate the compliance of neonatal intensive care unit (NICU) providers in performing urine cultures as a part of late-onset sepsis (LOS) evaluations following an educational intervention.

Study Design: A retrospective chart review for all LBW infants undergoing LOS evaluations was performed. An educational intervention was conducted to encourage NICU providers to perform urine cultures in LOS evaluations.

Factors Predictive of Mortality among Geriatric Patients Sustaining Low-Energy Blunt Trauma.

Background: In geriatric trauma patients, higher mortality rate is observed compared to younger patients. A significant portion of trauma sustained by this age group comes from low-energy mechanisms (fall from standing or sitting). We sought to investigate the outcome of these patients and identify factors associated with mortality.

The Association Between Gastroesophageal Reflux Disease and Non-Small Cell Lung Cancer: A Retrospective Case-Control Study.

Background: Lung cancer is a leading cause of mortality in the USA. Non-small cell lung cancer (NSCLC) contributes to 85% of all lung cancers. It is the most prevalent subtype amongst non-smokers, and its incidence has risen in the last 20 years.

The Association of Gender and Mortality in Geriatric Trauma Patients.

Unlabelled: The association of gender with mortality in trauma remains a subject of debate. Geriatric trauma patients have a higher risk of mortality compared to younger patients. We sought to evaluate the association of gender with mortality in a group of geriatric trauma patients presenting to an academic level 1 trauma center (trauma center designated by New York State capable of handling the most severe injuries and most complex cases).

Hemodynamic instability in the immediate postoperative setting after transcarotid artery revascularization.

Objective: Transcarotid artery revascularization (TCAR) is a relatively recent development in the management of carotid artery occlusive disease, the utilization of which is becoming more prevalent. This study aims to evaluate the timing, prevalence, and types of hemodynamic instability after TCAR.

Methods: We performed a retrospective review of all TCAR procedures performed at two tertiary care academic medical centers within a single hospital system from 2017 through 2019.

Low correlation between serum thyroglobulin and I radioiodine whole body scintigraphy: implication for postoperative disease surveillance in differentiated thyroid cancer.

Purpose: To evaluate postoperative serum thyroglobulin (Tg) as a reliable tumor marker in low-risk differentiated thyroid cancer (DTC).

Methods: Two hundred and three patients met the selection criteria of >18 years old; who had undergone total or near total thyroidectomy; had a postoperative Tg, and had undergone I pre ablation whole body scan (PA-WBS). The primary endpoint was the correlation between Tg level and functional remnant thyroid tissues.

Substantial interreader agreement for biopsy with reduction in biopsy rate: A multireader diagnostic performance study of ACR TI-RADS.

Purpose: To assess diagnostic performance of ACR TI-RADS in thyroid cancer detection and evaluate interobserver agreement among radiologists with lower interpreting experience.

Methods: Four radiologists retrospectively assessed 295 biopsied thyroid nodules from ultrasound studies performed between 2009 and 2019, blinded to histopathology. Diagnostic performance for cancer detection was determined individually, and interobserver agreement among four readers was evaluated with Fleiss kappa coefficient (ⱪ).

Single shot lymphoscintigraphy in breast cancer: Effective single tracer sentinel node detection protocol with reduction in procedural pain.

Purpose: Variation in protocols for axillary sentinel lymph node (SLN) mapping exists. We strive to evaluate the effectiveness of reduction in number of injections on reducing procedural pain, while maintaining nodal detection.

Methods: Over 7 years, the number of periareolar injections performed was reduced stepwise from 4 to 1.

Esophageal Food Impaction: A Retrospective Chart Review.

Background: Esophageal food impaction (EFI) is the third most common non-biliary emergency in gastroenterology, with an annual incidence rate of 13 episodes per 100,000 person-years and 1,500 deaths per year. Patients presenting with food impaction often have underlying esophageal pathology. We evaluated the possible risk factors for EFI in our study.

Can obstructive urolithiasis be safely excluded on contrast CT? A retrospective analysis of contrast-enhanced and noncontrast CT.

Purpose: The aim of this study was to determine if contrast-enhanced CT can safely exclude obstructive urolithiasis in patients with flank plain. We performed a retrospective cohort analysis to compare the negative predictive values of contrast-enhanced and non-contrast CTs for the detection of obstructing urolithiasis.

Methods: Through report analysis, we identified all non-contrast and contrast-enhanced CT examinations of the abdomen and pelvis performed on adult patients in the emergency department at a single, multi-site academic medical institution in 2017 with an indication of flank pain.

Implementation of a Multi-Modal Palliative Care Curriculum for Pediatric Residents.

Objectives: To evaluate the feasibility and efficacy of a new multi-modal pediatric palliative care curriculum. We sought to determine the effect on comfort in palliative care, knowledge, and change in behavior by utilizing these skills with patients, and determine which modalities were most effective for residents.

Study Design: 25 pediatric residents were exposed to the 4-part curriculum.

Knowledge and attitudes towards contraceptives among adolescents and young adults.

Background: Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions.

Methods: Females and males, aged 13 to 23 years old, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD.

Meta-Analysis of the Effect of Vascular Complications on Mortality in Patients Undergoing Femoral Venoarterial Extracorporeal Membrane Oxygenation.

Background: Extracorporeal membrane oxygenation (ECMO) has become an accepted treatment modality in the management of select patients with cardiopulmonary failure. As a result, its use has increased significantly over the past decade. However, the effect of complications on mortality is not clearly established.

Utility of ultrasound after a negative CT abdomen and pelvis in the emergency department.

Purpose: The purpose of this study is to assess the utility of an abdominal and/or pelvic ultrasound (US) performed within 24 h after a negative CT of the abdomen and pelvis (CTAP) in the emergency department (ED). The secondary endpoint is to assess whether there is a significant increase in length of stay (LOS) in the ED due to immediate US reimaging.

Method: We reviewed the imaging reports of 335 patients over the course of 3 years in our ED who had an US within 24 h after a negative CTAP.

Pediatric Research and Scholarship Committee: Single Institution Initiative to Enhance Scholarly Activity of Pediatric Residents.

Objective: We sought to improve scholarly activity of pediatric residents by providing residents with support and guidance from a committee of faculty and staff members dedicated to advancing research within the program while requiring minimal additional funding or resources.

Approach: Established in 2012, the Pediatric Research and Scholarship Committee (PRSC) ascertained research interests of pediatric residents and matched residents with scholarly activity mentors based on mutual interests and goals. We measured change in scholarly activity of residents after the development of the PRSC by reviewing resident presentations at national/regional meetings and manuscripts published pre- and post-PRSC.

Fluid resuscitation in patients with end-stage renal disease on hemodialysis presenting with severe sepsis or septic shock: A case control study.

Due to the potential risk of volume overload, physicians are hesitant to aggressively fluid-resuscitate septic patients with end-stage renal disease (ESRD) on hemodialysis (HD). Primary objective: To calculate the percentage of ESRD patients on HD (Case) who received ≥30 mL/Kg fluid resuscitation within the first 6 h compared to non-ESRD patients (Control) that presented with severe sepsis (SeS) or septic shock (SS). Secondary objectives: Effect of fluid resuscitation on intubation rate, need for urgent dialysis, hospital length of stay (LOS), intensive care unit (ICU) admission and LOS, need for vasopressors, and hospital mortality.