Faculty Bibliography

This review aims to compare current evidence for the use of corticosteroid injection (CSI) versus platelet-rich plasma (PRP) in the treatment of common pathologies of the shoulder, hip and knee.

AIM/OBJECTIVE:This integrative review examines the impact of team teaching in undergraduate and master's degree nursing programs. BACKGROUND:Increasing workloads for faculty are a challenge in nursing education. Team teaching allows shared responsibilities; work between two or more educators can help redistribute workloads and mitigate burnout. METHOD/METHODS:A systematic search of peer-reviewed articles in Cumulative Index to Nursing and Allied Health Literature, Education Resource Information Center, and PubMed yielded 12 relevant studies. RESULTS:Four key themes emerged: modeling behaviors, applying theoretical knowledge to practice, exposure to diverse perspectives, and faculty perspectives. Effective team teaching requires trust, communication, and collaboration among educators, requiring ongoing professional development. Team teaching can enhance diversity efforts in nursing education. CONCLUSION/CONCLUSIONS:Team teaching is a viable approach to optimizing the scholarship of teaching. Future research should explore educators' perspectives on team-teaching methods and measurable impacts on achieving learning outcomes.

INTRODUCTION/BACKGROUND:Acute esophageal necrosis (AEN) is a rare and lethal condition that may progress to sepsis and perforations. Most related literature comes from case reports; however, a few small reviews have been published. We conducted a large systematic review of AEN using PubMed, Medline, and Embase to organize data into one consolidated manuscript, find potential prognosticators of illness, and determine possible treatment guidelines for AEN. METHODS:Advanced searches were performed of all English case reports from 1990 to 2021 using medical subject heading terms. Data on patient age, sex, comorbidities, initial presentation, management, progression of illness, and hospital survival were collected. RESULTS:Our study included 226 articles, encompassing 319 cases. A total of 32.3% of patients had diabetes, 26.6% had hypertension, and 19.7% had alcohol use disorder. Overall, 66.5% presented with an upper gastrointestinal bleed and 21.9% developed sepsis or esophageal perforation. In total, 60.9% of patients were reported to have survived their illness, but 16.6% of cases did not have their discharge status documented. Interestingly, patients presenting with pain or ketoacidosis demonstrated improved survival. CONCLUSION/CONCLUSIONS:AEN becomes more prevalent as patients age and develop cardiovascular disease, which increases the risk of developing a hypoperfusive state and mucosal injury to the distal esophagus. Early fluid resuscitation, acid-reducing agents, and bowel rest may serve as potential lifesaving interventions, and antibiotics should be considered if there is concern for infection. Patients require close follow-up in anticipation of impending stricture. INTRODUCTION/BACKGROUND:Acute esophageal necrosis (AEN) is a rare and lethal condition that may progress to sepsis and perforations. Most related literature comes from case reports; however, a few small reviews have been published. We conducted a large systematic review of AEN using PubMed, Medline, and Embase to organize data into one consolidated manuscript, find potential prognosticators of illness, and determine possible treatment guidelines for AEN. METHODS:Advanced searches were performed of all English case reports from 1990 to 2021 using medical subject heading terms. Data on patient age, sex, comorbidities, initial presentation, management, progression of illness, and hospital survival were collected. RESULTS:Our study included 226 articles, encompassing 319 cases. A total of 32.3% of patients had diabetes, 26.6% had hypertension, and 19.7% had alcohol use disorder. Overall, 66.5% presented with an upper gastrointestinal bleed and 21.9% developed sepsis or esophageal perforation. In total, 60.9% of patients were reported to have survived their illness, but 16.6% of cases did not have their discharge status documented. Interestingly, patients presenting with pain or ketoacidosis demonstrated improved survival. CONCLUSION/CONCLUSIONS:AEN becomes more prevalent as patients age and develop cardiovascular disease, which increases the risk of developing a hypoperfusive state and mucosal injury to the distal esophagus. Early fluid resuscitation, acid-reducing agents, and bowel rest may serve as potential lifesaving interventions, and antibiotics should be considered if there is concern for infection. Patients require close follow-up in anticipation of impending stricture.

OBJECTIVE/UNASSIGNED:Sentinel lymph node biopsy (SLNB) for endometrial cancer staging may identify isolated tumor cells (ITCs). Although guidelines do not classify nodes with ITCs as positive, earlier papers reported that a significant proportion of gynecologic oncologists treat ITCs as they would positive nodes. The objective of this study was to examine practice patterns and determine if the presence of ITCs in endometrial cancer affects adjuvant treatment decision-making. METHODS/UNASSIGNED:test, and logistic regression were used with significance set at p < 0.05. RESULTS/UNASSIGNED:Of seven hundred thirty-four patients included, ITCs were identified in 41 patients (5.6 %). Deep myometrial invasion (61.0 % vs 20.5 %, p < 0.001) and lymphovascular invasion (58.4 % vs 17.7 %, p < 0.001) were more common in patients with ITCs than in those with negative lymph nodes. Patients with ITCs were more likely to receive adjuvant treatment (30 of 41, 73.2 % vs 289 of 693, 41.7 %, p < 0.001). When controlling for age, stage, histology, grade, and lymphovascular space invasion, ITCs were not associated with an increased likelihood of adjuvant therapy receipt. CONCLUSIONS/UNASSIGNED:Although patients with ITCs were more likely to receive adjuvant treatment, this was accounted for by other clinical and histological factors. Clinicians were likely to make decisions based on established risk factors, and more data are needed on the role of ITCs in the landscape of molecularly based decision making.

PURPOSE/OBJECTIVE:A novel larger 5.1Fr working channel flexible ureteroscope for Direct-In-Scope Suction (DISS) has recently been introduced. However, the optimal stone dust size for successful evacuation without working channel blockage is currently unknown. METHODS:In vitro assessment of the PU400A 9.2Fr ureteroscope (Zhuhai Pusen Medical Technology Co., Ltd, China) was performed with BegoStone particle sizes ≤ 2000 μm (size range 1000-2000 μm), ≤ 1000 μm (500-1000 μm), ≤ 500 μm (250-500 μm), ≤ 250 μm (125-250 μm) and ≤ 125 μm (63-125 μm), in a kidney calyx model. This was conducted with an empty working channel, and with occupancy by 150 μm Olympus, 200 μm Quanta, 270 μm Dornier laser fibers. Primary outcome was complete suction-evacuation without working channel blockage. Secondary outcome was evacuation speed for particle sizes that did not have blockage. RESULTS:/s respectively (ANOVA = p < 0.001). CONCLUSION/CONCLUSIONS:The 5.1Fr working channel DISS ureteroscope allows a stone particle size limit of 250 μm to be suction-evacuated without blockage, even with laser fiber occupancy. With a laser fiber, a smaller 150 μm fiber size allows better particle evacuation speeds. Urologists should therefore aim for a dust particle size of ≤ 250 μm in routine DISS with the 5.1Fr working channel ureteroscope, for effective intraoperative stone evacuation.

BACKGROUND:Shift work and scheduling are major contributors to occupational stress for nurses, leading to job dissatisfaction and risk of turnover. Nurse scheduling processes are complex, as they are dynamically linked to nurse staffing and patient demand. OBJECTIVE:This study sought to describe barriers and facilitators influencing job and scheduling satisfaction among staff nurses and nurse managers. METHODS:We used a qualitative descriptive design. The sampling frame included staff nurses and nurse managers employed at an urban academic medical center. Participants (N = 16) completed individual semi-structured Zoom interviews from August 2023 to February 2024, which were audio recorded and transcribed. Data were analyzed using content analysis. RESULTS:The overarching theme identified was "Scheduling is everything," reflecting the importance of scheduling for nurses' satisfaction in and outside of work. Both staff nurses and managers identified tensions between scheduling for patient care needs (e.g., adequate staffing) and scheduling to optimize staff needs (e.g., health, sleep). They also identified staffing shortfalls as a contributor to these scheduling tensions. Staff nurses reported that scheduling challenges compromised their health and well-being, caused work-family conflict, and influenced turnover intentions. Facilitators of scheduling satisfaction included scheduling flexibility, autonomy, and equity. Participants also provided pragmatic ideas for improving scheduling processes. CONCLUSIONS:Our study explored perspectives on job and scheduling satisfaction through the lens of both staff and managers. Scheduling challenges contribute to nurses' job dissatisfaction and turnover intentions. By increasing scheduling flexibility, equity, and integrating nurse-led innovations into the scheduling process, healthcare organizations can potentially increase nurse retention.

BACKGROUND:Coronary artery disease (CAD) is a highly prevalent condition which can lead to myocardial ischemia as well as acute coronary syndrome. Early diagnosis of CAD can improve patient outcomes through guiding risk factor modification and treatment modalities. SUMMARY/CONCLUSIONS:Testing for CAD comes with increased cost and risk; therefore, physicians must determine which patients require testing, and what testing modality will offer the most useful data to diagnose patients with CAD. Patients should have an initial risk stratification for pretest probability of CAD based on symptoms and available clinical data. Patients with a pretest probability less than 5% should receive no further testing, while patients with a high pretest probability should be considered for direct invasive coronary angiography. In patients with a pretest probability between 5 and 15%, coronary artery calcium score and or exercise electrocardiogram can be obtained to further risk stratify patients to low-risk versus intermediate-high-risk. Intermediate-high-risk patients should be tested with coronary computed tomography angiography (preferred) versus positron emission tomography or single photon emission computed tomography based on their individual patient characteristics and institutional availability. KEY MESSAGES/CONCLUSIONS:This comprehensive review aimed to describe the available CAD testing modalities, detail their risks and benefits, and propose when each should be considered in the evaluation of a patient with suspected CAD. BACKGROUND:Coronary artery disease (CAD) is a highly prevalent condition which can lead to myocardial ischemia as well as acute coronary syndrome. Early diagnosis of CAD can improve patient outcomes through guiding risk factor modification and treatment modalities. SUMMARY/CONCLUSIONS:Testing for CAD comes with increased cost and risk; therefore, physicians must determine which patients require testing, and what testing modality will offer the most useful data to diagnose patients with CAD. Patients should have an initial risk stratification for pretest probability of CAD based on symptoms and available clinical data. Patients with a pretest probability less than 5% should receive no further testing, while patients with a high pretest probability should be considered for direct invasive coronary angiography. In patients with a pretest probability between 5 and 15%, coronary artery calcium score and or exercise electrocardiogram can be obtained to further risk stratify patients to low-risk versus intermediate-high-risk. Intermediate-high-risk patients should be tested with coronary computed tomography angiography (preferred) versus positron emission tomography or single photon emission computed tomography based on their individual patient characteristics and institutional availability. KEY MESSAGES/CONCLUSIONS:This comprehensive review aimed to describe the available CAD testing modalities, detail their risks and benefits, and propose when each should be considered in the evaluation of a patient with suspected CAD.