Recent Publications by CFE Educators
Recent Published articles, books, and other scholarship by Academy members, CFE Education Scientists, and CFE Faculty.
Traumatic lacerations: what are the risks for infection and has the 'golden period' of laceration care disappeared?
2013
Authors: Quinn JV, Polevoi SK, Kohn MA
OBJECTIVE
To determine risk factors associated with infection and traumatic lacerations and to see if a relationship exists between infection and time to wound closure after injury.
METHODS
Consecutive patients presenting with traumatic lacerations at three diverse emergency departments were prospectively enrolled and 27 variables were collected at the time of treatment. Patients were followed for 30 days to determine the development of a wound infection and desire for scar revision.
RESULTS
2663 patients completed follow-up and 69 (2.6%, 95% CI 2.0% to 3.3%) developed infection. Infected wounds were more likely to receive a worse cosmetic rating and more likely to be considered for scar revision (RR 2.6, 95% CI 1.7 to 3.9). People with diabetes (RR 2.70, 95% CI 1.1 to 6.5), lower extremity lacerations (RR 4.1, 95% CI 2.5 to 6.8), contaminated lacerations (RR 2.0, 95% CI 1.2 to 3.4) and lacerations greater than 5 cm (RR 2.9, 95% CI 1.6 to 5.2) were more likely to develop an infection. There were no differences in the infection rates for lacerations closed before 3% (95% CI 2.3% to 3.8%) or after 1.2% (95% CI 0.03% to 6.4%) 12 h.
CONCLUSIONS
Diabetes, wound contamination, length greater than 5 cm and location on the lower extremity are important risk factors for wound infection. Time from injury to wound closure is not as important as previously thought. Improvements in irrigation and decontamination over the past 30 years may have led to this change in outcome.
View on PubMedThe 510(k) ancestry of a metal-on-metal hip implant.
2013
Authors: Ardaugh BM, Graves SE, Redberg RF
Comment on "dose-responses from multi-model inference for the non-cancer disease mortality of atomic bomb survivors" (Radiat. Environ. Biophys (2012) 51:165-178) by Schöllnberger et al.
2013
Authors: Little MP, Azizova TV, Bazyka D, Bouffler SD, Cardis E, Chekin S, Chumak VV, Cucinotta FA, de Vathaire F, Hall P, Harrison JD, Hildebrandt G, Ivanov V, Kashcheev VV, Klymenko SV, Laurent O, Ozasa K, Tapio S, Taylor AM, Tzoulaki I, Vandoolaeghe WL, Wakeford R, Zablotska L, Zhang W, Lipshultz SE
HIV voluntary counseling and testing at an abortion clinic: missed opportunities for diagnosis.
2013
Authors: Newmann SJ, Dufour MS, McFarland W, Oderman L, Kellogg T, Louie B, Drey EA
BACKGROUND
Most abortion clinics in the US do not provide opt-out HIV testing, and thus women electing abortion may not receive adequate screening for HIV. We sought to determine whether the standard practice of offering voluntary HIV counseling and testing (VCT) services to women electing abortion results in detection of undiagnosed HIV infection.
STUDY DESIGN
Two thousand twenty-five women electing abortion were consecutively offered VCT at a public hospital-based, urban abortion clinic. Unlinked, anonymous HIV surveillance testing was conducted subsequent to voluntary testing without patients knowing of the surveillance study testing at the time. Multivariable analysis was used to determine factors associated with opting for VCT.
RESULTS
Of the 13 women (0.6%) who tested positive for HIV, 8 had been previously diagnosed. Of the 5 women without previous diagnosis, only 1 opted for VCT. Overall, 530 (26%) women opted for VCT. Factors associated with opting for VCT in multivariable analysis (odds ratio, 95% confidence interval) were sex with an injection drug user (1.9, 1.1-3.2), presenting in the second trimester (1.3, 1.0-1.6), economic hardship (1.3, 1.0-1.5), partner difficulties (1.8, 1.3-2.4) and having public health insurance (1.6, 1.2-2.3).
CONCLUSIONS
HIV testing via VCT did not effectively diagnose previously undiagnosed HIV infections among women seeking abortion in this clinical setting.
View on PubMedNarrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics.
2013
Authors: McGill SK, Evangelou E, Ioannidis JP, Soetikno RM, Kaltenbach T
PURPOSE
Many studies have reported on the use of narrow band imaging (NBI) colonoscopy to differentiate neoplastic from non-neoplastic colorectal polyps. It has potential to replace pathological diagnosis of diminutive polyps. We aimed to perform a systematic review and meta-analysis on the real-time diagnostic operating characteristics of NBI colonoscopy.
METHODS
We searched PubMed, SCOPUS and Cochrane databases and abstracts. We used a two-level bivariate meta-analysis following a random effects model to summarise the data and fit hierarchical summary receiver-operating characteristic (HSROC) curves. The area under the HSROC curve serves as an indicator of the diagnostic test strength. We calculated summary sensitivity, specificity and negative predictive value (NPV). We assessed agreement of surveillance interval recommendations based on endoscopic diagnosis compared to pathology.
RESULTS
For NBI diagnosis of colorectal polyps, the area under the HSROC curve was 0.92 (95% CI 0.90 to 0.94), based on 28 studies involving 6280 polyps in 4053 patients. The overall sensitivity was 91.0% (95% CI 87.6% to 93.5%) and specificity was 82.6% (95% CI 79.0% to 85.7%). In eight studies (n=2146 polyps) that used high-confidence diagnostic predictions, sensitivity was 93.8% and specificity was 83.3%. The NPVs exceeded 90% when 60% or less of all polyps were neoplastic. Surveillance intervals based on endoscopic diagnosis agreed with those based on pathology in 92.6% of patients (95% CI 87.9% to 96.3%).
CONCLUSIONS
NBI diagnosis of colorectal polyps is highly accurate--the area under the HSROC curve exceeds 0.90. High-confidence predictions provide >90% sensitivity and NPV. It shows high potential for real-time endoscopic diagnosis.
View on PubMedResponse.
2013
Authors: Sanchez-Yague A, Kaltenbach T, Soetikno R
Management of the Premaxilla/Maxilla in Bilateral Cleft Lip and Palate.
2013
Authors: Karin Vargervik, Snehlata Oberoi
J Orthod Res
2013
Authors: Rheem S, Nielsen IL, Oberoi S.
Incidental findings in the maxillofacial region identified on cone-beam computed tomography scans.
2013
Authors: Stephen Rheem, Ib Leth Nielsen, Snehlata Oberoi
