2019
Effect of Travel Time for Thyroid Surgery on Treatment Cost and Morbidity
Ramirez A, Schneider E, Mehaffey J, Zeiger M, Hanks J, Smith P. Effect of Travel Time for Thyroid Surgery on Treatment Cost and Morbidity. The American Surgeon 2019, 85: 949-955. PMID: 31638505, DOI: 10.1177/000313481908500934.Peer-Reviewed Original ResearchConceptsHigh-volume centersThyroid surgeryPrimary outcomeHospital costsSingle high-volume centerMedian operative timeHealth care utilizationCertain patient populationsMultivariable regression modelingPatient's home addressHome addressPostoperative morbidityACS-NSQIPOperative timePatient populationUninsured statusThyroid diseaseEndocrine surgeryMorbidity riskThyroid proceduresSurgical careTime-related differencesPatient differencesDisease processPatients
2018
General Thoracic Surgery in Rwanda: An Assessment of Surgical Volume and of Workforce and Material Resource Deficits
Ramirez A, Nuradin N, Byiringiro F, Ntakiyiruta G, Giles A, Riviello R. General Thoracic Surgery in Rwanda: An Assessment of Surgical Volume and of Workforce and Material Resource Deficits. World Journal Of Surgery 2018, 43: 36-43. PMID: 30132227, PMCID: PMC6318006, DOI: 10.1007/s00268-018-4771-y.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnesthesiologyChildChild, PreschoolEquipment and Supplies, HospitalFemaleHealth WorkforceHospitals, PrivateHospitals, UniversityHumansInfantInfant, NewbornMaleMiddle AgedNeeds AssessmentRetrospective StudiesRwandaSimulation TrainingThoracic SurgeryThoracic Surgical ProceduresYoung AdultConceptsUniversity Teaching HospitalHuman Resources for Health (HRH) ProgramThoracic casesSurgical volumeSimulation trainingUniversity Teaching Hospital of KigaliUniversity Teaching Hospital of ButareWorld Health Organization formBaseline patient characteristicsOperative volumeRetrospective cohort studyGeneral surgery proceduresThoracic surgical careGeneral thoracic surgeryOperating room registriesHRH ProgramPearson chi-square testKing Faisal HospitalAddress barriersCapacity building programsChi-square testKruskal-Wallis testNeeds assessmentPatient accessReferral centerPreoperative Gastroesophageal Reflux Disorder Is Associated With Increased Morbidity in Patients Undergoing Abdominal Surgery
Tilak A, Ramirez A, Turrentine F, Sohn M, Jones R. Preoperative Gastroesophageal Reflux Disorder Is Associated With Increased Morbidity in Patients Undergoing Abdominal Surgery. Journal Of Surgical Research 2018, 232: 587-594. PMID: 30463778, PMCID: PMC6251493, DOI: 10.1016/j.jss.2018.07.051.Peer-Reviewed Original ResearchConceptsGastroesophageal reflux disorderPostoperative complication rateEsophageal diseaseReflux disorderComplication rateAbdominal operationsProcedure groupAmerican College of Surgeons National Surgical Quality Improvement ProgramSurgeons National Surgical Quality Improvement ProgramAbdominal aortic aneurysm repairNational Surgical Quality Improvement ProgramAssociated with increased postoperative complication ratesAssociated with increased morbiditySurgical Quality Improvement ProgramIntra-abdominal casesAortic aneurysm repairIntra-abdominal proceduresRisk of morbidityMultivariate logistic regressionVentral hernia repairAortoiliac repairQuality Improvement ProgramAneurysm repairEsophageal strictureWound complicationsLong-Term Skills Retention Following a Randomized Prospective Trial on Adaptive Procedural Training
Ramirez A, Hu Y, Kim H, Rasmussen S. Long-Term Skills Retention Following a Randomized Prospective Trial on Adaptive Procedural Training. Journal Of Surgical Education 2018, 75: 1589-1597. PMID: 29803772, PMCID: PMC6252163, DOI: 10.1016/j.jsurg.2018.03.007.Peer-Reviewed Original ResearchConceptsCentral venous catheter placementRandomized controlled trialsMedical studentsControlled trialsLong-term skill retentionSurvey assessed confidenceSimulation-based trainingTraining armChi-square testAssess confidenceSkill retentionInvestigate long-term outcomesTraining hospitalsTertiary care centerConventional trainingPractice volumeCare centerTrial completionVenous catheter placementRandomized prospective trialLong-term outcomesTrial outcomesStudy objectiveAverage scorePractice timeCreation, Implementation, and Assessment of a General Thoracic Surgery Simulation Course in Rwanda
Ramirez A, Nuradin N, Byiringiro F, Ssebuufu R, Stukenborg G, Ntakiyiruta G, Daniel T. Creation, Implementation, and Assessment of a General Thoracic Surgery Simulation Course in Rwanda. The Annals Of Thoracic Surgery 2018, 105: 1842-1849. PMID: 29476717, PMCID: PMC5964001, DOI: 10.1016/j.athoracsur.2018.01.043.Peer-Reviewed Original ResearchConceptsGeneral surgery residentsThoracic proceduresSurgery residentsLow-middle income country settingFellowship training opportunitiesSimulation courseDiaphragm repairLow-middle income countriesIncome country settingsStatistically significant improvementUnivariate analysisResident knowledge baseSecondary objectivesSimulated surgeryLocal facultyIncome countriesCountry settingsKnowledge assessmentTraining levelTraining opportunitiesResident feedbackParticipants' responsesLikert scaleEnhance confidenceSignificant improvement
2016
Using Interdisciplinary Workgroups to Educate Surgery Residents in Systems-Based Practice
Gillen J, Ramirez A, Farineau D, Hoke T, Schirmer B, Williams M, Lau C. Using Interdisciplinary Workgroups to Educate Surgery Residents in Systems-Based Practice. Journal Of Surgical Education 2016, 73: 1052-1059. PMID: 27372271, PMCID: PMC5124388, DOI: 10.1016/j.jsurg.2016.05.017.Peer-Reviewed Original ResearchConceptsSystems-based practiceSystem-based practiceInterdisciplinary workgroupCompetency of systems-based practiceFrontline health care providersAccreditation Council for Graduate Medical Education competenciesHealth care teamHealth care providersHealth care professionalsSurgery residentsEducation of residentsHands-on educational experiencesCare teamInterprofessional collaborationCare providersCare professionalsHealth systemTeam-building exercisesWorkflow issuesInterdisciplinary communicationResident educationMeaningful educationSystem issuesSystems-basedResidentsClinical efficacy of 2-phase versus 4-phase computed tomography for localization in primary hyperparathyroidism
Ramirez A, Shada A, Martin A, Raghavan P, Durst C, Mukherjee S, Gaughen J, Ornan D, Hanks J, Smith P. Clinical efficacy of 2-phase versus 4-phase computed tomography for localization in primary hyperparathyroidism. Surgery 2016, 160: 731-737. PMID: 27302106, PMCID: PMC4975639, DOI: 10.1016/j.surg.2016.04.016.Peer-Reviewed Original ResearchConceptsPositive predictive valueFour-dimensional computed tomographyComputed tomography protocolComputed tomographyMultiglandular diseaseParathyroid localizationOperative findingsPredictive valueFour-phase computed tomographyLocalization of abnormal glandsRadiation doseTechnical surgical successEffective radiation doseFisher's exact testTomography protocolAbnormal glandsPrimary hyperparathyroidismSurgical successReoperative casesParathyroid weightSurgical outcomesTechnical successClinical efficacyOperative treatmentClinical outcomes
2015
Defining the effects of age and gender on immune response and outcomes to melanoma vaccination: a retrospective analysis of a single-institution clinical trials’ experience
Ramirez A, Wages N, Hu Y, Smolkin M, Slingluff C. Defining the effects of age and gender on immune response and outcomes to melanoma vaccination: a retrospective analysis of a single-institution clinical trials’ experience. Cancer Immunology, Immunotherapy 2015, 64: 1531-1539. PMID: 26392296, PMCID: PMC4644444, DOI: 10.1007/s00262-015-1758-5.Peer-Reviewed Original ResearchConceptsDisease-free survivalT cell responsesOverall survivalImmune responseOlder patientsCancer vaccinesClinical outcomesResected stage IIB-IV melanomaCD8+ T cell responsesStage IIB-IV melanomaLonger disease-free survivalImpact of patient ageMelanoma-associated peptidesCancer vaccine trialsClinical trial experienceIncidence of IRCumulative incidence rateKaplan-Meier estimatesClass I MHCMelanoma vaccineMenopausal statusPatient ageSurvival outcomesStratify patientsFemale patients