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Snapshot Theater: Trauma, Adult II 1730: EVALUATION OF MIDDLE MENINGEAL ARTERY EMBOLIZATION OUTCOMES AT A LEVEL ONE TRAUMA CENTER
No full textArtificial Intelligence in Surgical Coding: Evaluating Large Language Models for Current Procedural Terminology Accuracy in Hand Surgery.
No full textPURPOSE: The advent of large language models (LLMs) like ChatGPT has introduced notable advancements in various surgical disciplines. These developments have led to an increased interest in the use of LLMs for Current Procedural Terminology (CPT) coding in surgery. With CPT coding being a complex and time-consuming process, often exacerbated by the scarcity of professional coders, there is a pressing need for innovative solutions to enhance coding efficiency and accuracy.
METHODS: This observational study evaluated the effectiveness of five publicly available large language models-Perplexity.AI, Bard, BingAI, ChatGPT 3.5, and ChatGPT 4.0-in accurately identifying CPT codes for hand surgery procedures. A consistent query format was employed to test each model, ensuring the inclusion of detailed procedure components where necessary. The responses were classified as correct, partially correct, or incorrect based on their alignment with established CPT coding for the specified procedures.
RESULTS: In the evaluation of artificial intelligence (AI) model performance on simple procedures, Perplexity.AI achieved the highest number of correct outcomes (15), followed by Bard and Bing AI (14 each). ChatGPT 4 and ChatGPT 3.5 yielded 8 and 7 correct outcomes, respectively. For complex procedures, Perplexity.AI and Bard each had three correct outcomes, whereas ChatGPT models had none. Bing AI had the highest number of partially correct outcomes (5). There were significant associations between AI models and performance outcomes for both simple and complex procedures.
CONCLUSIONS: This study highlights the feasibility and potential benefits of integrating LLMs into the CPT coding process for hand surgery. The findings advocate for further refinement and training of AI models to improve their accuracy and practicality, suggesting a future where AI-assisted coding could become a standard component of surgical workflows, aligning with the ongoing digital transformation in health care.
TYPE OF STUDY/LEVEL OF EVIDENCE: Observational, IIIb
Intracranial Hemorrhage in the Setting of Elevated α-Tocopherol Levels (P10-7.010).
No full textOBJECTIVE: Vitamin E, or tocopherol, is a lipid-soluble antioxidant that inhibits lipid peroxidation and scavenges reactive oxygen species. Additionally, it may inhibit platelet aggregation and cellular proliferation and decrease the availability of clotting factors, such as vitamin K. Vitamin E supplementation is beneficial in preventing cardiovascular events. However, toxicity due to its anticoagulatory effects may cause hemorrhage. We present a case of intracerebral hemorrhage in a patient with elevated vitamin E levels and no known risk factors.
BACKGROUND: A 66-year-old woman, previously healthy, not on any prescription medications but was on Vitamin E daily, presents with headache and left-sided weakness. On presentation, vital signs are normal, and the exam revealed a right gaze preference, left homonymous hemianopsia, and left upper and lower extremity drift. Computed tomography angiogram (CTA) head showed a right frontal hematoma and distal M2 occlusion. The following day, a magnetic resonance image (MRI) brain showed a stable right frontal intraparenchymal hematoma with no underlying infarction. We sent serum levels for α-tocopherol, which were elevated at 25.8 mg/L.Vitamin E supplementation was discontinued, and the patient was discharged to acute inpatient rehabilitation.
DESIGN/METHODS: NA.
RESULTS: NA.
CONCLUSIONS: Vitamin E\u27s ability to inhibit platelet aggregation or inhibition of vitamin K-dependent factors is the leading explanation for hemorrhage. The effects of platelet aggregation inhibition in healthy individuals are still unknown. There are a handful of case reports of healthy patients with no significant history on vitamin E supplements presenting with hemorrhage and no other etiology found. However, data has not been overwhelming, and an increased sample size is needed. The CTA head revealed a distal M2 occlusion, but it felt incidental as the bleeding site was at a remote location. MRI did not suggest an underlying infarction. We aim to raise awareness amongst clinicians to inquire about the patient\u27s supplementation regimen and advocate for further investigation
Cryptic Hemorrhage in a Cystic Lesion: A Rare Case of Thunderclap Headache from Pineal Apoplexy during Third-Trimester Pregnancy (P6-12.002)
No full textEmergence of ST3390: A non-pigmented HA-MRSA clone with enhanced virulence.
No full textBACKGROUND: One of the most successful and widely-distributed hospital-associated lineages of MRSA is CC5. These strains are known from widespread antibiotic resistance, but less severe disease than CA-MRSA counterparts. Recently, CC5 descendant lineages have appeared globally with hypervirulent properties.
METHODS: Herein we use genomic analyses to study the epidemiology of a rare CC5 MRSA sequence type, ST3390, circulating within Tampa General Hospital (TGH). We employ genetic tools alongside
RESULTS: To date, there have only been 50 recorded instances of infection caused by ST3390 globally, with 36 of those occurring at TGH. Genomic analysis of strains identified numerous
CONCLUSIONS: This is the first study to characterize the pathogenicity and genomic architecture of the rare MRSA lineage ST3390. Our work provides a deeper understanding of the clonal expansion of CC5, and the wider diversification o
TCR CDR3 chemical complementarity to HPV epitopes is associated with a better outcome for cervical cancer.
No full textDespite the fact that HPV vaccines are likely to lead to a significant reduction in cervical cancer occurrence, there remains cervical cancer incidence independent of the vaccine and cervical cancer arising in the absence of vaccination. Thus, continued efforts are needed to address the potential parameters of cervical cancer that could impact therapy and could lead to additional ways of reducing cervical cancer death rates. Adaptive immune receptor recombinations were obtained from the cancer genome atlas (TCGA) cervical cancer database through tumor exome and RNAseq files as well as from the independent Cancer Genome Characterization Initiative (CGCI) cervical cancer dataset. T-cell receptor (TCR) complementarity determining region-3\u27s (CDR3s) were then assessed, based on chemical complementarity to human papillomavirus (HPV) T-cell epitopes. Results indicated increased overall survival probabilities consistently across the three TCR datasets with TCR CDR3 chemical complementarity to the same HPV epitopes, specifically immune epitope database (IEDB) designations: IEDB-1625373, IEDB-174148, and IEDB-110943. Among other potential applications of these results, the results may indicate HPV epitopes that could be useful targets for immunotherapy
