Dontre' Douse - Academia.edu (original) (raw)

Papers by Dontre' Douse

Journal of Neurosurgery

OBJECTIVE Antifibrinolytics, such as tranexamic acid (TXA), have been shown to decrease intraoper... more OBJECTIVE Antifibrinolytics, such as tranexamic acid (TXA), have been shown to decrease intraoperative blood loss across multiple surgical disciplines. However, they carry the theoretical risk of thromboembolic events secondary to induced hypercoagulability. Therefore, the aim of this study was to systematically review the available literature and perform a meta-analysis on the use of TXA in meningioma resection to assess thromboembolic risks. METHODS The PubMed, Web of Science, and Google Scholar databases were reviewed for all randomized controlled trials presenting primary data on TXA use during resection of intracranial meningiomas. Data were gathered on operative duration, venous thromboembolic complications, deep venous thrombosis, use of allogeneic blood transfusion, estimated blood loss (EBL), and postoperative hemoglobin. Patients who received TXA were compared with controls who did not receive TXA intraoperatively using random-effects models. RESULTS A total of 508 unique ...

Access microbiology, Oct 1, 2019

Introduction. Visceral leishmaniasis, caused by the Leishmania donovani complex, is responsible f... more Introduction. Visceral leishmaniasis, caused by the Leishmania donovani complex, is responsible for over 20 000 deaths per year. This disease often affects the immunocompromised with an increased prevalence in those with human immunodeficiency virus (HIV). The immunocompromised are not only more susceptible to infection, but disseminated disease including gastric leishmaniasis. This is a case of gastric leishmaniasis occurring in a non-endemic region in a patient with comorbid HIV. Case Presentation. The patient is a 39 year old originally from Central America currently living in Southeast Georgia. His history is significant for HIV, alcohol abuse, tobacco dependency and bone marrow biopsy-proven leishmaniasis. He denied any recent travel. At initial presentation, he had abdominal pain, nausea/vomiting, chills and dysphagia along with leukopenia and thrombocytopenia. Treatment with amphotericin B was initiated for his leishmaniasis as well as highly active antiretroviral therapy (HAART). The patient was discharged home on a 3 month course of amphotericin B with continued HAART therapy. Following resolution of his acute symptoms, six months later, the patient developed acute abdominal pain with nausea prompting presentation to the emergency department. Leishmaniasis was found again following bone marrow biopsy and the patient restarted amphotericin B and HAART. Several years later the patient presented again with similar symptoms, this time with accompanying rectal bleeding. The patient received an esophagogastroduodenoscopy and on gastric mucosal biopsy was found to have gastric leishmaniasis. Conclusion. This manuscript highlights the key features of this case, including recognizing leishmaniasis clinically, proving diagnosis through definitive testing and understanding the connection between leishmaniasis and HIV.

American Journal of Otolaryngology, Sep 1, 2023

Laryngoscope, May 30, 2023

Access microbiology, Sep 1, 2019

Introduction. This case is a presentation of isolated central nervous system (CNS) Mucormycosis i... more Introduction. This case is a presentation of isolated central nervous system (CNS) Mucormycosis in an immunocompetent patient. This case is unique in its demonstration of isolated CNS involvement while lacking clear evidence elucidating an entry point. Case presentation. The patient is a 36-year-old man without a pertinent past medical history, who initially presented with altered mental status and a 5-day history of progressively slurred speech. His social history is significant for intravenous drug use and outdoor pest control work. The patient's head computed tomography (CT) scan without contrast demonstrated the presence of possible bilateral infarcts or masses involving the basal ganglia and periventricular white matter. The patient then progressed to facial diplegia with new onset hemiplegia. High-dose steroids were initiated due to concern for neurosarcoidosis. A lumbar puncture was ordered due to minimal improvement and suggested an inflammatory process. A stereotactic brain biopsy was then performed, demonstrating non-caseating granulomatous inflammation with giant cells. Liposomal amphotericin B was added to cover possible fungal etiology. The pathology report was consistent with an isolated cerebral mucormycosis infection. The etiology remained elusive with clear paranasal sinuses and no cutaneous manifestations. Due to extensive gray matter involvement, the patient was not a candidate for surgery. Conclusion. This is a report of mucormycosis in a seemingly immunocompetent patient with either isolated CNS involvement or disseminated mucormycosis without an identifiable source. Although this patient did have two risk factors including intravenous drug use and outdoor working history, his lack of peripheral involvement demonstrates an uncommon presentation.

Otolaryngologic Clinics of North America, Apr 1, 2021

Otolaryngology continues to have one of the lowest percentages of black physicians of any surgica... more Otolaryngology continues to have one of the lowest percentages of black physicians of any surgical specialty, a number than has not improved in recent years. The history of exclusion of black students in medical education as well as ongoing bias affecting examination scores, clerkship grades and evaluations, and honors society acceptance of black students may factor into the disproportionately low number of black otolaryngology residents. In order to increase the number of black physicians in otolaryngology, intentional steps must be taken to actively recruit, mentor, and train black physicians specializing in otolaryngology.

Laryngoscope, Jul 18, 2023

Journal of Neurological Surgery Part B: Skull Base

Introduction The American Association of Neurological Surgeons (AANS), North American Skull Base ... more Introduction The American Association of Neurological Surgeons (AANS), North American Skull Base Society (NASBS), American Rhinologic Society (ARS), and American Neurotology Society (ANS) fellowship directories are important information repositories for skull base surgical fellowship programs. However, there is limited research on the amount and depth of information available through these resources. The objective of the present study is to assess Web site accessibility and information availability for individual fellowship programs listed within the AANS, NASBS, ARS, and ANS fellowship directories. Methods Lists of all accredited skull base surgical programs were obtained from the AANS and NASBS fellowship directories. Duplications in listed programs were removed, and systematic queries via an online search engine were conducted to identify fellowship Web sites. From each available Web site, information pertaining to 24 different variables was collected and organized into two categ...

Head & Neck

ObjectivesOropharyngeal squamous cell carcinoma (OPSCC) has been rising. This manuscript looks to... more ObjectivesOropharyngeal squamous cell carcinoma (OPSCC) has been rising. This manuscript looks to explore racial disparities in the surgical management of OPSCC.MethodsA cancer database was queried for patients with OPSCC diagnosed from 2004 to 2017. Univariate and multivariable logistic regressions were used to evaluate associations between patient race/ethnicity, surgical treatment, and reasons for lack of surgery.Results37 306 (74.3%) patients did not undergo surgery, while 12 901 (25.7%) patients did. Non‐Hispanic black (NHB) patients were less likely to undergo surgery than other races (17.9% vs. 26.5%; p < 0.0001). In clinical discussions, the Asian, Native American, Hawaiian, Pacific Islander (ANAHPI), and unknown race group was more likely to directly refuse surgery when recommended (2.5% vs. 1.5%; p = 0.015).ConclusionRacial differences exist in treatment for OPSCC. NHB patients are less likely to actually undergo surgical management for OPSCC, while other patients are m...

American Journal of Otolaryngology

Operative Neurosurgery, Sep 26, 2022

JAMA Otolaryngology–Head & Neck Surgery

The Laryngoscope, 2022

OBJECTIVES To identify the differences in sensitivity and accuracy between ultrasound-guided and ... more OBJECTIVES To identify the differences in sensitivity and accuracy between ultrasound-guided and palpation-guided fine needle aspirations (FNA) of suspicious lymph nodes in patients with human papillomavirus (HPV) (+) oropharyngeal squamous cell carcinoma (OPSCC). Additional objectives included identifying patient specific factors affecting biopsy accuracy and evaluating potential differences in accuracy between fine and core needle biopsies. STUDY DESIGN Retrospective chart review. MATERIALS AND METHODS A retrospective study of diagnostic sensitivity was completed at a single tertiary care center between 1/1/2006-12/31/2016. Participants included patients who underwent pretreatment FNA biopsy with HPV(+)OPSCC confirmed pathologically following neck dissection or excisional lymph node biopsy. A true positive (TP) on FNA biopsy was defined as an FNA biopsy concerning for squamous cell carcinoma (SCC) that was confirmed on excisional biopsy or neck dissection. A false negative (FN) was defined as a negative FNA but metastatic disease identified on excisional biopsy or neck dissection. Sensitivity was calculated as TPs/(TPs + FNs). Sensitivity was compared among techniques using chi-square and Fisher exact tests. RESULTS A total of 209 FNA biopsies among 198 patients were included in the study, including 31 (15%) palpation-guided FNAs, 160 (77%) ultrasound-guided FNAs, and 18 (9%) ultrasound-guided FNA + core biopsies. Sensitivity was significantly different among palpation-guided FNA, ultrasound-guided FNA, and ultrasound-guided FNA + core biopsies (48% vs. 83% vs. 94%, respectively; P < .001) but there was no significant difference in sensitivity between ultrasound-guided FNA versus ultrasound-guided FNA + core biopsies (P = .31). CONCLUSION The use of ultrasound guidance in FNA biopsies of nodal metastases in HPV(+)OPSCC improves sensitivity compared to palpation guidance alone. Ultrasound guided biopsies are preferred in patients with suspected nodal metastasis from HPV(+)OPSCC. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.

Access Microbiology

Otolaryngologic Clinics of North America