Rahul Suresh Mhaskar

• Physician, MPH, PhD
• Professor (Full) at University of South Florida

Purpose To systematically evaluate the long-term outcomes of ventral hernia repair (VHR) and reassess its classification as a definitive surgical intervention. This review synthesizes evidence on postoperative complications including recurrence, chronic pain, and patient-reported outcomes to characterize the long-term burden of VHR and its impact o...

Introduction: The existing literature presents varying opinions on the appropriate dosage of stereotactic radiosurgery (SRS) for the recurrence of nonfunctional pituitary adenomas (NPAr). While it is theorized that administering higher doses may reduce the likelihood of recurrence, there is a growing concern that such doses could compromise neurolo...

Background Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy...

Introduction: Hand sanitizer use and media coverage increased throughout the coronavirus-2019 pandemic. In this study our goal was to examine and compare the incidence, demographics, and clinical outcomes of exposures to alcohol-based hand sanitizers (ABHS) before and during the COVID-19 pandemic in the state of Florida. Methods: We analyzed statew...

Introduction: Hepatocellular carcinoma (HCC) patients have a heightened prevalence of low bone mineral density (BMD) and the development of osteoporosis. Osteoporosis screening guidelines only recommend dual-energy X-ray absorptiometry (DEXA) scans for females 65 and older and males 70 and older. We set out to analyze the incidence of low BMD in HC...

Background Postoperative complications in body contouring surgery have been linked to several factors, including body mass index, diabetes, cardiovascular disease, and skin resection weight. Prior weight loss by surgical means is another predisposing factor for postoperative complications following body contouring. This study aims to examine these...

Objectives Social media platforms like Facebook, X (formally Twitter), and Instagram bridge pathology programs with other health professionals, prospective students, and the public, but the extent of social media usage by residency programs remains unexplored. This study investigates the current landscape of social media utilization by pathology pr...

Background/Objectives: Current literature has demonstrated the benefits of transversus abdominis plane (TAP) blocks for reducing postoperative pain and opioid consumption for an array of surgical procedures. Some randomized controlled trials and retrospective studies have compared ultrasound guidance TAP blocks completed by anesthesiologists (US-TA...

Introduction The gold‐standard diagnostic test for gastroparesis is gastric emptying scintigraphy (GES). Although a 4‐h GES is recommended in adult guidelines, no similar guidelines exist in the pediatric population, with many hospitals utilizing a 2‐h scan to reduce radiation exposure and save time. Methods We performed a systematic review and me...

Integrating artificial intelligence (AI) into healthcare prompts the need to measure its proficiency relative to human experts. This study evaluates the proficiency of ChatGPT, an OpenAI language model, in offering guidance concerning bariatric surgery compared to bariatric surgeons. Five clinical scenarios representative of diverse bariatric surge...

Introduction: T-cell redirecting bispecific antibodies (BsAb) are transforming the care of patients with relapsed/refractory (RR) multiple myeloma (MM). However, despite being a disease of older adults (OA), these patients remain under-represented in pivotal clinical trials and there are limited data to inform the management of this subgroup. To ad...

Dermatology remains highly competitive, with strong USMLE Step 1 scores traditionally crucial for securing residency positions. The 2023–2024 cycle introduced significant changes, including pass/fail USMLE Step 1 score reports and an expanded program signaling system. This study explores dermatology residency applicant profiles within this new cont...

Background Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), often results in significant morbidity among patients with moderate to severe forms. While biologics and small molecules are effective in inducing remission, many patients experience refractory disease or extra-intestinal manifestations. This st...

Background: Artificial intelligence (AI)-generated explanations about medical topics may be clearer and more accessible than traditional evidence-based sources, enhancing patient understanding and autonomy. We evaluated different AI explanations for patients about common diagnoses to aid in patient care. Methods: We prompted ChatGPT 3.5 , Google Ba...

Background American football is the most popular sport in the United States, with over 5.6 million people >6 years old playing the sport. Fractures in American football athletes are significant, as they compromise an athlete's performance and can also lead to prolonged recovery periods, affecting team dynamics and player careers. Analyzing these in...

Introduction: Hepatocellular carcinoma (HCC) patients have a heightened prevalence of low bone mineral density (BMD) and the development of osteoporosis. Osteoporosis screening guidelines only recommend DEXA scans for females 65 and older and males 70 and older. We set out to analyze the incidence of low bone mineral density in HCC patients under 6...

Introduction: Specialists in poison information are responsible for following-up with exposure cases managed at healthcare facilities. However, the amount of time, call components, and barriers met when completing an initial healthcare facility follow-up call in which a large amount of data and clinical recommendations are shared is not well descr...

Background and Objectives: Artificial intelligence (AI), such as ChatGPT and Bard, has gained popularity as a tool in medical education. The use of AI in family medicine has not yet been assessed. The objective of this study is to compare the performance of three large language models (LLMs; ChatGPT 3.5, ChatGPT 4.0, and Google Bard) on the family...

Achalasia is a neurodegenerative disorder affecting esophageal sphincter function. Treatment options include non-surgical and surgical approaches, such as Heller myotomy (HM). Combining Dor fundoplication with HM is controversial but may prevent gastroesophageal reflux disease (GERD). This retrospective cohort study aimed to assess whether HM with...

Background/Objectives: The hypercoagulable state associated with COVID-19 infection is associated with adverse outcomes and mortality. Studies have also demonstrated high rates of venous thromboembolism (VTE) events among patients with sepsis. We aimed to evaluate how the increase in thrombotic events in critically ill patients with COVID-19 infect...

Background Leaks following bariatric surgery, while rare, are potentially fatal due to risk of peritonitis and sepsis. Anastomotic leaks and gastro-gastric fistulae following Roux-En-Y gastric bypass (RYGB) as well as staple line leaks after sleeve gastrectomy have historically been treated multimodally with surgical drainage, aggressive antibiotic...

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) facilitate weight loss. Weight regain off therapy is concerning. We reported the case of a 35-year-old male prescribed oral semaglutide with 22.7 kg weight loss over 120 days. Herein, we describe the clinical course when discontinuing GLP-1 RA therapy, one approach to maintaining weight loss aft...

Introduction The purpose of this study is to investigate the impact of preoperative comorbidities, including depression, anxiety, type 2 diabetes mellitus, obstructive sleep apnea, hypothyroidism, and the type of surgery on %EBWL (percent estimated body weight loss) in patients 1 year after bariatric surgery. Patients who choose to undergo bariatri...

Background Laparoscopic surgery remains the mainstay of treating foregut pathologies. Several studies have shown improved outcomes with the robotic approach. A systematic review and meta-analysis comparing outcomes of robotic and laparoscopic hiatal hernia repairs (HHR) and Heller myotomy (HM) repairs is needed. Study Design PubMed, Embase and Sco...

Social media is increasingly being used by the public as a medium for health information. Unfortunately, misinformation has become widely available on these sites, often being provided using content that is designed to be more popular and engaging, and it is difficult for the public to differentiate between what is true and what is false. TikTok is...

Some dietary patterns are associated with inflammation, while others lower inflammation and improve health. However, many people cannot follow a complete, healthy diet. Therefore, this study's aim was to identify specific foods associated chronic inflammation and mortality. The study used Multi-Ethnic Study of Atherosclerosis (MESA) research materi...

Purpose Use of biologic or synthetic mesh in hernia repair shifts is based on evolving evidence. Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh is a potential alternative to biologic and synthetic mesh in ventral hernia repair (VHR). This meta-analysis assesses the efficacy of P4HB mesh in clean and contaminated surgical settings. Methods Two aut...

Teaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understand clinical reasoning instruction. Previously repo...

Sex differences in the incidence and mortality are evident in a wide range of cancers. This is not only due to sex-related variations in behavioral cancer risk factors, but also due to biological and molecular effects of sexual differentiation. Focusing on immunotherapeutic approaches like immune checkpoint inhibition or allogeneic stem cell transp...

Background: On-target off-tumor toxicities of anti-CD19 CAR T-cell therapy include B-cell aplasia and hypogammaglobulinemia. Long term B-cell aplasia is hypothesized to represent functional CAR T-cell engraftment (Melenhorst, Nature 2022), while peripheral blood B-cell recovery represents the loss of functional CAR-T cells against target over time....

Background Endobronchial forceps are commonly used for complex IVC filter removal and after initial attempts at IVC filter retrieval with a snare have failed. Currently, there are no clear guidelines to help distinguish cases where primary removal should be attempted with standard snare technique or whether attempts at removal should directly be st...

Alzheimer’s disease (AD) is a multifactorial neurodegenerative disease characterized by cognitive and behavioral changes in older adults. Emerging evidence suggests poor oral health is associated with AD, but there is a lack of large-scale clinical studies demonstrating this link. Herein, we used the TriNetX database to generate clinical cohorts an...

Reduction mammaplasties are routinely performed on women of child-bearing age, yet there still exists some uncertainty regarding a patient’s ability to breastfeed following the procedure. This is due to inconsistent definitions of “successful” breastfeeding, a variety of pedicles implemented, and inadequate follow-up in the published literature. Ou...

Background The objective of this study is to demonstrate the safety and feasibility of anti-reflux gastric bypass (ARGB) as a treatment for symptomatic massive paraesophageal hernias (PEH) in the obese population. Both gastroesophageal reflux disease (GERD) and PEH are particularly prevalent in the obese patient population, and obesity adversely af...

Background This retrospective cohort study aims to investigate emergency department (ED) visits and readmission after bariatric surgery among patients with a history of anxiety and/or depression. We predict that patients with a reported history of anxiety and/or depression will have more ED visits in the year following surgery than patients without...

Purpose: The main dose-limiting toxicity of anthracyclines is cardiotoxicity. Clonal hematopoiesis (CH), somatic mutations in hematopoietic stem or progenitor cells in patients without hematologic malignancy, is also associated with risk for adverse cardiovascular events and worse outcomes overall. We hypothesize that CH increases risk for doxorub...

Background: Shivering is often encountered in patients undergoing targeted temperature management (TTM) after cardiac arrest. The most efficient, safe way to prevent shivering during TTM is not clearly defined. Objective: The purpose of this study was to evaluate the impact of shivering management using a stepwise shivering protocol on time to targ...

At least 70% of US adults have metabolic disease. However, less is done to address early disease (e.g., overweight, obesity, prediabetes) versus advanced disease (e.g., type 2 diabetes mellitus, coronary artery disease). Given the burden of advanced metabolic disease and the burgeoning pandemics of obesity and prediabetes a systematic response is r...

Introduction: The prevalence of tobacco use in the Veteran population and among Veterans Health Administration patients remains high, resulting in significant health and economic consequences. This problem has generated many tobacco research studies and clinical interventions, which often rely upon tobacco use status data previously recorded in el...

Introduction Despite using anti-coagulation therapy in hospitalized coronavirus disease 2019 (COVID-19) patients, they have high rates of pulmonary embolism (PE) and deep vein thrombosis (DVT). The main objective of this study was to evaluate the association between vitamin D deficiency and thrombotic events (defined as the occurrence of a new PE o...

Real-world evidence suggests a trend toward inferior survival of patients receiving CD19 chimeric antigen receptor (CAR) T-cell therapy in Europe (EU) and with tisagenlecleucel. The underlying logistic, patient- and disease-related reasons for these discrepancies remain poorly understood. In this multicenter retrospective observational study, we st...

Background Osteoporotic vertebral compression fractures (OVCF) represent a substantial concern, as they are associated with significant increases in morbidity and mortality. One option for the management of these patients is balloon kyphoplasty, in which a balloon is inflated within the collapsed vertebral body. Following this, the cavity is filled...

Objectives: The transition from medical student to intern is associated with a significant increase in workloads and responsibilities. This includes using the electronic medical record (EMR), which can lead to challenges in information gathering and patient care; however, no formal residency interventions exist in the use of an EMR for information...

Introduction and hypothesis: During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed...

Background The Hispanic population is the fastest growing ethnic minority in the United States, contributing to nearly half of the population growth over the last decade. Unfortunately, this population suffers from lower-than-average health literacy rates, leading to poorer health outcomes. Per the American Medical Association and National Institut...

Purpose: To evaluate the safety and efficacy of yttrium-90 (90Y) radioembolization as first-line treatment for unresectable intrahepatic cholangiocarcinoma (ICC). Materials and methods: This prospective study enrolled patients with ICC without extrahepatic metastasis, and never received chemotherapy, liver embolization, radiation therapy. The tu...

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation remains as one of the more technically challenging endovascular procedures. Portal vein access from the hepatic vein often requires multiple needle passes, which increases procedure times, risk of complications, and radiation exposure. With its bi-directional maneuverability...

Background Chimeric antigen receptor T- Cell (CAR-T) immunotherapy has been a breakthrough treatment for various hematological malignancies. However, cardiotoxicities such as new-onset heart failure, arrhythmia, acute coronary syndrome and cardiovascular death occur in 10–15% of patients treated with CAR-T. This study aims to investigate the change...

Background Healthcare disparities continue to be an ongoing struggle in Bariatrics. Limited availability of Spanish online material may be a correctible barrier for accessibility to Hispanic patients. We sought to evaluate accredited Bariatric Centers of Excellence (COE) for Spanish readability via their websites to determine accessibility for Span...

Background: Breast cancer patients with locally advanced breast cancer who require radical mastectomy are left with large chest wall defects. This poses a significant reconstructive challenge as many high-risk patients require timely postmastectomy adjuvant therapy. While the reverse abdominoplasty technique is commonly used for aesthetic improvem...

Introduction: Effects of pulmonary function test (PFT) results on perioperative outcomes were investigated after robotic-assisted video-thoracoscopic (RAVT) pulmonary lobectomy. Methods: We retrospectively analyzed 706 consecutive patients who underwent RAVT lobectomy by one surgeon over 10.8 years. Preoperative (preop) forced expiratory volume...

785 Background: Socioeconomic deprivation has been described as a barrier to cancer clinical trial participation. However, few studies have examined socioeconomic deprivation using patient-level or granular geocoded designations. To overcome this challenge, the Area Deprivation Index (ADI) was used to assess neighborhood socioeconomic deprivation i...

Purpose: To determine the effect of resident- vs attending-led surgeries on patient outcomes in ophthalmic surgery. Design: Systematic review and meta-analysis. Methods: Two independent authors searched PubMed, EMBASE, and Cochrane Library from inception to March 2022. Categorical data from studies were pooled to report odds ratio (OR) and 95%...

Purpose: To describe the clinical evaluation course, treatments, and outcomes of patients with a primary complaint of hoarseness due to suspected laryngopharyngeal reflux (LPR). Methods: A retrospective chart review was conducted of patients with a primary complaint of hoarseness with acid reflux as the suspected cause at a single institution be...

Introduction Case reports form the base layer of the evidence pyramid, describing new or emerging diseases, side effects to treatments, common presentations of rare diseases, or rare presentations of common diseases. An important scholarly pursuit, writing case reports can be hindered by lack of time, training, and mentorship. Here, we describe a w...

Lumbar punctures (LP) are routinely used to administer intrathecal chemotherapy for children and adults with hematologic malignancies. The current guidelines suggest a platelet threshold of ≥ 50 × 109/L prior to LP for intrathecal chemotherapy (ITC). This can be challenging in patients with hematological malignancies who are thrombocytopenic. We co...

Background Two of the most common foregut operations are laparoscopic Heller myotomy and laparoscopic Nissen fundoplication. Robotic assistance, compared to standard laparoscopic approach, may potentially grant surgeons advantages such as enhanced visualization and dexterity. This study compares patient outcomes for Heller myotomy (HM) and Nissen f...

Background Atrial fibrillation is a common arrhythmia previously linked to systemic inflammation, which has been correlated with leukocyte and prealbumin levels. We sought to identify predictors of postoperative atrial fibrillation (POAF) following robotic-assisted pulmonary lobectomy. Methods This retrospective cohort study included 709 consecuti...

Fine Needle Aspiration (FNA) has modified all methods for diagnosing thyroid cancer; and in conjunction with the Bethesda System and the genomic sequencing classifiers (GSC), clinicians can objectively identify the risk of malignancy of thyroid nodules prior to surgical interventions. To further characterize these thyroid nodules, the Afirma Xpress...

Study Objective Obesity, as defined as a BMI of greater than 30 kg/m2, has been associated with increased surgical risk and increased technical difficulty. Many studies have evaluated ways of combating these challenges, including patient positioning and abdominal entry, however little has been reported in regard to ancillary trocar insertion site a...