A minimally invasive approach to the infected aorta with novel endovascular use of biocomposite antibiotic material.

We have presented the case of a symptomatic, primarily infected aortic pseudoaneurysm treated with endovascular stent graft exclusion and adjunctive use of a long-acting biocomposite antibiotic material injected directly into the pseudoaneurysm sac. We have described preparation of the biocomposite antibiotic material and the catheter-directed delivery technique in detail. Although the use of long-acting antibiotic materials such as antibiotic beads has been well described when performing open surgery in an infected field, the application of these materials in endovascular procedures has been less certain. The techniques we have described have the potential to promote field sterilization in a minimally invasive manner for patients with aortic infections who could be poor candidates for open surgery.

Inconsistencies Between Physician-Reported Disclosures at the AAOS Annual Meeting and Industry-Reported Financial Disclosures in the Open Payments Database.

BACKGROUND: The purpose of this study was to determine the rate and type of inconsistencies between disclosures self-reported by physicians at a major academic meeting in the United States and industry-reported disclosures in the Open Payments database for a concordant time period. METHODS: Disclosures for every first and last author from the United States with a medical degree of a podium or poster presentation at the 2014 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting were collected and were compared with the disclosures reported in the Open Payments database to determine if any inconsistencies were present and, if so, within which category. RESULTS: In total, 1,925 total AAOS presenters were identified, and 1,113 met the inclusion criteria. Based on AAOS disclosures, 432 (39%) should have been listed within the Open Payments database. There were 125 presenters (11%) who reported an AAOS disclosure and thus should have been included in the Open Payments database, but were not included. An additional 259 presenters (23%) had ≥1 AAOS disclosures that were not reported or were improperly categorized in the Open Payments database. Inconsistencies were more common for authors who had significantly more poster presentations (p < 0.001), podium presentations (p = 0.01), total presentations (p < 0.001), and AAOS disclosures (p < 0.001) and a significantly higher value of payments in the Open Payments database (p < 0.001). CONCLUSIONS: In this sample, there was a 35% rate of inconsistency between physician-reported financial relationships for presenters at the AAOS Annual Meeting and industry-reported relationships published in the Open Payments database.