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Rurality as a predictor of melanoma stage and treatment in Indiana: a retrospective cohort study
No full textNovel use of 3D printing for preoperative dose estimation in the first case of GammaTile spine implantation
No full textPURPOSE: For a patient who had two previous courses of external beam radiation therapy for rectosigmoid adenocarcinoma and presented with painful, recurrent disease in the sacrum, this study describes the first use of Cs-131 LDR GammaTile therapy outside of the brain and demonstrates a novel use of 3D printing for preoperative dose estimation.
MATERIAL AND METHODS: A personalized 3D-printed model of the patient\u27s spine was created using segmented MRI data, differentiating uninvolved bone, tumor, and thecal sac and nerve roots, with a Stratasys J5 MediJet® Printer. This model was used to simulate surgical resection and placement of dummy radioactive sources. A CT scan of the model facilitated preoperative dose calculations, including physical dose using Eclipse planning software and biologically effective dose (BED) using MIM Maestro software. The predicted dose was then compared to the postimplant dosimetry for the actual patient.
RESULTS: For the relevant organ at risk (thecal sac), the max dose (D(0.035cc)) was calculated accurately within 8.0% for physical dose and within 10.0% for BED when comparing the dose estimated using our 3D-printed model and the patient\u27s postimplant dosimetry.
CONCLUSIONS: 3D printing can be used preoperatively to estimate dose to critical organs at risk for patients receiving surgical resection followed by Cs-131 LDR implantation in the spine and can be especially valuable in the context of reirradiation
Neuromonitoring in Neuroscience Nursing: Collaboration From the 2025 International Neuroscience Nursing Symposium
No full textINTRODUCTION: Neuromonitoring enhances patient assessment in neuroscience nursing, yet its integration varies globally. At the 2025 International Neuroscience Nursing Research Symposium, nurses from 16 countries discussed the adoption of neuromonitoring devices. This proceedings article explores international perspectives on neuromonitoring use, barriers, and facilitators.
METHODS: Participants summarized their country\u27s neuromonitoring technology level, key facilitators and barriers to adoption, and devices with the greatest potential impact.
RESULTS: Significant disparities exist in neuromonitoring accessibility. Developed countries frequently use continuous electroencephalography, intracranial pressure monitoring, and pupillometry, whereas lower-resource settings face financial and training limitations. Key facilitators include policy support, funding, and interdisciplinary training, whereas barriers include cost, limited resources, and competency gaps.
CONCLUSION: Nurses worldwide recognize how neuromonitoring may improve outcomes. International collaboration, standardization of training, and technological advancements could help bridge disparities in access and implementation. Addressing systemic barriers and investing in education and policy support will enhance equitable neuromonitoring integration, ultimately improving neurological patient care across diverse healthcare settings
Athletic Performance at the National Football League Scouting Combine After Arthroscopic Meniscal Surgery
No full textBACKGROUND: Meniscal surgery is common and debilitating in National Football League (NFL)-bound athletes. Although statistical performance has been demonstrated after surgery, functional performance as measured at the NFL Combine is not well-defined.
PURPOSE/HYPOTHESIS: The purpose of this study was to determine the functional performance, production scores, athleticism scores, overall scores, and draft position of NFL Combine participants after meniscal surgery compared with a matched control group. It was hypothesized that there would be no difference in functional performance or graded scores between athletes with meniscal surgery compared with controls.
STUDY DESIGN: Cohort Study; Level of evidence, 3.
METHODS: NFL-caliber athletes who had previous arthroscopic meniscal repair or meniscectomy and participated in the NFL Scouting Combine between 2014 and 2024 were compared with a control group. Data included the 40-yard dash, 10-second split, vertical, broad jump, shuttle, 3-cone drill, production, athleticism, and overall scores, prospect grades, and draft position.
RESULTS: A total of 48 athletes were included in the repair group; 43 athletes were included in the meniscectomy group, with the same number of controls after matching. Compared with controls, players in the meniscal repair group had significantly slower 3-cone drill (7.40 +/- 0.43 vs 7.20 +/- 0.38 seconds; P = .018), shuttle drill (4.51 +/- 0.26 vs 4.38 +/- 0.26 seconds; P = .016), lower athleticism (69.74 +/- 12.95 vs 76.13 +/- 11.28; P = .012), and overall scores (70.95 +/- 14.22 vs 77.47 +/- 8.30; P = .007). There was no significant difference in the 40-yard dash (P = .439) or vertical tests (P = .559). Players in the meniscectomy group had a significantly slower shuttle compared with controls (4.45 +/- 0.31 vs 4.34 +/- 0.18 seconds; P = .047), lower athleticism (69.62 +/- 12.53 vs 76.67 +/- 10.84; P = .007), and overall scores (70.59 +/- 10.56 vs 75.24 +/- 9.52; P = .035). There was no significant difference in the 40-yard dash (P = .164) or vertical tests (P = .108). There was no significant correlation between the NFL Combine performance and time from surgery.
CONCLUSION: While overall athletic performance remained largely unaffected by arthroscopic meniscal repair or meniscectomy, specific drills, such as the 3-cone and shuttle drills, demonstrated significant declines, suggesting a negative effect on agility and quickness. Metrics used to score NFL prospects were also inferior in the meniscal repair and meniscectomy groups. These findings highlight the potential effects of meniscal surgery on athletic performance, underscoring the need for surgeon guidance on expectant postsurgical functional deficits for NFL-caliber athletes
Rotator Cuff Repair Augmented With a Reinforced Bioabsorbable Autobiologic Matrix
No full textRotator cuff tears are one of the most common shoulder pathologies in the adult population, present in approximately 25% of individuals in their 60s and 50% in individuals in their 80s. With several techniques and technological advances in repairing symptomatic rotator cuff tears, the rate of retear rates remains elevated. Synthetic grafts have been developed to aid with rotator cuff repair by providing biomechanical advantage, improved healing at bone tendon interface, while also remaining a cost-effective option when compared with costly revision rates. BioCharge Autobiologic Matrix is a synthetic scaffold approved by the Food and Drug Administration and developed to augment rotator cuff repairs by improving the ultimate load to failure rate while also providing improved enthesis architecture at the tendon-bone interface when observed at a microscopic level. The goal of this Technical Note is to describe the technique of rotator cuff repair with BioCharge augmentation
Letter to the Editor on Elevated Risk of Infection and Reoperation in Low-Energy Gunshot Tibial Fractures: A Comparative Analysis
No full text
The current landscape of single-port robotic surgery in urology
No full textThe advent of the purpose-built da Vinci single-port robotic platform marks a pivotal advancement in minimally invasive urological surgery. Designed to overcome the ergonomic and technical limitations of prior single-site approaches, the single-port system enables complex procedures through a single incision, with enhanced dexterity, optimized use of confined spaces and improved cosmetic and peri-operative outcomes. The single-port system has been increasingly used across a wide range of urological indications, including robot-assisted radical prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive surgeries such as pyeloplasty and ureteral re-implantation. Innovative access strategies, such as the single-port transvesical and low anterior access approaches, have facilitated regionalized and multi-quadrant surgeries without the need for repositioning or robot re-docking. These advances have translated into reduced morbidity, faster recovery and increased feasibility of opioid-sparing, same-day discharge protocols. As surgical expertise deepens and technology evolves, the single-port robotic platform stands as a refinement of minimally invasive surgery, and also as a potential paradigm shift in urological practice
Response to letter regarding maternal and fetal outcomes across hypertensive pregnancy subtypes
No full textAmerican Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer
No full textBACKGROUND: Lung cancer remains a predominant cause of cancer-related deaths worldwide, and there are notable geographic and institutional differences in both diagnostic and staging approaches. To address this, the American Association for Bronchology and Interventional Pulmonology (AABIP) convened a multidisciplinary committee to craft evidence-based and evidence-informed recommendations for diagnosing peripheral pulmonary nodules and performing convex probe endobronchial ultrasound (CP-EBUS)-guided mediastinal staging.
METHODS: A modified Delphi method guided the creation and refinement of 9 Population, Intervention, Comparator, Outcome (PICO) questions. A systematic literature review, updated through March 2023, served as the basis for drafting recommendations. The panel used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence and relied on National Institute for Health and Care Excellence (NICE) language to express the strength of each recommendation. Where suitable, meta-analyses were completed; otherwise, systematic reviews and consensus among experts provided the evidence for guidance.
RESULTS: Nine recommendations were ultimately proposed: 6 were supported by meta-analyses and 3 by systematic reviews. The topics include comparing diagnostic yield and complication rates between peripheral bronchoscopy and transthoracic needle biopsy, the use of multiple biopsy instruments and the role of rapid on-site evaluation (ROSE) during peripheral bronchoscopy, and best practices for CP-EBUS-guided mediastinal staging. Several critical considerations emerged, such as lesion size, evolving technologies in bronchoscopy, and the importance of both available resources and local expertise.
CONCLUSION: These guidelines aim to standardize and streamline recommendations for the bronchoscopic diagnosis and staging of lung cancer. Since rapid technological progress and observational data play significant roles in this field, ongoing research and evidence updates will be vital to refining best practices. Clinicians are advised to tailor these recommendations according to local circumstances, the unique needs of their patients, and any new findings as they develop