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Targeted Nipple Areola Complex Reinnervation in Gynecomastia Mastectomy: A Case Report.
No full textTargeted nipple areola complex (NAC) reinnervation (TNR) to restore nipple and chest sensation has been previously described in patients undergoing breast reconstruction and gender-affirming mastectomy. A healthy 32-year-old male, with grade II gynecomastia with severe skin laxity and a BMI of 25 kg/
A Propensity Score Matched Comparison of Patient Insurance Status with Discharge To In-Patient Rehabilitation Among Children Hospitalized with Acute Traumatic Brain Injury
Get PDFPrevalence of Vitamin D Deficiency and Effect of Supplementation in Children with Sickle Cell Disease
Get PDFDetermining the Optimal Age for Head Injury Screening and Associated Triage Level Protocols.
No full textRetrospective Analysis of Bleeding and Wound Complications After Preoperative Administration of Ketorolac in Acute Appendicitis
Get PDFABSTRACT:
Introduction:
Opioids are a mainstay of acute pain management and provide excellent analgesia for severe pain. However, their side effect profile and complication rates raise concerns regarding routine administration.
Methods:
This study is a retrospective cohort study of 1415 patients in a single tertiary care center comparing bleeding and operative complications in patients administered ketorolac prior to appendectomy.
Results:
There was no difference between the ketorolac and non-ketorolac groups regarding blood loss (0.7% vs 0.6%, p=0.572) and hemoperitoneum (0.4% vs 0.6%, p = 0.43) There was no difference between the groups regarding need for re-exploration (0.6% vs 0.6%, p=0.643).
Discussion:
The use of the cyclooxygenase inhibitor, ketorolac, did not result in an increase of surgical complications in patients undergoing appendectomy.
Keywords:
Peri-Operative, Analgesia, Opioid Use, Substance Use, Ketorolac, NSAI
Long-term prognostic role of adiponectin in stable coronary artery disease: A meta-analysis of prospective studies.
No full textBACKGROUND: The persistent burden of cardiovascular (CV) disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.
AIM: To provide insights into how adiponectin can predict all-cause mortality and major adverse CV events (MACE) in patients with coronary artery disease (CAD) and to determine the prognostic value of adiponectin in predicting all-cause mortality and MACE in patients with stable CAD.
METHODS: We conducted a systematic search on PubMed, Scopus, and Google Scholar to find relevant studies published through June 2023 evaluating the long-term prognostic role of adiponectin in patients with stable CAD. Using a random effects model with 95%CI, we estimated the odds ratio (OR) while assessing heterogeneity through
RESULTS: After screening, we included five prospective studies involving 3225 patients who were followed up for a median duration of 3.8 years. Within the study population, prevalent risk factors included hypertension, diabetes, hyperlipidemia, and smoking. The commonly prescribed medications were angiotensin-converting enzyme inhibitors, beta blockers, and statins. The combined adjusted OR for all-cause mortality was found to be 2.51 (95%CI: 1.36-4.62), showing heterogeneity (
CONCLUSION: Higher levels of adiponectin were found to be associated with an increased risk of long-term mortality and MACE in patients with CAD, which highlights its potential as a cost-effective marker for risk assessment and guiding treatment strategies. Further research on the role of adiponectin could greatly influence decision-making and resource allocation in CV care
Screening of Babesia microti Proteomic Microarrays With Acute and Convalescent Serum of Patients Reveals Novel Targets of Early IgM and IgG Antibodies.
No full textBabesia microti is the cause of a potentially fatal emerging parasitic infection transmitted by ticks. Rapid bedside diagnostic tests are urgently needed. To identify antigens that are targeted by early immune responses, we enrolled 30 patients with confirmed B. microti infection. We used 9 acute, 8 convalescent, and 9 uninfected control sera to screen proteome microarrays of B. microti. We identified 17 antigens that were recognized by IgM and/or IgG antibodies. Twelve of these antigens had not been reported previously. Our approach suggests that there are many antigens that could be used as the basis of rapid bedside diagnostic tests
QMVAPJDAWL Performance of A Robotic Assisted Laparoscopic Gastro-Gastric Fistula Takedown
No full textEllen Pekar University of Pennsylvania; John Fam Tower Health/Drexel University Introduction: A 65 yo female with history of open roux-en-y gastric bypass in 2005 presented with chronic epigastric pain. The patient reported a history of chronic marginal ulcers and was on BID dosing of her PPI with continued symptoms. Method: EGD performed showing healing marginal ulcers and a 5 mm gastro-gastric fistula. Preoperative CT scan obtained confirming diagnosis. Decision was made to undergo G-G fistula takedown. Access obtained in the supraumbilical position with a 5mm Optiview trocar. 12 mm port placed to the right of the umbilicus. 8 mm port placed in the right lateral abdomen. Two 8 mm ports placed in the left side of the abdomen. 5mm port upsized to 8 mm port. Extensive adhesiolysis performed taking down adhesions from pouch, liver, and gastrojejunostomy to surrounding structures. EGD performed confirming anatomy. Roux limb divided distal to gastrojejunostomy using white load on a sureform stapler. Short gastric vessels ligated. Gastric remnant transected at antrum using two blue loads. Pouch transected proximal to gatrojejunostomy using a blue load. Two layer handsewn anastomosis with 2-0 stratafix created between roux limb and gastric pouch. Leak test negative. Gastric remnant removed. Results: Patient doing well postoperatively with resolution of epigastric pain 41 days after surgery. Conclusion: A robotic laparoscopic revision with excision of gastrojejunostomy, partial gastrectomy, and takedown of gastro-gastric fistula is an effective method for dealing with gastro-gastric fistula after previous Roux-en-y gastric bypass