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Food assistance experiences of food-insecure community members in Baton Rouge, Louisiana: a qualitative study
No full textFood insecurity is correlated with a higher probability of numerous chronic diseases. There is a need to understand the challenges of people with food insecurity and their perceptions and use of programs, such as the Supplemental Nutrition Assistance Program (SNAP), in addressing food needs. Semi-structured phone interviews were conducted with food-insecure patients within a local regional medical center in Baton Rouge. Through qualitative analysis, we identified two major themes describing food assistance program utilization, including SNAP, and other food behaviors: shortfalls of support systems and adaptive behaviors. This information can contribute to the improvement of successful solutions for food insecurity
Overview of exosomal non-coding RNAs in cardiovascular disease using high throughput sequencing
No full textNon-coding RNAs including miRNAs, long-ncRNAs, and circular RNAs play crucial roles in cell-to-cell communication and epigenetic regulation. They control gene expression at multiple levels, including transcriptional, post-transcriptional, and translational, thereby influencing associated signaling pathways. Encapsulated within exosomes, micro-vesicles, and apoptotic bodies, ncRNAs can be transported between cells while being protected from harsh environmental conditions. Studies have shown various expression patterns across different cell types and in various physiological and pathological states. However, the precise correlations and extent of their contribution to diseases are still under investigation. Recent studies have reported the involvement of extracellular vesicle-associated ncRNAs in the pathogenesis of cardiovascular diseases, such as hypertension. This involvement has been linked to the regulation of a range of cellular and molecular pathways, including the renin-angiotensin system. Because these exosomes can be stably detected and measured in body fluids, they hold promise as tools for both diagnosis and therapy. This review explores the potential diagnostic utility of cell-derived circulating extracellular vesicle ncRNA-based biomarkers and therapeutic approaches in cardiovascular diseases, utilizing the Next-Generation Sequencing techniques. Additionally, we address significant challenges, recent advancements, and prospects of extracellular vesicle biomarkers, with a focus on their clinical applications in the context of cardiovascular diseases and hypertension
63368 Strategic Assessment of Project ECHO® Dermatology in the Deep South: A SWOT Approach.
No full textAmerican Academy of Dermatology (AAD) Annual Meeting 2025; March 7 - 11, 2025; Orlando, F
50 Landmark Papers every Plastic Surgeon Should Know
No full textThe ideal material for reconstruction of a breast is fat and skin. Most current methods of autogenous reconstruction use myocutaneous flaps. We investigated the feasibility of transfer of skin and fat from the lower abdomen without muscle sacrifice. The flap is based on one, two, or three perforators of the deep inferior epigastric vessels. The study will demonstrate both experimentally and clinically this original technique for breast reconstruction. A total of 15 breasts have been successfully reconstructed with this technique. This technique has all of the advantages of the free transverse rectus abdominis myocutaneous flap with decreased possibility of ventral hernia or muscle weakness
Timing matters: Early versus delayed surgery for neurogenic thoracic outlet syndrome and its impact on reoperation and pain outcomes
No full textINTRODUCTION: We evaluated the impact of the timing of brachial plexus neurolysis in conjunction with rib sparing scalenectomy or first rib resection on surgical and pain-related outcomes by comparing patients who underwent surgery within 3 months of diagnosis of neurogenic thoracic outlet syndrome (early) to those operated after 3 months (delayed). METHODS: This is a propensity-matched, multi-institutional retrospective database study. Patient demographics and surgical and pain outcomes were collected for 5 years after surgery. We used the Chi-squared test and logistic regression for analysis. RESULTS: A total of 2593 patients were included (n=1380 early; n=1213 delayed). After 1:1 propensity matching (n=1069), there was no difference in pneumothorax, hemorrhage, infection, or re-do neurolysis procedure between the groups. Acute pain did not significantly differ between the groups. Chronic pain outcomes favored early surgery. At 6 months, the chronic pain rate was significantly lower in the early group (6.83% vs. 10.3%; OR 0.66 [0.50-0.88]; p \u3c 0.005), and this trend persisted through 5 years (14.5% vs. 22.36%; OR 0.65 [0.54-0.78]; p \u3c 0.0001). The rate of myalgia was also lower in the early cohort at 3 months (1.03% vs. 2.81%; OR 0.37 [0.19-0.73]; p \u3c 0.005), and this trend persisted through 5 years (6.83% vs. 11.79%; OR 0.58 [0.44-0.76]; p \u3c 0.0001). CONCLUSION: Early surgery within 3 months of presentation for patients with neurogenic thoracic outlet syndrome is associated with significantly reduced long-term rates of chronic pain and myalgia. These findings support early surgical intervention to optimize pain-related outcomes. Our results should be interpreted by considering the variable symptom duration prior to diagnosis, as this may affect the observed benefit of early surgery
Risk Factors and Clinical Outcomes Among Adult Patients with Isolated Blunt Cerebrovascular Injuries: A National Analysis
No full textBACKGROUND: Blunt cerebrovascular injury (BCVI) is a rare but serious trauma complication linked to high stroke risk and mortality, often presenting without symptoms and delaying diagnosis. Despite known risk factors, data remain limited on outcomes, especially in patients with concurrent traumatic brain injury (TBI). Additionally, optimal management strategies, particularly for high-grade injuries, remain unclear. OBJECTIVE: The purpose of this study is to evaluate the incidence of BCVI, the associated risk factors, and outcomes for patients with BCVI with or without TBI to improve overall prognosis and outcomes in this patient population. METHODS: This retrospective cohort analysis utilized the American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database (2017-2021). The study population included adult (age ≥ 16 years) blunt trauma patients with Injury Severity Score (ISS) of ≥ 9 and severe isolated (Abbreviated Injury Scale [AIS] head and neck ≥ 3, all other regions \u3c 3) BCVI. Patients were then stratified based on the presence or absence of concomitant mild-moderate TBI (AIS head ≤ 2). Clinical outcomes were compared between BCVI and non-BCVI patients, including incidence of ischemic stroke, mortality rate, intensive care unit length of stay, ventilator-free days, and BCVI risk factors such as cervical spine fracture, mandibular fracture, basilar skull fracture, and presenting Glasgow Coma Scale (GCS) ≤ 8. RESULTS: Of 2,172 patients with isolated BCVI, 1,262 (58.1%) had carotid artery injuries and 910 (41.9%) had vertebral artery injuries. Among non-TBI patients, BCVI was significantly associated with cervical spine fractures (OR: 11.60, p \u3c .001), mandibular fractures (OR: 2.87, p \u3c .001), GCS ≤ 8 (OR: 1.65, p = .001), and ischemic stroke (OR: 19.32, p \u3c .001). Among TBI patients, BCVI was significantly associated with cervical spine fractures (OR: 6.79, p \u3c .001), mandibular fractures (OR: 2.10, p \u3c .001), and ischemic stroke (OR: 40.67, p \u3c .001). CONCLUSIONS: Patients with BCVI had significantly higher odds of presenting with cervical spine and mandibular fractures in addition to ischemic stroke compared to those without BCVI. Understanding the risk factors for BCVI can help guide further investigations and support prompt diagnosis, optimizing care, and improving patient outcomes
Perioperative Antibiotics in Sialendoscopy: A Retrospective Cohort Study
No full textOBJECTIVE: The use of perioperative antibiotics in sialendoscopy is nonstandardized and subject to surgeon preference. This study examines the association between perioperative antibiotic use in interventional submandibular gland sialendoscopy with stone removal and postoperative infection rates. METHODS: A multi-institutional retrospective cohort study of academic otolaryngology practices. Patients who underwent sialendoscopy of the submandibular gland for stone removal from January 1, 2015 to December 31, 2023 were included. Data were collected on patient demographics, comorbidities, disease factors, perioperative factors, and antibiotic use. The primary exposure was isolated postoperative antibiotic use. Secondary and tertiary exposures included any perioperative antibiotic use and isolated intraoperative antibiotic use. The primary outcome was postoperative infection. RESULTS: A total of 399 patients from four institutions were included, with an overall rate of infection of 5.01%. Perioperative antibiotics were used in 57.6% of cases, including intraoperatively in 44.9% and postoperatively in 31.1%. There was no statistically significant difference in infection rates between those who received postoperative antibiotics (RR: 1.48, 95% CI: 0.62-3.53), intraoperative antibiotics (RR: 1.10, 95% CI: 0.46-2.64), any perioperative antibiotics (RR: 1.01, 95% CI: 0.43-2.37), and no antibiotics. Additionally, postoperative antibiotic use was directly associated with age, history of prior sialendoscopy, stent placement, and systemic steroid use, and inversely associated with basket retrieval. CONCLUSIONS: We found no association between the use of perioperative antibiotics and postoperative infection rates. While specific subgroups of patients with complex pathologies or high-risk intraoperative findings may benefit, this study suggests antibiotics are not indicated for routine interventional sialendoscopy procedures on the submandibular glands
Revision Total Hip Arthroplasty | Ch 23
No full textTrochanteric slide osteotomy (TSO) is not commonly used during modern complex primary or revision THA, likely due to the rise of the extended trochanteric osteotomy, as well as modular femoral implants that enable distal fixation with only a small amount of intact diaphyseal bone. TSO consists of a greater trochanteric osteotomy via the posterolateral approach to the hip that preserves the adductor and vastus lateralis attachments. This approach allows for increased exposure to both the femoral canal and the acetabulum while preserving abductor function and preventing proximal migration of the trochanteric fragment
The Clinical Anatomy of the Vascular System | Ch 14
No full textIn human embryological development, the great arteries of the head, neck, and thorax all mature from six paired pharyngeal arches. These arches house a core of spongy, primitive mesoderm called mesenchyme. This mesenchyme present in the arches gives rise to the aortic arch arteries, embryologic precursors to the great arteries