Women in Hand Surgery: Leadership and Legacy.

Although women have existed in medicine and surgery for thousands of years, challenges continue to persist to date. Despite being discouraged and excluded from training, sponsorship, and opportunities, throughout the history of Hand Surgery, female surgeons have found ways to contribute significantly to science, our organizations, each other, changing the culture, and engaging the next generation of female trainees. This article integrates historical facts with oral history about Hand Surgery training, national societies, interest groups, achievements, and lived experiences to tell the history and legacy of women in Hand Surgery.

Melanoma in Pregnancy and Pediatrics.

Rare variants of melanoma include melanoma in pregnancy and pediatric melanoma. Because of their low incidence, treatment recommendations are based on standards of treatment for cutaneous melanoma; however, each of these forms requires specific considerations during diagnosis, staging, and treatment.

Beware of the B(e)all valve: mistaken valve identity, 30-year survival, and valve replacement.

Effective management of patients after the implantation of mechanical cardiac valves includes correct recognition of each valve and its related complications. Herein, we present the case of a patient who had undergone implantation of a floating-disc Beall-Surgitool mitral valve in 1976 and developed multiple valve-related complications. Over 30 years and in multiple medical centers, the device was mistakenly assumed to be a "ball" valve.

Persistence of cognitive impairment after resolution of overt hepatic encephalopathy.

Background & Aims: In patients with cirrhosis, hepatic encephalopathy (HE) has acute but reversible as well as chronic components. We investigated the extent of residual cognitive impairment following clinical resolution of overt HE (OHE).

Methods: Cognitive function of cirrhotic patients was evaluated using psychometric tests (digit symbol, block design, and number connection [NCT-A and B]) and the inhibitory control test (ICT).

Origin of a common trunk for the inferior phrenic arteries from the right renal artery: a new anatomic vascular variant with clinical implications.

The inferior phrenic arteries constitute a pair of important vessels, supplying multiple organs including the diaphragm, adrenal glands, esophagus, stomach, liver, inferior vena cava, and retroperitoneum. The vast majority (80-90%) of inferior phrenic arteries originate as separate vessels with near equal frequency from either the abdominal aorta or the celiac trunk. Infrequently, the right and left inferior phrenic arteries can arise in the form of a common trunk from the aorta or from the celiac trunk.

Utilization of excimer laser debulking for critical lesions unsuitable for standard renal angioplasty.

Background: The energy emitted by ultraviolet laser is avidly absorbed in atherosclerotic plaques. Conceptually, it could be applied for debulking of selected atherosclerotic renal artery stenoses. We describe early experience with revascularization of critical renal artery lesions deemed unsuitable for standard renal angioplasty.

Minimal hepatic encephalopathy is associated with motor vehicle crashes: the reality beyond the driving test.

Unlabelled: Patients with minimal hepatic encephalopathy (MHE) have impaired driving skills, but association of MHE with motor vehicle crashes is unclear. Standard psychometric tests (SPT) or inhibitory control test (ICT) can be used to diagnose MHE. The aim was to determine the association of MHE with crashes and traffic violations over the preceding year and on 1-year follow-up.