Solid Waste and Associated Environmental Impact of WALANT Carpal Tunnel Release Performed Across Three Clinical Settings.

Purpose: Carpal tunnel release (CTR) remains the most common hand and wrist surgery in the United States, with an estimated 500,000 procedures per year. The introduction of wide-awake local anesthetic, no tourniquet (WALANT) technique and use of a minor sterile field has allowed CTR procedures to be performed in a clinic setting. Our study aimed to quantify the solid waste and related emissions associated with WALANT CTR procedures performed in a hospital operating room, ambulatory surgical center, and clinic.

Optimizing Aesthetic Outcomes in Autologous Breast Reconstruction: 20 Pearls for Practice.

Autologous breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap is an excellent option for many patients proceeding with mastectomy for surgical management of their breast cancer. As microsurgical techniques and results improve and ensure consistent flap survival, optimizing aesthetic outcomes may become a primary focus. This article outlines 20 tips that can improve aesthetic results in DIEP flap breast reconstruction, based on our senior author's 8-year career in microsurgical breast reconstruction, with an emphasis on enhanced cosmesis.

CO laser resurfacing for burn and traumatic scars of the hand and upper extremity.

Background: Scar formation is a normal part of the proliferative phase in wound healing where collagen is remodelled to better approximate normal skin. When collagen is not effectively redistributed, excessive scarring may occur. Recently, CO laser has emerged as an adjunct in improving scar quality via remodelling and redistribution of dermal collagen fibres.

Surgical management of advanced hidradenitis suppurativa via a one-stage procedure: A single-center experience.

Background: Hidradenitis suppurativa (HS) is a debilitating skin condition; in severe forms it requires excision and skin grafting for cure. This is commonly performed as a multi-stage procedure; we explored single-stage operation as a more efficient alternative.

Methods: Retrospective review 2007-2018 evaluating outcomes of patients undergoing single-stage surgery.

False positive bronchoalveolar lavage galactomannan: Effect of host and cut-off value.

Objectives: Bronchoalveolar lavage galactomannan (BAL-GM) is a mycological criterion for diagnosis of probable invasive aspergillosis (IA) per European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORT-MSG) consensus criteria, but its real-world positive predictive value (PPV) has not been well-studied. Our aim was to estimate the PPV of BAL-GM in a contemporary cohort of patients with positive BAL-GM.

Methods: We identified consecutive patients with ≥1 positive BAL-GM value (index ≥ 0.

Pruritic Rash in a Patient with Hodgkin's Lymphoma.

Bleomycin-induced flagellate erythema (FE), a skin finding associated with cutaneous deposition of bleomycin, is so called due to its characteristic pattern of whip-like, linear streaks. As bleomycin use in standard chemotherapeutic regimens has decreased, the clinical diagnosis has become increasingly rare. The authors present a case of a 43-year-old female patient with Hodgkin's lymphoma on her first cycle of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) treatment, who subsequently developed a diffuse rash classic for FE.

Initial Treatment of Cancer Patients with Fluconazole-Susceptible Dose-Dependent Candida glabrata Fungemia: Better Outcome with an Echinocandin or Polyene Compared to an Azole?

The 28-day crude mortality rate in 68 cancer patients with fluconazole-susceptible dose-dependent fungemia started on treatment (within 48 h after blood culture collection) with an echinocandin or liposomal amphotericin-B was better (30%) than those treated with azole monotherapy (52%) ( = 0.07). After adjusting for confounders, azole monotherapy also was associated with worse 28-day survival (hazard ratio, 3.

The Effects of Double Gloving on Microsurgical Skills.

Objective To determine whether double gloving would negatively affect participants' ability to perform a simulated microsurgical task. Study Design Randomized single-blinded controlled crossover trial. Setting Temporal bone laboratory of an academic otolaryngology department.

Retigabine holds KV7 channels open and stabilizes the resting potential.

The anticonvulsant Retigabine is a KV7 channel agonist used to treat hyperexcitability disorders in humans. Retigabine shifts the voltage dependence for activation of the heteromeric KV7.2/KV7.

Plexin-B2 promotes invasive growth of malignant glioma.

Invasive growth is a major determinant of the high lethality of malignant gliomas. Plexin-B2, an axon guidance receptor important for mediating neural progenitor cell migration during development, is upregulated in gliomas, but its function therein remains poorly understood. Combining bioinformatic analyses, immunoblotting and immunohistochemistry of patient samples, we demonstrate that Plexin-B2 is consistently upregulated in all types of human gliomas and that its expression levels correlate with glioma grade and poor survival.

A human phospholipid phosphatase activated by a transmembrane control module.

In voltage-sensitive phosphatases (VSPs), a transmembrane voltage sensor domain (VSD) controls an intracellular phosphoinositide phosphatase domain, thereby enabling immediate initiation of intracellular signals by membrane depolarization. The existence of such a mechanism in mammals has remained elusive, despite the presence of VSP-homologous proteins in mammalian cells, in particular in sperm precursor cells. Here we demonstrate activation of a human VSP (hVSP1/TPIP) by an intramolecular switch.

Matrix metalloproteinase-7 regulates cleavage of pro-nerve growth factor and is neuroprotective following kainic acid-induced seizures.

The neurotrophin nerve growth factor (NGF) regulates neuronal growth, differentiation, and survival during development. However, the precursor of NGF, proNGF, is a potent apoptotic ligand for the p75 neurotrophin receptor (p75(NTR))-sortilin complex. The mechanisms that regulate cleavage of proNGF, therefore, are critical determinants of whether this factor promotes neuronal survival or death.

Bedside sonographic measurement of optic nerve sheath diameter as a predictor of increased intracranial pressure in children.

Study Objective: We investigate the test performance of emergency physician-performed sonographic measurement of optic nerve sheath diameter for diagnosis of increased intracranial pressure.

Methods: Children between the ages of 0 and 18 years with suspected increased intracranial pressure were prospectively recruited from the emergency department and ICU of an urban, tertiary-level, freestanding pediatric facility. Pediatric emergency physicians with goal-directed training in ophthalmic sonography measured optic nerve sheath diameter.

The crying infant.

Infants with the chief complaint of crying can present a diagnostic dilemma to the health care provider. This article discusses the differential diagnosis and management of the crying infant.