Operative Management of Complications Following Intestinal Vaginoplasty: A Case Series and Systematic Review.

Objective: To describe the authors' experience with surgical management of complications following intestinal vaginoplasty and review the literature on incidence of complications following gender-affirming intestinal vaginoplasty.

Methods: Retrospective chart review identified patients presenting with complications following prior intestinal vaginoplasty requiring operative management. Charts were analyzed for medical history, preoperative exam and imaging, intraoperative technique, and long-term outcomes.

An update on gender-affirming phallus construction using the radial forearm free-flap.

Aims: The history of phallus construction parallels the advances made in plastic and reconstructive surgery whereby the era of microsurgery revolutionized numerous techniques. In 1993, we reported our early experience in phalloplasty. While the originally presented technique was a modification of the original design reported by Chang and Hwang, we now present further modifications of the past 30 years.

Thinking outside the box: Alternative techniques for gender affirming phalloplasty.

Aims: The benefits of gender affirmation surgery have long been established, and with improved access to care, these operations are being performed with increased frequency. As these surgeries continue to be performed, the surgical techniques continue to evolve. Phalloplasty, or the creation of a phallus, remains one of the most complex surgical endeavors in which a variety of factors influence surgical decision making.

Gender-affirming Phalloplasty: A Postoperative Protocol for Success.

Unlabelled: Increased access to care and insurance coverage has led to an increase in gender-affirming surgeries performed in the United States. Gender-affirming phalloplasty has a variety of donor sites and surgical techniques including both pedicled and free flaps. Although surgical techniques and patient outcomes are well-described, no reports in the literature specifically discuss postoperative management, which plays a crucial role in the success of these operations.

Hematoma following gender-affirming mastectomy: A systematic review of the evidence.

Background: Hematomas are reported to be the most common immediate complication in patients undergoing gender-affirming mastectomy, with rates substantially higher than those associated with other types of breast surgery. This study sought to examine the breadth of current literature and provide evidence-based explanations regarding the development of hematomas in chest masculinizing surgery and technical considerations for reducing their incidence.

Methods: A systematic review was conducted to identify all articles related to gender-affirming mastectomy published through September 2021.

Current Concepts in Maxillary Reconstruction.

Defects involving the midface and maxilla pose unique challenges to reconstructive surgeons. The maxilla serves as the central keystone of the face and interfaces with various other facial subunits to affect form and function. Reconstructive methods range from prosthetics to free tissue transfer, and the indications for different options are reviewed here.

Fire as a driver of fungal diversity - A synthesis of current knowledge.

Fires occur in most terrestrial ecosystems where they drive changes in the traits, composition, and diversity of fungal communities. Fires range from rare, stand-replacing wildfires to frequent, prescribed fires used to mimic natural fire regimes. Fire regime factors, including burn severity, fire intensity, and timing, vary widely and likely determine how fungi respond to fires.

Systematic analysis of in the North American Rocky Mountain alpine zone.

(Russulales) is an important ectomycorrhizal fungal genus in Arctic and alpine regions where it occurs with , and , yet a complex phylogenetic analysis of the genus in these habitats is lacking. This research compared collections of from the Rocky Mountain alpine (Colorado, Montana, Wyoming) with reference specimens from Arctic and alpine habitats, mostly in Europe, using an in-depth morphological study and a phylogenetic analysis of the nuc rDNA internal transcribed spacer region ITS1-5.8S-ITS2 (ITS barcode) and the second largest subunit of the RNA polymerase II gene ().

subgenus , unexpected diversity and significant differences in species compositions between western and eastern North America.

The focus of this paper is the North American species of in subg. . Eighteen species, including twelve new ones, and two tentative (aff.

Nodulose-spored from the Rocky Mountain alpine zone molecularly linked to European and type specimens.

(Inocybaceae) is one of the most diverse ectomycorrhizal genera in arctic and alpine habitats where the primary hosts are , and . Subgenus is common in these habitats and typically characterized by the presence of thick-walled pleurocystidia. Here, we focus on species that have angular or nodulose spores.

Intergroup Randomized Phase III Study of Postoperative Oxaliplatin, 5-Fluorouracil, and Leucovorin Versus Oxaliplatin, 5-Fluorouracil, Leucovorin, and Bevacizumab for Patients with Stage II or III Rectal Cancer Receiving Preoperative Chemoradiation: A Trial of the ECOG-ACRIN Research Group (E5204).

Background: The addition of bevacizumab to chemotherapy improved outcomes for patients with metastatic colon cancer. E5204 was designed to test whether the addition of bevacizumab to mFOLFOX6, following neoadjuvant chemoradiation and definitive surgery, could improve overall survival (OS) in patients with stage II/III adenocarcinoma of the rectum.

Subjects, Materials, And Methods: Patients with stage II/III rectal cancer who had completed neoadjuvant 5-fluorouracil-based chemoradiation and had undergone complete resection were enrolled.

The genus in the Rocky Mountain Alpine Zone.

Numerous taxa of have been reported in association with , , and in arctic-alpine habitats. However, species are notoriously difficult to delineate because morphological features overlap, and previously there was little reliable molecular data available. Recent progress in ITS-sequencing within the genus, coupled with an extensive database of parametrically described collections, now allows comparisons between species and their distributions.

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer.

Background: Among patients with metastatic pancreatic cancer, combination chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) leads to longer overall survival than gemcitabine therapy. We compared the efficacy and safety of a modified FOLFIRINOX regimen with gemcitabine as adjuvant therapy in patients with resected pancreatic cancer.

Methods: We randomly assigned 493 patients with resected pancreatic ductal adenocarcinoma to receive a modified FOLFIRINOX regimen (oxaliplatin [85 mg per square meter of body-surface area], irinotecan [180 mg per square meter, reduced to 150 mg per square meter after a protocol-specified safety analysis], leucovorin [400 mg per square meter], and fluorouracil [2400 mg per square meter] every 2 weeks) or gemcitabine (1000 mg per square meter on days 1, 8, and 15 every 4 weeks) for 24 weeks.

Health related quality of life in older or frail patients with advanced colorectal cancer treated with dose reduced capecitabine.

Objectives: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial.

A Phase I Study of Irinotecan, Capecitabine (Xeloda), and Oxaliplatin in Patients With Advanced Colorectal Cancer.

Background: The objective of the present phase I study was to define the dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) of irinotecan, capecitabine, and oxaliplatin given in combination (IXO regimen) to patients with previously untreated, unresectable advanced or metastatic colorectal cancer (CRC).

Patients And Methods: Patients received oxaliplatin followed by irinotecan as intravenous infusions on day 1, with oral capecitabine taken twice daily (BID) on days 2 to 15 of a 3-week cycle. The dose ranges were explored as follows: oxaliplatin, 75 to 120 mg/m; irinotecan, 160 to 230 mg/m; capecitabine, 750 to 1000 mg/m BID.

Real-life treatment of metastatic colorectal cancer with regorafenib: a single-centre review.

Background: Various tyrosine kinase signalling pathways affect the development and progression of colorectal cancer (crc). In clinical trials, regorafenib has been associated with a survival benefit in metastatic crc (mcrc). We assessed the safety and efficacy of regorafenib in real-world patients.

Spring and early summer species of Cortinarius, subgenus Telamonia, section Colymbadini and /Flavobasilis, in the mountains of western North America.

Seven species of Cortinarius, subgenus Telamonia, section Colymbadini and /Flavobasilis, are reported from conifer forests in the mountains of western North America. They typically produce basidiomes in the spring and summer. Only one species, C.

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016.

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents.

Endoluminal Treatments for Obesity and Related Hypertension: Updates, Review, and Clinical Perspective.

Purpose Of Review: Obesity is a global epidemic that continues to grow and results in related conditions such as hypertension and diabetes despite established interventions, thus suggesting the importance of new technologies.

Recent Findings: Endoscopic interventions are vast in scope and effectiveness. Intra-gastric balloons appear to dominate the field at this time, but a recent FDA-approved technique, the Aspire device, may soon cause a shift in the treatment paradigm.

Bariatric surgery in managing diabetes mellitus.

Purpose Of Review: Obesity is a worldwide epidemic, having profound effects on Western populations. Bariatric surgery has long been employed to treat obesity and its related comorbidities. Over time, researchers have amassed significant data to support bariatric surgery in the pursuit of treating diabetes mellitus.

PANCREOX: A Randomized Phase III Study of Fluorouracil/Leucovorin With or Without Oxaliplatin for Second-Line Advanced Pancreatic Cancer in Patients Who Have Received Gemcitabine-Based Chemotherapy.

Purpose The standard of care for second-line therapy in patients with advanced pancreatic cancer after gemcitabine-based therapy is not clearly defined. The CONKO-003 phase III study reported a survival benefit with second-line fluorouracil (FU) and oxaliplatin using the oxaliplatin, folinic acid, and FU (OFF) regimen. PANCREOX was a phase III multicenter trial to evaluate the benefit of FU and oxaliplatin administered as modified FOLFOX6 (mFOLFOX6; infusional fluorouracil, leucovorin, and oxaliplatin) versus infusional FU/leucovorin (LV) in this setting.