Effect of Enhanced Recovery After Surgery in Morbidly Obese Patients Undergoing Free Flap Breast Reconstruction.

Background: Enhanced Recovery After Surgery (ERAS) pathways have been widely implemented across many surgical practices, including autologous breast reconstruction. However, the benefits of ERAS in the morbidly obese population have yet to be defined.

Methods: A retrospective chart review of patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction at our institution from 2017 to 2022 was performed.

The Financial Impact of a Co-Surgeon in Breast Microsurgery.

Introduction: Co-surgeon approaches for autologous breast reconstruction have demonstrated improvements in operative efficiency. The health system financial impact, however, warrants further investigation.

Methods: Retrospective review of consecutive autologous reconstructions between 2017-2022.

Evaluation of Rhode Island's Early Geographic COVID-19 Vaccine Prioritization Policy.

To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities.

Rebuilding Caribbean Environmental Health Post-Crisis Programs: A Preliminary Study for Virtual Mentorship.

After the hurricanes in 2017 in the U.S. Caribbean, it was essential to rebuild, strengthen, and sustain essential environmental health (EH) services and systems.

Effectiveness of Liposomal Bupivacaine Transversus Abdominis Plane Block in DIEP Flap Breast Reconstruction: A Randomized Controlled Trial.

Background: Transversus abdominis plane (TAP) blocks improve pain control and reduce narcotic medication requirements in various surgical procedures. Liposomal bupivacaine may provide more sustained analgesia. This study compared pain-related outcomes between standard bupivacaine and liposomal bupivacaine TAP blocks after autologous breast reconstruction.

Surveying mental health stressors of emergency management professionals: Factors in recruiting and retaining emergency managers in an era of disasters and pandemics.

Emergency managers are responsible for managing crises and disasters, and while their work is essential, it can be stressful and impact their mental health, particularly during the COVID-19 pandemic. This study aimed to examine the mental health of professional emergency managers and factors associated with their intent to leave the field before and during the COVID-19 pandemic. A total of 903 respondents completed an online survey assessing their secondary traumatic stress, emergency reaction strategies, organizational culture, age, length of time in primary position, the highest level of education as well as other metrics.

A deep population reference panel of tandem repeat variation.

Tandem repeats (TRs) represent one of the largest sources of genetic variation in humans and are implicated in a range of phenotypes. Here we present a deep characterization of TR variation based on high coverage whole genome sequencing from 3550 diverse individuals from the 1000 Genomes Project and H3Africa cohorts. We develop a method, EnsembleTR, to integrate genotypes from four separate methods resulting in high-quality genotypes at more than 1.

Investing in Retail Food Safety: Assessing the NEHA-FDA Retail Flexible Funding Model Grant Program's Distribution Through an SDOH Lens.

Social Determinants of Health (SDOH) have a major impact on community health and quality of life. Healthy People 2030 has an increased focus on SDOH, given their contribution to health disparities and inequalities as a social phenomenon. Despite advances in food hygiene and sanitation, structural disparities related to SDOH leave food systems vulnerable.

Preliminary Analysis of an Advanced Health Care Practitioner-Led Home-Visit Primary Care Program for High-Risk Patients Reduced Health Care Costs and Utilization.

MemorialCare Medical Group (MCMG) designed and implemented an advanced health care practitioner (AHP)-led home-visit primary care program to address the needs of a frail older adult population, who struggled with arriving for in-office care. We sought to perform a preliminary analysis to determine the program's efficacy. We conducted a retrospective review of patients enrolled in the program through tabulation of total costs of care, inpatient visits (IPVs), emergency department visits (EDVs), and 30-day readmissions (30DRs) 1-year pre-enrollment and postenrollment.

Optimizing perioperative outcomes in autologous breast reconstruction.

Perioperative optimization in surgery is paramount to the success of an operation. This especially applies to autologous breast reconstruction where small details can make the difference between success and failure. In this article, the authors discuss a wide array of aspects of perioperative care in autologous reconstruction and best practices.

A deep population reference panel of tandem repeat variation.

Tandem repeats (TRs) represent one of the largest sources of genetic variation in humans and are implicated in a range of phenotypes. Here we present a deep characterization of TR variation based on high coverage whole genome sequencing from 3,550 diverse individuals from the 1000 Genomes Project and H3Africa cohorts. We develop a method, EnsembleTR, to integrate genotypes from four separate methods resulting in high-quality genotypes at more than 1.

Paraneoplastic pemphigus and Castleman's disease: a case report and a revision of the literature.

Background: In literature, a few reports described an association between paraneoplastic pemphigus (PNP) and Castelman's disease (CD), but no consensus have been proposed for the diagnostic-therapeutical approach. Aim of this study is to present a case report and explore the relationship between PNP and CD in pediatric patients, focusing on clinical manifestations, histopathological findings, treatment and outcome to find elements for an early diagnosis.

Case Presentation: We present the clinical case of a 13 years old girl with a challenging diagnosis of PNP and CD who underwent therapy at first with Rituximab and then with Siltuximab, for the control of symptoms.

Is Nitropaste Effective in Stressed Flaps?

Topical nitroglycerine (nitropaste) is an agent that has seen popularization in plastic surgery in recent years. A low-cost medication functioning, by inducing vasodilation primarily in the venous system and inhibiting platelet aggregation, has shown the ability to provide benefits in clinically concerning skin flaps. In random-pattern skin flaps, research shows that topical nitroglycerine decreases flap loss and increases the percentage of viable tissue.

Pathomorphogenesis of Glycogen-Ground Glass Hepatocytic Inclusions (Polyglucosan Bodies) in Children after Liver Transplantation.

Seventeen out of 764 liver biopsies from transplanted (Tx) livers in children showed glycogen-ground glass (GGG) hepatocytic inclusions. The inclusions were not present in pre-Tx or in the explanted or donor's liver. Under the electron microscope (EM), the stored material within the cytosol appeared as non-membrane-bound aggregates of electron-lucent globoid or fibrillar granules, previously described as abnormally structured glycogen and identified as Polyglucosan bodies (PB).

Metastatic Adenocarcinoma of the Lung Presenting as a Soft Tissue Mass.

Lung cancer is the leading cause of cancer death in the United States, with more than 230,000 new cases, and approximately 150,000 deaths estimated for 2018. Lung cancer most commonly metastasizes to the brain, liver, lungs, bone, and adrenal system; however, there have been several cases of spread to soft tissues, with an incidence rate of approximately 0.75-9%.

Necrotizing Soft Tissue Infection of the Breast during COVID-19 Pandemic.

Necrotizing soft tissue infection has been historically recognized as a severe, rapidly spreading soft tissue infection associated with a very high risk of mortality. Cases of primary necrotizing fasciitis of the breast are rarely described but often fatal. We present a case of necrotizing soft tissue infection of the right breast extending to the anterior abdominal wall in a 39-year-old obese female, with a history of tobacco use.

Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design.

Objective: This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better alternative for aortic aneurysm patients as it is minimally invasive and has been demonstrated to decrease the length of hospital stay.

Methods: We retrospectively reviewed data for patients undergoing EVAR between the years of 2005 and 2013.

Report of a case involving novel use of a post-operative esophagogastroduodenoscopy to re-evaluate a duodenal ulcer bleed.

Introduction: Acute gastrointestinal (GI) bleeding can be a life-threatening condition. This is usually diagnosed and managed by an upper GI tract endoscopy. When treating actively bleeding duodenal ulcers, surgical intervention, or arterial embolization by Interventional Radiology (IR) is warranted in the event of failed initial management.

A case of simultaneous abdominal wall reconstruction and creation of diverting ostomy in a ventral hernia with loss of domain.

Introduction: Diverting ostomies are traditionally used as a bridge to primary resection in patients with an obstructing mass, or severe inflammatory bowel disease [1]. In some cases, severe infections or non-healing wounds can be better managed after the diversion of fecal material away from the area [2]. In this case report, we discuss a patient who underwent a diverting loop colostomy placement through a ventral hernia defect with primary repair of the hernia in one procedure.

Pediatric Soft Tissue Tumors With BCOR ITD Express EGFR but Not OLIG2.

Introduction: Somatic internal tandem duplication of 3' of ( ITD) has been found in clear cell sarcomas of the kidney (CCSK), soft tissue undifferentiated round cell sarcomas/primitive myxoid mesenchymal tumors of infancy (URCS/PMMTI), and a subgroup of central nervous system high-grade neuroepithelial tumors (CNS-HGNET). ITD+ tumors share morphologic features. Expression of OLIG2 and epidermal growth factor receptor (EGFR) has been reported in CNS-HGNET with ITD.

Prostatic Artery Embolization Using 100-300-μm Trisacryl Gelatin Microspheres to Treat Lower Urinary Tract Symptoms Attributable to Benign Prostatic Hyperplasia: A Single-Center Outcomes Analysis with Medium-Term Follow-up.

Purpose: To report medium-term outcomes of prostatic artery embolization (PAE) using 100-300-μm trisacryl gelatin microspheres to treat lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) and to evaluate how cone-beam computed tomography-measured prostate gland volume (PGV), median lobe enlargement (MLE), age, and Charlson Comorbidity Index (CCI) affect these results.

Materials And Methods: Seventy-four consecutive patients who underwent PAE from April 2014 through August 2018 were retrospectively reviewed. Patients had International Prostate Symptom Score (IPSS) >12, Quality of Life (QoL) score >2, prostate gland volume (PGV) >40 mL, age older than 45 years, and medical therapy failure.

Prostatic Artery Embolization in Nonindex Benign Prostatic Hyperplasia Patients: Single-center Outcomes for Urinary Retention and Gross Prostatic Hematuria.

Objective: To present outcomes for prostatic artery embolization (PAE) to treat urinary retention and gross prostatic hematuria in nonindex benign prostatic hyperplasia patients.

Materials And Methods: Seventy-five patients undergoing PAE from December 2013 to August 2018 (age = 77.5 ± 8.

Case-Control Comparison of Conventional End-Hole versus Balloon-Occlusion Microcatheter Prostatic Artery Embolization for Treatment of Symptomatic Benign Prostatic Hyperplasia.

Purpose: To compare procedural metrics and clinical improvement for prostatic artery embolization (PAE) performed with a balloon-occlusion (BO) versus end-hole (EH) microcatheter in patients with benign prostatic hyperplasia.

Materials And Methods: Retrospective review was performed of 129 patients undergoing PAE with 100-300 μm Embosphere microspheres from April 2013 through August 2018. Microcatheter selection was nonrandom, based on prostatic artery anatomy.

Meaningful relief with flurbiprofen 8.75 mg spray in patients with sore throat due to upper respiratory tract infection.

Aim: Evaluate the efficacy of flurbiprofen 8.75 mg spray for sore throat relief.

Patients & Methods: Randomized, double-blind study in adults with sore throat due to upper respiratory tract infection who took flurbiprofen (n = 249) or placebo spray (n = 256).