Growth defect of domain III glycoprotein B mutants of human cytomegalovirus reverted by compensatory mutations co-localizing in post-fusion conformation.

Cell entry is a crucial step for a virus to infect a host cell. Human cytomegalovirus utilizes glycoprotein B (gB) to fuse the viral and host cell membranes upon receptor binding of gH/gL-containing complexes. Fusion is mediated by major conformational changes of gB from a metastable pre-fusion to a stable post-fusion state whereby the central trimeric coiled-coils, formed by domain (Dom)III α helices, remain structurally nearly unchanged.

Racial and ethnic differences in transfusion rates in adolescent scoliosis surgery: Preoperative anemia as a mediator of disparity.

Background: Pediatric patients from minoritized racial and ethnic groups receive red blood cell (RBC) transfusions more frequently while undergoing major surgical procedures. Our objective was to identify the contribution of preoperative anemia to racial and ethnic differences in RBC transfusion rates in adolescent spine surgery.

Study Design And Methods: This is a multicenter, retrospective cohort study of the National Surgical Quality Improvement Program Pediatric database, 2016 to 2021 for patients in the United States and Canada.

Red Blood Cell Transfusions Are Not Associated With Incident Complications or Poor Outcomes in Patients With Intracerebral Hemorrhage.

Background Anemia is associated with poor intracerebral hemorrhage (ICH) outcomes, yet the relationship of red blood cell (RBC) transfusions to ICH complications and functional outcomes remains unclear. We investigated the impact of RBC transfusion on hospital thromboembolic and infectious complications and outcomes in patients with ICH. Methods and Results Consecutive patients with spontaneous ICH enrolled in a single-center, prospective cohort study from 2009 to 2018 were assessed.

Impact of Anesthetic Exposures on the Neurocognitive Profiles of Pediatric Brain Tumor Survivors: A New Direction for Research and Multidisciplinary Collaboration.

Primary brain tumors are the most commonly diagnosed solid tumors in children, and pediatric brain tumor survivors experience lasting, pervasive deficits of neurocognitive functioning. Repeated exposure to anesthetic drugs is a necessary component not only of surgical resection but also of multimodal cancer care for the youngest patients with brain tumors. The potential for anesthetic neurotoxicity to worsen neurocognitive outcomes in this vulnerable group, therefore, warrants our attention and further study through multi-disciplinary collaboration.

Allogeneic Red Blood Cell Transfusion and Infectious Complications Following Pediatric Spinal Fusion: NSQIP-P Analysis.

Unlabelled: Substantial bleeding occurs during spinal fusion surgery in the pediatric population, and many patients receive allogeneic red blood cell transfusion (ARBT) for the treatment of resulting perioperative anemia. ARBT is thought to increase vulnerability to postoperative infections following major surgical procedures, but studies of this relationship in children undergoing spinal fusion have yielded conflicting results.

Methods: Patients who underwent spinal fusion before the age of 18 years were identified from the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2016 to 2019 databases, along with patient and procedure-specific characteristics, transfusion events and volumes, and postoperative infectious complications such as wound-related infection, pneumonia, urinary tract infection (UTI), and sepsis.

COVID-19 in Pediatric Patients: A Systematic Review.

Introduction: The coronavirus disease (COVID)-19 pandemic has been an enormous global health burden, resulting in hundreds of millions of documented infections and more than 3 million deaths. Increasing reports characterizing the effects of COVID-19 in pediatric populations have been published during the course of the pandemic. We performed a systematic review to assess the scope of diagnosis, treatment, and management of COVID-19 in pediatric patients.

A Tale of Two Supercities: Early COVID-19 Outcomes Reflect Social Vulnerability in New York City and San Francisco.

In this narrative review, anesthesiologists at 2 large hospital systems in New York City and San Francisco compare early coronavirus disease 2019 (COVID-19) public health outcomes while considering the role played by social vulnerability and relevant approaches in their 2 cities. An iterative search process allowed for a broad review of medical and public policy research, as well as newspaper reports, expert opinion, and multimedia sources, with the goal of exploring the importance of crowding, the labor force, and social identity in pandemic experiences. Related struggles, pitfalls, and successful interventions in both locales are summarized.

Development of a preoperative risk score predicting allogeneic red blood cell transfusion in children undergoing spinal fusion.

Background: Children undergoing spinal fusion often receive blood products. The goal of this study was to develop a preoperative score to help physicians identify those who are at risk of allogeneic red blood cell (RBC) transfusion.

Study Design And Methods: This retrospective study of children undergoing spinal fusion in the ACS-NSQIP Pediatric database (2016-2019) aimed at identifying risk factors associated with allogeneic RBC transfusion.

Do Antifibrinolytic Agents Reduce the Risk of Blood Transfusion in Children Undergoing Spinal Fusion?: A Propensity Score-matched Comparison Using a National Database.

Study Design: Retrospective cohort.

Objective: To evaluate the effectiveness and safety of antifibrinolytic (AF) agents in reducing perioperative blood transfusion in pediatric patients undergoing spinal fusion.

Summary Of Background Data: The potential for AF to decrease bleeding and reduce exposure to allogenic transfusions has led to widespread off-label use in a number of major pediatric surgical procedures.

A Multivariable Model Predictive of Unplanned Postoperative Intubation in Infant Surgical Patients.

Background: Unplanned postoperative intubation is an important quality indicator, and is associated with significantly increased mortality in children. Infant patients are more likely than older pediatric patients to experience unplanned postoperative intubation, yet the literature provides few characterizations of this outcome in our youngest patients. The objective of this study was to identify risk factors for unplanned postoperative intubation and to develop a scoring system to predict this complication in infants undergoing major surgical procedures.

Comparative effectiveness of opioid replacement agents for neonatal opioid withdrawal syndrome: a systematic review and meta-analysis.

Objective(s): To compare short-term treatment outcomes of opioid pharmacotherapy for neonatal opioid withdrawal syndrome (NOWS).

Study Design: PubMed/MEDLINE, Embase, PsycINFO, and The Cochrane Library were searched from inception through September 30, 2018. Primary outcome was treatment duration (LOT).

Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.

Background: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source.

Cosmetic Concerns Related to the Posttraumatic Nose without Nasal Obstruction.

Because of its prominent position on the facial skeleton, the nose is commonly injured. Though significant trauma can result in nasal obstruction, there is also considerable concern for potential cosmetic deformity. Repairing traumatic deformities is complex and can involve all aspects of the nose, including the bony and cartilaginous framework as well as the soft tissue envelope.

Techniques for rejuvenation of the neck platysma.

This article reviews evaluation and techniques for neck rejuvenation. It includes a detailed overview of cervical rhytidectomy and discusses the potential complications associated with surgical correction. A review of clinical outcomes in the literature is also included.

Analgesic efficacy of continuous intravenous magnesium infusion as an adjuvant to morphine for postoperative analgesia: a systematic review and meta-analysis.

Background: The efficacy of perioperative intravenous magnesium administration on postoperative opioid use, opioid-related side effects (e.g., nausea and vomiting) and pain are uncertain, as randomized controlled trials on this topic have reported disparate results.

Morbidity and cost of odontogenic infections.

Objective: Cost analysis of deep neck space infections from odontogenic origin and review of the morbidity of potentially preventable complications.

Study Design: Case series with chart review.

Setting: Level 1 trauma center and academic safety net hospital.

Orthodromic temporalis tendon transfer: anatomical considerations.

Objectives: To define (1) at-risk structures during the orthodromic temporalis tendon transfer and (2) achievable tendon length without temporal releasing incisions or perioral lengthening materials.

Methods: Ten fresh cadavers provided 20 hemifaces for dissection. Measurements and photographic documentation were used to examine the parotid duct, masseteric artery, inferior alveolar nerve, internal maxillary artery, and mobilized tendon relative to adjacent landmarks.

Bilobed Zenker's diverticula.

A bilobed Zenker's diverticulum is an uncommon finding. Given the rarity of these bilobed pharyngeal pouches, their management can pose a clinical dilemma. We advocate transoral endoscopic division and stapling of the larger lobe as the management of choice for this clinical finding.

Long-term prognosis of pulmonary hypertension in silicosis.

Sixty patients with silicosis were examined by right heart catheterization and lung function tests during 1958-1966. In the 12-20 years follow-up the information was received of 57 patients (95%). 38 patients died (66.