Dolphin Pituitary Gland: Immunohistochemistry and Ultrastructural Cell Characterization Following a Novel Anatomical Dissection Protocol and Non-Invasive Imaging (MRI).

The pituitary gland regulates essential physiological processes in mammals. Despite its importance, research on its anatomy and ultrastructure in dolphins remains scarce. Using non-invasive imaging technology (MRI) and a novel skull-opening and dissection protocol, this study characterizes the dolphin pituitary through immunohistochemistry (IHC) and transmission electron microscopy (TEM).

A registration strategy to characterize DTI-observed changes in skeletal muscle architecture due to passive shortening.

Skeletal muscle architecture is a key determinant of muscle function. Architectural properties such as fascicle length, pennation angle, and curvature can be characterized using Diffusion Tensor Imaging (DTI), but acquiring these data during a contraction is not currently feasible. However, an image registration-based strategy may be able to convert muscle architectural properties observed at rest to their contracted state.

Validation of the WIfI Classification in the Vascular Quality Initiative database.

Objectives: The Society for Vascular Surgery Wound Ischemia foot Infection classification (WIfI) was introduced in 2014 and has been validated in multiple institutional series as a useful tool to assess the severity of chronic limb-threatening ischemia (CLTI) and predict the risk of major amputation after lower extremity revascularization (LER). The Vascular Quality Initiative (VQI) peripheral vascular interventions (PVI) database captures data on wounds, ischemia, and infection, which are key components of the WIfI score, but does not provide the complete WIfI stage. The aim of this study is to validate the WIfI classification in the VQI PVI database and analyze the different combinations of components.

Electromagnetic tracking system for position and orientation detection of deep brain stimulation electrodes during surgery.

This paper describes a 3D electromagnetic tracking (EMT) system, based on quasi-static magnetic fields and a sub-millimeter 3D magnetometer, providing complete localization - both spatial and angular positions - during surgical procedures. By integrating miniaturized sensors into surgical tools, such as deep brain stimulation (DBS) electrodes, this tracking system offers complementary or alternative solutions for X-ray imaging. Each spatial position in the measurement volume (MV) is uniquely encoded by a vector of four magnetic field amplitudes using the multilateration principle.

Outcomes of Mechanical Thrombectomy for Acute Limb Ischemia at a Tertiary Referral Center.

Objective: Acute limb ischemia (ALI) harbors high risk of limb loss and mortality. We reviewed the use and outcomes of mechanical thrombectomy devices in the management of ALI at a tertiary referral center.

Methods: ALI cases with duration of symptoms <2 weeks and treated with mechanical thrombectomy at a tertiary referral center between 2016-2024 were reviewed.

Ticagrelor Monotherapy Following Short-Term DAPT in ACS Undergoing PCI: A Systematic Review and Meta-Analysis.

Background: Dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is the standard of care. However, it is associated with a higher incidence of bleeding events. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of short-term DAPT.

World Health Organization priority antimicrobial resistance in and healthcare-associated bloodstream infections in Brazil (ASCENSION): a prospective, multicentre, observational study.

Background: Carbapenem-resistant (CRE), (CRAB), (CRPA), methicillin-resistant (MRSA) and vancomycin-resistant (VRE) are listed by World Health Organization (WHO) as priority antimicrobial-resistant bacteria. Data on WHO Priority Antimicrobial resistance Phenotype (WPAP) bacteria from low- and middle-income countries are scarce. In this study, we investigated the occurrence of WPAP in healthcare-associated bloodstream infections (BSI) in Brazil, an upper-middle-income country in South America.

Management of a large pseudomeningocele and cerebrospinal fluid fistula after microsurgical resection of recurrent lipomyelomeningocele in children.

Objective: Symptomatic retethering in pediatric patients following complex spinal dysraphism surgery for lipomyelomeningocele (LMMC) repair occurs in approximately 20% of cases. Common complications after repeat surgery for retethering include infection, pseudomeningocele (PMC), and cerebrospinal fluid (CSF) fistula. The authors of this report aim to describe the treatment options for large PMCs or CSF fistulas in a series of patients who underwent repeat surgery for recurrent LMMC at their institution.

Society for Vascular Surgery Compensation Study of Vascular Surgeons in the United States.

Objective: The Society for Vascular Surgery (SVS) partnered with Phairify, Inc., an organization with experience in physician compensation data compilation for several other medical specialties, to survey its membership and assess factors influencing vascular surgeon compensation.

Methods: The SVS Compensation Study Task Force developed a vascular surgery-specific survey between January 2023 and May 2023, including experience level, academic rank, bonuses, incentives, gender, race, ethnicity, geography, on-call pay, and other factors influencing overall reimbursement.

Lung cancer in Asia: the impact of climate change.

The escalating global threat of climate change is becoming more evident. The climate crisis intersects with another major challenge: lung cancer. With Asia already bearing half the global cancer burden, the impact of climate-related events on health and on lung cancer care specifically are profound.

The association of reduced ejection fraction with the outcomes of endovascular abdominal aortic aneurysm repair.

Objective: It is estimated that 20% of patients undergoing elective abdominal aortic aneurysm repair suffer from cardiomyopathy. This study examines the impact of reduced ejection fraction (EF) on the outcomes of endovascular aneurysm repair (EVAR) and compares the different types of cardiomyopathies causing reduction of EF. Our hypothesis is that reduction in EF is associated with higher mortality after EVAR.

Oligodendroglia Are Primed for Antigen Presentation in Response to Chronic Stress-Induced Microglial-Derived Inflammation.

Chronic stress is a major contributor to the development of major depressive disorder, one of the leading causes of disability worldwide. Using a model of repeated social defeat stress in mice, we and others have reported that neuroinflammation plays a dynamic role in the development of behavioral deficits consistent with social avoidance and impaired reward responses. Animals susceptible to the model also exhibit hypomyelination in the medial prefrontal cortex, indicative of changes in the differentiation pathway of cells of the oligodendroglial lineage (OLN).

Outcomes of Concomitant Mitral Intervention in Hypertrophic Obstructive Cardiomyopathy Surgery?: A Systematic Review and Meta-Analysis of Contemporary Evidence.

The 2020 American Heart Association Guidelines advise not to perform mitral valve replacement (MVR) during septal myectomy (SM) to alleviate outflow obstruction. This study aims to review outcomes after concomitant mitral valve (MV) intervention versus SM alone. We conducted a comprehensive literature search across Embase, PubMed, and Scopus.

Fronto-orbital advancement with patient-specific 3D-printed implants and robot-guided laser osteotomy: an in vitro accuracy assessment.

Purpose: The use of computer-assisted virtual surgical planning (VSP) for craniosynostosis surgery is gaining increasing implementation in the clinics. However, accurately transferring the preoperative planning data to the operating room remains challenging. We introduced and investigated a fully digital workflow to perform fronto-orbital advancement (FOA) surgery using 3D-printed patient-specific implants (PSIs) and cold-ablation robot-guided laser osteotomy.

Early minimally invasive image-guided eNdoscopic evacuation of iNTracerebral hemorrhage: a phase II pilot trial.

Background: Whether minimally invasive endoscopic surgery (ES) improves survival and functional outcome in people with spontaneous supratentorial intracerebral hemorrhage (SSICH) is unknown.

Methods: This is a single-center pilot study performed between July 2021 to January 2023. Any supratentorial hematoma with a volume between 20 mL and 100 mL was endoscopically evacuated within 24 h after bleeding onset.

Implementation of a Patient-Specific Opioid Taper Calculator for Total Hip and Knee Arthroplasty: A Pre- and Post-Implementation Study.

Background: Given the association between high opioid use and postoperative complications after total joint arthroplasty, it is important to prescribe opioids responsibly in the postoperative period. While many pain regimen protocols exist to try and limit opioid use, an optimal approach to narcotic prescription for arthroplasty patients is yet to be established. This study evaluated the effects of using an individualized opioid taper calculator for patients undergoing elective primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Hormone Regulation of Corticotropin-Releasing Factor Receptor 1 in the Female Mouse Brain.

Introduction: Corticotropin-releasing factor receptor 1 (CRFR1) is a key regulator of neuroendocrine and behavioral stress responses. Previous studies have demonstrated that CRFR1 in certain hypothalamic and preoptic brain areas is modified by chronic stress and during the postpartum period in female mice, although the potential hormonal contributors to these changes are unknown.

Methods: This study focused on determining the contributions of hormones associated with stress and the maternal period (glucocorticoids, prolactin, estradiol/progesterone) on CRFR1 levels using a CRFR1-GFP reporter mouse line and immunohistochemistry.

Innovating neurosurgical training: a comprehensive evaluation of a 3D-printed intraventricular neuroendoscopy simulator and systematic review of the literature.

Objective: The objective of this study was to develop and evaluate a low-cost 3D-printed simulator to improve the ability of neurosurgical residents to handle and coordinate endoscopes in performing technically demanding procedures such as neuroendoscopic removal of ventricular tumors or endoscopic third ventriculostomy (ETV).

Methods: The simulator was developed, printed in-house, and evaluated in a trial involving neurosurgery residents who performed ETV and intraventricular tumor resection tasks using it. Participants completed a questionnaire that assessed various aspects of the simulator's effectiveness, including anatomical visualization, procedural understanding, competency enhancement, and subjective impressions.

Virtual reality for patient informed consent in skull base tumors and intracranial vascular pathologies: A pilot study.

Purpose: With the growing demand for shared decision-making and patient-centered care, optimal informed consent (IC) has gained relevance. Virtual reality (VR) has seen significant technological advancements, and its medical applications currently include surgical planning and medical education. This pilot study investigates the feasibility of VR-enhanced informed consent (VR-IC) in neurosurgery to improve preoperative IC and patient satisfaction.

Enhancing anti-EGFRvIII CAR T cell therapy against glioblastoma with a paracrine SIRPγ-derived CD47 blocker.

A significant challenge for chimeric antigen receptor (CAR) T cell therapy against glioblastoma (GBM) is its immunosuppressive microenvironment, which is densely populated by protumoral glioma-associated microglia and macrophages (GAMs). Myeloid immune checkpoint therapy targeting the CD47-signal regulatory protein alpha (SIRPα) axis induces GAM phagocytic function, but CD47 blockade monotherapy is associated with toxicity and low bioavailability in solid tumors. In this work, we engineer a CAR T cell against epidermal growth factor receptor variant III (EGFRvIII), constitutively secreting a signal regulatory protein gamma-related protein (SGRP) with high affinity to CD47.

Assessment of Interrater Reliability and Accuracy of Cerebral Aneurysm Morphometry Using 3D Virtual Reality, 2D Digital Subtraction Angiography, and 3D Reconstruction: A Randomized Comparative Study.

Background/objectives: Detailed morphometric analysis of an aneurysm and the related vascular bifurcation are critical factors when determining rupture risk and planning treatment for unruptured intracranial aneurysms (UIAs). The standard visualization of digital subtraction angiography (DSA) and its 3D reconstruction on a 2D monitor provide precise measurements but are subject to variability based on the rater. Visualization using virtual (VR) and augmented reality platforms can overcome those limitations.

Open and endovascular treatment of the common femoral artery in a tertiary care center.

Objectives: Endovascular treatment of peripheral arterial disease involving the common femoral artery (CFA) remains controversial. This study compares the perioperative and long-term outcomes of open and endovascular lower extremity revascularization (LER) involving the CFA.

Methods: A retrospective analysis of all patients undergoing LER for peripheral arterial disease in a tertiary care center was performed.

Ruptured Complex Aortoiliac Aneurysm in an Elderly Patient With a Kidney Transplant Presenting With Sciatica.

Common iliac artery aneurysms are uncommon, with an estimated incidence of less than 0.01% in adults and accounting for only 1% of all intra-abdominal aneurysms. While the risk of rupture is approximately 5%, it increases significantly to 29% once the aneurysm reaches 4 cm.