Prepectoral Breast Reconstruction Prompts Revisiting the Anatomical Boundaries of the Breast: A Radiographic and Cadaveric Study.

Background: This study aimed to determine the location of superficial fascial system condensations in relation to classic anatomical breast boundaries. Cadaveric studies have provided some understanding, but knowledge about the precise location of these condensations remains limited.

Methods: Preoperative breast magnetic resonance imaging (MRI) was conducted to assess the fascial condensations defining the breast footprint relative to landmarks such as the latissimus, clavicle, sternal border, and inframammary fold.

The Impact of Social Determinants of Health on the Treatment of Distal Radius Fracture.

Background: Disparities in social determinants of health (SDH) have been shown to play an increasingly important role in the equitable delivery of health care. Distal radius fractures (DRFs) are among the most common upper-extremity injuries encountered. This study aims to examine the influence of economic, educational, social, environmental, and healthcare disparities on management of these injuries.

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.

Gender-Affirming Surgery Improves Mental Health Outcomes and Decreases Antidepressant Use in Patients with Gender Dysphoria.

Background: Patients with gender dysphoria face significant health disparities and barriers to care. Transition-related care includes hormonal therapy, mental health care, and gender-affirming surgery. Studies have described favorable surgical outcomes and patient satisfaction; however, the degree to which these procedures affect mental health conditions is not fully understood.

The Mechanism of Cannabichromene and Cannabidiol Alone Versus in Combination in the Alleviation of Arthritis-Related Inflammation.

Background: Patients suffering from arthritis have limited treatment options for nonoperative management. In search of pain relief, patients have been taking over-the-counter cannabinoids. Cannabidiol (CBD) and cannabichromene (CBC) are minor cannabinoids with reported analgesic and anti-inflammatory properties and have been implicated as potential therapeutics for arthritis-related pain.

Traditional Neuroma Management Strategies: A Systematic Review.

Background: In this systematic review, the authors discuss traditional management strategies of neuromas. Surgical management can be described as either passive and ablative or active and reconstructive. Our aim was to evaluate the evidence supporting traditional management strategies in patients affected by neuromas.

Components of Existing National Surgical Site Infection Surveillance Programs Based on a Case Series of Low- and Middle-Income Countries: Building Blocks for Success and Opportunities for Improvement.

Surgical site infection (SSI) surveillance programs are recommended to be included in national infection prevention and control (IPC) programs, yet few exist in low- or middle-income countries (LMICs). Our goal was to identify components of surveillance in existing programs that could be replicated elsewhere and note opportunities for improvement to build awareness for other countries in the process of developing their own national surgical site infection surveillance (nSSIS) programs. We administered a survey built upon the U.

Is nerve coaptation associated with improved sensation after microvascular breast reconstruction? A systematic review.

Background: Sensation after autologous breast reconstruction is an increasingly important outcome. Several studies demonstrated improved sensation with flap neurotization but utilized heterogenous measures and follow-up intervals. This review evaluates sensory outcomes after neurotization using uniform, objective outcome measurements.

A Cohort Study of an Enhanced Recovery Pathway for Pancreatic Surgery at a Community Hospital.

Background: Enhanced recovery after surgery (ERAS) pathways have been shown to improve pancreatic surgery outcomes, though feasibility in a community hospital remain unclear. We hypothesized that an ERAS protocol would reduce hospital length of stay (LOS) without increased morbidity.

Methods: An ERAS pathway was initiated for patients undergoing pancreatic surgery at a community cancer center and compared to a historical cohort.

Safety and efficacy of transcarotid artery revascularization in a community hospital.

Objective: We evaluated the outcomes and complications of transcarotid artery revascularization (TCAR) outside of academic vascular surgery programs.

Methods: An institutional review board-approved retrospective study was performed. Data from all cases of TCAR performed at a community hospital from May 2017 to February 2020 were collected and analyzed.

Left Carotid Artery Thrombosis Due to Thromboangiitis Obliterans.

Thromboangiitis obliterans (TAO, Buerger disease) is a segmental, non-atherosclerotic vasculitis that causes occlusion of the small and medium sized vessels of the distal extremities. In rare cases, it can affect vessels in the gastrointestinal, cerebrovascular, coronary, and renal systems. The etiology of thromboangiitis obliterans is unknown, but there is a strong association with smoking in the development and the progression of the disease.

Surgical Outcomes of Distal Pancreatectomy in Elderly Patients.

Background: The extent to which age impacts surgical outcomes remains poorly characterized. This study aims to evaluate the impact of age on 30-day outcomes in patients after distal pancreatectomy.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2017), distal pancreatectomy patients were identified and age-stratified, groups A (≤75 years) and B (>75 years).

Is the Isolation of Associated with Outcomes from Intra-Abdominal Infection? No, But the Receipt of an Empiric Anti-Pseudomonal Agent Is.

is isolated at variable rates from intra-abdominal infections (IAI). Not all recommended empiric regimens for IAI include anti- activity, for example, ceftriaxone and metronidazole. We hypothesized that within an adult population, is a relatively rare isolate and has no association with mortality, and thus, empiric therapy with anti- activity is not warranted.

The Volume-Outcome Relationship and Traveling for Hepatobiliary and Pancreatic Surgery: A Quantitative Analysis of Patient Perspectives.

Despite the well-established relationship between volume and outcomes, patients continue to have procedures performed at low-volume hospitals. The factors patients use to make the complex decision of where to have hepatopancreaticobiliary (HPB) surgery remain poorly characterized. A novel survey instrument was administered to all patients who had undergone HPB surgery at two university-affiliated community hospitals.

Cervical cancer recurrence presenting as abdominal wall mass and accompanying cellulitis.

Background: Most recurrences of early stage cervical cancer occur in the pelvis or lymphatic system. Distant metastases occur in a minority of patients. Large abdominal wall recurrence presenting as cellulitis and intra-abdominal mass is unusual and presents diagnostic as well as treatment challenges.

Survey of National Surgical Site Infection Surveillance Programs in Low- and Middle-Income Countries.

Surgical site infection (SSI) surveillance programs are strongly recommended as a core component of effective national infection prevention and control (IPC) programs. Participation in national SSI surveillance (nSSIS) programs has been shown to decrease reported SSIs among high-income countries (HICs), and it is expected that the same is possible among low- and middle-income countries (LMICs). We sought to determine what, if any nSSIS programs exist among LMICs.

Neurodevelopmental outcomes of preterm infants: a recent literature review.

Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference.

Methods: A literature search was conducted through PubMed for articles published between January 2018 and September 2019.

PDE4 subtypes in cancer.

Cyclic nucleotide phosphodiesterases (PDE) break down cyclic nucleotides such as cAMP and cGMP, reducing the signaling of these important intracellular second messengers. Several unique families of phosphodiesterases exist, and certain families are clinically important modulators of vasodilation. In the current work, we have summarized the body of literature that describes an emerging role for the PDE4 subfamily of phosphodiesterases in malignancy.

Effective reduction in stress induced postoperative hyperglycemia in bariatric surgery by better carb loading.

Background: Preoperative carbohydrate loading is a recommended component of enhanced recovery protocols (ERP's), however the impact on postoperative stress-induced insulin resistance remains poorly studied in both diabetics and non-diabetics.

Methods: Using our ERP, a preoperative grape juice group (Grape) was compared to the use of 25 g maltodextrin/3 g citrulline (G.E.

Trends in surgery and disparities in receipt of surgery for intrahepatic cholangiocarcinoma in the US: 2005-2014.

Background: Intrahepatic cholangiocarcinoma (IHC) is a malignancy with an increasing incidence. Surgery is the only treatment modality associated with long term survival. The objective of this study is to utilize a nationwide representative database to quantify the trends in incidence, and surgery for IHC in the United States from 2004-2014, as well as identify any disparities in the receipt of surgery.