Computed tomography-based automated 3D measurement of femoral version: Validation against standard 2D measurements in symptomatic patients.

To validate 3D methods for femoral version measurement, we asked: (1) Can a fully automated segmentation of the entire femur and 3D measurement of femoral version using a neck based method and a head-shaft based method be performed? (2) How do automatic 3D-based computed tomography (CT) measurements of femoral version compare to the most commonly used 2D-based measurements utilizing four different landmarks? Retrospective study (May 2017 to June 2018) evaluating 45 symptomatic patients (57 hips, mean age 18.7 ± 5.1 years) undergoing pelvic and femoral CT.

Heart failure management at home: a non-randomised prospective case-controlled trial (HeMan at Home).

Background/objectives: Heart failure (HF) is a growing clinical and economic burden for patients and health systems. The COVID-19 pandemic has led to avoidance and delay in care, resulting in increased morbidity and mortality among many patients with HF. The increasing burden of HF during the COVID-19 pandemic led us to evaluate the quality and safety of the Hospital at Home (HAH) for patients presenting to their community providers or emergency department (ED) with symptoms of acute on chronic HF (CHF) requiring admission.

Are degenerative findings detected on traction MR arthrography of the hip associated with failure of arthroscopic femoroacetabular impingement surgery?

Objectives: To identify preoperative degenerative features on traction MR arthrography associated with failure after arthroscopic femoroacetabular impingement (FAI) surgery.

Methods: Retrospective study including 102 patients (107 hips) undergoing traction magnetic resonance arthrography (MRA) of the hip at 1.5 T and subsequent hip arthroscopic FAI surgery performed (01/2016 to 02/2020) with complete follow-up.

Auxiliary Partial Orthotopic Liver Transplant as a Rescue Procedure for Acute Liver Failure with Extra-Small-for-Size Grafts: A Report of 2 Cases.

Auxiliary partial orthotopic liver transplant is a complex technique whereby a partial liver graft is transplanted in the orthotopic position, leaving behind a portion of the native liver. In acute liver failure, auxiliary partial orthotopic liver transplant serves as a rescue therapy and bridge for the native liver to regenerate. Auxiliary partial orthotopic liver transplant was initially considered a technically challenging procedure with inferior results versus orthotopic liver transplant.

Interaction between Age and Primary Site on Survival Outcomes in Primary GI Melanoma over the Past Decade.

Background: Primary malignant melanomas of the Gastrointestinal mucosa are uncommon. Most cases of gastrointestinal (GI) melanomas are secondary, arising from metastasis at distant sites. The purpose of this study is to assess to what extent the interaction between independent prognostic factors (age and tumor site) of primary GI melanoma influence survival.

Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding: A nationwide analysis.

Background: The optimal timing of esophagogastroduodenoscopy (EGD) and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding (NVUGIB) remains an area of active research.

Aim: To identify independent predictors of outcomes in patients with NVUGIB, with a particular focus on EGD timing, anticoagulation (AC) status, and demographic features.

Methods: A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICD-9 codes from the National Inpatient Sample database.

A small erythropoietin derived non-hematopoietic peptide reduces cardiac inflammation, attenuates age associated declines in heart function and prolongs healthspan.

Background: Aging is associated with increased levels of reactive oxygen species and inflammation that disrupt proteostasis and mitochondrial function and leads to organism-wide frailty later in life. ARA290 (cibinetide), an 11-aa non-hematopoietic peptide sequence within the cardioprotective domain of erythropoietin, mediates tissue protection by reducing inflammation and fibrosis. Age-associated cardiac inflammation is linked to structural and functional changes in the heart, including mitochondrial dysfunction, impaired proteostasis, hypertrophic cardiac remodeling, and contractile dysfunction.

A Deep Learning Method for Quantification of Femoral Head Necrosis Based on Routine Hip MRI for Improved Surgical Decision Making.

(1) Background: To evaluate the performance of a deep learning model to automatically segment femoral head necrosis (FHN) based on a standard 2D MRI sequence compared to manual segmentations for 3D quantification of FHN. (2) Methods: Twenty-six patients (thirty hips) with avascular necrosis underwent preoperative MR arthrography including a coronal 2D PD-w sequence and a 3D T1 VIBE sequence. Manual ground truth segmentations of the necrotic and unaffected bone were then performed by an expert reader to train a self-configuring nnU-Net model.

Reproducibility of T and T quantification in a multi-vendor multi-site study.

Objective: To evaluate the multi-vendor multi-site reproducibility of two-dimensional (2D) multi-echo spin-echo (MESE) T mapping (product sequences); and to evaluate the longitudinal reproducibility of three-dimensional (3D) magnetization-prepared angle-modulated partitioned k-space spoiled gradient echo snapshots (MAPSS) T and T mapping (research sequences), and 2D MESE T mapping, separated by 6 months, in a multi-vendor multi-site setting.

Methods: Phantoms and volunteers (n = 5 from each site, n = 20 in total) were scanned on four 3 T magnetic resonance (MR) systems from four sites and three vendors (Siemens, General Electric, and Phillips). Two traveling volunteers (3 knees) scanned at all 4 sites at baseline and 6-month follow-up.

Automated knee cartilage segmentation for heterogeneous clinical MRI using generative adversarial networks with transfer learning.

Background: This study aimed to build a deep learning model to automatically segment heterogeneous clinical MRI scans by optimizing a pre-trained model built from a homogeneous research dataset with transfer learning.

Methods: Conditional generative adversarial networks pretrained on the Osteoarthritis Initiative MR images was transferred to 30 sets of heterogenous MR images collected from clinical routines. Two trained radiologists manually segmented the 30 sets of clinical MR images for model training, validation and test.

Laparoscopic Transgastric Resection of a Large Gastric GIST: A Case Report and Review of Literature.

 Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Their primary treatment is surgical.  Here we report a case of a 36-year-old male patient who was being evaluated for weakness, anemia, and melena.

Pediatric living donor intestine transplant following an atypical complication of COVID-19: A unique case report from India.

Coronavirus disease-19 (COVID-19) infection causing severe gastrointestinal complications is rare. A 9-year-old child after recovering from mild COVID-19 infection developed small bowel gangrene due to superior mesenteric artery thrombosis. He required resection of entire necrotic small bowel along with caecum causing ultra-short bowel syndrome.

Monosegment Liver Allografts for Liver Transplantation in Infants Weighing Less Than 6 kg: An Initial Indian Experience.

Background: Living donor liver transplantation in small infants is a significant challenge. Liver allografts from adults may be large in size. This is accompanied by problems of graft perfusion, dysfunction, and the inability to achieve primary closure of the abdomen.

Acclimation to a thermoneutral environment abolishes age-associated alterations in heart rate and heart rate variability in conscious, unrestrained mice.

Mice are among the most widely used translational models of cardiovascular aging and offer a method to quickly assess lifespan changes in a controlled environment. The standard laboratory temperature (20-22 °C), however, imposes a cold stress on mice that causes an increase in sympathetic nervous system-mediated activation of brown adipose tissue (BAT) to maintain a core body temperature of 36-37 °C. Thus, while physiologic data obtained recapitulate human physiology to a certain degree, interpretations of previous research in mice may have been contaminated by a cold stress, due to housing mice below their thermoneutral zone (30 °C).

Neuroendocrine carcinomas of the gallbladder: Lessons learnt from cases at opposite ends of the spectrum.

Neuroendocrine tumors are the rarest tumors of gallbladder. The most aggressive variant is neuroendocrine carcinoma which represents about 0.5% of all gallbladder carcinomas and 0.

Donor derived HSV hepatitis in a kidney transplant recipient leading to liver fibrosis and portal hypertension.

The unexpected transmission of donor-derived infection through organ transplantation is a rare event with current donor screening practices. In this case report we describe a probable donor-derived transmission of Herpes Simplex Virus (HSV)-2 via deceased donor kidney transplantation resulting in HSV hepatitis in the recipient. This manifested as acute liver failure which resolved with appropriate anti-viral therapy.

Lymphocyte depletion and risk of acute rejection in renal transplant recipients at increased risk for delayed graft function.

Delayed graft function (DGF) is a risk factor for acute rejection (AR) in renal transplant recipients, and KDIGO guidelines suggest use of lymphocyte-depletion induction when DGF is anticipated. We analyzed the United Network for Organ Sharing/Organ Procurement and Transplantation Network (UNOS/OPTN) database to assess the impact of induction immunosuppression on the risk of AR in deceased kidney recipients based on pretransplant risk of DGF using a validated model. Recipients were categorized into 4 groups based upon the induction immunosuppression: (1) Rabbit anti-thymocyte globulin (rATG); (2) Alemtuzumab (C1H); (3) IL2-receptor antagonists (IL2-RA; basiliximab or daclizumab), and (4) No antibody induction.

A study of events between the onset of symptoms and hospital admission in patients with acute abdomen.

Background: Acute abdomen is a common surgical emergency. Prompt investigation and treatment, including surgical intervention, is critical in reducing morbidity and mortality.

Methods: We carried out a prospective observational study at a large urban secondary healthcare centre in India.

Tubulointerstitial Injury and Drugs of Abuse.

Drug abuse is widespread in many populations, and patients abusing illicit substances are at a significantly increased risk of kidney injury. The tubulointerstitial compartment is a common target of these nephrotoxic agents. This review will cover some of the common illicit drugs and will focus on the tubulointerstitial injuries seen in the setting of drug abuse.

Factors Impacting Mortality in the Pre-Hospital Period After Road Traffic Accidents in Urban India.

Background: India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world.

Objectives: We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates.

Patients And Methods: A prospective observational study was carried out in a metro area in India over a period of one year.

Outcomes of a conservative approach to management in amoebic liver abscess.

Context: Unfortunately, there is confusion among the medical community regarding the management of amoebic liver abscess (ALA). Therapeutic options range from simple pharmacotherapy to use of interventions like a needle or catheter aspiration under ultrasound guidance to surgical intervention. There is a plethora of thresholds for parameters such as the maximum diameter of the abscess and volume on ultrasound examination suggested by various authors to serve as a criterion to help to decide when to use which modality in these cases.

A Prospective Randomized Comparative Study of Vaginal, Abdominal, and Laparoscopic Hysterectomies.

Purpose: The present study is a prospective, randomized comparative study of abdominal, vaginal and laparoscopic hysterectomies comparing various parameters such as indications, blood loss, post operative pain, time taken for surgery, intraoperative and postoperative complications and total hospital stay.

Materials And Methods: 50 patients were selected in each group over a period of 18 months. The patients were selected in such a way that they could be operated by all 3 routes.

Adjuvant Radiotherapy in Early-Stage Breast Cancer: Evidence-Based Options.

Background: Patients with a diagnosis of early-stage breast cancer are offered the option of either mastectomy or breast-conserving therapy (BCT) secondary to multiple randomized trials demonstrating equivalent long-term outcomes. Traditionally, BCT has used standard whole-breast irradiation (SWBI) after breast-conserving surgery, although several alternatives have emerged during the past few decades.

Methods: This report reviews key studies supporting each radiation technique and its respective eligibility criteria to assist clinicians in deciding which adjuvant radiotherapy options are appropriate for their patients.

Why have we embraced minimally invasive surgery and ignored enhanced recovery after surgery?

There has been a lot of enthusiasm about minimally invasive surgery (MIS) in the surgical community in recent times. Some of the main reasons for this are an unmatched appeal to patients, doctors and healthcare systems alike. Push from the industry also serves as an important reason for its popularity.