Ultrasound Appearance of the Endometrium Post-Radiofrequency Ablation.

Objective: To describe the ultrasonographic appearance of the post-ablative endometrium to improve knowledge of its sonographic findings.

Methods: This was an Institutional Review Board approved prospective study of patients who underwent second-generation endometrial ablation from 2016 to 2019 at a single health system. Patients had postoperative transvaginal ultrasounds at 2, 6, and 12 months.

The Impact of Heroin Self-Administration and Environmental Enrichment on Ventral Tegmental CRF1 Receptor Expression.

Background: There is a strong link between chronic stress and vulnerability to drug abuse and addiction. Corticotropin releasing factor (CRF) is central to the stress response that contributes to continuation and relapse to heroin abuse. Chronic heroin exposure can exacerbate CRF production, leading to dysregulation of the midbrain CRF-dopamine-glutamate interaction.

Milnacipran Ameliorates Executive Function Impairments following Frontal Lobe Traumatic Brain Injury in Male Rats: A Multimodal Behavioral Assessment.

Traumatic brain injuries (TBIs) affect more than 10 million patients annually worldwide, causing long-term cognitive and psychosocial impairments. Frontal lobe TBIs commonly impair executive function, but laboratory models typically focus primarily on spatial learning and declarative memory. We implemented a multi-modal approach for clinically relevant cognitive-behavioral assessments of frontal lobe function in rats with TBI and assessed treatment benefits of the serotonin-norepinephrine reuptake inhibitor, milnacipran (MLN).

Comparing the structural dynamics of the human KCNE3 in reconstituted micelle and lipid bilayered vesicle environments.

KCNE3 is a single transmembrane protein of the KCNE family that modulates the function and trafficking of several voltage-gated potassium channels, including KCNQ1. Structural studies of KCNE3 have been previously conducted in a wide range of model membrane mimics. However, it is important to assess the impact of the membrane mimics used on the observed conformation and dynamics.

Comparison of Contrast-Enhanced Ultrasound Versus Magnetic Resonance Imaging in the Detection and Characterization of Uterine Leiomyomas.

Objectives: Uterine fibroids are common findings in women with pelvic pain and abnormal uterine bleeding. The reference standard test in the pretreatment evaluation of fibroids is contrast-enhanced magnetic resonance (MR) imaging. This study compared the number, size, location, and enhancement of uterine fibroids identified by contrast-enhanced ultrasound (CEUS) and MR.

Preoperative Gabapentin for Minimally Invasive Hysterectomy: A Randomized Controlled Trial.

Study Objective: To evaluate whether a single dose of gabapentin given preoperatively reduces narcotic use 24 hours after minimally invasive hysterectomy (MIH).

Design: Randomized controlled trial.

Setting: Single academic-affiliated community hospital.

Incidence and predictors of failed second-generation endometrial ablation.

Background: The need for any treatment following an endometrial ablation is frequently cited as "failed therapy," with the two most common secondary interventions being repeat ablation and hysterectomy. Since second-generation devices have become standard of care, no large cohort study has assessed treatment outcomes with regard to only these newer devices. We sought to determine the incidence and predictors of failed second-generation endometrial ablation, defined as the need for surgical re-intervention.

Utility of anesthetic block for endometrial ablation pain: a randomized controlled trial.

Background: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting.

Objective: The aim of this study was to evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation.

The Need for Clinical Hand Education in Emergency Medicine Residency Programs.

Background: Complaints related to the hands, wrists, and fingers comprise approximately 3.7 million emergency department visits annually. The complexity of this subject can confound timely diagnosis and treatment, particularly if the treating physician has not received specialized training.

Does Time Affect Patient Satisfaction and Health-Related Quality of Life After Reduction Mammoplasty?

Objective: A total of 62,611 patients with breast hypertrophy underwent breast reduction surgery in 2013 in the United States to improve their symptoms and health-related quality of life. While multiple studies utilizing various outcome instruments demonstrate the efficacy of reductive surgery, it is presently unknown how the postoperative course affects patient satisfaction and health-related quality of life as measured by the BREAST-Q. Our objective was to determine the temporal relationship of patient satisfaction and health-related quality of life after reduction mammoplasty.

An Algorithm for Building an Electronic Database.

Objective: We propose an algorithm on how to create a prospectively maintained database, which can then be used to analyze prospective data in a retrospective fashion. Our algorithm provides future researchers a road map on how to set up, maintain, and use an electronic database to improve evidence-based care and future clinical outcomes.

Methods: The database was created using Microsoft Access and included demographic information, socioeconomic information, and intraoperative and postoperative details via standardized drop-down menus.

Traditional Versus Simulation Resident Surgical Laparoscopic Salpingectomy Training: A Randomized Controlled Trial.

Study Objectives: To evaluate the effectiveness of the porcine training model for obstetrics-gynecology (OB/GYN) residents in laparoscopic salpingectomy.

Design: Randomized, controlled single-blinded trial.

Classification: Canadian Task Force Classification I.

A novel three serum phospholipid panel differentiates normal individuals from those with prostate cancer.

Background: The results of prostate specific antigen (PSA) and digital rectal examination (DRE) screenings lead to both under and over treatment of prostate cancer (PCa). As such, there is an urgent need for the identification and evaluation of new markers for early diagnosis and disease prognosis. Studies have shown a link between PCa, lipids and lipid metabolism.

Outcomes of delayed abdominal-based autologous reconstruction versus latissimus dorsi flap plus implant reconstruction in previously irradiated patients.

Background: Local recurrence after breast conservation therapy is usually managed with salvage mastectomy. Multiple methods of reconstruction are possible, although delayed autologous reconstruction provides the most reliable results.

Methods: We compared complications in delayed abdominal-based [transverse rectus abdominis muscle (TRAM)/deep inferior epigastric perforator (DIEP)] reconstruction with delayed latissimus dorsi plus implant-based reconstruction in previously irradiated breasts.

The use of the multi-island vertical rectus abdominis myocutaneous flap in head and neck reconstruction.

Background: Head and neck cancer extirpation frequently creates complex 3-dimensional defects involving both intraoral and external tissues. Reconstruction can be accomplished either with 2 free flaps, a simultaneous free and pedicle flap, or a single double-island folded free flap. Herein, the outcomes and rationale for reconstruction of multilaminar head and neck defects using the multi-island vertical rectus abdominis myocutaneous (MI-VRAM) flap are reported.

Treatment of keratoacanthoma: Is intralesional methotrexate an option?

Background: Keratoacanthomas (KAs) are a variant of squamous cell carcinomas. Some KAs have shown aggressive behaviour, leading to metastasis and death. Surgical excision is the treatment of choice for most KA patients.

A new dimension: robotic reconstruction in plastic surgery.

Background: Robot-assisted surgery was first approved by the Federal Drug Administration in 1994. The robotic system has the advantages of three-dimensional visualization of the operating field, 7° range of motion, tremor elimination, 360°of freedom at 10-mm distance, and a comfortable, seated operating posture. The purpose of this paper is to present a new surgical tool, the robot, for use in reconstructive surgery.

Prescription medication borrowing among adult patients at an urban medical center.

Prescription medication borrowing can result in adverse health outcomes. We aimed to study the patterns of borrowing prescription medications in an adult urban population seeking healthcare in the outpatient, emergency, and inpatient units of an urban medical center. Participants indicated whether they (1) had a primary care doctor, medical insurance, a prior history of substance abuse, psychiatric disorders, or chronic pain; and (2) had borrowed a prescription medication.

Median cleft of the upper lip: a rare case.

Median cleft lip is a midline vertical cleft through the upper lip. This is a rare anomaly with very few cases described in the literature. Median cleft lip has been thought to be associated with hypertelorism or hypotelorism.

Keloid treatment: is there a role for acellular human dermis (Alloderm)?

Background: Keloid management is faced with high recurrence rates. Keloid fibroblasts lack the normal negative feedback mechanism resulting in an exuberant scar formation. Alloderm doesn't undergo the same proliferative process as keloidal scar dermis.

Comparison of wound education in medical schools in the United States, United kingdom, and Germany.

Objective: Millions of patients are treated annually in the United States, United Kingdom, and Germany with either acute or chronic wounds. The purpose of this study is to compare how the medical education systems in the United States, Germany, and United Kingdom have prepared their physician trainees to deal with clinical issues of wounds.

Methods: A retrospective study was performed in the United States by obtaining medical school curriculum data from the American Association of Medical Colleges, 2005.

Wound education: American medical students are inadequately trained in wound care.

Millions of patients are treated annually in the United States with either acute or chronic wounds, costing billions of dollars. This is a retrospective study designed to quantify the directed education that medical students receive in their 4 years of training on 3 wound-related topics: physiology of tissue injury, physiology of wound healing, and clinical wound healing. The mean hours of education in physiology of tissue injury at 50 American medical schools are 0.

Ethnic differences in endorsement of the Protestant work ethic: the role of ethnic identity and perceptions of social class.

The authors examined ethnic differences in endorsement of the Protestant work ethic (PWE; M. Weber, 1905) among Black (n = 96) and White (n = 149) college students and tested whether differences in ethnic identity and perceptions of social class mediated the relationship between ethnicity and the endorsement of PWE values. Blacks were higher in levels of ethnic identity, more likely to see themselves as working or middle class, and less likely to endorse the PWE.

Uncommon leg ulcers in the lower extremity.

Objective: To determine the prevalence of uncommon ulcers, unrelated to venous or arterial etiology, in patients presenting to vascular clinics.

Methods: This was a multicenter prospective study of consecutive patients presenting with lower extremity ulceration. The settings were university hospital outpatient centers and venous clinics.