Split-Thickness Skin Grafting for the Management of Traumatic Pretibial Hematomas.

Pretibial traumatic hematomas, a subtype of subcutaneous tension hematomas, are a frequent but understudied injury seen predominantly among the elderly. This patient cohort has a high incidence of comorbidities and frailty. They are frequently taking antiplatelet medications and systemic anticoagulants.

A systematic review and meta-analysis of double trophectoderm biopsy and/or cryopreservation in PGT: balancing the need for a diagnosis against the risk of harm.

Background: To prevent the transfer of embryos affected by monogenic conditions and/or chromosomal defects, preimplantation genetic testing (PGT) requires trophectoderm biopsy and cryopreservation. In 2-6% of biopsies, the diagnosis may be inconclusive due to DNA amplification failure or low-quality results. In these cases, a round of re-warming, re-biopsy, and re-cryopreservation is required to obtain a genetic diagnosis.

A multicycle approach through DuoStim with a progestin-primed ovarian stimulation (PPOS) protocol: a valuable option in poor prognosis patients undergoing PGT-A.

Purpose: This study is to evaluate the effectiveness of a PPOS protocol in poor prognosis patients undergoing IVF with DuoStim and PGT-A versus the conventional protocol with GnRH antagonist.

Methods: Retrospective cohort study encompassing 444 couples obtained matching one PPOS-DuoStim with two antagonist-DuoStim cycles at a private IVF center between 2020 and 2023 (average maternal age: 40 years, average cumulus-oocyte complexes collected after the first stimulation: 5). The study was powered to exclude a two-sided different euploid blastocyst rate per MII oocytes (EBR per MII) in the two groups (alpha = 0.

ICSI and PGT-A in PCOS phenotype-D patients: a matched case-control study versus idiopathic infertile women.

Purpose: To assess oocyte competence and embryo chromosomal constitution in phenotype-D PCOS women undergoing ICSI for PGT-A at the blastocyst stage.

Methods: Retrospective study at a private IVF center. In the period 2013-2021, 58 naïve phenotype-D PCOS women (i.

Laparoscopic Hartmann's procedure for complicated diverticulitis is associated with lower superficial surgical site infections compared to open surgery with similar other outcomes: a NSQIP-based, propensity score matched analysis.

Background: Open Hartmann's procedure has traditionally been the procedure of choice to treat complicated diverticulitis. We analyzed the ACS-NSQIP database to compare outcomes in patients who underwent emergent laparoscopic Hartmann's procedure (LHP) to those who had an open Hartmann's procedure (OHP).

Study Design: Data analyzed from 2015 to 2019 using ICD-10 codes.

Preventing and Controlling Healthcare-Associated Infections: The First Principle of Every Antimicrobial Stewardship Program in Hospital Settings.

Antimicrobial resistance (AMR) is one of the main public health global burdens of the 21st century, responsible for over a million deaths every year. Hospital programs aimed at improving antibiotic use, referred to as antimicrobial stewardship programs (ASPs), can both optimize the treatment of infections and minimize adverse antibiotics events including the development and spread of AMR. The challenge of AMR is closely linked to the development and spread of healthcare-associated infection (HAIs).

A Quality Improvement Initiative to Implement Focused Family Meetings in the Surgical Intensive Care Unit: Does It Matter?

Communication with families is essential to improve satisfaction, especially in the critical care setting. We sought to identify patients who were not recovering as expected and to improve communication with their families. We implemented a novel algorithm, incorporating clinical and social criteria, to determine which patients could benefit from additional communication.

Baseline gut microbiota diversity and composition and albendazole efficacy in hookworm-infected individuals.

Soil-transmitted helminth (STH) infections account for a significant global health burden, necessitating mass drug administration with benzimidazole-class anthelmintics, such as albendazole (ALB), for morbidity control. However, ALB efficacy shows substantial variability, presenting challenges for achieving consistent treatment outcomes. We have explored the potential impact of the baseline gut microbiota on ALB efficacy in hookworm-infected individuals through microbiota profiling and machine learning (ML) techniques.

Bariatric and general surgical procedures in obese patients with a history of venous thromboembolism and concurrent anticoagulation therapy.

Objective: The objective of this study was to examine the use and outcomes of perioperative anticoagulation (AC) in obese patients with a known history of venous thromboembolism event (VTE).

Method: A retrospective review of a prospective database for patients with a VTE history undergoing bariatric and general surgery at a single center (1/2008-12/2017) was performed. Factors assessed included demographics, surgical details, and outcomes.

Abdominal hernias secondary to non-penetrating trauma. A systematic review.

Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024.

The impact of urban configuration types on urban heat islands, air pollution, CO emissions, and mortality in Europe: a data science approach.

Background: The world is becoming increasingly urbanised. As cities around the world continue to grow, it is important for urban planners and policy makers to understand how different urban configuration patterns affect the environment and human health. However, previous studies have provided mixed findings.

Scanning the aged to minimize missed injury: An Eastern Association for the Surgery of Trauma multicenter study.

Background: Despite the high incidence of blunt trauma in older adults, there is a lack of evidence-based guidance for computed tomography (CT) imaging in this population. We aimed to identify an algorithm to guide use of a pan-scan (head/cervical spine [C-spine]/torso) or a selective scan (head/C-spine ± torso). We hypothesized that a patient's initial history and examination could be used to guide imaging.

Gut microbiota composition in travellers is associated with faecal lipocalin-2, a mediator of gut inflammation.

Introduction: We examined the gut microbiota of travellers returning from tropical areas with and without traveller's diarrhoea (TD) and its association with faecal lipocalin-2 (LCN2) levels.

Methods: Participants were recruited at the Hospital Clinic of Barcelona, Spain, and a single stool sample was collected from each individual to perform the diagnostic of the etiological agent causing gastrointestinal symptoms as well as to measure levels of faecal LCN2 as a biomarker of gut inflammation. We also characterised the composition of the gut microbiota by sequencing the region V3-V4 from the 16S rRNA gene, and assessed its relation with the clinical presentation of TD and LCN2 levels using a combination of conventional statistical tests and unsupervised machine learning approaches.

MALrisk: a machine-learning-based tool to predict imported malaria in returned travellers with fever.

Background: Early diagnosis is key to reducing the morbi-mortality associated with P. falciparum malaria among international travellers. However, access to microbiological tests can be challenging for some healthcare settings.

Machine learning approach to identify malaria risk in travelers using real-world evidence.

Background: Pre-travel consultation and chemoprophylaxis measures for malaria are a key component in the prevention of imported malaria in travelers. In this study we report a predictive tool for assessing personalized malaria risk in travelers based on the analysis of electronic medical records from travel consultations. The tool aims to guide physicians in the recommendation of appropriate prophylaxis prior to their trip.

Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle.

In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP). This narrative review aims to present a bundle for the correct SAP administration and evaluate the evidence supporting it.

Predictors of Length of Hospital Stay After Reduction of Internal Hernia in Patients With a History of Roux-en-Y Gastric Bypass.

Background: Postoperative internal hernias after Roux-en-Y gastric bypass (RYGB) have an incidence of 2%-9% and are a surgical emergency. Evidence on factors associated with length of stay (LOS) after emergent internal hernia reduction in RYGB patients is limited.

Methods: This is a retrospective review of patients who underwent internal hernia reduction after RYGB at our tertiary care center over a 5 year period from 2015 to 2020.

Sociodemographic, lifestyle, and environmental determinants of vitamin D levels in pregnant women in Spain.

Introduction: Vitamin D deficiency (<20 ng/mL circulating levels) is a worldwide public health concern and pregnant women are especially vulnerable, affecting the health of the mother and the fetus. This study aims to evaluate the sociodemographic, lifestyle, and environmental determinants associated with circulating vitamin D levels in Spanish pregnant women.

Methods: We used data from the Spanish INMA ("Infancia y Medio Ambiente") prospective birth cohort study from the regions of Gipuzkoa, Sabadell, and Valencia.

A novel mini-invasive finger-prick protocol for preparing blood micro-samples for morphological analysis of human erythrocytes by scanning electron microscopy.

Here we describe the development and optimization of a new protocol for the preparation and surface imaging by scanning electron microscope of human erythrocytes from blood micro-samples obtained by finger prick. By testing several key pre-analytical conditions for blood sampling, erythrocyte preservation, storage and imaging, we designed a rapid new minimally-invasive reproducible method for obtaining uniform deposition of an adequate number of erythrocytes with well-preserved morphology on a substrate. The possibility of obtaining reliable reproducible high resolution morphometric data on peripheral erythrocytes makes this protocol valuable for diagnostic and basic research purposes.

Robotic-assisted completion cholecystectomy with repair of cholecystoduodenal fistula.

Post-cholecystectomy syndrome (PCS) is a well-documented complication of incomplete cholecystectomy. The etiology is often post-surgical chronic inflammation from unresolved cholelithiasis, which is secondary to anatomical abnormalities, including a retained gallbladder or a large cystic duct remnant (CDR). An exceedingly rare consequence is retained gallstone fistulization into the gastrointestinal tract.

A new hazard scenario at Vesuvius: deadly thermal impact of detached ash cloud surges in 79CE at Herculaneum.

Diluted pyroclastic density currents are capable to cause huge devastation and mortality around volcanoes, and temperature is a crucial parameter in assessing their lethal power. Reflectance analysis on carbonized wood from ancient Herculaneum allowed a new reconstruction of the thermal events that affected buildings and humans during the 79CE Vesuvius eruption. Here we show that the first PDC entered the town was a short-lived, ash cloud surge, with temperatures of 555-495 °C, capable of causing instant death of people, while leaving only a few decimeters of ash on ground, which we interpret as detached from high concentration currents.