Age-Specific Strategies in Pediatric Vascular Trauma: A Comparative Analysis of Surgical and Heparin-Based Conservative Treatments.

Background Pediatric vascular trauma, although rare, poses significant clinical challenges due to the potential for long-term morbidity, including limb compromise and growth abnormalities. This study addresses the gap in standardized treatment protocols by evaluating the efficacy of heparin-based conservative treatments compared to surgical interventions in children under 13 years of age. Methods A retrospective observational study was conducted at a referral center, reviewing institutional records from January 2010 to December 2020.

Laryngopharyngeal Reflux: Effect of Antireflux PPI Therapy on Nasal Congestion and Olfaction.

Objective: Laryngopharyngeal reflux (LPR) is responsible for many otorhinolaryngology manifestations. There is little evidence regarding the LPR impact on olfaction. No other study has investigated the efficacy of proton pump inhibitors (PPIs) on olfaction.

Robotic Versus Laparoscopic Versus Open Surgery for Non-Metastatic Pancreatic Neuroendocrine Tumors (pNETs): A Systematic Review and Network Meta-Analysis.

: This systematic review, using pairwise and network meta-analyses, aimed to compare the intraoperative, short-term, and long-term postoperative outcomes of minimally invasive surgery (MIS) and open surgery (OS) for the management of pancreatic neuroendocrine tumors (pNETs). : Studies reporting on the effects of robotic, laparoscopic, and open surgery on pNETs published before November 2023 on PubMed, Scopus, and CENTRAL were analyzed. : Thirty-two studies with 5379 patients were included in this review, encompassing 2251 patients undergoing MIS (1334 laparoscopic, 508 robotic, and 409 unspecified MIS) and 3128 patients undergoing OS for pNETs management.

Clinical, Lab, and Radiological Evolution of an Adult Patient With Unilateral Cortical Lesion in Anti-Myelin Oligodendrocyte Glycoprotein (MOG)-Associated Encephalitis With Seizures and Anti-Glial Fibrillary Acidic Protein (GFAP) Positive Antibodies.

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease refers to a clinical and radiological spectrum of demyelinating disorders of the Central Nervous System. We report the case of a female adult patient presenting to our department with an episode of seizures and cognitive dysfunction, compatible with Gerstmann syndrome. Brain MRI revealed a high T2 and DWI signal unilateral cortical lesion at the inferior left parietal lobe and leptomeningeal contrast enhancement.

Transfusion-related acute lung injury/transfusion-associated circulatory overload in a child with non-transfusion dependent thalassemia and aplastic crisis due to acute parvovirus B19 infection.

We present a never-transfused girl with thalassemia intermedia who was admitted for febrile aplastic crisis due to human parvovirus B19. After a first transfusion of packed red blood cells, she developed pulmonary oedema. She improved with supportive care including the use of intravenous diuretics.

Interferon-gamma driven elevation of CXCL9: a new sepsis endotype independently associated with mortality.

Background: Endotype classification becomes the cornerstone of understanding sepsis pathogenesis. Macrophage activation-like syndrome (MALS) and immunoparalysis are the best recognized major endotypes, so far. Interferon-gamma (IFNγ) action on tissue macrophages stimulates the release of the cytotoxic chemokine CXCL9.

Simultaneous Bilateral Primary Choroidal Melanoma Linked to Bilateral Ocular Melanocytosis: A Rare Case Study.

BACKGROUND Choroidal melanoma is the most common primary intraocular tumor in adults. Most primary choroidal melanomas are unilateral and unifocal. Bilateral primary choroidal melanomas are considered to be a rare occurrence.

The Anaconda One-Lok stent graft for the treatment of infrarenal abdominal aortic aneurysms: clinical results, technical, and mechanical characteristics.

Introduction: The Anaconda aortic stent graft is a trimodular endovascular stent graft with an active infrarenal fixation suitable for the treatment of infrarenal abdominal aortic aneurysms with an infrarenal neck angulation ≤90°. A unique magnet-based mechanism facilitates the cannulation of the contralateral leg.

Areas Covered: The present article provides a complete description of the third-generation Anaconda endograft, the Anaconda One-Lok, its clinical performance and the related technical and mechanical characteristics as well as a brief comparison between itself and other similar endografts.

Effectiveness of hand reconstruction techniques for the treatment of postburn contractures of the hand: A systematic review.

Introduction: Despite the multitude of preventative methods, postburn hand contractures are poorly controlled and often require surgery. However, there is no consensus on which hand reconstruction technique is most efficacious. This systematic review aims to compare the efficacy of available postburn hand contracture reconstruction techniques over the long term and to evaluate the quality of current literature.

Modulation of Metabolomic Profile in Sepsis According to the State of Immune Activation.

Objective: To investigate the metabolomic profiles associated with different immune activation states in sepsis patients.

Design: Subgroup analysis of the PROVIDE (a Personalized Randomized trial of Validation and restoration of Immune Dysfunction in severe infections and Sepsis) prospective clinical study.

Setting: Results of the PROVIDE study showed that patients with sepsis may be classified into three states of immune activation: 1) macrophage-activation-like syndrome (MALS) characterized by hyperinflammation, sepsis-induced immunoparalysis, and 3) unclassified or intermediate patients without severe immune dysregulation.

Finger-controlled nonultrasonic lens extractor.

Purpose: To report initial surgical experience and learning curve with a new finger-controlled, ultrasoundless lens extractor device and provide insights for future surgical endeavors.

Setting: Bascom Palmer Eye Institute, Miami, Florida.

Design: Single-center, noncomparative, retrospective, consecutive case series.

Regulation of plasma soluble receptors of TNF and IL-1 in patients with COVID-19 differs from that observed in sepsis.

Objectives: IL-1α/β and TNF are closely linked to the pathology of severe COVID-19 and sepsis. The soluble forms of their receptors, functioning as decoy receptors, exhibit inhibitory effects. However, little is known about their regulation in severe bacterial and viral infections, which we aimed to investigate in this study.

Breakage and detachment of the rigid cystoscope's distal tip: an unusual case of urological instrument malfunction.

Herein, we describe an unusual case of cystoscope damage during a planned laser cystolithotripsy in a 65-year-old male with a previous history of radical prostatectomy for prostate cancer and subsequent serial urethral dilations for bladder neck contracture. Upon crossing the penile urethra without exerting significant pressure, we noticed the cystoscope's distal metallic tip detachment. Therefore, we re-introduced another 22Fr cystoscope and removed the broken part with alligator forceps.

Being a medical trainee in Greece: Aims and key aspects of the Greek Survey of Medical Work and Education.

Anyone reading this text has probably been a medical trainee once. What was your training like? More importantly, did anyone during your training ask you what your training was like? For example, did anyone ask you if you were satisfied with your training or if you worked a little or a lot? Probably not. The origin of medical specialty training is that of informal apprenticeship.

Outcomes of Free Vascularized Fibular Grafts in Treating Massive Forearm Skeletal Defects.

Introduction: Reconstructing long bone defects in the upper limbs, particularly the radius and ulna, poses significant challenges. These defects, resulting from trauma, tumors, infections, or congenital anomalies, require precise surgical intervention for functional restoration. Traditional non-vascularized autogenous bone grafts have limitations, such as resorption and limited biological activity.

Anterior Cruciate Ligament Reconstruction Utilizing Double Adjustable-Loop Suspensory Fixation Devices Provides Good Clinical Outcomes in Patients under the Age of 40 Years at Two-Year Follow-Up.

Anterior cruciate ligament reconstruction (ACLR) using double adjustable fixation gained popularity in the last decade due to its minimally invasive technique. However, suspensory fixation devices could be related to recurrent instability, poor clinical outcomes, and patient dissatisfaction. The present study aims to evaluate the clinical outcomes following ACLR using double adjustable-loop suspensory fixation devices in the demanding population of young patients.

Assessment of De-Escalation of Empirical Antimicrobial Therapy in Medical Wards with Recognized Prevalence of Multi-Drug-Resistant Pathogens: A Multicenter Prospective Cohort Study in Non-ICU Patients with Microbiologically Documented Infection.

Antimicrobial resistance poses a major threat to human health worldwide and the implementation of antimicrobial stewardship programs (ASPs), including antimicrobial de-escalation (ADE), is a multifaceted tool for minimizing unnecessary or inappropriate antibiotic exposure. This was a prospective observational study of 142 non-Intensive Care Unit (ICU) patients with microbiologically documented infection who were initially administered empirical antimicrobial therapy and admitted to the medical wards of 6 tertiary-care hospitals in Greece from January 2017 to December 2018. Patients were divided into two groups, the ADE and non-ADE group, based on whether ADE was applied or not, respectively.

Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients.

Purpose: Regional anaesthesia techniques provide highly effective alternative to general anaesthesia. Existing evidence on the effect of spinal anaesthesia (SA) on cardiac diastolic function is scarce. This study aimed to evaluate the effects of a single-injection, low-dose SA on left ventricular end-diastolic pressures (LVEDP) using echocardiography in euvolaemic patients undergoing elective vascular surgery.

Corneal changes after large (9mm) lateral rectus muscle recession measured with Pentacam®.

The aim of this study was to evaluate alterations in corneal astigmatism, axial anterior corneal curvature, anterior chamber depth, and central corneal thickness (CCT) two months after the unilateral recession of lateral rectus muscle in children. This prospective study included 37 children with intermittent exotropia who would undergo unilateral lateral rectus muscle recession. All measurements were performed using Pentacam®.