Gastric necrosis secondary to gastric volvulus in a paraesophageal hernia: a case report.

Hiatal hernias are commonly encountered in clinical practice. In certain cases, especially in large hiatal hernias, gastric volvulus can occur. Patients with volvulus typically will present with vomiting, chest pain, shortness of breath, and dysphagia.

Posterior Reversible Encephalopathy Syndrome (PRES) and the Uncommon Sequela: Mesial Temporal Sclerosis.

Posterior reversible encephalopathy syndrome is often linked to conditions like hypertension and is characterized by reversible brain edema. The development of mesial temporal sclerosis as a consequence of posterior reversible encephalopathy syndrome is an uncommon clinical outcome.  We report a 48-year-old female who initially presented with severe iron deficiency anemia, hypertension, and septic tenosynovitis requiring surgical drainage with subsequent development of posterior reversible encephalopathy syndrome accompanied by endocarditis.

A Case Report of Primary Melanoma of the Urethra.

We illustrate a notable case of an 83-year-old male who presents to a community hospital with abdominal pain and hematuria. A few days after admission, an ulcerated lesion was found to be visible toward the ventral aspect of the penis, as well as bright red blood at the urethral meatus. An excisional biopsy of the urethral meatus, mid-urethra, and urethral tissue was done, and immunohistochemistry helped support the diagnosis of primary melanoma of the urethra.

Repair of a rat calvaria defect with injectable strontium (Sr)-doped polyphosphate dicalcium phosphate dehydrate (P-DCPD) ceramic bone grafts.

The trace element strontium (Sr) enhances new bone formation. However, delivering Sr, like other materials, in a sustained manner from a ceramic bone graft substitute (BGS) is difficult. We developed a novel ceramic BGS, polyphosphate dicalcium phosphate dehydrate (P-DCPD), which delivers embedded drugs in a sustained pattern.

Efficacy and safety of vibrating capsule in treatment of chronic idiopathic constipation: a systematic review and meta-analysis of randomized controlled trials.

Background: Multiple pharmacological interventions and modalities are available for managing chronic idiopathic constipation (CIC), with variable efficacy. Vibrating capsule (VC) is a device that has shown variable results in alleviating constipation by tactile stimulation of the colonic wall and inducing peristalsis. This meta-analysis is to investigate the efficacy and safety of this modality.

Impact of Antihypertensive Medication Changes After Renal Denervation Among Different Patient Groups: SPYRAL HTN-ON MED.

Background: The SPYRAL HTN-ON MED (Global Clinical Study of Renal Denervation With the Symplicity Spyral Multi-electrode Renal Denervation System in Patients With Uncontrolled Hypertension in the Absence of Antihypertensive Medications)trial showed significant office and nighttime systolic blood pressure (BP) reductions in patients with hypertension following renal denervation (RDN) compared with sham-control patients, despite similar 24-hour BP reductions. We compared antihypertensive medication and BP changes among prespecified subpopulations.

Methods: The multicenter, randomized, sham-controlled, blinded SPYRAL HTN-ON MED trial (n=337) evaluated BP changes after RDN compared with a sham procedure in patients with hypertension prescribed 1 to 3 antihypertensive drugs.

Combination of transarterial radioembolization with atezolizumab and bevacizumab for intermediate and advanced staged hepatocellular carcinoma: A preliminary report of safety and feasibility.

Purpose: The IMbrave150 Phase III trial demonstrated the superiority of atezolizumab and bevacizumab (Atezo/Bev) over sorafenib for unresectable hepatocellular carcinoma (HCC). The present study aims to evaluate the feasibility of TARE in combination with Atezo/Bev for the treatment of intermediate and advanced staged HCC.

Methods: A retrospective review at a single institution was performed between May 2021 and December 2022.

Effect of Commercially Available Wound Irrigation Solutions on Uninfected Host Tissue in a Murine Model.

Background: Commercially available irrigation solutions are used to reduce bacterial contamination and prevent surgical site infections. However, the effect of these solutions on the healing capacity of tissue has not been well-established. The purpose of this study was to investigate the effects of 5 commercially available irrigation solutions on host tissue in a murine model.

Mobile Atheroma in the Left Internal Carotid Artery: A Case of Impending Doom!

A 69-year-old male presented for evaluation of a carotid bruit. Carotid ultrasound demonstrated the unique finding of a large, highly mobile atheroma in the proximal left internal carotid artery. The presence of a mobile atheroma confers an even higher risk of stroke, so this presentation posed a dilemma in terms of endovascular versus open surgical management strategies.

Two-Stage Anatomic Myocutaneous Flap Dissection in Cranioplasty: Technical Nuances and Single-Surgeon Experience.

Background And Objectives: Temporalis muscle management remains one of the most challenging aspects of cranioplasty, which accounts for considerable rates of dissection-related complications. Since 2019, the senior author has developed and consistently used a methodical, two-stage anatomic dissection technique to separate the scalp and temporalis muscle from the underlying brain. This technique is believed to facilitate dissection and minimize the risk of brain injury, while optimizing cosmetic outcomes.

Does Tighter Glycemic Control Beyond Hemoglobin A1c of 8% Improve Outcome for Lumbar Spine Surgery? A MSSIC Study.

Background And Objectives: Diabetes mellitus is associated with increased risk of postoperative adverse outcomes. Previous studies have emphasized the role of glycemic control in postoperative complications. This study aims to ascertain whether controlling hemoglobin A1c (HbA1c) lower than 8% preoperatively results in meaningful risk reduction or improved outcomes.

Carotid Artery Stenting Versus Carotid Artery Endarterectomy in Asymptomatic Severe Carotid Stenosis: An Updated Meta-Analysis.

Carotid artery stenting (CAS) and carotid artery endarterectomy (CEA) are revascularization options for the management of severe carotid disease in asymptomatic patients. We aimed to compare the peri-procedural outcomes of the two modalities. A systematic review of the databases PUBMED, EBSCO, and Cochrane Library was performed.

Which patient should have preference for liver transplantation: ALD?

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Rare case of mortality after hemorrhagic property of esthesioneuroblastoma.

Esthesioneuroblastoma is a tumor arising from olfactory neuroepithelium with an incidence of four per million. This case presents a rare nasal cavity neoplasm with hemorrhagic properties that may lead to significant sequelae. We present a 69-year-old male patient who presented with worsening altered mental status over the past 6-7 months.

Peer review journal publication rates of award-winning presentations from a multi-disciplinary multi-institutional medical education consortium annual research forum: 40-year experience.

Introduction: Resident research has been mandated by the Accreditation Council of Graduate Medical Education across all specialties. Southeast Michigan Center for Medical Education (SEMCME) has an annual Research Forum for resident competition, and we assessed the publication status of award-winning presentations.

Methods: The SEMCME Research Forum's winning presentations from 1978 to 2018 were reviewed.

Midline Sacral Fractures: Review of the Literature.

Introduction: Sacral fractures are an important consideration in high-energy traumas associated with injuries to the pelvic ring that confer much of pelvic stability. A midline longitudinal sacral fracture (MLS) is a relatively rare fracture pattern, with only 23 cases of MLS fractures reported in the literature to date. This systematic review evaluates overall mechanisms of MLS injury, associated injuries, complications, management, and fracture prognosis.

An Uncommon Focus of a Common Phenomenon: Superior Vena Cava Triggering Atrial Fibrillation.

Ablation of atrial fibrillation most commonly involves the pulmonary veins; however, the superior vena cava (SVC) is an important potentially arrhythmogenic structure that should not be overlooked. This case report demonstrates an excellent example of triggering activity localized to the SVC and the subsequent conversion to sinus rhythm with ablation of the SVC.

Identification and Ablation of an Incidental Concealed Accessory Pathway During Atrial Fibrillation Ablation.

A 69-year-old man with persistent atrial fibrillation (AF) experiencing recurrences of suspected paroxysmal atrial tachycardia was referred for repeat ablation. He had previously undergone pulmonary vein isolation in 2016. He was suspected to be experiencing a tachycardia involving the mitral isthmus or left-sided veins initially; however, electroanatomic mapping did not reveal a circuit involving these structures.

Comparing EUS-directed Transgastric ERCP (EDGE) Versus Laparoscopic-Assisted ERCP Versus Enteroscopic ERCP: A Network Meta-analysis.

Background: Management of choledocholithiasis in patients with Roux-en-Y gastric bypass surgery is challenging. This study aims to compare technical success rates, adverse events, and procedural time between 3 current approaches: endoscopic ultrasound-directed transgastric Endoscopic retrograde cholangiopancreatography (ERCP) (EDGE), enteroscopy-assisted ERCP (E-ERCP), and laparoscopic-assisted ERCP (LA-ERCP).

Methods: A systematic search of 5 databases was conducted.

Prolonged Gastrointestinal Manifestations After Recovery From COVID-19.

Background & Aims: Acute enteric infections are well known to result in long-term gastrointestinal (GI) disorders. Although COVID-19 is principally a respiratory illness, it demonstrates significant GI tropism, possibly predisposing to prolonged gut manifestations. We aimed to examine the long-term GI impact of hospitalization with COVID-19.

Perioperative outcomes of hypertrophic cardiomyopathy: An insight from the National Readmission Database.

Background: Data regarding hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing noncardiac surgery is lacking. We sought to examine the perioperative outcomes of HOCM patients undergoing noncardiac surgery using a national database.

Methods: We used the National readmission database from 2016 to 2019.

Total Hip Arthroplasty After Proximal Femoral Nailing: Preoperative Preparation and Intraoperative Surgical Techniques.

The combination of an aging population and increased utilization of total hip arthroplasty (THA) is leading to a higher incidence of conversion THA, defined as conversion from previous hip fracture surgery to THA. Conversion THA is a more technically challenging, time-consuming, and costly procedure compared to primary THA and frequently involve more medically complex patients. Thus, the aim of this review is to provide a rubric for surgeons to use when preparing for a conversion THA.

Basal Ganglia Ischemic Stroke: The Unforeseen Progression of Tuberculosis Epididymo-Orchitis.

Tuberculosis is an infectious disease with broad pulmonary and extrapulmonary clinical manifestations. Central nervous system tuberculosis (CNS-TB) is a complex extrapulmonary infection known for its diverse clinical features including meningitis, tuberculoma, and spinal arachnoiditis. Particularly, tuberculosis meningitis can further lead to complications such as ischemic stroke.