Current state of the definition and terminology related to weight recurrence after metabolic surgery: review by the POWER Task Force of the American Society for Metabolic and Bariatric Surgery.

Bariatric surgery continues to be the most reliable treatment for the disease of obesity. Despite excellent results, some patients experience weight recurrence with or without concomitant recurrence of co-morbidities. There is currently no standard definition for clinically significant weight recurrence after bariatric surgery so that patients and clinicians have a platform from which to plan treatment.

The Feasibility of Translaminar Screws in the Subaxial Cervical Spine: Computed Tomography and Cadaveric Validation.

Background: The use of translaminar screws may serve as a viable salvage method for complicated cases. To our understanding, the study of the feasibility of translaminar screw insertion in the actual entire subaxial cervical spine has not been carried out yet. The purpose of this study was to report the feasibility of translaminar screw insertion in the entire subaxial cervical spine.

Coronary vasospasm complicating atrial fibrillation ablation: a case report and review of the literature.

Radiofrequency ablation is one of the alternative treatment strategies in patients with atrial fibrillation. With the increasing number of such ablation procedures being performed it is important for the physicians to be aware of the associated complications. We present a very rare case of severe triple coronary vessel spasm during radiofrequency catheter ablation.

Diagnosis and management of acute gastroenteritis in the emergency department.

There are approximately 178 million cases of acute gastroenteritis annually in the United States, resulting in 473,000 hospitalizations and 5000 deaths. The vast majority of these cases are of viral etiology, self-limited, and require only supportive care; nonetheless, patients at high risk due to extremes of age or immunosuppression often require specific therapy to ensure resolution of symptoms. With this common ED presentation, there are many potential decisions related to resource utilization and management.

Celiac Plexus Block: Management of Abdominal Pain in Patients With Late-Stage Cancer.

Background: A majority of patients with abdominal cancer report intractable abdominal pain as their disease progresses. For intractable abdominal pain related to malignancy, celiac plexus block can provide relief and reduce the use of oral opioids, helping to improve quality of life.

Objectives: The aim of this article is to explore the feasibility and effectiveness of celiac plexus block as a pain management option for patients with late-stage abdominal cancer.

Validation of a Postextubation Dysphagia Screening Tool for Patients After Prolonged Endotracheal Intubation.

Background: Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available.

Real-Time Automated Sampling of Electronic Medical Records Predicts Hospital Mortality.

Background: Real-time automated continuous sampling of electronic medical record data may expeditiously identify patients at risk for death and enable prompt life-saving interventions. We hypothesized that a real-time electronic medical record-based alert could identify hospitalized patients at risk for mortality.

Methods: An automated alert was developed and implemented to continuously sample electronic medical record data and trigger when at least 2 of 4 systemic inflammatory response syndrome criteria plus at least one of 14 acute organ dysfunction parameters was detected.

Postinfarct VSD management using 3D computer printing assisted percutaneous closure.

Postinfarct VSD (PIVSD) carries a grim prognosis. The mainstay of management has been surgical repair. The advent of septal occluder devices has offered an attractive alternative to surgical repair.

Review of Ultrasound-Guided Radial Artery Catheter Placement.

Radial artery catheters are commonly placed for continuous blood pressure monitoring, frequent arterial blood gas analysis, or frequent blood sampling for diagnostic testing. Radial artery cannulation can be challenging and ultrasound guidance has emerged as a valuable adjunct for the placement of radial artery catheters. The advantages of ultrasound guidance include: real-time visualization of landmarks, improved pre-procedure planning, reduction in complications, less time spent at the bedside, and improved first-attempt success rates.

Should patients with chronic liver disease receive venous thromboembolism prophylaxis?

Chronic liver disease has long been considered the prime example of acquired bleeding disorders due to its associated coagulopathies, namely elevated international normalized ratio (INR) and thrombocytopenia. Recent evidence has shown that patients with chronic liver disease also are at risk for hospital-acquired venous thromboembolism (VTE). The safety and efficacy of low-dose anticoagulants for VTE prophylaxis have not been firmly established in this patient population.

Clinical utility of treprostinil in the treatment of pulmonary arterial hypertension: an evidence-based review.

Pulmonary arterial hypertension (PAH) remains a progressive disease without a cure, despite the development of several treatment options over the past several decades. Its management strategy consists of the endothelin receptor antagonists (ambrisentan, bosentan, macitentan), phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil), and prostacyclin analogs (epoprostenol, treprostinil, iloprost). Treprostinil, a stable prostacyclin analog, displays vasodilatory effects in the pulmonary vasculature, as well as antiplatelet aggregation properties.

Necrotizing enterocolitis in a neonate: a case study using negative pressure wound therapy.

Background: Necrotizing enterocolitis (NEC) is a disease of the intestine detrimental that occurs in approximately 10% of neonates who weigh 1500 g or less; it is associated with a 25% mortality rate. Additional abdominal wall defects and disturbance of environmental surroundings further compromise the likelihood of mortality. Early intervention and aggressive surgical treatment have been shown to decrease the mortality rate of this disease process.

Leaking heart: ticking time bomb!

Context: Cardiac rupture is a very important but under-recognized complication of acute myocardial infarction and usually happens within a week of the event. Sometimes it can be subacute and may not be typical of an acute blow out rupture. Hence careful evaluation is needed as a missed or delayed diagnosis can be fatal.

Use of ACIST™ contrast injection device in carotid artery stenting in high-surgical-risk patients.

Objective: The objective is to see if use of the ACIST™ device during carotid stenting would be feasible without an increase in primary end points when compared to historic controls.

Background: Carotid stenting has been studied as an effective alternative to endarterectomy in high-surgical-risk patients. Traditional angiography involves manual contrast injection.

"Snake" shaped vegetation in right coronary artery.

Infective endocarditis is a rare cause of coronary embolism. This can result in myocardial infarction. Prompt identification is necessary as management is different from a regular myocardial infarction.

Chronic total occlusions: successful recanalization of very old lesions.

Purpose: The treatment of chronic total occlusion is thought to be the final frontier in treating coronary artery disease nonsurgically. In the past, an old occlusion was not likely to be treated successfully percutaneous. We have had success in revascularizing some very old 20 plus year old occlusions percutaneously.

Pyogenic liver abscess secondary to disseminated streptococcus anginosus from sigmoid diverticulitis.

Pyogenic liver abscess secondary to dissemination from Sigmoid Diverticulitis is rare. Streptococcus Anginosus has been linked to abscesses but has been rarely reported from a Sigmoid Diverticulitis source. We report a case of liver abscess in which the source was confounding but eventually was traced to Sigmoid Diverticulitis on laparotomy.

Epstein Barr Virus-positive large T-cell lymphoma presenting as acute appendicitis 17 years after cadaveric renal transplant: a case report.

Introduction: The majority of post-transplant lymphoproliferative disorders in renal transplant patients are of the B-cell phenotype, while the T-cell phenotype is rare. We report a case of Epstein Barr Virus-positive, T-cell lymphoma in a renal transplant patient, presenting unusually as acute appendicitis.

Case Presentation: A 45-year-old Hispanic male renal transplant patient presented with right-side abdominal pain 17 years after transplant.

A novel method of ventricular closure following transapical access.

Aim: left ventricular direct access and sheath placement through a minithoracotomy has been utilized to allow minimally invasive valvular surgery. One potential problem encountered is the closure of the ventricular puncture incision in a beating heart. Our aim was to develop a sutureless closure technique that does not leave behind a foreign body exposed on the endocardial surface.

Diabetic cardiomyopathy.

Individuals with diabetes are at a significantly greater risk of developing cardioymyopathy and heart failure despite adjusting for concomitant risks such as coronary artery disease or hypertension. This has led to the increased recognition of a distinct disease process termed as "diabetic cardiomyopathy." In this article, we perform an extensive review of the pathogenesis and treatment of this disease.

The Impella ventricular assist device: use in patients at high risk for coronary interventions: successful multivessel percutaneous coronary intervention in a 62-year-old high-risk patient.

The Impella Recover LP 2.5 (Abiomed, Danvers, MA, USA) is a ventricular assist device that is easily placed and has low adverse events. It helps unload myocardial demand and enables revascularization in patients who are otherwise at extreme risk for percutaneous coronary intervention (PCI).

Polytetrafluoroethylene-covered stents: 15 years of hope, success and failure.

Even after almost 15 years, polytetrafluoroethylene-covered stents are an important part of the armory of cardiac catheterization laboratory. They are invaluable in the emergent management of coronary perforations and are also used in the treatment of coronary aneurysms and fistulae. However, they are no longer routinely used in the treatment of saphenous venous graft disease.