Systemic therapy for non-clear cell renal cell carcinomas: A systematic review.

Objective: Renal cell carcinoma (RCC) is the most common kidney cancer, with clear cell RCC being the predominant subtype. However, non-clear cell RCC constitutes a significant proportion of cases, presenting distinct challenges in treatment due to its varied histological subtypes. Despite recent advancements, the optimal therapeutic approach for non-clear cell RCC remains uncertain due to limited high-quality evidence.

Impact of anticoagulation therapy on outcomes in patients with cirrhosis and portal vein thrombosis: A large-scale retrospective cohort study.

Introduction: Portal vein thrombosis in cirrhotic patients presents a significant clinical challenge. This study aims to (1) explore the impact of anticoagulation therapy on patient outcomes; (2) comparative outcomes in portal vein thrombosis treated between direct oral anticoagulant and Vitamin K Antagonist (VKA).

Materials And Methods: We leveraged the TriNetX database to analyze a cohort comprising 4224 patients with liver cirrhosis and PVT who were treated with anticoagulation, alongside a comparison group of 15,300 patients with the same conditions but not receiving anticoagulation therapy.

Medicare billing and utilization trends in vascular surgery.

Objective: Within the past decade, Medicare Part B reimbursements for various surgical procedures have been declining, whereas health care expenses continue to increase. As a result, hospitals may increase service charges to offset losses in revenue, which may disproportionately affect underinsured patients. Our analysis aimed to characterize Medicare billing and utilization trends across common vascular surgical procedures.

Interactions Between Endogenous Opioids and the Immune System.

The endogenous opioid system, which consists of opioid receptors and their ligands, is widely expressed in the nervous system and also found in the immune system. As a part of the body's defense machinery, the immune system is heavily regulated by endogenous opioid peptides. Many types of immune cells, including macrophages, dendritic cells, neutrophils, and lymphocytes are influenced by endogenous opioids, which affect cell activation, differentiation, proliferation, apoptosis, phagocytosis, and cytokine production.

Over-the-Scope-Clip Iatrogenic Ligation of the Gastroduodenal Artery: A Case Report.

BACKGROUND The Over-the-Scope-Clip (OTSC) System is a class of endoscopic clips intended to provide improved strength and tissue capture compared to conventional through-the-scope clips. These clips are generally safe and effective in managing many gastrointestinal conditions, with a low overall adverse event rate. Although the OTSC has been used to treat gastrointestinal bleeding and bowel perforations for many years, it often is relegated to second-line therapy and has only recently become a first-line hemostatic therapy for gastrointestinal bleeding.

Sinus Tachycardia Following COVID-19 and Its Implications.

Background Within the cardiovascular system, sinus tachycardia has been a noted finding in patients with post-COVID-19 syndrome (symptoms persisting beyond 12 weeks post-infection). To better understand post-COVID-19 tachycardia, we examined the prevalence of sinus tachycardia 12-16 weeks after diagnosis of SARS-COV-2 infection and its correlation with intensive care utilization, ventilator use, and mortality in vaccinated and unvaccinated patients. Methods We identified adult patients in the TriNetX COVID-19 Research Network with confirmed SARS-COV-2 diagnosis from January 20th, 2020, to February 14th, 2022, and sinus tachycardia 12-16 weeks after diagnosis.

Pulmonic valve fibroelastoma-A rare incidental finding.

Primary cardiac neoplasms are a rare, commonly benign, tumor with an approximate incidence rate of 0.02%. Papillary fibroelastoma (PFE), a common form of primary cardiac neoplasms, typically present as a mass on the aortic and mitral valves, while rarely presenting as a pulmonary valve tumor.

NAD Precursors Reverse Experimental Diabetic Neuropathy in Mice.

Abnormal NAD signaling has been implicated in axonal degeneration in diabetic peripheral neuropathy (DPN). We hypothesized that supplementing NAD precursors could alleviate DPN symptoms through increasing the NAD levels and activating the sirtuin-1 (SIRT1) protein. To test this, we exposed cultured Dorsal Root Ganglion neurons (DRGs) to Nicotinamide Riboside (NR) or Nicotinamide Mononucleotide (NMN), which increased the levels of NAD, the SIRT1 protein, and the deacetylation activity that is associated with increased neurite growth.

Prevalence of hepatitis C among pregnant women in an Appalachian population.

The opioid crisis has adversely affected West Virginia's pregnant and infant populations. With high rates of opioid use disorder and neonatal abstinence syndrome, West Virginia has the highest rates of Hepatitis C (HCV) acute infection among pregnant women. To better understand how HCV impacts an already high-risk population, the study purpose was to (1) describe its prevalence among women receiving prenatal care at a single tertiary care clinic in Appalachia and compare with state and national rates, and (2) determine whether it is associated with preterm birth (gestation <37 weeks).

A Nationwide Analysis of Fluid Resuscitation Outcomes in Patients With Acute Pancreatitis.

Background: Traditionally, fluid resuscitation has been the foundation of effective acute pancreatitis (AP) treatment. Experts advocate for aggressive intravenous fluid (IVF) resuscitation, especially within the first 24 hours. Research suggests limited efficacy of this approach; in fact, some studies show there may be a risk of increased complications.

Residency Experience With Physical Examination- and Ultrasound-Indicated Cerclage: A Single Center Retrospective Study.

Cervical insufficiency, the dilation of the cervix in the absence of contractions or labor, can cause second-trimester pregnancy loss or preterm birth. Cervical cerclage is a common treatment for cervical insufficiency and has 3 indications for placement: history, physical examination, and ultrasound. The purpose of this study was to compare pregnancy and birth outcomes for physical examination- and ultrasound-indicated cerclage.

Genetic Considerations in the Tumorigenesis, Diagnosis, and Treatment of Differentiated Thyroid Cancer: Current State of the Science.

Thyroid nodules remain a common diagnosis encountered in general and endocrine surgical practice, and thyroid cancer appears to be increasing in incidence in both the United States and worldwide. The understanding of the complex genetics surrounding thyroid neoplasia has increased substantially in recent years and, consequently, has become a consideration in risk stratification, diagnosis, prognosis, and treatment. Molecular genetic analysis of thyroid nodules is now a readily available technology for diagnostic purposes via analysis of fine-needle aspiration biopsy (FNAB) specimens.

Long-Term Outcomes of Revascularization Compared to Deferral in Stable Coronary Artery Disease: a Review.

Purpose Of Review: The aim of this study is assessing the long-term outcomes of revascularization compared to deferral in stable coronary artery disease with available literature.

Recent Findings: The overall safety of stable coronary artery disease using IFR has been well established. There have been very few studies that have examined the safety of deferral of revascularization vs revascularization.

Southeastern Surgical Congress Presidential Address: "Finding Your Own Unique Place Within the House of Surgery".

The term the "House of Surgery" is often used in conversation, but the origin of the phrase is not well known to most. In the following article, the origin of the phrase is explained, as is its relevance to the maintenance of a strong surgical community in today's world. In addition, examples are provided as to how each surgeon can find their own unique role in the House of Surgery, with the goal being to increase understanding and collaboration tween surgeons in all types of practice settings.

Medial versus lateral camera port placement for robotic nephron-sparing surgery: evaluating surgical complications and outcomes.

As the growing popularity of robotic-assisted laparoscopic procedures for the treatment of renal cancer increases, there exists a variation in surgical technique among institutions and surgeons alike. One variation that exists in robotics is the anatomical placement of the camera port (medial versus lateral camera port placement). The purpose of this study is to evaluate surgical complications and outcomes in comparison to site of camera port placement during nephron-sparing surgery in an academic setting.

NAD Precursors Repair Mitochondrial Function in Diabetes and Prevent Experimental Diabetic Neuropathy.

Axon degeneration in diabetic peripheral neuropathy (DPN) is associated with impaired NAD metabolism. We tested whether the administration of NAD precursors, nicotinamide mononucleotide (NMN) or nicotinamide riboside (NR), prevents DPN in models of Type 1 and Type 2 diabetes. NMN was administered to streptozotocin (STZ)-induced diabetic rats and STZ-induced diabetic mice by intraperitoneal injection at 50 or 100 mg/kg on alternate days for 2 months.

Everything Old is New Again: Applying the Lessons from Halsted's Life and Work to Today's Surgical Landscape.

The name of Dr William Halsted is synonymous with innovation and excellence in surgery. The life of Dr Halsted, although known for both accomplishments and personal challenges, continues to provide valuable insight as to how we, as 21 century surgeons, might best address today's surgical challenges. The following manuscript details some of the ways in which Dr Halsted's life and teachings provide important lessons that remain relevant even today.

A Comparison of Component Separation With Porcine Acellular Dermal Reinforcement to Bovine Acellular Dermal Matrix in the Repair of Significant Midline Ventral Hernia Defects.

Background: The optimal material for reinforcement of complex abdominal ventral hernia repair (VHR) remains controversial. Biologic prostheses such as porcine and bovine acellular dermal matrix (PADM/BADM) have shown favorable results, but few head-to-head comparisons between the two types exist. We sought to provide such a comparison.

Clinical Outcome of Drug-Eluted Stenting (Zilver PTX) in Patients With Femoropopliteal Occlusive Disease a Single Center Experience.

Background: Few industry sponsored trials reported satisfactory outcomes in the use of drug-eluting stents (DES) for treatment of femoropopliteal arterial disease. This study analyzed the early/late clinical outcome from a real world single center.

Patient Populations/methods: A total of 115 limbs treated with Zilver PTX were analyzed for: major adverse limb event (MALE: above ankle limb amputation/major intervention at 1 year), major adverse events (MAEs; death, amputation, and target lesion thrombosis/reintervention), primary patency (based on duplex ultrasound ± ankle brachial indexes), limb salvage, and amputation free survival rates (AFS) at 1 and 2 years.

Predicting perinatal outcomes with an obstructive sleep apnea screening tool.

The objective was to determine if a screening tool for obstructive sleep apnea could be used to predict adverse perinatal outcomes. This was a prospective observational study of patients receiving prenatal care and universally screened for obstructive sleep apnea with the STOP Questionnaire (four questions related to noring, iredness during daytime, bserved apnea, and high blood ressure). Confounding variables were included in a backwards logistic regression model to predict adverse perinatal outcomes.

Use of drug-eluting stents in patients with critical limb ischemia and infrapopliteal arterial disease: a real-world single-center experience.

Background: Although no drug-eluting stent (DES) has been approved by the Food and Drug Administration to treat infrapopliteal arterial disease, several industry-sponsored trials have reported the outcomes with the use of paclitaxel or sirolimus DESs. To the best of our knowledge, only one study to date has reported on the use of everolimus DESs for infrapopliteal arterial disease. In the present study, we analyzed the clinical outcomes with everolimus DESs in our real-world, single-center experience.

Device profile of the MobiusHD EVBA system for the treatment of resistant hypertension: overview of its mechanism of action, safety and efficacy.

Introduction: Early promising results of renal nerve denervation awakened interest in developing medical device alternatives for patients with resistant hypertension. The subsequent sham-controlled renal nerve denervation randomized trials were disappointing leading researchers and innovators to explore alternative device and trial designs to address this significant unmet need. We describe the innovation process leading to the first endovascular carotid baroreflex amplification device currently undergoing clinical trials in the United States and Europe.