Outcome comparison of rotational ankle fractures: Supination external rotation versus pronation external rotation.

Background: Ankle fractures are among the most common types of fractures in the orthopaedic field, and the Lauge-Hansen classification is commonly used to categorize rotational ankle fractures. This study evaluated and compared the clinical and radiological outcomes of surgically treated supination external rotation (SER) and pronation external rotation (PER) injuries of grades III or IV.

Methods: We retrospectively reviewed and enrolled 104 patients who underwent open reduction and internal fixation for SER or PER injuries classified as Grades III or IV between January 2016 and December 2021, all performed at a single center.

Simultaneous Symmetrizing Surgery on the Contralateral Breast in Unilateral Autologous Breast Reconstruction is Cost-Effective.

BACKGROUND Simultaneous symmetrizing surgery at the time of unilateral free flap reconstruction has been described as a method to facilitate single stage breast reconstruction. However, the impact on cost and number of additional procedures is not well described. METHODS Patients with unilateral free flap reconstruction were identified in national administrative data from 2017-2021 and followed for one year.

Hypertension at diagnosis of coarctation of the aorta as a risk factor for recoarctation.

Background: Coarctation of the aorta (CoA) is a narrowing of the aorta that affects 5-8% of congenital heart defects. Treatment options include surgical repair or transcatheter management with endovascular stenting or balloon dilatation. Late complications after operative repair include systemic hypertension, aortic valve abnormalities, aortic aneurysm, and recoarctation.

Tests for diagnosis of postpartum haemorrhage at vaginal birth.

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Accurate diagnosis of PPH can prevent adverse outcomes by enabling early treatment.

Objectives: What is the accuracy of methods (index tests) for diagnosing primary PPH (blood loss ≥ 500 mL in the first 24 hours after birth) and severe primary PPH (blood loss ≥ 1000 mL in the first 24 hours after birth) (target conditions) in women giving birth vaginally (participants) compared to weighed blood loss measurement or other objective measurements of blood loss (reference standards)?

Search Methods: We searched CENTRAL, MEDLINE, Embase, Web of Science Core Collection, ClinicalTrials.

The Value of Orbital Exenteration for Eyelid Sebaceous Carcinoma in Stages II to IV: A Cohort Study of 78 Patients.

Purpose: To evaluate the prognosis of eyelid sebaceous carcinoma (SeC) in patients with disease stage worse than IIA.

Methods: This retrospective, single-center study included 78 SeC patients. For stage II patients, 1:3 propensity score matching (PSM) was applied between those undergoing orbital exenteration and those receiving eye-sparing treatments.

2024 Scholars' Research Symposium Abstract: Analysis of First 50 Liver Transplants in a Rural Midwest Medical Center.

Introduction: Chronic liver disease, a progressive deterioration of liver function, has become a significant health problem in the United States. According to the National Vital Statistics Report 2017 from the Center for Disease Control and Prevention, approximately 4.5 million adults have been diagnosed with chronic liver disease and cirrhosis (end-stage liver disease), which is 1.

High And Intermediate-High Risk Pulmonary Embolism Management: A 5-Year Intensive Care Unit Casuistic Review.

Background And Objectives: The optimal management of high-risk and intermediate-high-risk Pulmonary Embolism (PE) is a matter of ongoing debate. This paper aims to assess the short and long-term clinical outcomes associated with different treatment approaches for high-risk and intermediate-high-risk PE within an Intensive Care Unit (ICU) and identify potential areas for improvement.

Methods: We conducted a retrospective analysis of patients admitted to an ICU with high and intermediate-high-risk PE between January 2018 and December 2023.

Segmentectomies: 5-Year Experience Of A Center.

Introduction: Segmental anatomical resections have been a subject of debate in recent years. There is increasing evidence that these procedures may offer some advantages in the treatment of early-stage lung cancer, with overall survival (OS) and disease-free survival (DFS) similar to those seen in lobar anatomical resections.

Materials And Methods: We conducted a retrospective analysis of patients who underwent segmentectomy at Santa Marta Hospital (HSM) between January 2018 and September 2022.

A Timeline From Index Procedure To Complex Reinterventions For Thoracoabdominal Aortic Dissection.

The optimal management of acute type A aortic dissection (ATAAD) remains a controversial subject. While some surgeons opt for a hemiarch approach to minimize bypass and cross-clamping time, others prefer partial or total arch replacement to prevent the need for additional operations. The advent of hybrid approaches offers a variety of options to the aortic surgeon in treating ATAAD.

Pancoast Tumors: 11-Year Single-Centre Experience.

Introduction: Pancoast tumors encompass any tumor located on the lung apex, extending into structures in the thoracic inlet and, often, leading to the characteristic clinical syndrome. The main goal of this study is to analyze the response to multimodal treatment and outcome of patients with Pancoast tumors.

Materials And Methods: We performed a retrospective cohort single center study of patients with superior sulcus nonsmall cell lung carcinomas who underwent surgery between January of 2011 and February of 2022.

Differences of microbial growth and biofilm formation among periprosthetic joint infection-causing species: an animal study.

Purpose: The most frequently used surgical procedures for periprosthetic joint infections (PJIs) are debridement, antibiotics, and implant retention (DAIR), as well as single- or two-stage revision arthroplasty. The choice of surgery is made depending on the full maturation of the biofilm layer. The purpose of this study was to evaluate the biofilm formation and microbial growth using common PJI-causing agents and compare its development on the implant surface.

Generative Artificial Intelligence Use in Healthcare: Opportunities for Clinical Excellence and Administrative Efficiency.

Generative Artificial Intelligence (Gen AI) has transformative potential in healthcare to enhance patient care, personalize treatment options, train healthcare professionals, and advance medical research. This paper examines various clinical and non-clinical applications of Gen AI. In clinical settings, Gen AI supports the creation of customized treatment plans, generation of synthetic data, analysis of medical images, nursing workflow management, risk prediction, pandemic preparedness, and population health management.

Maternal and perinatal outcomes after implementation of a more active management in late- and postterm pregnancies in Sweden: A population-based cohort study.

Background: The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. We evaluated maternal and perinatal outcomes after a national shift from expectancy and induction at 42+0 weeks to a more active management of late-term pregnancies in Sweden offering induction from 41+0 weeks or an individual plan aiming at birth or active labour no later than 42+0 weeks.

Methods And Findings: Women with a singleton pregnancy lasting 41+0 weeks or more with a fetus in cephalic presentation (N = 150,370) were included in a nationwide, register-based cohort study.

How has the diagnostic approach to parathyroid localization techniques evolved in the past decade? Insights from a single-center experience.

The standardization of preoperative imaging in primary hyperparathyroidism is one of the current challenges of endocrine surgery. A correct localization of the hypersecretory gland by neck ultrasound and 99mTc-sestamibi (MIBI) scintigraphy are not sufficiently sensitive in some cases. In recent years, CT-4D, 18F-Fluorocholine PET/CT, and radio-guided parathyroidectomy have come into common use.

The current landscape of artificial intelligence in oral and maxillofacial surgery- a narrative review.

Objective: This narrative review aims to explore the current applications and future prospects of AI within the subfields of oral and maxillofacial surgery (OMS), emphasizing its potential benefits and anticipated challenges.

Methods: A detailed review of the literature was conducted to evaluate the role of AI in oral and maxillofacial surgery. All domains within OMS were reviewed with a focus on diagnostic, therapeutic and prognostic interventions.

The CASPAR study protocol. Can cervical stiffness predict successful vaginal delivery after induction of labour? a feasibility, cohort study.

Background: Induction of labour (IOL) is a common obstetric intervention in the UK, affecting up to 33% of deliveries. IOL aims to achieve a vaginal delivery prior to spontaneous onset of labour to prevent harm from ongoing pregnancy complications and is known to prevent stillbirths and reduce neonatal intensive care unit admissions. However, IOL doesn't come without risk and overall, 20% of mothers having an induction will still require a caesarean section birth and in primiparous mothers this rate is even higher.

Enhanced sensitivity and scalability with a Chip-Tip workflow enables deep single-cell proteomics.

Single-cell proteomics (SCP) promises to revolutionize biomedicine by providing an unparalleled view of the proteome in individual cells. Here, we present a high-sensitivity SCP workflow named Chip-Tip, identifying >5,000 proteins in individual HeLa cells. It also facilitated direct detection of post-translational modifications in single cells, making the need for specific post-translational modification-enrichment unnecessary.

Rare Case of Immediate Postoperative Acute Gout Flare Associated With Surgical Management of Facial Abscess of Odontogenic Origin-Case Report.

Gout is caused by monosodium urate crystal deposition within joints and periarticular structures. It is characterized by the typical arthritis symptoms such as pain, swelling, and redness usually involving the first metatarsophalangeal joint. Recurrent attacks of gout are common, especially after major surgical procedures during which intense cell turnover takes place and can lead to hyperuricemia and accumulation of monosodium urate crystals.

Safety and efficiency of trainees performing bilateral internal thoracic artery coronary bypass grafting using the T-graft technique.

Objectives: Aim of this study was to assess safety and efficiency of multiarterial coronary bypass grafting using bilateral internal thoracic arteries in T-graft technique performed by trainees.

Methods: Patients from January 2005 to February 2023 who had undergone multiarterial coronary bypass grafting using bilateral internal thoracic arteries in T-graft technique were analysed. Patients were divided into two groups based on the primary surgeon: Consultant and Trainees.

Differences in time to surgery and defect sizes after Mohs micrographic surgery for black versus white patients with cutaneous squamous cell carcinoma.

Few studies have examined outcomes for Mohs micrographic surgery (MMS) for cutaneous squamous cell carcinoma (cSCC) in Black versus White patients. We compared time to surgery and defect sizes after MMS between Black versus White patients with cSCC. Patients with biopsy-proven cSCC treated with MMS at the Hospital of the University of Pennsylvania were identified from a prospectively maintained database (2006-2023).

Carbohydrate and wound healing in critically ill burn patients: A retrospective cohort study.

Two randomized controlled trials conducted in acutely burned patients found clinical benefits with higher carbohydrate (60-65% of total energy), lower fat (12-15%) nutrition, to include faster wound healing, fewer wound infections, decreased hospital stay, and less pneumonia. The primary purpose of this study was to assess whether our change in practice to a higher proportion of carbohydrates (60%) with 25% of energy from protein, and 15% of energy from fat was associated with improved wound healing rates. Secondary outcomes evaluated included invasive fungal wound infections, ischemic bowel, sepsis, and mortality.

Personalized Dynamic Prediction Model for Biopsy Timing in Patients With Prostate Cancer During Active Surveillance.

Importance: Active surveillance (AS) for patients with prostate cancer (PC) often includes fixed repeat prostate biopsies that do not account for the varying risk of reclassification to significant disease. Given the invasive nature and potential complications of biopsies, a personalized approach is needed to balance the burden of biopsies with the risk of missing disease progression.

Objective: To develop and externally validate a dynamic model that predicts an individual's risk of PC reclassification during AS.

Cost-Effectiveness of Noninvasive Colorectal Cancer Screening in Community Clinics.

Importance: Several noninvasive tests for colorectal cancer screening are available, but their effectiveness in settings with low adherence to screening and follow-up colonoscopy is not well documented.

Objective: To assess the cost-effectiveness of and outcomes associated with noninvasive colorectal cancer screening strategies, including new blood-based tests, in a population with low adherence to screening and ongoing surveillance colonoscopy.

Design, Setting, And Participants: The validated microsimulation model used for the decision analytical modeling study projected screening outcomes from 2025 to 2124 for a simulated cohort of 10 million individuals aged 50 years in 2025 and representative of a predominantly Hispanic or Latino patient population served by a Federally Qualified Health Center in Southern California.

Biomechanics of flail chest injuries: tidal volume and respiratory work changes in multiple segmental rib fractures.

Background: Flail chest (FC) injuries are segmental osseous injuries of the thorax that typically result from high-energy blunt trauma and regularly occur in multiple trauma (MT) patients. FC injuries are associated with paradoxical chest wall movements and, thus, have a high risk of respiratory insufficiency or even death. An increasing number of studies recommend an early surgical stabilization of FC injuries, but a definite trigger that would indicate surgery has, thus far, not been identified.