The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction: A Multi-institutional Analysis of 10,177 Cases.

Background: Direct-to-implant (DTI) breast reconstruction offers immediate aesthetic and psychological benefits, but the role of acellular dermal matrix (ADM) remains debated. Using a multi-institutional database, this study evaluates and compares outcomes between ADM-assisted and non-ADM DTI procedures.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2022 was queried to identify female patients who underwent DTI breast reconstruction for oncological purposes.

Perioperative Outcomes in Patients with and Without Chronic Preoperative Therapeutic Anticoagulation Undergoing Metabolic Surgery at an Academic Medical Center.

Patients on chronic anticoagulation undergoing metabolic surgery represent an increased risk of complications, including both bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The optimal perioperative management of patients who are receiving chronic anticoagulation therapy (CAT) is complex. In the colorectal surgery literature, patients on CAT have a 10% rate of peri-procedural bleeding and a 3% rate of thromboembolism.

Outcomes of the Paul Glaucoma Implant in Refractory Secondary Glaucoma.

Purpose: To evaluate the efficacy and safety of the Paul Glaucoma Implant (PGI) surgery in patients with secondary glaucomas.

Patients And Methods: Retrospective chart review of adult patients with medically recalcitrant secondary glaucoma who underwent PGI implantation at a single tertiary center between August 2022 and June 2023. The primary outcome measure was surgical success.

Infection Screening and Vaccination of Adult and Pediatric Patients with Autoimmune Inflammatory Rheumatic Diseases: An Emirati Delphi Consensus.

Introduction: Patients with autoimmune and inflammatory rheumatic diseases (AIIRD) have an increased susceptibility to infections due to their compromised immune systems and the use of immunosuppressive therapies. Infections are a leading cause of morbidity and mortality in these patients, emphasizing the need for strategies such as infection control and vaccination to prevent avoidable harm to both patients and healthcare workers. This study aims to provide expert consensus on infection screening and vaccination guidelines for AIIRD patients.

Narrative review of recent developments and the future of penicillin allergy de-labelling by non-allergists.

This article outlines recent developments in non-allergist delivered penicillin allergy de-labelling (PADL), discusses remaining controversies and uncertainties and explores the future for non-allergist delivered PADL. Recent developments include national guidelines for non-allergist delivered PADL and validation of penicillin allergy risk assessment tools. Controversies remain on which penicillin allergy features are low risk of genuine allergy.

Improving Therapeutic Adherence and Reducing Therapeutic Inertia in the Management of People with Cardiometabolic Diseases: A Call-to-Action from the Middle East.

Hypertension, dyslipidemia, and type 2 diabetes are highly prevalent and poorly controlled cardiometabolic diseases in the Middle East. Therapeutic non-adherence and therapeutic inertia are major contributors to this suboptimal disease control. Regardless of the cardiometabolic disease, evidence-based solutions may be used to improve therapeutic non-adherence and overcome inertia, and thereby help to alleviate the heavy burden of cardiovascular disease in the Middle East.

Risk Factors Associated with Post-COVID-19 Conditions Among Diabetes Patients in the United Arab Emirates.

Background: A substantial subset of individuals recovering from the Coronavirus disease 2019 (COVID-19) continues to experience persistent symptoms. Individuals with type 2 diabetes face increased morbidity and mortality following COVID-19 infection. This study aimed to identify risk factors for developing post-COVID-19 conditions among COVID-19 patients with diabetes compared to those without diabetes in the United Arab Emirates.

Exploring the safety and feasibility of intracameral Aprokam® (cefuroxime sodium) in pediatric cataract surgery.

Purpose: To describe the safety and assess the feasibility of using intracameral cefuroxime sodium (Aprokam®) during congenital cataract surgery as a preventive measure for endophthalmitis.

Design: Monocentric, prospective, observational pilot study.

Setting: San Giuseppe Hospital, University of Milan, Milan, Italy.

Assessment and treatment considerations for patients with colorectal liver metastases: AHPBA consensus guideline and update for surgeons.

Background: Colorectal cancer most commonly metastasizes to the liver. While various treatment strategies have been developed, surgical management of these patients has vital implications on the prognosis and survival of this group of patients. There remains a need for a consensus guideline regarding the surgical evaluation and management of patients with colorectal liver metastases (CRLM).

Young Onset Chronic Inflammatory Back Pain: A Diagnostic Dilemma Between Axial Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis.

Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axSpA) share similarities in both clinical presentation and radiological findings, making the diagnostic process challenging. We report the case of a 30-year-old male with a longstanding history of back pain with an initial diagnosis of young-onset DISH. However, a diagnosis of axSpA was ultimately pursued based on his age and clinical presentation.

Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.

Background And Aims: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear.

Methods: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD.

Multidisciplinary Teamwork in Management of Dislodged Prosthetic Aortic Valve Leaflet.

Mechanical valve leaflets have the potential to detach and migrate to unintended locations, leading to life- and limb-threatening situations. We report a unique case of a dislodged mechanical aortic valve leaflet in the right iliac artery bifurcation after a redo mitral valve replacement. This was promptly recognized by input from a multidisciplinary team, allowing immediate correction of the aortic valve insufficiency followed by staged retrieval of the dislodged leaflet to avoid vascular complications.

Changes in pulse pressure variation induced by passive leg raising test to predict preload responsiveness in mechanically ventilated patients with low tidal volume in ICU: a systematic review and meta-analysis.

Background: Pulse pressure variation (PPV) is limited in low tidal volume mechanical ventilation. We conducted this systematic review and meta-analysis to evaluate whether passive leg raising (PLR)-induced changes in PPV can reliably predict preload/fluid responsiveness in mechanically ventilated patients with low tidal volume in the intensive care unit.

Methods: PubMed, Embase, and Cochrane databases were screened for diagnostic research relevant to the predictability of PPV change after PLR in low-tidal volume mechanically ventilated patients.

Hemizygous Moesin (MSN) Gene Deletion in an Adult With Chronic Neutropenia.

X-linked moesin-associated immunodeficiency (X-MAID) is a recently identified combined immunodeficiency caused by a mutation in the moesin () gene. It is characterized by cytopenias, hypogammaglobulinemia, poor immune response to vaccine antigens, and increased susceptibility to early-life infections. We report a patient with adult-onset neutropenia, lymphopenia, inadequate response to the pneumococcal polysaccharide vaccine (PPSV23), and recurrent bacterial infections associated with a hemizygous deletion.

Prediction of Major Adverse Cardiovascular Events in Patients with Peripheral Artery Disease Using Circulating Immunomodulatory Proteins.

The leading cause of death for people with peripheral artery disease (PAD) is major adverse cardiovascular events (MACE), including heart attacks and strokes. However, research into biomarkers that could help predict MACE in patients with PAD has been limited. Immunomodulatory proteins are known to significantly influence systemic atherosclerosis, suggesting they could be useful prognostic indicators for MACE in patients with PAD.

Diagnostic and Management Challenges in Interferon-γ Release Assay-Positive Patient with Sarcoid Panuveitis from a Non-Endemic Tuberculosis Region.

Purpose: To report a case of biopsy-proven sarcoidosis in a patient with panuveitis and a positive interferon-gamma release assay (IGRA) from a non-endemic tuberculosis (TB) country.

Methods: Case report.

Results: A 26-year-old male from the United Arab Emirates (UAE) presented with granulomatous panuveitis characterized by mutton-fat keratic precipitates, anterior chamber and vitreous cells, and retinal vasculitis.

Transcatheter Mitral Valve Repair in a Patient with Osteogenesis Imperfecta: A Case Report and Literature Review.

With the emergence of less invasive transcatheter valvular therapies, there remains a limited understanding of the feasibility and durability of these approaches in patients with osteogenesis imperfecta and whether they can offer a suitable alternative to conventional surgery. In this context, and with a focus on mitral repair, we report on a case of mitral transcatheter edge-to-edge repair in a patient with osteogenesis imperfecta and conduct a comprehensive review of the characteristics and outcomes of reported osteogenesis imperfecta cases undergoing surgical or transcatheter mitral repair. Given the high burden of complications of surgery in this population, transcatheter mitral repair could potentially serve as a suitable alternative to conventional surgery in this challenging population.

A multi-centre UK-based survey on angioedema secondary to acquired C1 inhibitor deficiency.

Background: Acquired angioedema due to C1-inhibitor deficiency (AAE-C1-INH) is very rare compared to its prototype, hereditary angioedema. An updated characterisation of the AAE-C1-INH cohort in UK is required to inform management.

Objectives: To describe the disease burden of AAE-C1-INH, long-term prophylaxis (LTP) and the clinical, immunochemical and treatment profiles of AAE-associated diseases in UK.

Anterior uveitis, pigmentary retinopathy, and pars plana exudates in Celiac disease.

Purpose: To report a case of bilateral anterior uveitis, pigmentary retinopathy, and pars plana exudates in a patient with Celiac disease with complete resolution of inflammation following gluten-free diet.

Methods: Retrospective case report.

Results: A 19-year-old Asian Indian girl presented with bilateral non-granulomatous anterior uveitis for the past 2 months.

Slow-Coagulation Transscleral Cyclophotocoagulation in Pseudoexfoliation Glaucoma.

Purpose: To evaluate the outcomes of slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) in pseudoexfoliation glaucoma (PXG).

Methods: A single-center, retrospective non-comparative study including consecutive patients with medically uncontrolled PXG who underwent SC-TSCPC (1250-milliwatt power and 4-second duration). The primary outcome measure was surgical success (defined as intraocular pressure (IOP) between 6 - 21 mmHg with ≥20% reduction compared to baseline and no need for further glaucoma surgeries or development of vision-threatening complications).

When Elevated Creatinine Is Not What It Seems: Intraperitoneal Urinary Leak Mimicking Acute Kidney Injury.

Acute kidney injury (AKI) is typically classified as prerenal, renal, or postrenal in etiology, with postrenal often referring to obstructive causes. However, certain uncommon conditions, such as intraperitoneal urinary leaks, may not fit clearly into these categories. In patients with a recent history of pelvic procedure, a complication such as intraperitoneal urinary leak can mimic AKI due to urine reabsorption across the peritoneum.

Further evidence that a specific homozygous variant results in non-syndromic maculopathy and can be mistaken for prior ocular toxoplasmosis infection.

Introduction: Round atrophic macular scars with a hyperpigmented rim in an otherwise healthy child are characteristic for prior ocular toxoplasmosis infection, the most common etiology of self-resolved retinitis in immunocompetent patients. However, a specific homozygous gene mutation (NM_148960: :c.263T>A; p.

The Role of Different Modalities of Regenerative Therapies in the Treatment of Erectile Dysfunction: A Global Survey and Global Andrology Forum Expert Recommendations.

Purpose: There is increased interest in regenerative therapies (RTs) to treat erectile dysfunction (ED). However, the need for society's guidelines has led to varied practices. This study aims to investigate current global practices, address the heterogeneity in treatment protocols and evaluations, and establish expert recommendations in clinical practice.

Identification and Evaluation of Angiogenesis-Related Proteins That Predict Major Adverse Cardiovascular Events in Patients with Peripheral Artery Disease.

Background: The most common cause of death in patients with peripheral artery disease (PAD) are major adverse cardiovascular events (MACEs), including myocardial infarction (MI) and stroke. However, data on biomarkers that could be used to help predict MACEs in patients with PAD to guide clinical decision making is limited. Angiogenesis-related proteins have been demonstrated to play an important role in systemic atherosclerosis and may act as prognostic biomarkers for MACEs in patients with PAD.