Ethanol and the Limitations of the Osmol Gap.

Study Objective: The osmol gap can help detect and manage those with toxic alcohol exposure, and it is altered by all alcohols including ethanol. The optimal correction for ethanol that would allow accurate detection of an alternative alcohol is unclear.

Methods: We conducted a prospective cohort study to assess baseline variations in osmol gap, and then to assess the validity of 2 commonly used coefficients (correction factors) for ethanol.

Mechanical Wear of Degraded Articular Cartilage.

Purpose: To evaluate the mechanical wear of cartilage with different types of degradation.

Methods: Bovine osteochondral explants were treated with interleukin-1β (IL-1β) to mimic inflammatory conditions, with chondroitinase ABC (ChABC) to specifically remove glycosaminoglycans (GAGs), or with collagenase to degrade the collagen network during 5 days of culture. Viscoelastic properties of cartilage were characterized via indentation.

Measurement and Assessment of Head-to-Helmet Contact Forces.

Purpose: To evaluate the population variation in head-to-helmet contact forces in helmet users.

Methods: Four different size Kevlar composite helmets were instrumented with contact pressure sensors and chinstrap tension meters. A total number of 89 volunteers (25 female and 64 male volunteers) participated in the study.

A Multicenter Study on the Relationship of Tumor Lesion Location with Bilateral Parametrial Involvement and Pelvic Lymph Node Metastasis in Cervical Squamous Cell Carcinoma.

Background: This study aimed to explore the relationship of cervical tumor lesion location (CTLL) with bilateral parametrial involvement (PI) and pelvic lymph node metastasis (LNM).

Methods: The study retrospectively analyzed the clinicopathologic and imaging data of patients with cervical squamous cell carcinoma (SCC) retrieved from multiple centers. According to the CTLL, patients were allocated to three groups: a middle one third group, a unilaterally dominant group, and the entire-region group.

Posterior Hepatectomy and Inferior Vena Cava Graft Reconstruction for En Bloc Resection of a Hepatocellular Carcinoma: A Tribute to Couinaud's Liver Anatomy Description.

Background: Hepatocellular carcinoma (HCC) associated with major vasculature tumor extension is considered an advanced stage of disease to which palliative radiotherapy or chemotherapy is proposed. Surgical resection associated with chemotherapy or chemoembolization could be an opportunity to improve overall survival and recurrence-free survival in selected cases in a high-volume hepatobiliary center. Moreover, it has been 25 years since Couinaud described the entity of a posterior liver located behind an axial plane crossing the portal bifurcation.

Global metabolomic alterations associated with endocrine-disrupting chemicals among pregnant individuals and newborns.

Background: Gestational exposure to non-persistent endocrine-disrupting chemicals (EDCs) may be associated with adverse pregnancy outcomes. While many EDCs affect the endocrine system, their effects on endocrine-related metabolic pathways remain unclear. This study aims to explore the global metabolome changes associated with EDC biomarkers at delivery.

Osilodrostat improves blood pressure and glycemic control in patients with Cushing's disease: a pooled analysis of LINC 3 and LINC 4 studies.

Purpose: To evaluate the effect of osilodrostat and hypercortisolism control on blood pressure (BP) and glycemic control in patients with Cushing's disease.

Methods: Pooled analysis of two Phase III osilodrostat studies (LINC 3 and LINC 4), both comprising a 48-week core phase and an optional open-label extension. Changes from baseline in systolic and diastolic BP (SBP and DBP), fasting plasma glucose (FPG), and glycated hemoglobin (HbA) were evaluated during osilodrostat treatment in patients with/without hypertension or diabetes at baseline.

What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery.

Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache.

Analysis of the protective effect of hydrogen sulfide over time in ischemic rat skin flaps.

Background: Hydrogen sulfide (HS) is a widely studied gasotransmitter, and its protective effect against ischemia-reperfusion damage has been explored in several studies. Therefore, a requirement exists for a comprehensive study about HS effects on ischemia-reperfusion damage in flap surgery. The aim of this study is to examine the effect of hydrogen sulfide by creating ischemia-reperfusion injury in the vascular-stemmed island flap prepared from the rat groin area.

DIEP flap reconstruction for sacrectomy defects: Two case reports.

Introduction: Vertical rectus abdominis myocutaneous (VRAM) flap is the most common option for large sacral defect reconstruction but is known to have donor-site abdominal morbidity compared to deep inferior epigastric perforator (DIEP) flaps.

Report: Fifty-seven and 63 year-old men were admitted for large sacral soft tissue defects after tumour excisions. They both underwent an inferiorly based pedicled vertical DIEP flap passed transabdominally with successful postoperative outcomes and not any abdominal wall complication.

Determinants of dementia diagnosis in U.S. primary care in the past decade: A scoping review.

Background: Alzheimer's disease and related dementias (ADRD) are chronically underdiagnosed in the U.S., particularly among minoritized racial and ethnic groups.

Association of Chronic Obstructive Pulmonary Disease and Mortality following Thoracic and Complex Endovascular Aortic Repair.

Objectives: This study assessed the association between chronic obstructive pulmonary disease (COPD) severity and postoperative mortality among patients undergoing thoracic endovascular aortic repair (TEVAR) and complex endovascular aortic repair (CEVAR).

Methods: A retrospective review of the Vascular Quality Initiative database identified elective TEVAR and CEVAR cases from 2013-2022 with endograft proximal landing zone ≥2 for thoracic or complex abdominal aortic disease. Symptomatic disease, ruptures, and urgent/emergent surgeries were excluded.

Biomarkers and Social Determinants in atherosclerotic Arterial Diseases: A Scoping Review.

Background: Arterial diseases like coronary artery disease, carotid stenosis, peripheral artery disease, and abdominal aortic aneurysm have high morbidity and mortality, making them key research areas. Their multifactorial nature complicates patient treatment and prevention. Biomarkers offer insights into the biochemical and molecular processes, while social factors also significantly impact patients' health and quality of life.

A Multivariate Analysis of a Modified Frailty Index on Perioperative Morbidity and Mortality Following Non-Emergent Endovascular Aortic Aneurysm Repair.

Objective: Frailty has become an increasingly recognized perioperative risk stratification tool. While frailty has been strongly correlated with worsening surgical outcomes, the individual determinants of frailty have rarely been investigated in the setting of aortic disease. The aim of this study was to examine the determinants of an 11-factor modified frailty index (mFI-11) on mortality and postoperative complications in patients undergoing endovascular aortic aneurysm repair (EVAR).

Non-Occlusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.

Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.

Time until operation for elective endovascular aortic aneurysm repair in Canadian Vascular Centers using the Canadian Vascular Quality Initiative Registry.

Objectives: Optimal timing for intervention for abdominal aortic aneurysms remains unclear. Given the increased rupture risk with larger aneurysms, timely intervention is critical. This study sought to examine endovascular aortic aneurysm repairs (EVAR) delays across Canadian centers, focusing on potential differences related to geography, sex and race.

Evaluation of autologous venous allograft for lower limb in the treatment of critical limb ischemia. The REVATEC (REVAscularisation par greffons veineux bioproTEC) study.

Objective: Chronic limb-threatening ischemia (CLTI) requires revascularization whenever it is possible. The great saphenous vein represents the surgical conduit of choice. However, it is not always available, in particular in multi-operated patients.

Chronic hand ischemia in pediatric patients due to brachial artery injury after supracondylar humerus fracture.

Objectives: Brachial artery injury due to displaced supracondylar fracture (SC) of the humerus in children may present with pink pulseless hand (PPH), denoting a well perfused hand without radial pulse, or acute hand ischemia. Some reports state that brachial artery reconstruction is not necessary in children with persisting PPH, but the reports on long-term consequences such as intermittent claudications, growth retardation and ischemic contracture in children with pulseless hand are scarce and often misinterpreted. The objective of our analysis was to assess the long-term outcomes of children with brachial artery injury associated with SC fracture.