Mortality and Morbidity After Open Surgical Lower Extremity Revascularization in Patients With Peripheral Artery Disease and Concurrent Abdominal Stoma.

Objectives: Patients with peripheral artery disease (PAD) often require treatment with open lower extremity revascularization (LER). Patients with PAD often have other comorbidities and associated conditions that affect procedural outcomes, including abdominal stomas. The aim of this work is to investigate the impact that stomas may have on postoperative outcomes and complications.

A Case of Suspected Neurosarcoidosis Evading Diagnosis With Cervical Biopsy.

Neurosarcoidosis is a rare manifestation of sarcoidosis, posing diagnostic challenges due to its varied clinical presentation and the lack of definitive diagnostic tests. We present a case of a 46-year-old African American female with progressive ascending bilateral sensory loss, weakness, and a bifrontal headache. Despite undergoing extensive diagnostic workup including cerebrospinal fluid analysis, neuroimaging, and bronchoscopic evaluation, a definitive diagnosis remained elusive.

Prognostication: A fading Hippocratic art?

Over the past 75 years modern medicine has advanced in its ability to diagnose and treat many diseases. However, the medical profession's ability to prognosticate the course and outcome of an illness has not satisfied the needs of many patients. Physicians must not lose the ability, or desire, to consider the whole person in relation to a patient's disease.

EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults.

Background: As the population ages, more older adults are presenting for surgery. Age-related declines in physiological reserve and functional capacity can result in frailty and poor outcomes after surgery. Hence, optimizing perioperative care in older patients is imperative.

Keep Fingers on the CpG Islands.

The post-genomic era has ushered in the extensive application of epigenetic editing tools, allowing for precise alterations of gene expression. The use of reprogrammable editors that carry transcriptional corepressors has significant potential for long-term epigenetic silencing for the treatment of human diseases. The ideal scenario involves precise targeting of a specific genomic location by a DNA-binding domain, ensuring there are no off-target effects and that the process yields no genetic remnants aside from specific epigenetic modifications (i.

Navigating the Pitfalls of Lung Cancer Screening: A Case Study on the Risks and Costs of Negative Screenings.

Lung cancer is the leading cause of cancer-related deaths in the United States. Low-dose computed tomography is the preferred screening method for high-risk individuals. However, with a false-negative rate reaching 15%, this method can underestimate disease prevalence and delay necessary treatment.

Demographic Disparities in Lung Cancer Mortality and Trends in the United States From 1999 Through 2020: A Population-Based CDC Database Analysis.

Background: Lung cancer is the leading cause of cancer-related mortality in the United States and is projected to account for 127,070 deaths in 2023. Although the lung cancer mortality rate has been decreasing over the last decade, demographic disparities in mortality still exist. We sought to determine the impact of demographic factors on lung cancer mortality and trends in the United States.

Torsional Deformity Significantly Impacts Lateral Ankle Radiographic Imaging Parameters.

Background Optimal lateral ankle imaging is important for the diagnosis and treatment of multiple ankle conditions. The effects of limb deformity on lateral ankle imaging are not well described and are clarified in this osteological study. Materials and methods We utilized an osteological collection and imaged all specimens after the first positioning of the talus in the lateral position and positioning the tibia and fibula to match.

Updated understanding of the protein-DNA recognition code used by C2H2 zinc finger proteins.

C2H2 zinc-finger (ZF) proteins form the largest family of DNA-binding transcription factors coded by mammalian genomes. In a typical DNA-binding ZF module, there are twelve residues (numbered from -1 to -12) between the last zinc-coordinating cysteine and the first zinc-coordinating histidine. The established C2H2-ZF "recognition code" suggests that residues at positions -1, -4, and -7 recognize the 5', central, and 3' bases of a DNA base-pair triplet, respectively.

Multidisciplinary expert consensus statements and recommendations for use of hypochlorous acid as a solution for negative pressure wound therapy with instillation.

Background: HOCl (eg, pHAp) preserved solutions have antimicrobial properties and are considered safe and effective for wound management. NPWTi-d (or NPWTi) is an established adjunctive wound modality for a variety of wound etiologies in various anatomic locations in which an instillate solution dwells on the surface of the wound to assist in wound bed preparation. A variety of solutions have been used, including 0.

A Meta-Analysis of Success Rates of One-Stage Versus Two-Stage Revisions in Knee Prosthetic Joint Infections.

Prosthetic joint infections (PJIs) pose significant challenges following total joint arthroplasties and cause profound complications. They are associated with significant morbidity and mortality. One-stage revision involves the removal of the infected implant and simultaneous re-implantation of a new prosthesis in a single surgical procedure.

Application of machine learning for lung cancer survival prognostication-A systematic review and meta-analysis.

Introduction: Machine learning (ML) techniques have gained increasing attention in the field of healthcare, including predicting outcomes in patients with lung cancer. ML has the potential to enhance prognostication in lung cancer patients and improve clinical decision-making. In this systematic review and meta-analysis, we aimed to evaluate the performance of ML models compared to logistic regression (LR) models in predicting overall survival in patients with lung cancer.

Fungal Prosthetic Joint Infection: A Case Series and Review of the Literature.

Introduction: Fungal prosthetic joint infections comprise less than 1% of prosthetic joint infections. Thus, little is known regarding optimal management. This study aims to characterize the microbiology, surgical and medical management, and outcomes for these complex infections.

Hippocrates, the first aphorism, and decorum: A personal view of caution and guidance regarding Generation Z students.

Generation Z students can be challenging. The Internet, the Covid-19 epidemic, its political aftermath, and the substantial online educational content they have been required to endure, has left them with a perspective towards a work-life balance to which we older, more experienced faculty are not accustomed. Here, I give caution and guidance to my colleagues regarding their interactions with this cohort through my reading of the Hippocratic corpus.

Addition of a Second Calcaneal Pin for Spanning Ankle External Fixation.

Spanning ankle external fixation is a commonly used technique for the treatment of fractures of the lower extremity. Traditionally, a single pin is placed in the safe zone of the calcaneus to provide a point of traction for fracture reduction and stabilization. Complications include infection and pin loosening with subsequent loss of fracture reduction.

Refractory Ischemic Priapism Following Hemodialysis.

Priapism, characterized by prolonged and painful penile erection, is a rare urological emergency with diverse etiologies. We present a case of refractory ischemic priapism following hemodialysis in a 57-year-old male with a history of type II diabetes mellitus, hypertension, and end-stage renal disease. Despite standard conservative management, the patient's condition persisted, necessitating penile distal shunting through an intracorporeal dilatation plus Al-Ghorab corporoglandular shunt.