Machine Learning Confirms Nonlinear Relationship between Severity of Peripheral Arterial Disease, Functional Limitation and Symptom Severity.

Background: Peripheral arterial disease (PAD) involves arterial blockages in the body, except those serving the heart and brain. We explore the relationship of functional limitation and PAD symptoms obtained from a quality-of-life questionnaire about the severity of the disease. We used a supervised artificial intelligence-based method of data analyses known as machine learning (ML) to demonstrate a nonlinear relationship between symptoms and functional limitation amongst patients with and without PAD.

One Anastomosis Gastric Bypass in Morbidly Obese Patients with BMI ≥ 50 kg/m: a Systematic Review Comparing It with Roux-En-Y Gastric Bypass and Sleeve Gastrectomy.

Background: To explore the role of one anastomosis (Mini) gastric bypass (OAGB) for the super-obese patients.

Method: Literature review was performed in March 2019 as per PRISMA guidelines.

Results: A total of 318 patients were identified.

Late Presentation of a 9 mm Bullet in the Ureteropelvic Junction Causing Acute Renal Failure in a Solitary Functioning Left Kidney.

Urinary obstruction as a result of a late complication of a gunshot wound is rarely reported. Bullet shell fragments may migrate from their initial location into an area causing obstruction. In this study, we present a case of a left renal calculus surrounding a 9 mm gun shell in a patient with a solitary functioning left kidney.

A vascular access and midlines program can decrease hospital-acquired central line-associated bloodstream infections and cost to a community-based hospital.

Background: We propose that substituting central lines with midlines can help reduce the total number of central line catheter-days as well as central line-associated bloodstream infections (CLABSIs), thereby reducing the associated costs and the resulting increased length of stay. A midline or vascular access program in a community hospital can bring about these positive changes.

Objectives: Our objective is to evaluate whether the institution of a midline program for vascular access at a community hospital can reduce the number of central line catheter-days and the associated CLABSI rate, incidence, and cost.

Five easy-to-master uses for point-of-care ultrasound.

Clinicians are increasingly becoming familiar with the value of limited, focused point-of-care ultrasonography (POCUS) to help answer discrete clinical questions. Ultrasound education is being taught in medical schools and physician assistant (PA) and PA postgraduate programs nationwide. This article introduces five basic POC ultrasound scans that can easily be mastered by practicing PAs.

Direct Extension of Prostatic Adenocarcinoma Protruding Through the Urethral Meatus.

Prostate cancer involving the anterior urethra is rare with few cases describing isolated recurrence to the anterior urethra. This case describes a patient with a history of metastatic prostate cancer who subsequently developed advanced prostate cancer involving the entire urethra with extension from the prostatic urethra to the urethral meatus. This will help future healthcare providers recognize this metastatic pattern as a possibility and explore this option when presented with a bleeding mass at the urethral meatus of unknown origin.

Laparoscopic mini-gastric bypass in patients age 60 and older.

Background: Bariatric surgery in patients over age 60 was previously not considered, due to higher risk. The author presents a study of patients ≥60 years who underwent laparoscopic mini-gastric bypass (LMGB), to evaluate outcomes with follow-up to 6 years.

Methods: From 2007-2013, a prospectively maintained database was reviewed and patients ≥60 years were identified.

Percutaneous patent foramen ovale closure using Helex and Amplatzer devices without intraprocedural echocardiographic guidance.

Objectives: We compared procedural outcomes of patients undergoing patent foramen ovale (PFO) closure using Helex (W.L. Gore & Assoc.

Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients.

Background: The ideal management of the super-super obese patient (SSO) is unclear and controversy exists as to the choice of procedure as well as the risk for increased morbidity and mortality. I present my experience of laparoscopic mini-gastric bypass (LMGB) in 16 SSO patients with early follow-up results.

Methods: Review of a prospectively maintained database was performed.