The Presence of Pigment Incontinence in Sinonasal Mucosal Melanoma.

Background: Regression is an immunological phenomenon described in cutaneous melanoma whereby tumor is replaced with tumor-infiltrating lymphocytes, granulation tissue, and mature fibroblasts often accompanied by pigment incontinence (accumulation of melanin in the upper dermis). Pigment incontinence results in grossly pigmented lesions that may be mistaken for viable tumor and has not been described in sinonasal mucosal melanoma (SNMM). This study investigates the presence of regression and pigment incontinence in patients with SNMM.

Evolution of the Surgical Treatment of Ulnar Collateral Ligament Injuries.

Since Dr. Frank Jobe performed the initial surgery on Tommy John in 1974, the ulnar collateral ligament (UCL) reconstruction (UCLR), colloquially "Tommy John Surgery," described in 1986 has evolved as the gold standard treatment for UCL tears. The crux of technique modifications involve flexor pronator mass (FPM) management, ulnar nerve transposition (UNT), graft selection, or graft-fixation options.

Proton Pump Inhibitor Usage in Urban vs. Rural Intensive Care Units: A Narrative Review of Implications for Standardization of Care.

Intensive care unit (ICU) patients frequently require and benefit from stress ulcer prophylaxis (SUP) using proton pump inhibitors (PPIs). Despite recognized benefits, PPIs are overutilized in patients who do not have high-risk factors predisposing them to clinically significant gastrointestinal bleeding (CSGIB), including mechanical ventilation and coagulopathy. This overuse increases the risk of adverse effects associated with PPIs.

A novel 3D printing method for a notched eye plaque "dummy" for uveal melanoma brachytherapy.

Purpose: Suture preplacement by the ocular oncology surgeon is a critical step before inserting a radioactive plaque for ocular melanoma brachytherapy. We report on a novel 3D-printing method to create a custom "dummy" plaque applicator for the 22 mm notched gold plaque using in-house 3D-printing.

Methods: A computer-aided design (CAD) file was created replicating a heavily used gold plaque that no longer has a satisfactory "dummy" plaque.

Navigating COPD in Aging Populations: Insights Into Pathophysiology and Comprehensive Care.

Chronic obstructive pulmonary disease (COPD) poses a significant and growing health burden among aging populations, marked by increasing prevalence and complex management challenges specific to elderly patients. This review explores the multifaceted interplay between COPD and aging, highlighting overlapping pathophysiological processes and comorbidities that complicate diagnosis and treatment. We examine age-specific management strategies, emphasizing the need for tailored approaches that account for the unique physical, cognitive, and health-related quality of life impacts on older adults.

Socioeconomic influences on stroke outcomes: A comprehensive zip code-based hospital analysis.

Background And Objectives: Stroke remains a leading cause of morbidity and mortality worldwide. Socioeconomic disparities significantly affect the treatment and outcomes of cardiovascular and cerebrovascular diseases, including acute ischemic stroke. This study examines patients treated at Thomas Jefferson University Hospital, with ZIP code-based socioeconomic data predominantly representing areas in Pennsylvania and New Jersey, as the majority of patients originate from these regions.

Patient centered HCC surveillance - complementary roles of ultrasound and CT/MRI.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide and is the fastest growing cause of cancer death in the United States (U.S.) In the U.

Neurocritical Complications of Basal Cell Carcinoma With Intracranial Invasion.

Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for the majority of non-melanoma-type skin cancers. BCC is slow-growing and locally aggressive but rarely metastasizes.Although scarce, important consequences of untreated or recurrent BCC of the scalp are direct invasion into the skull, meninges, and/or brain.

Impact of Antidepressant Use on Intraoperative Blood Loss and Transfusion Rates in Lumbar Fusion Surgery.

Objective: A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery.

Postoperative Ketamine May be Associated with Venous Thromboembolism in Chronic Opioid Users After Spine Surgery.

Objective: Venous thromboembolism (VTE) is a serious postoperative adverse event after spine surgery. In patients with pain refractory to typical multimodal analgesia regimens after spine surgery, whom are often chronic opioid users, perioperative ketamine is an alternative analgesic that has grown in popularity. The aim of this study is to assess the risk of VTE in chronic opioid users undergoing spine surgery.

Peripheral Venous Ultrasound.

After clinical evaluation, especially clinical prediction rules, appropriately ordered venous duplex has become the standard test for evaluating and excluding deep vein thrombosis (DVT). Ultrasound is useful for lower- and upper-extremity veins. Protocols include grayscale, color Doppler, and spectral Doppler.

Peripheral Arterial Ultrasound.

Peripheral arterial ultrasound is an important technique to evaluate vascular disease. Protocols include grayscale, color Doppler and spectral Doppler. Arterial duplex is used to evaluate patients with claudication to characterize atherosclerotic disease.

Utilization of Enhanced Recovery After Surgery (ERAS) protocol in pediatric laparoscopic sleeve gastrectomy: a quality improvement project.

Background: The obesity epidemic has led to an increased number of adolescents requiring metabolic and bariatric surgery (MBS), but there is paucity of data on the impact of implementing all aspects of Enhanced Recovery After Surgery (ERAS) protocols to improve outcomes in this population.

Methods: We implemented a comprehensive ERAS pathway for adolescents undergoing laparoscopic sleeve gastrectomy (LSG). Key elements included pre-operative fasting with carbohydrate loading in the morning of surgery, comprehensive anti-emetic and analgesic regimens including intra-operative lidocaine infusion (initiated before formal ERAS launch), regional anesthesia, and early goal-directed ambulation.

MR-proANP levels in Acute ischemic stroke and clinical outcomes: a systematic review and meta-analysis.

In patients with acute ischemic stroke, midregional proatrial natriuretic peptide (MR-proANP) has shown promise in preliminary studies for risk stratification. The objective of this study is to evaluate the prognostic utility of MR-proANP in AIS, focusing on its ability to predict 90-day functional outcomes, mortality rates, and the presence of atrial fibrillation (Afib). A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus, following PRISMA guidelines.