Enhanced recovery after surgery (ERAS) for craniotomies in the treatment of brain tumors: A systematic review.

Introduction: Postoperative complications after craniotomy for brain tumors include pain, nausea/vomiting, and infection. A standardized enhanced recovery after surgery (ERAS) protocol is not widely accepted for this common neurosurgical procedure. Few studies have explored its application.

Surgical Outcomes of Awake Craniotomy for Treatment of Arteriovenous Malformations in Eloquent Cortex: A Systematic Review.

Objective: Arteriovenous malformations (AVMs) located in eloquent brain regions are historically associated with a poor prognosis. Awake craniotomy (AC) with the adjunct of brain mapping has the potential of identifying non-eloquent gyri to maximize resection, thereby theoretically decreasing the risk of neurologic deficits. With limited evidence regarding the efficacy of AC in treatment of eloquent AVMs, this review aims to investigate its surgical outcomes.

Duloxetine for Postoperative Pain Control Following Knee or Hip Replacement: A Systematic Review and Meta-Analysis.

Background: Duloxetine is a Food and Drug Administration-approved selective norepinephrine reuptake inhibitor for treating depression, anxiety, fibromyalgia, and neuropathic and chronic musculoskeletal pain. This meta-analysis aims to evaluate the efficacy of duloxetine in reducing pain and postoperative opioid use following lower extremity total joint arthroplasty.

Methods: A literature search was performed, identifying randomized controlled trials investigating duloxetine for pain management after total hip and total knee arthroplasty.

Frequency and Outcomes of Cervical Spine Computed Tomography Imaging on Alcohol-Intoxicated Patients in the Emergency Department.

Background: Cervical spinal (c-spine) injuries range greatly in severity from minor ligamentous injuries to osteoligamentous instability with spinal cord injuries. Initial evaluation begins with stabilization as needed and immediate immobilization. Current practice as to whether the c-spine can be cleared clinically without radiographic evaluation is often guided by using the National Emergency X-Radiography Utilization Study Low-Risk Criteria and the Canadian C-Spine Rule.

Caring for Patients Using Methamphetamines: An Interprofessional Collaborative Approach.

Methamphetamine use is increasing in the U.S. and in Missouri, as are the number of deaths associated with its use.

Internal carotid artery position to characterize risk for vessel injury in pediatric intraoral trauma.

Objective: The internal carotid artery (ICA) lies in close anatomic proximity to the oropharynx and is at risk for injury in the instance of intraoral trauma. The objectives of this study are to describe the position of the ICA relative to the oropharynx and identify patient risk factors related to its position.

Methods: A total of 100 patients aged 12 months to 7 years 11 months who received computed tomography (CT) of the neck were randomly selected.

Rectus femoris transfers with and without a hamstring lengthening will not change hip kinematics in children with cerebral palsy.

Background: A rectus femoris transfer (RFT) surgery with and without a hamstring lengthening (HSL) is used to treat stiff-knee gait in children with cerebral palsy (CP). While current literature has reported that a RFT surgery improves the kinematics at the knee, little is known about the kinematic changes at the hip.

Research Question: Does a RFT surgery change hip joint kinematics in children with CP?

Methods: This retrospective study included children (<18 years old) diagnosed with CP, who underwent a RFT procedure, and who were seen at our institution's accredited clinical motion laboratory.

Airway anomalies in patients with 22q11.2 deletion syndrome: A scoping review.

Objective: People with 22q11.2 deletion syndrome (22q11DS) can present with a wide variety of findings. Various airway anomalies have been described intermittently within this syndrome, but this feature has not been extensively investigated.

Army Health Systems Doctrine and Training in Relation to Antibiotics: A Systematic Review.

Introduction: In the early 2000s when Tactical Combat Casualty Care was developed, the adoption of prophylactic antibiotic use was not mainstream. Back then, guidelines were derivative of civilian trauma guidelines which did not include widespread prophylactic antibiotic use. Current protocols across the DoD have embraced the use of prophylactic antibiotic use before reaching a military treatment facility as evidenced by Tactical Combat Casualty Care guidelines and several Joint Trauma System Clinical Practice Guidelines.

Cerebrospinal Fluid Leaks: A Case Series of Sinus Opacification on Computed Tomography (CT) Imaging.

Introduction: Cerebrospinal fluid (CSF) leaks occur when fluid seeps through a dural or skull base defect, typically in the nose or ear. CSF leaks commonly are identified and diagnosed by use of computed tomography (CT) and CT cisternogram. CT findings suggestive of a CSF leak include a skull-based bone defect along with opacification of the contiguous sinus.

Historical and current perspectives on blood endothelial cell heterogeneity in the brain.

Dynamic brain activity requires timely communications between the brain parenchyma and circulating blood. Brain-blood communication is facilitated by intricate networks of brain vasculature, which display striking heterogeneity in structure and function. This vascular cell heterogeneity in the brain is fundamental to mediating diverse brain functions and has long been recognized.

Vomiting and risk of endotracheal intubation related to preoperative doxycycline use for dilation and evacuation.

Objective: To describe the rate of vomiting from oral doxycycline 200 mg given the night before second trimester dilation and evacuation (D&E), proportion of anesthesia modalities, and anesthetic complications.

Study Design: We conducted a single-institution retrospective cohort study of patients presenting for second trimester D&E (14-0/7 to 23-6/7 weeks gestation) July 1, 2019-June30, 2020 following their scheduled preoperative visit as identified by billing codes. We recorded vomiting within 30 minutes of ingestion, anesthetic modality, and anesthetic complications.

Mohs Micrographic Surgery for Dermatofibrosarcoma Protuberans in 15 Patients: The University of Arkansas for Medical Sciences Experience.

Background: Dermatofibrosarcoma protuberans (DFSP) is an uncommon, locally aggressive malignancy with wide local excision (WLE) or Mohs micrographic surgery (MMS) representing the treatment of choice. This article illustrates the experience of a single academic institution in treating DFSP with MMS and adds two particularly large, difficult closures of the glabella/central forehead and sternum to the body of literature.

Objective: To report the results of 15 patients with DFSP treated with MMS over a five-year period by a single Mohs surgeon at the University of Arkansas for Medical Sciences (UAMS).

Transabdominal lidocaine to induce fetal demise: a cohort study.

Introduction: We sought to assess the efficacy of transabdominal intrafetal lidocaine to achieve fetal demise before pregnancy termination.

Methods: This study was a retrospective cohort analysis of patients undergoing transabdominal intrafetal lidocaine injections prior to abortion procedures after 24 weeks from January 2018 to June 2020 at DuPont Clinic, an outpatient obstetrics and gynaecology clinic in Washington, DC, USA. We recorded data on maternal factors, gestational age, time of injection and fetal asystole, and injection dose and location.

The historical development and an overview of contemporary keratoprostheses.

Corneal blindness is a major cause of ocular morbidity that affects 4.5 million people worldwide. Though penetrating keratoplasty is an excellent option for most patients with corneal blindness, there are various conditions for which corneal transplantation carries a low likelihood of success.

An Evaluation of Evidence Underpinning Management Recommendations in Tobacco Use Disorder Clinical Practice Guidelines.

Introduction: Clinical practice guidelines(CPGs) are important tools for medical decision-making. Given the high prevalence and financial burden associated with tobacco use disorder(TUD), it is critical that recommendations within CPGs are based on robust evidence. Systematic reviews(SRs) are considered the highest level of evidence, thus, we evaluated the quality of SRs underpinning CPG recommendations for TUD.

'Why aren't you on PrEP? You're a gay man': reification of HIV 'risk' influences perception and behaviour of young sexual minority men and medical providers.

Public health models and medical interventions have often failed to consider the impact of reductionist HIV 'risk' discourse on how sexual minority men interpret, enact and embody biomedical knowledge in the context of sexual encounters. The aim of this study was to use an anthropological lens to examine sexual minority men's perception of HIV risk and experience within the medical system in order to examine the influence of risk discourse on their health, behaviour and social norms. In-depth interviews ( = 43) were conducted with a racially, ethnically and socioeconomically diverse sample of young sexual minority men and explored HIV-related beliefs and experiences, as well as their interactions with healthcare providers.

Osteopathic Manipulative Treatment as an Intervention to Reduce Stress, Anxiety, and Depression in First Responders: A Pilot Study.

In this pilot study, we examined the efficacy of Osteopathic Manipulative Treatment (OMT) for improving symptoms of stress, anxiety, and depression (SAD) to determine a correlation between overall improvement in health and quality of life for first responders. Participants received weekly OMT or sham OMT targeting autonomic imbalance. Indicators of SAD were examined pre- and post-study.

Exploring the Influence of a Pandemic on Medical Education.

A shift occurred in medical school education due to the novel coronavirus disease-19 (COVID-19) pandemic. It has been more than a year since the start of the pandemic, and many medical schools have had to adapt quickly. The medical school curriculum had to be changed in order to accommodate the risk of the virus, which has caused an interruption in clinical education for both preclinical and clinical medical students.

It Is Time for an Oil Change: Polyunsaturated Fatty Acids and Human Health.

Polyunsaturated fatty acids (PUFAs) such as docosahexaneoic acid (DHA) and eicosapentaneoic acid (EPA), play a critical role in a variety of neuronal functions, including facilitating neuronal growth and differentiation, increasing the density of the neuritic network, modulating cell membrane fluidity, regulating intracellular signaling and gene expression, and exhibiting antioxidant characteristics. Dietary DHA is selectively enriched and actively retained in the central nervous system, mainly in synaptic membranes, dendrites, and photoreceptors. In this review, we highlight the myriad roles of PUFAs in brain function and human health.

At the Intersection of Gut Microbiome and Stroke: A Systematic Review of the Literature.

Ischemic and hemorrhagic stroke are associated with a high rate of long-term disability and death. Recent investigations focus efforts to better understand how alterations in gut microbiota composition influence clinical outcomes. A key metabolite, trimethylamine N-oxide (TMAO), is linked to multiple inflammatory, vascular, and oxidative pathways.