Congenital Paradoxical Lower Eyelid Retraction With Upgaze due to an Anomalous Extraocular Muscle.

Congenital anomalous orbital structures are rare and associated with strabismus, globe retraction, and dystopia. The authors present a case of congenital paradoxical right lower eyelid retraction with upgaze due to an anomalous extraocular muscle in a 17-year-old, healthy, female patient. Orbital computed tomography showed an intraconal, inferolateral soft-tissue band extending from the orbital apex to the inferior oblique muscle and lower eyelid.

Pharmacists' guide to the management of organ donors after brain death.

Purpose: This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs.

Summary: The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients.

Preoperative Prolapse Stage as Predictor of Failure of Sacrocolpopexy.

Objectives: Our aim was to determine if there was a correlation between the preoperative prolapse stage and postoperative recurrence of prolapse 1 year after sacrocolpopexy. Our null hypothesis is that the preoperative stage of prolapse does not increase the risk of recurrence.

Methods: This is a multicenter cohort study from 3 centers.

Early Post-transplant Lymphoproliferative Disease in the Donor Ureter Without Systemic Involvement: A Case Report.

Background: Post-transplant lymphoproliferative disease is a serious complication of renal transplantation. Major risk factors include Epstein-Barr virus (EBV) seronegativity and induction immunosuppression with lymphocyte-depleting agents.

Results: We present a case of a 50-year year-old woman with very early onset PTLD confined to the donor ureter.

Effect of paravertebral nerve blocks on narcotic use after mastectomy with reconstruction.

Introduction: Pain control outcomes using local anesthetic delivery systems vs usual narcotics at our institution revealed that use of local anesthetic delivery systems decreased narcotic use greater than 40% in patients with no reconstruction but had very little effect in patients receiving reconstruction. As part of our quality improvement program, the anesthesiology department trained and began offering paravertebral blocks (PVBs) to patients having reconstruction. We reviewed pain control outcomes to understand how the use of paravertebral nerve blocks affected narcotic use in reconstructed patients.

Glomerular endothelial vesicles in a renal allograft: an unusual pattern of immunoglobulin deposition in a patient with biclonal gammopathy of unknown significance.

Paraproteins have varied effects on the kidney on the basis of molecular structure, concentration, and renal function. Prototypical patterns include myeloma cast nephropathy, monoclonal immunoglobulin deposition disease, and amyloid, among others. We report a 69-year-old man with end-stage diabetic nephropathy and biclonal gammopathy of unknown significance.

Technical factors associated with anastomotic leak after Roux-en-Y gastric bypass.

Background: Anastomotic leak is one of the most serious complications after Roux-en-Y gastric bypass (RYGB). Our objective was to examine the relationship between technical factors and incidence of clinically relevant anastomotic leak after RYGB in longitudinal assessment of bariatric surgery (LABS). The setting of the study was 11 bariatric centers in the United States, university, and private practice.

Prospective study of colorectal enhanced recovery after surgery in a community hospital.

Importance: Enhanced recovery after surgery (ERAS) colorectal programs have shown to be successful at reducing length of stay in many international and academic centers; however, their efficacy in a community hospital setting remains unclear.

Objective: To determine if favorable results could be reproduced in a community hospital setting using our ERAS program, which was developed using core ERAS guidelines with the goal of accelerated recovery while also addressing other important outcomes affecting patient experience and safety.

Design, Setting, And Participants: Prospective study of ERAS program, a multidisciplinary effort involving anesthesia, preadmission staff, nursing, and surgery staff at a community hospital.

Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study.

Background: The global burden of atrial fibrillation (AF) is unknown.

Methods And Results: We systematically reviewed population-based studies of AF published from 1980 to 2010 from the 21 Global Burden of Disease regions to estimate global/regional prevalence, incidence, and morbidity and mortality related to AF (DisModMR software). Of 377 potential studies identified, 184 met prespecified eligibility criteria.

Is bariatric surgery safe in patients who refuse blood transfusion?

Background: A small, but significant, number of patients undergoing bariatric surgery refuse blood transfusion for religious or other personal reasons. Jehovah's Witnesses number more than 1 million members in the United States alone. The reported rates of hemorrhage vary from .

Surveillance and modification of immunosuppression minimizes BK virus nephropathy.

Background/aims: Infection of a transplanted kidney with the polyomavirus, BK, is associated with poor allograft survival.

Methods: In an attempt to prevent this transplant complication, we studied 144 consecutive transplant recipients for the presence of BK infection with plasma and urine PCR testing at 1, 2, 3, 6 and 12 months. Viruria alone was followed by serial studies.

Spectrum of cutaneous hyperalgesias/allodynias in neuropathic pain patients.

Objectives: The aim of this study was to discern the pathophysio-logical bases for neuropathic hyperalgesias.

Methods: In this study, neurological and neurophysiological evaluation of 132 consecutive hyperalgesia patients using rigorous clinical and laboratory protocols were carried out.

Results: Two discrete semeiologic entities emerged: classic neurological vs atypical, fulfilling taxonomically complex regional pain syndrome (CRPS) II and I, respectively.