When common cognitive biases impact debriefing conversations.

Healthcare debriefing is a cognitively demanding conversation after a simulation or clinical experience that promotes reflection, underpinned by psychological safety and attention to learner needs. The process of debriefing requires mental processing that engages both "fast" or unconscious thinking and "slow" intentional thinking to be able to navigate the conversation. "Fast" thinking has the potential to surface cognitive biases that impact reflection and may negatively influence debriefer behaviors, debriefing strategies, and debriefing foundations.

Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.

Introduction: Endoscopic submucosal dissection (ESD) allows for curative en-bloc resection of dysplastic gastrointestinal (GI) tract lesions. However, it is associated with postoperative adverse events (AEs) such as pain, bleeding, and perforation. Dexmedetomidine, an α2-receptor agonist, has emerged as a promising adjunct sedative for ESD under moderate sedation, offering anxiolysis and analgesia.

Utility of ultrasound imaging in the diagnosis of postoperative complications following upper extremity tendon repair.

Operated tendons are impacted by an inciting trauma and the subsequent treatment and will never again appear as they were prior to the insult. Post-operative tendons have unique ultrasound (US) findings that can be helpful to the surgeon in evaluating the success of repair, status of healing and confirmation that the repair remains intact. The advantage of US over physical exam or other imaging modalities is that it offers both static and dynamic assessment.

A feasibility model for restructuring the role of the hand surgeon taking call at a level I trauma center.

Background: The discrepancy between the volume of hand-related consults and the concurrent lack of specialized hand surgeons available continues to strain an overburdened system. Recent attention has focused on the redistribution of this workload towards management in the outpatient realm.

Methods: This is a retrospective review of hand consults for the plastic surgery service over summer and winter intervals at a Level I trauma center.

Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis of Individual Patient Data.

Background And Objective: The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) in the era of immune checkpoint inhibitors (ICIs) is controversial. We aimed to investigate the survival benefit of CN in patients with mRCC treated with ICIs.

Methods: We searched the EMBASE, MEDLINE, and Web of Science databases up to August 26, 2023 to identify studies comparing overall survival (OS) for patients with mRCC treated with ICIs with or without CN.

Autoimmune Hepatitis and Vitamin D Deficiency: A Nationwide Perspective.

Background: Vitamin D deficiency is linked to worse outcomes in patients with chronic liver diseases (CLD). However, data in patients with autoimmune hepatitis (AIH) remain limited.

Aims: We aimed to assess the impact of vitamin D deficiency on the outcomes of individuals with AIH.

Supplementary oxygen efficacy for chronic pulmonary disorders and exertion desaturation.

Introduction: Exertion-induced desaturation (EID) is a common complication of numerous pulmonary disorders and often treated with supplementary oxygen during exertion. We performed a systematic review and meta-analysis of randomised clinical trials (RCTs) to evaluate the efficacy of supplementary oxygen for EID in pulmonary disorders.

Material And Methods: Medline and Embase were systematically searched from July 2022 to June 2023 following PRISMA guidelines.

Pediatric opioid use-associated neurotoxicity with cerebellar edema (POUNCE) syndrome.

Introduction: Unfortunately, children are not spared from the devastating effects of the ongoing opioid epidemic. In rare cases, young children exposed to opioids present with unique neuroimaging findings affecting the white matter, reminiscent of what was once seen with diacetylmorphine (heroin)-associated leukoencephalopathy. This constellation of findings is termed the pediatric opioid use-associated neurotoxicity with cerebellar edema (POUNCE) syndrome.

Comparison of predictors of survival among fulminant myocarditis patients undergoing veno-arterial extracorporeal membrane oxygenation in the adult and pediatric populations.

Background: Fulminant myocarditis (FM) is a potentially life-threatening disease that requires emergency care. The authors' study aims to explore clinical outcomes and predictors of survival when using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for the treatment of FM in adult and pediatric patients to analyze differences between both populations.

Methods: PubMed, Scopus, Web of Science, and Cochrane databases were searched for studies reporting the effect of VA-ECMO on patients diagnosed with fulminant myocarditis.

Nontransplant treatment approaches for myeloid neoplasm with mutated TP53.

TP53-mutated myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) remain a challenging spectrum of clonal myeloid disease with poor prognosis. Recent studies have shown that in AML, MDS, and MDS/AML with biallelic TP53 loss, the TP53-mutated clone becomes dominant. These are highly aggressive diseases that are resistant to most chemotherapies.

What medical students and residents learned from reflection through patients' perspectives: a qualitative study.

Objectives:  The purposes of this study were to identify reflective processes from patients' points of view for difficult patient-doctor interactions and learn how the processes made medical students and residents aware of their own medical practice.  These processes were compared in two countries (US and Japan).

Methods:  The study was a descriptive qualitative study utilizing semi-structured interviews.

Users of chronic prescription opioids decrease in the first 12 months following bariatric surgery.

Objective: Obesity is an independent risk factor for chronic pain frequently treated with opioids. Our study investigated the effect of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.

Methods: Using the IBM MarketScan database (2010-2017), we analyzed adult chronic opioid users who underwent bariatric surgery.

The Impact of Proton Pump Inhibitor Use on Fusion Rates Following Single-level Anterior Cervical Discectomy and Fusion.

Study Design: Cohort study.

Objective: This study explores how proton pump inhibitors (PPIs) affect fusion rates following anterior cervical discectomy and fusion (ACDF), using a large-scale data analysis.

Background: ACDF is essential for treating cervical disc herniation leading to myelopathy and radiculopathy, involving disc removal and vertebral fusion, crucial for long-term stability and symptom relief.

Long-term outcomes after first-ever posterior circulation stroke and the prognostic significance of the New England Medical Center Posterior Circulation Registry stroke classification: A prospective study from the Athens Stroke Registry.

Background: There is paucity of data on the long-term outcomes after acute ischemic posterior circulation stroke (PCS). Additionally, the long-term prognostic value of the New England Medical Center-Posterior Circulation Registry (NEMC-PCR) classification of PCS has not been studied.

Patients And Methods: All consecutive patients with PCS registered in the Athens Stroke Registry between 01/1993 and 12/2012 were prospectively followed for up to 10 years and included in the analysis.

Serum β‑hCG as a prognostic marker for colorectal adenocarcinoma in women of reproductive age: A case report and literature review.

Serological and histological examinations have unveiled the presence of free β subunit of human chorionic gonadotropin (β-hCG) in some cases of colorectal adenocarcinoma. The present study describes an unusual case of a young female patient afflicted with rapidly advancing adenocarcinoma of the sigmoid colon. Despite the absence of pregnancy indications on an ultrasound and curettage, a notable elevation of β-hCG was detected in the serum, alongside positive staining in the tumor tissue.

Perioperative assessment of colorectal anastomoses with flexible endoscopy.

Flexible sigmoidoscopy has emerged as a vital tool for the purpose of assessing colorectal anastomoses: a procedure that can play a crucial role in reducing postoperative complications. The present technical note aims at describing a comprehensive strategy for the perioperative evaluation of colorectal anastomoses integrity. An endoscopic grading system is utilized to categorize findings, ensuring consistency and external validity.