Safety and efficacy of ketamine use in patients with vaso-occlusive crisis: A systematic review and meta-analysis.

Introduction: Sickle cell disease (SCD) is characterized by acute episodes called vaso-occlusive crises (VOC). VOC is marked by severe pain due to blocked blood vessels by sickled cells. Ketamine has been reported to be effective and safe in managing VOC in SCD patients.

Flow diverter versus stent-assisted coiling treatment for managing dissecting intracranial aneurysms: A systematic review and meta-analysis.

Background: Dissecting intracranial aneurysms (DIAs) have been treated through endovascular reconstructive manners, such as flow diverters (FDs) and stent-assisted coiling (SAC). Notably, no robust evidence has compared both approaches. Hence, the authors conducted a meta-analysis to compare their outcomes.

Endoscopic management of colonic perforations.

Purpose Of Review: We will review the current management of colonic perforations, with particular emphasis on iatrogenic perforations caused by colonoscopy, the leading etiology. We will focus on recently developed endoscopic techniques and technologies that obviate morbid emergency surgery (the standard management approach in years past).

Recent Findings: Colonic perforations are rare but potentially fatal complications of both diagnostic and therapeutic colonoscopy resulting in death in approximately 5% of cases with the mortality increasing with delay in diagnosis and treatment.

Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.

Background: Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking.

Methods: We conducted an international randomized trial involving 1600 patients with atrial fibrillation who had an elevated score (≥2 in men and ≥3 in women) on the CHADS-VASc scale (range, 0 to 9, with higher scores indicating a greater risk of stroke) and who underwent catheter ablation.

The experience with Hugo™ robot-assisted surgery on complex gynecological patients in Panama.

The Hugo robotic assisted surgery system is a relatively new robotic platform developed by Medtronic. The study objective was to describe the experience of using Hugo robotic assisted surgery in gynecological surgeries and compare robotic assisted surgery-related outcomes between complex and non-complex gynecological patients at the Pacifica Salud Hospital. We performed secondary data retrospective analysis of 144 consecutive patients who underwent gynecological surgery with Hugo robotic assisted surgery system (Medtronic) at the Pacifica Salud hospital in Panama City from July 19, 2021, to August 3, 2023.

The Impact of Tobacco Smoking on Systemic Sclerosis, Idiopathic Inflammatory Myositis, and Systemic Lupus Erythematosus.

This narrative review aims specifically to explore the relationship between tobacco exposure and systemic sclerosis (SSc), idiopathic inflammatory myositis (IIM), and systemic lupus erythematosus (SLE). Relevant articles were obtained by searching key terms such as "tobacco," "smoking," "scleroderma," "myositis," "lupus," and "Sjögren's" in PubMed and Google Scholar databases. The selected articles ranged from the years 2010 to 2023.

Orogastric Tube Fracture and Ingestion in a Patient With Hyperacute Delirium: A Unique and Potentially Catastrophic Complication.

Orogastric tubes (OGTs) are frequently used to administer feeds and medications to critically ill patients. They are inserted blindly, with a low first-pass success rate and frequent benign complications. OGT fractures and ingestion are exceedingly rare, with only two cases reported to date.

Classification of musical hallucinations and the characters along with neural-molecular mechanisms of musical hallucinations associated with psychiatric disorders.

Background: Musical hallucinations (MH) involve the false perception of music in the absence of external stimuli which links with different etiologies. The pathomechanisms of MH encompass various conditions. The etiological classification of MH is of particular importance and offers valuable insights to understand MH, and further to develop the effective treatment of MH.

Spontaneous Heterotopic Pregnancy: A Case Report of a Potentially Life-Threatening Condition.

Heterotopic pregnancy involves the coexistence of both an intrauterine and an extrauterine pregnancy occurring simultaneously. The spontaneous incidence of heterotopic pregnancy in the general population has been estimated to be 1/30,000. This report discusses the case of a 37-year-old female who presented to the emergency department with vaginal bleeding and lower abdominal pain.

Idiopathic Granulomatous Mastitis, Erythema Nodosum, and Polyarthritis.

Idiopathic granulomatous mastitis (IGM) is an inflammatory-mediated rare disease that can be linked to rare manifestations. Erythema nodosum (EN) and polyarthritis, seen in a multitude of autoinflammatory and autoimmune diseases, have been rarely linked to IGM. Despite the cause of IGM being unclear, Corynebacterium infections are thought to play a role in the pathophysiology of IGM.

Dehydrated Amnion Chorion Membrane versus standard of care for diabetic foot ulcers: a randomised controlled trial.

Objective: Diabetic foot ulcers (DFUs) continue to challenge wound care practitioners. This prospective, multicentre, randomised controlled trial (RCT) evaluated the effectiveness of a dehydrated Amnion Chorion Membrane (dACM) (Organogenesis Inc., US) versus standard of care (SoC) alone in complex DFUs in a challenging patient population.

An update on the endocrine manifestations of antiphospholipid syndrome.

Antiphospholipid Syndrome (APS), characterized by hypercoagulability and pregnancy morbidity, poses a significant clinical challenge when involving organ systems, such as the endocrine system. APS can directly and indirectly influence the anterior and posterior lobes of the pituitary gland. The thyroid gland exhibits involvement, especially in patients with positive anticardiolipin antibodies, yet the clinical significance of the relationship with APS remains elusive.

The impact of nicotine smoking on spondyloarthritis and rheumatoid arthritis.

Objective: Nicotine has major side effects on human health through numerous mechanisms, one of which is the alteration of the immune system and its genetic components. Such alteration can be a predisposing factor for autoimmune diseases such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). This review aims to shed light on the effects of nicotine smoking on the pathophysiology, clinical presentation, and management of SpA and RA.

Adult-Onset Still's Disease Following COVID-19 Infection in a Patient Receiving Nirmatrelvir/Ritonavir: A Case Report.

SARS-CoV-2 (COVID-19) has been associated with numerous complications, including autoimmune and autoinflammatory diseases. The surge of cytokines following COVID-19 infection or vaccination has been proposed to contribute to immune dysregulation, which might subsequently give rise to an autoinflammatory syndrome. Adult-onset Still's disease (AOSD) is one of the rare autoinflammatory diseases characterized by a surge of cytokines.

Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo-Surgical Aortic Valve Replacement in Patients With Aortic Stenosis: A Systematic Review and Meta-analysis.

Aortic stenosis is a common and significant valve condition requiring bioprosthetic heart valves with transcatheter aortic valve replacement (TAVR) being strongly recommended for high-risk patients or patients over 75 years. This meta-analysis aimed to pool existing data on postprocedural clinical as well as echocardiographic outcomes comparing valve-in-valve (ViV)-TAVR to redo-surgical aortic valve replacement to assess the short-term and medium-term outcomes for both treatment methods. A systematic literature search on Cochrane Central, Scopus, and Medline (PubMed interface) electronic databases from inception to August 2023.

Cemented vs Cementless Robotic-Assisted Total Knee Arthroplasty Yield Similar Short-Term Clinical Outcomes.

Background: In primary total knee arthroplasty (TKA), there is ongoing controversy about optimal fixation (cemented vs cementless). Cemented TKA remains the gold standard, with the largest body of long-term evidence available to support it. However, cementless TKA implants are gaining popularity due to potential biomechanical advantages and a growing body of literature supporting survivorship.