Travel Burden as a Measure of Healthcare Access and the Impact of Telehealth within the Veterans Health Administration.

Background: Travel is a major barrier to healthcare access for Veteran Affairs (VA) patients, and disproportionately affects rural Veterans (approximately one quarter of Veterans). The CHOICE/MISSION acts' intent is to increase timeliness of care and decrease travel, although not clearly demonstrated. The impact on outcomes remains unclear.

Long-term Outcomes of Persistent Postoperative Opioid Use: A Retrospective Cohort Study.

Objective: To determine the association between PPOU and the long-term risk of OUD and opioid overdose.

Summary Background Data: PPOU is a commonly used outcome in the surgical literature; its incidence and risk factors have been well described. However, its association to long term outcomes, including OUD and opioid overdose, is unknown.

Surgical management of adult-onset cystic hygroma in the axilla.

Introduction: Lymphatic malformations are commonly recognized as relatively benign congenital masses affecting infants and children in the perinatal period. In children, these masses are most commonly found in the neck, and are occasionally seen in other areas of the body.

Presentation Of Case: A 58-year-old man presented with an acute axillary swelling measuring approximately 20cm in length, 12cm in AP width, and 7cm in depth.

Comparing brief stress management courses in a community sample: mindfulness skills and progressive muscle relaxation.

This study sought to compare a five-week mindfulness meditation (MM) course to a five-week course that taught progressive muscle relaxation (PMR). Forty-three adults from the community were randomly assigned to either MM (n = 19) or PMR (n = 24) courses after responding to flyers and other advertisements for a free stress management course. Mindfulness meditation participants practiced meditation significantly more often than PMR participants practiced relaxation during the intervention period (F[1, 43] = 7.

Autologous tunica vaginalis and subcapsular orchiectomy: a hormonal therapy for prostate cancer.

Two novel surgical procedures that combine an autologous tunica vaginalis pedicle graft (TVG) with a subcapsular orchiectomy (SCOT) were evaluated in asymptomatic patients with rising prostate-specific antigen (PSA) values following radiation therapy, a radical retropubic prostatectomy, or a newly diagnosed prostatic cancer with bony metastasis. In the SCOT I procedure, the TVG was secured to the inner wall of the tunica albuginea. In the SCOT II procedure, the TVG was folded and secured to the external wall of the tunica albuginea.

Phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction in patients with diabetes mellitus.

Sildenafil, a phosphodiesterase 5 (PDE5) inhibitor, has become a first-line therapy for diabetic patients with erectile dysfunction (ED). The efficacy in this subgroup, based on the Global Efficacy Question, is 56% vs 84% in a selected group of non-diabetic men with ED. Two novel PDE5 inhibitors, tadalafil (Lilly ICOS) and vardenafil (Bayer), have recently completed efficacy and safety clinical trials in 'general' and diabetic study populations and are now candidates for US FDA approval.