Efficacy of transversus abdominis plane block in postoperative pain management of laparoscopic totally extraperitoneal inguinal hernia repair: a propensity score-matched analysis.

Purpose: Transversus abdominis plane (TAP) block is a promising technique for postoperative pain control. In this study, we aimed to evaluate the efficacy of the TAP block in managing postoperative pain after laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.

Methods: In this retrospective study, medical records of patients who had received ultrasonography-guided TAP blocks after surgery from January 2019 to August 2023 were reviewed and compared with those of patients who had not received.

Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index.

Background: Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction.

Matching Into Integrated Plastic Surgery: The Impact of USMLE Step 1 Transition to Pass/Fail: Did the 2019 Predictions Come True in 2024?

Background: The first class of integrated plastic surgery residency applicants with pass/fail (P/F) step 1 assessments occurred during the 2023-2024 Match cycle. This study analyzes the results of a 2024 postmatch survey to program directors (PDs) regarding the impact of the conversion to P/F step 1 scoring and compares the results to the 2019 survey that attempted to predict how this conversion would influence decision-making when it was initially announced.

Methods: A 26-item survey evaluating PDs' perspectives on applicant characteristics and the application process following P/F step 1 scoring was distributed March 2024.

Glycoprotein 350-targeted chimeric antigen receptor T-cell therapy for nonneoplastic chronic active Epstein-Barr virus infection: a case report.

Background: Chronic active Epstein-Barr virus (CAEBV) infection is a rare disease in which the Epstein-Barr virus (EBV) persists and replicates, causing chronic symptoms and fatal complications. The treatment of CAEBV is still evolving. Our case report showed a new therapy for CAEBV.

Metabolic cardiomyopathy associated with a compound heterozygous variant in NAD(P)HX dehydratase: a case report and literature review.

Background: Metabolic cardiomyopathy is characterized by structural and functional changes to the heart and interstitial fibrosis without coronary artery disease or hypertension. Inborn metabolic defects are a common cause of cardiomyopathy in children. There are more than 40 kinds of inborn metabolic defects that cause cardiomyopathy.

Usefulness and safety of remimazolam in upper gastrointestinal endoscopy: A comparative study between elderly and non-elderly patients.

Objectives: In gastroenterology, sedation demand is increasing, although elderly patients are more prone to experiencing adverse events. Remimazolam, a novel ultra-short-acting benzodiazepine, may reduce recovery time after endoscopic procedures.

Methods: This study was a secondary analysis of the investigator-initiated trial, which investigated the efficacy and safety of remimazolam in gastrointestinal endoscopy (REM-IICT JP01).

Endoscopic incisional balloon dilation combined with anti-scarring agents for postoperative esophageal anastomotic strictures.

The management of locally advanced esophageal cancer typically involves esophagectomy; however, postoperative complications, particularly anastomotic stricture, remain prevalent. Anastomotic stricture can severely compromise patients' quality of life by leading to difficulties in food intake. Although endoscopic balloon dilation has become a standard treatment for gastrointestinal strictures, its efficacy is often limited due to the risk of perforation and the potential for recurrent stricture, necessitating multiple interventions.

Motivators and Barriers to Seeking Metabolic and Bariatric Surgery Among Adolescents: A Qualitative Study.

Background: The prevalence of severe obesity among adolescents has increased the use of metabolic and bariatric surgery (MBS) as a therapeutic option. Understanding factors influencing adolescent MBS choice and the support needed to undergo MBS is crucial for improving health outcomes. This study examines the motivations and support needs of a diverse sample of adolescents seeking MBS via the patient voice.

Neuronal subset-specific -deficient mice do not exhibit deficits in sensorimotor gating processes.

Deficits in sensorimotor gating have been reported in individuals with autism spectrum disorder (ASD), as well as in ASD murine models. However, this behavior has not been examined in the neuronal subset-specific (NS)- knockout (KO) model of ASD. KO mice exhibit hyperactivity of the PI3K/AKT/mTOR signaling pathway which is implicated in the onset of autistic deficits.

Medical researchers' perception of sharing of metadata from case report forms.

Introduction: Publishing medical metadata stored in case report forms (CRFs) is a prerequisite for the development of a learning health system (LHS) by fostering reuse of metadata and standardization in health research. The aim of our study was to investigate medical researchers' (MRs) willingness to share CRFs, to identify reasons for and against CRF sharing, and to determine if and under which conditions MRs might consider sharing CRF metadata via a public registry.

Methods: We examined CRF data sharing commitments for 1842 interventional trials registered on the German Clinical Trials Registry (DRKS) from January 1, 2020, to December 31, 2021.

Total Hip Arthroplasty for Avascular Necrosis in a Patient With Hemophilia B.

Avascular necrosis (AVN) of the femoral head accounts for up to 10% of all total hip arthroplasties performed annually. Typically associated with intravascular coagulation, AVN is extremely rare in patients with bleeding disorders such as hemophilia B. In this report, we describe the therapeutic management of a 46-year-old male with hemophilia B, presenting with chronic left hip pain and AVN of the femoral head.

Concomitant Pulmonary and Biliary Manifestations of Ulcerative Colitis: A Case Report.

Ulcerative colitis can present with extra-intestinal manifestations, including interstitial lung disease and primary sclerosing cholangitis. When pulmonary symptoms precede gastrointestinal, diagnosis can be challenging. Consideration of Ulcerative colitis in patients with unexplained lung and hepatic pathology is crucial, as a failure of timely intervention can lead to multiorgan complications.

Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review.

The twin reversed arterial perfusion (TRAP) sequence is a rare complication associated with monochorionic twins. It is characterized by blood flow from the umbilical artery of the normal (pump) twin to the umbilical artery of the abnormal (acardiac) twin via artery-to-artery anastomosis. This condition is associated with 100% mortality in the acardiac twin and a high rate of perinatal morbidity and mortality in the pump twin, primarily due to intrauterine hypoxic injury, heart failure, and prematurity.

Morrey Award 2023: radial head donor plug for capitellum osteochondral autograft transfer: a cadaveric biomechanical analysis.

Background: Limitations to using the knee as donor cartilage include cartilage thickness mismatch and donor site morbidity. Using the radial head as donor autograft for capitellar lesions may allow for local graft harvest without distant donor site morbidity. The purpose of this study is to demonstrate the feasibility of performing local osteochondral autograft transfer from the nonarticular cartilaginous rim of the radial head to the capitellum.

Translation, cross-cultural adaptation, validity, and reliability of the Indonesian version of the Oxford Shoulder Score for patients with shoulder pain.

Background: No questionnaire is currently available for use in patients with shoulder pain in an Indonesian-speaking population. This study aimed to translate the Oxford Shoulder Score (OSS) into Indonesian and assess its validity and reliability for use in Indonesian-speaking patients with shoulder pain.

Methods: After a forward and backward translation procedure, the validity and reliability of the questionnaire were investigated.

The clinical course and outcomes following arthroscopic frozen shoulder 360° release.

Background: Frozen shoulder (FS) is a debilitating inflammatory condition affecting the shoulder capsule that causes significant pain and stiffness. Its etiology, pathophysiology, and treatment remain poorly understood. Although regarded as self-limiting, FS can have profound implications on the activities of daily living and usually takes 1-4 years to resolve on its own accord.

Virtual assessment of internal rotation in reverse shoulder arthroplasty based on statistical shape models of scapular size.

Background: The purpose of this study was to assess impingement-free internal rotation (IR) in a virtual reverse shoulder arthroplasty simulation using a Statistical Shape Model based on scapula size.

Methods: A database of over 10,000 scapulae utilized for preoperative planning for shoulder arthroplasty was analyzed with a Statistical Shape Model to obtain 5 scapula sizes including the mean and 2 standard deviations. For each scapula model, one glenosphere size (33-42 mm) was selected as the best fit based on consensus among 3 shoulder surgeons.

Does morbid obesity negatively impact perioperative outcomes following elective reverse shoulder arthroplasty?: a propensity-matched comparative study.

Background: The incidence of primary reverse total shoulder arthroplasty (rTSA) and the prevalence of obesity have increased in the United States. Despite this, the literature assessing the effect of morbid obesity (body mass index≥40 kg/m) on perioperative surgical outcomes remains inconsistent.

Methods: A retrospective review of consecutive elective primary rTSA cases from January 2016 through September 2023 at a single tertiary referral center was performed.

Regrowth Rate of a Cardiac Myxoma After Percutaneous Aspiration.

Cardiac myxomas are typically treated surgically; however, the operative mortality and recurrence rates are not negligible. In the current report we describe a case of repeat percutaneous aspiration of a right atrial myxoma. The report supports feasibility of the procedure, provides the asymptomatic timeframe after debulking, and the regrowth rate.

Novel Use of a Catheter-Based Device Retrieval System for Percutaneous Treatment of Recurrent Atrial Myxoma.

Surgical resection is standard of care for the treatment of atrial myxoma. However, the optimal management strategy for recurrent cardiac tumors is less clear. Here we report the novel use of a catheter-based device retrieval system for the removal of a recurrent cardiac myxoma.

A Severely Calcified, Undilatable, Coronary Artery Stenosis: Impact of Serial Lithotripsy on Calcium Fracture and Lumen Expansion.

Percutaneous coronary intervention of a severely calcified coronary artery stenosis is associated with stent underexpansion and adverse outcomes. Intravascular lithotripsy (IVL) is a novel technology for fracturing calcified plaque in the coronary artery. We describe the first case of a severely calcified, undilatable coronary artery lesion.

Indirect Ballistic Injury Resulting in Non-ST-Segment Elevation Myocardial Infarction.

Gunshot-related myocardial injuries typically result from direct penetrating injury by the traversing bullet. We present a case of gunshot-related myocardial injury in the absence of direct penetrating injury to the cardiac structures and describe alternative mechanisms for ballistic-induced injury.

Tongue Squamous Cell Carcinoma With Cardiac Metastases.

A 60-year-old man with squamous cell carcinoma of the tongue had atypical chest pain and mild troponin elevation. No significant electrocardiogram changes or arrhythmias were noted. Cardiac magnetic resonance revealed several myocardial metastases with pericardial involvement, confirmed by positron emission tomography/computed tomography.

Clinical Presentation and Percutaneous Treatment of Hemolytic Anemia Associated With Paravalvular Leak After TAVR.

Paravalvular leak (PVL) following transcatheter aortic valve replacement (TAVR) is an established complication, albeit rarely associated with hemolytic anemia. This report details 3 cases of significant hemolytic anemia attributed to TAVR-induced PVL, each with distinct clinical presentations and manifestations. These cases underscore the diverse and occasionally subtle clinical presentation of aortic PVL-associated hemolytic anemia.