Utilizing Preoperative Rectus Sheath Blocks to Decrease Opioid Administration During Pediatric Umbilical Hernia Repair.

Introduction: Regional anesthetic blocks are an adjunct to decrease pediatric opioid utilization and improve perioperative pain control. We compared opioid use in patients who underwent umbilical hernia repair (UHR) with or without preoperative bilateral rectus sheath block (BRSB).

Methods: We conducted a single-center retrospective cohort study evaluating opioid use in patients <18 years who underwent an UHR.

Pediatric ECMO Outcomes in Children With Severe Infections: Does Infectious Source Matter?

Background: Although Extracorporeal Membrane Oxygenation (ECMO) utilization in pediatric patients with cardiopulmonary failure due to infection improves mortality, it is unclear whether the infectious etiology impacts outcomes. The aim of this study is to compare ECMO outcomes in children with sepsis and severe acute lung injury secondary to infections based on culture data.

Methods: A retrospective review was done of patients aged <18 with severe infections whose management included ECMO from 2013 to 2022 at a quaternary children's hospital.

Immigrant experiences of harm in sexual and reproductive healthcare in Spain.

The medical encounter represents a site where patients may be harmed, with intersecting vulnerabilities shaping the risk and nature of this harm. Sexual and reproductive healthcare is an important site for exploring this dynamic. Questions concerning how immigrant women experience sexual and reproductive healthcare abound, with researchers and practitioners calling for greater attention to a population whose experiences are underrepresented in existing literature.

Development of a predictive model for pediatric intranasal drug delivery with nasal sprays: Leveraging intersubject variability in anatomical dimensions, administration-related parameters, and airway patency.

In this study, we examined the correlation between anatomical dimensions, spray administration parameters, pressure drop across 40 pediatric nasal cavities, and in vitro posterior drug delivery (PDD) using Nasacort ALLERGY 24HR and FLONASE SENSIMIST nasal suspensions sprays, with different nozzle and actuation designs. The importance of each parameter and their interaction in the outcome (PDD) was evaluated. To do so, initially we measured anatomical and administration-related parameters, and the pressure drop of each cavity.

Impact of continuous positive airway pressure therapy on restless legs syndrome in patients with coexistent obstructive sleep apnea: A qualitative systematic review.

Introduction: Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway collapse during sleep. Restless legs syndrome (RLS) is a sleep-related movement disorder characterized by an uncomfortable urge to move the legs, especially during inactivity and evenings. Both OSA and RLS are common with significant overlap: RLS is present in up to 36% of those with OSA.

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy.

Background: Cross-sectional studies have reported neurocognitive performance deficits in obsessive-compulsive disorder (OCD), particularly on tasks assessing response inhibition and proactive control over stimulus-driven behaviors (task control). However, it is not clear whether these deficits represent trait-like markers of OCD or are state-dependent.

Methods: This study examined performance on two neurocognitive tasks in OCD patients (N = 26) before and after cognitive behavioral therapy (CBT) and matched healthy controls (HCs, N = 19).

The benefit of national clinical guidelines for open lower limb fractures in reducing healthcare burden: A length of inpatient stay cost-analysis.

Introduction: Severe open lower limb fractures are complex and costly injuries. Studies reporting the costs associated with these injuries, the economic impact of complications, and the clinical benefit of adherence to national guidelines have been previously reported. However, the economic benefits of national guidelines and their relationship with length of inpatient stay have not been described.

Severe postoperative pancreatitis following treatment of peritoneal metastases.

Postoperative pancreatitis is an unusual complication of upper abdominal surgery that can result in severe morbidity and has been associated with postoperative death. It can be caused by trauma to the surface of the gland, injury to pancreatic ducts, vascular compromise, ductal obstruction within the pancreas parenchyma or because of duodenal stagnation. Our database of peritoneal surface malignancy patients was surveyed in a search for patients who manifested signs and symptoms of severe postoperative pancreatitis.

Intergenerational transfer of micro(nano)plastics in different organisms.

Micro(nano)plastics (MNPs), widely distributed in the environment, can be ingested and accumulated by various organisms. Recently, the transgenerational transport of MNPs from parental organisms to their offspring has attracted increasing attention. In this review, we summarize the patterns, specific pathways, and related mechanisms of intergenerational transfer of MNPs in plants, non-mammals (zooplankton and fish) and mammals.

A novel Cu-coordinated fluorescent sensing system for specific detection of glyphosate and its applications in environmental and biological systems.

Glyphosate is a non-selective herbicide widely used in agriculture, and its overexposure poses significant health and environmental risks. Herein, a novel Cu-coordinated fluorescent sensing system (HYBC-Cu system) based on acylhydrazone groups was designed, capable of glyphosate-specific recognition. The HYBC-Cu system was constructed with simple steps, with the advantages of short recognition time (< 1 min), good specificity, anti-interference, and excellent sensitivity (LOD = 95 nM).

Clinical risk factors for mortality in low severity acute epidural hematoma.

Background: Epidural hematomas (EDH) pose life-threatening risks with considerable morbidity and mortality if left untreated. The prognosis for patients with low-severity acute EDH managed conservatively is variable, with limited understanding of risk factors. This study aims to identify clinical risk factors for mortality in low-severity acute epidural hematoma patients managed conservatively, helping clinicians recognize cases where deviation from conservative management may be necessary.

Sodium fluorescein video Angiography-Assisted clipping of intracranial Aneurysms: A systematic review and Meta-Analysis.

Objectives: Ensuring aneurysm exclusion while maintaining vessel patency is crucial during intracranial aneurysm clipping. Although digital subtraction angiography (DSA) is the gold standard for intraoperative vascular imaging, some centers have reported using fluorescein sodium video angiography (FNa-VA). However, a synthesis of these findings is still lacking.

Factors associated with ICU stays after endovascular treatments for unruptured intracranial aneurysms: A review study.

Background: For unruptured intracranial aneurysms (UIAs), conservative management is often possible. However, when direct treatment is warranted, endovascular treatments (EVTs) provide an effective minimally invasive approach. These procedures still necessitate careful patient monitoring, frequently in the Intensive Care Unit (ICU).

Fluorescence-guided inguinal hernia repair with heightened nerve visualization to prevent chronic post-operative inguinal pain: Case report.

Introduction: Iatrogenic injury to the ilioinguinal nerve and its branches during anterior inguinal hernia repair is a cause of chronic inguinal pain in up to 12 % of patients undergoing this operation. The risk of nerve injury is high, given the nerves' relatively small caliber and strictly-confined space through which they pass. In the current report, we describe using a novel fluorescence imaging system developed to detect nerve autofluorescence in a 66-year-old man who presented with a left-sided Type II inguinal hernia and underwent inguinal hernioplasty.

Mealtime challenges from the perspectives of adolescents with anorexia nervosa and atypical anorexia nervosa and their caregivers enrolled in family-based treatment.

Objective: This study identified mealtime challenges and emotions experienced during challenges among adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) and their caregivers during the early phase of family-based treatment (FBT).

Method: Caregivers with high expressed emotion (i.e.

Urine exosome biomarkers of obesity after Lekhana Basti treatment - Report of a pilot study.

Background: Obesity is a rising risk factor for various diseases including cardiovascular diseases and Cancer. The limitations of targeted obesity-treatment approaches employed in the clinic presently underscore the importance of developing integrative management strategies for identification of specific biomarkers of obesity.

Objectives: Given the specificity of exosome/extracellular vesicle (EV) biomarkers, we aimed here to identify the EV biomarkers of Ayurveda treatment - Lekhana Basti - for Obesity.

What happens after menopause? (WHAM): A prospective controlled study of cognition 24 months after premenopausal risk-reducing salpingo-oophorectomy.

Objective: Women with BRCA1/2 pathogenic variants considering risk-reducing bilateral oophorectomy (RRSO) may be concerned about potential effects of surgical menopause on cognition. Whether RRSO affects cognition and whether hormone therapy (HT) modifies this effect remains uncertain. This study aimed to prospectively measure the effect of premenopausal RRSO on cognition and the modifying effects of HT up to 24 months.

The influence of cardiopulmonary bypass residual volume processing technique on blood management in cardiac surgical patients.

Post-cardiopulmonary bypass (CPB) blood processing is an important component of blood management during cardiac surgery. The purpose of this study is to evaluate several methods of processing post-CPB residual blood. Using a multi-institutional national database (SpecialtyCare Operative Procedural rEgistry [SCOPE]), 77,591 cardiac surgical operations performed in adults (>18 years) between January 2017 and September 2022 were reviewed.

Associations between interpersonal and community-level violence experiences and HIV outcomes: implications for violence screening in Ryan White Clinics.

Violence experience, interpersonal and community-level, is commonly reported by people living with HIV (PLWH). Understanding the impact of the various forms of violence on HIV outcomes is critical for prioritizing violence screening and support resources in care settings. From February 2021 to December 2022, among 285 PLWH purposively sampled to attain diversity by gender, race/ethnicity, and HIV care retention status in Atlanta, Georgia, we examined interpersonal and community violence experiences and proxy measures of violence (post-traumatic stress disorder (PTSD), anxiety, depression) and their associations with HIV outcomes (engagement and retention in care and HIV viral suppression) using multivariable analysis.

Orthopaedic Sports Injuries in an Aging Population: Current Trends and Future Projections.

Background: The elderly US population is growing quickly and staying active longer. However, there is limited information on sports-related injuries in older adults.

Hypotheses: (1) National estimate and incidence of sports-related orthopaedic injuries in the US elderly population have increased over the last 10 years, (2) types and causes of sports-related injuries in the elderly have changed, and (3) elderly sports-related injuries will increase more than the number of treating physicians by 2040.

Prospective multi-centre analysis of rural trauma team development training for medical trainees and traffic law enforcement professionals in Uganda: an interrupted time series study.

Background: Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of rural trauma team training amongst medical trainees and traffic law enforcement professionals in Uganda.

Methods: Prospective multi-centre interrupted time series analysis of an interventional training based on the 4th edition of rural trauma team development course of the American College of Surgeons.

From research to practice: bridging the implementation gap on the use of tranexamic acid in total knee arthroplasty.

Background: The use of intravenous tranexamic acid (TXA), an antifibrinolytic agent, has been shown to effectively reduce total blood loss and transfusion rates in total knee arthroplasty (TKA). The aim of this paper is to evaluate the implementation lag and clinical uptake of the use of TXA for primary TKA after publication of two landmark studies. Additionally, it assessed the efficacy of TXA use in TKA in reducing post-operative blood transfusions and hospital length of stay (LOS).

Gardnerella vaginalis-binding IgA in the urethra of sexually experienced males.

Background: Genital inflammation increases HIV susceptibility and is associated with the density of pro-inflammatory anaerobes in the vagina and coronal sulcus. The penile urethra is a critical site of HIV acquisition, although correlates of urethral HIV acquisition are largely unknown. While Streptococcus mitis is a consistent component of the urethral flora, the presence of Gardnerella vaginalis has been linked with prior penile-vaginal sex and urethral inflammation.

Enhancing immunotherapy efficacy with synergistic low-dose radiation in metastatic melanoma: current insights and prospects.

Recent advances in oncology research have highlighted the promising synergy between low-dose radiation therapy (LDRT) and immunotherapies, with growing evidence highlighting the unique benefits of the combination. LDRT has emerged as a potent tool for stimulating the immune system, triggering systemic antitumor effects by remodeling the tumor microenvironment. Notably, LDRT demonstrates remarkable efficacy even in challenging metastatic sites such as the liver (uveal) and brain (cutaneous), particularly in advanced melanoma stages.