Laparoendoscopic single-site surgery for the placement of an adjustable gastric band: a large cohort comparison.

Background: Laparoendoscopic single-site (LESS) surgery has been shown to be a well-tolerated alternative for the placement of an adjustable gastric band. To date, only small series have suggested that this approach may provide potential clinical benefits over standard multiport laparoscopy. The objective of this study was to compare the outcomes of patients undergoing LESS adjustable gastric banding (LESS-AGB) and a cohort of patients undergoing standard multiport laparoscopic adjustable gastric banding (LAGB).

Safety of echocardiographic contrast in hospitalized patients with pulmonary hypertension: a multi-center study.

Aims: Echocardiographic contrast (EC) improves the diagnostic accuracy of suboptimal echocardiograms. In October 2007, the Food and Drug Administration (FDA) placed a black box warning on the label of the perflutren-based agents Definity and Optison, contraindicating their use in patients with pulmonary hypertension (PHT) and unstable cardiopulmonary status, after serious cardiopulmonary reactions occurred in temporal relation to EC administration. In 2008 and 2011, the FDA revised the black box warning allowing their use in this same population.

Robotic-assisted resection of an intrapericardial bronchogenic cyst.

The advantages of robotic-assisted surgery have been well described and include improved three-dimensional visualization, increased precision of dissection, and the absence of tremor. These characteristics are particularly useful in the mediastinal dissection of major vascular structures. We present a case of an intrapericardial bronchogenic cyst resected with robotic assistance.

Morbidity and mortality after hepatic and pancreatic resections: results from one surgeon at a low-volume urban hospital over thirty years.

Background: Recent reviews of state and national databases suggest that hospital volume is inversely proportional to morbidity after hepatic and pancreatic resection. Volume may be a surrogate marker for factors such as coordination of care and surgeon training. The authors hypothesized that low-volume centers can obtain acceptable outcomes if these requirements are satisfied.

Successful treatment of Old World cutaneous leishmaniasis caused by Leishmania infantum with posaconazole.

Old World cutaneous leishmaniasis is a widespread and potentially disfiguring protozoal infection that is endemic in the Mediterranean basin, Africa, and parts of Asia. Human infection is caused by several species of Leishmania parasites, such as Leishmania infantum. Available systemic and topical treatments vary in efficacy and are often unjustified due to their toxicity.

Cardiac tamponade in a patient with dengue fever and lupus nephritis: a case report.

Cases of small pericardial effusion have been reported in association with dengue fever (DF), largely with dengue hemorrhagic fever during epidemic outbreaks. However, cardiac tamponade developed by a patient with DF has not yet been reported in the English literature. We report a case of cardiac tamponade in a patient with DF and lupus nephritis.

Transient left ventricular apical ballooning after a cocaine binge.

Left ventricular apical ballooning is an increasingly reported phenomenon with an onset that is usually triggered by severe and often acute emotional incidents. We report a rare case of acute left ventricular apical ballooning syndrome, mimicking acute ST-elevation myocardial infarction, in a post menopausal woman whose only predisposing factor was an all-night cocaine binge.

Hepatobiliary ultrasound.

The use of ultrasound technology in the emergency department(ED) is a recent and fast-growing phenomenon. Ultrasound is an extremely valuable tool for the evaluation of gallbladder (GB) dis-ease in the ED for several reasons: this disease is a common medical problem, cholecystitis can present in different ways clinically,the nature of the GB allows it to be well visualized by ultrasound,and ultrasound has many benefits and few complications associated with its use. This article reviews the focused examination of the GB, with specific attention to test characteristics (sensitivity,specificity, positive predictive value, and negative predictive value)when performed by emergency physicians in the ED.

"Band aid" surgery: upper sternal split incision for valve surgery in adults. A modified technique.

A limited 10 cm upper sternotomy to the level of the third right intercostal space with preservation of the entire length of the left half of the sternum (quarter sternotomy) allows: 1) exposure for aortic valve surgery; 2) utilization of standard equipment and cannulation techniques; 3) preservation of both internal thoracic arteries and 4) early discharge from the hospital. Three patients, all female, aged 45, 62 and 67, two with severe aortic insufficiency and one with severe aortic stenosis, underwent replacement. In two, a St.