Endoscopic Resection of Large Non-Pedunculated Colonic Polyps Without Submucosal Injection Is Safe and Effective with Adequate Technique.

: Endoscopic resection with lift polypectomy using submucosal injection (SI) for large non-pedunculated colorectal polyps is recommended to facilitate complete mucosal resection and decrease the risk of perforation; however, there are no studies comparing the safety and efficacy of large polypectomies with and without lift polypectomy. We aimed to evaluate the feasibility and safety of the polypectomy technique without SI compared to the routine use of SI. : We performed a single tertiary center retrospective study evaluating all consecutive large non-pedunculated colorectal polyps (≥20 mm) referred to expert endoscopists in polypectomy from 2018 through 2021.

Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR.

Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).

Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.

Standardizing postoperative pain control for decompression of pediatric Chiari type I malformation by limiting narcotic usage.

Objective: The aim of this study was to assess the effectiveness of a postoperative multimodal pain control protocol on perioperative pain scores in children undergoing decompression for Chiari type I malformation (CM-I).

Methods: This retrospective matched cohort study included patients < 21 years of age who underwent elective suboccipital craniectomy and C1 laminectomy for CM-I with or without duraplasty at a single center from January 2020 to July 2023. A standardized, multimodal postoperative pain protocol was implemented in August 2021 that did not use narcotic patient-controlled analgesia.

An Updated Demographic Profile of Orthopaedic Surgery Using a New ABOS Data Set.

Introduction: The orthopaedic surgery physician workforce is predominately White and male and has been identified as the least diverse medical specialty. Increasing efforts toward diversification within orthopaedic surgery are underway. Evaluating the effectiveness of these programs requires a thorough understanding of the current demographic profile of the profession.

Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III.

Background: Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes.

Consensus Recommendations for the Management of Neurosarcoidosis: A Delphi Survey of Experts Across the United States.

Background And Objectives: Neurosarcoidosis poses a diagnostic and management challenge due to its rarity, phenotypic variability, and lack of randomized controlled studies to guide treatment selection. Recommendations for management based on expert opinion are useful in clinical practice and provide a framework for designing prospective studies.

Methods: In this Delphi survey study, specialists with experience in managing patients with neurosarcoidosis were invited to anonymously complete 2 surveys about key elements of evaluation, diagnosis, treatment, monitoring, and long-term management of neurosarcoidosis.

A multifactorial, evidence-based analysis of pathophysiology in Spaceflight Associated Neuro-Ocular Syndrome (SANS).

The National Aeronautics and Space Administration (NASA) in the United States has been studying a fascinating and unique constellation of neuro-ophthalmic findings collectively known as Spaceflight Associated Neuro-Ocular Syndrome (SANS). SANS is unique to the space environment of microgravity and produces novel physiological and pathological findings that have no direct terrestrial equivalent. The neuro-ophthalmic phenomenon is a major physiologic barrier to future planetary spaceflight.

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Iodoform in Surgical Practice: A Comprehensive Review of Its Historical Evolution, Clinical Applications, and Safety Profiles.

Iodoform, a halogenated organic compound, has been a cornerstone in surgical practice due to its potent antiseptic and antimicrobial properties. This comprehensive review examines the historical evolution, mechanism of action, clinical applications, and safety profile of iodoform across various surgical disciplines. Historically significant formulations like Whitehead's varnish and bismuth iodoform paraffin paste (BIPP) demonstrated remarkable efficacy in wound healing during the late 19th and early 20th centuries.

The Impact of Additional Fractures and Polytrauma on Complications in Patients Undergoing Femoral Neck Fracture Fixation.

Background: While there have been significant advancements in recent years, complications following fixation for femoral neck fractures remain a concern. This retrospective cohort study aimed to investigate the influence of polytrauma and additional fractures on the occurrence of complications in patients who underwent surgical fixation for femoral neck fractures. The study focused on analyzing patient demographics, comorbidities, fracture classifications, fixation methods, and the likelihood of experiencing post-operative complications, with a specific emphasis on the impact of polytrauma and additional fractures.

The Influence of Patient Provider Educational Interactions and Associated Preoperative Variables on Outcomes in the Hip Dysplasia Population.

Background: Patient provider interactions influence patient treatment adherence, clinical outcomes, patient satisfaction, and an overall patient's engagement in healthcare decisions. The purpose of this study was to examine the effectiveness of patient provider educational interactions and associated variables on patient reported outcomes in the hip dysplasia population.

Methods: A secondary data analysis was completed with 6-month postoperative survey data from participants, who had undergone periacetabular osteotomy.

Efficacy of Intraoperative Intra-Articular Morphine on Post-Operative Pain and Opioid Consumption Following Hip Arthroscopy.

Background: The use of intraoperative intra-articular morphine has been suggested to lower postoperative pain scores and opioid use. We sought to evaluate the effectiveness of intra-articular morphine with 0.75% ropivacaine when compared to the use of ropivacaine alone.

Orthopedic Surgery <50 Days Following Covid-19 Infection Is Not Associated With Increased Postoperative Complications.

Background: Recent literature indicates that COVID-19 infection is a negative predictor of good outcomes following elective orthopedic surgery. However, the ideal timing of surgery after infection is unclear. The purpose of this study was to compare the rates of post-operative complications between those who underwent elective orthopedic surgery <50 days and >50 days after COVID-19 infection.

Hip Dysplasia Diagnosed After Skeletal Maturity: Factors Associated With Progression to Osteoarthritis.

Background: Hip dysplasia diagnosed after skeletal maturity is distinct from developmental dysplasia of the hip (DDH) in infants and young children. While the natural history of DDH in infants and young children is well-established, the association between hip dysplasia diagnosed after skeletal maturity and osteoarthritis is less clear. This narrative review summarizes existing literature assessing characteristics of hip dysplasia diagnosed after skeletal maturity associated with progression to osteoarthritis.

The Cost of Routine Clinic Visits Following Spinal Fusion for Adolescent Idiopathic Scoliosis.

Background: The institutional standard follow-up schedule for patients undergoing spinal instrumentation and fusion for adolescent idiopathic scoliosis (AIS) is return to clinic at 6-weeks and 3 months post-procedure for radiographs. COVID-19 prompted a change in this practice and most routine post-op visits were performed virtually during that time. The purpose of this study is to estimate the cost and benefit of in-person visits to inform the relative value of in-person follow-up using data from the year prior to COVID changes.

The Albright-Losee Low Profile Pivot Shift Test for ACL Deficiency.

Background: Recognizing ACL injuries on the field and in the office can be very challenging in awake and apprehensive patients. Despite high specificity, many published "pivot-shift" techniques have limited acceptance mainly because of unsatisfactory sensitivity. We describe in detail, four specific modifications and provide a critical review of our clinical experiences to empower the new user's readiness to master a novel screening procedure for ACL disruption.

Diabetes Endothelial Keratoplasty Study: Methods and Impact on the Use of Corneas From Donors With Diabetes for Descemet Membrane Endothelial Keratoplasty.

Purpose: Describe aims, methods, characteristics of donors, donor corneas and recipients, and potential impact of the Diabetes Endothelial Keratoplasty Study (DEKS).

Methods: The DEKS is a randomized, clinical trial to assess graft success and endothelial cell density (ECD) 1 year after Descemet membrane endothelial keratoplasty (DMEK) using corneas from donors with versus without diabetes in a 1:2 minimization assignment. Diabetes severity in the donor is assessed by medical history, postmortem HbA1c, and donor skin advanced glycation end-products and oxidation markers.

Phenotypes of Pelvic Organ Prolapse.

Importance: The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.

Objectives: We hypothesize that clinically meaningful prolapse "phenotypes" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency.

Necrosis of pleomorphic adenoma of the lacrimal gland with acute and chronic arteriolar occlusion.

Pleomorphic adenoma of the lacrimal gland (PALG) is a benign neoplasm typically presenting with gradual, painless globe displacement and/or lid swelling. We report an atypical case of PALG in a 53-year old male presenting acutely, mimicking orbital cellulitis. Imaging demonstrated an extraconal rim-enhancing soft-tissue lesion medial to the left lacrimal gland, involving superior rectus and levator palpebrae superioris.

Neoadjuvant Concurrent Chemoradiation and Esophagectomy for Esophageal Cancer: Outcomes With New-Onset Atrial Fibrillation.

This illustrates the outcomes of patients with esophageal cancer undergoing neoadjuvant concurrent chemoradiation and esophagectomy, specifically focusing on those who develop new-onset atrial fibrillation (NOAF). Statistically significant findings (p < 0.05, dark red) increased mortality and ventricular fibrillation, as well as trends of (p > 0.

Phase 2 Open-Label Trial of Brentuximab Vedotin with Pembrolizumab in PD-1 Pretreated Metastatic Non-Small Cell Lung Cancer and Metastatic Cutaneous Melanoma.

Purpose: Brentuximab vedotin (BV) is hypothesized to selectively deplete T regulatory cells (Tregs) that express CD30 and re-sensitize tumors to anti-(PD-1) therapy. This study evaluated responses to BV+pembrolizumab post PD-1 and explored corresponding biomarkers.

Methods: 55 patients with metastatic non-small cell lung cancer (NSCLC) and 58 with metastatic cutaneous melanoma received ≥1 dose of BV+pembrolizumab.

Bibliometric Analysis of the Composition of Landmark Cerebral Venous Sinus Thrombosis Research.

Background: Cerebral Venous Sinus Thrombosis (CVST) is a relatively rare type of stroke, accounting for less than 3% of all stroke cases, and is associated with significant morbidity and mortality in young females. However, when promptly diagnosed and treated, it can have favorable outcomes. Several knowledge gaps remain regarding pathophysiology, diagnosis, and management of CVST, so critical assessment of past and present research could help close these gaps or establish targeted future research goals.