Robotic Rectus Abdominis Myoperitoneal Flap for Posterior Vaginal Wall Reconstruction: Experience at a Single Institution.

The adoption of robotic surgery has been widespread and increasing amongst gynecologic surgeons given the ability to decrease morbidity. It is important that plastic surgeons adjust their reconstructive algorithm to ascertain the benefits of robotic-assisted surgery. Herein we report our outcomes of robotic-assisted rectus abdominis muscle reconstruction of the posterior vaginal wall along with a current literature review on robotic-assisted reconstructive pelvic surgery.

Diagnosis and Prognostic Implications of Primary Intraosseous Carcinoma: A Case Report and Literature Review.

Primary Intraosseous Carcinoma (PIOC) is a rare and aggressive squamous cell carcinoma (SCC) derived from remnants of odontogenic epithelium with no initial connection to oral mucosa. Due to the rarity of the disease, etiology and epidemiology are not clearly defined. The most affected site is the posterior mandible, and clinical features include swelling of the jaw, jaw pain, and sensory disturbances.

Informed Consent and Digit Replantation: Current State and Recommendations for Ethical Patient Care.

The importance of informed consent and the value of shared decision-making in hand surgery are well-established and particularly critical in the setting of digit amputation when considering replantation. Informed consent requires an understanding of not only the immediate and long-term risks and benefits of surgery, as well as the risks and alternatives involved, but also the capacity of the patient to make a medical decision. However, patients who have acutely sustained a disfiguring trauma are often in distress and may not fully process the consent discussion.

Spontaneous Coronary Artery Dissection in a Patient With Cardiogenic Shock: To Revascularize or Not to Revascularize?

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome in young patients. Supportive care is recommended for most uncomplicated cases. However, it is unclear if revascularization plays a role in treating SCAD, particularly in the setting of cardiogenic shock.

Base of Tongue Squamous Cell Carcinoma With Metastasis to the Mandibular Symphysis: A Case Report.

Squamous cell carcinoma (SCC) is the most common malignancy of the oropharynx (OP). Treatment of OP SCC includes chemotherapy, radiation, and/or surgery. OP SCC can spread via direct extension, lymphatics, or hematogenously.

MultiCenter Study of Intra-Abdominal Abscess Formation After Major Operative Hepatic Trauma.

Introduction: One of the significant complications of operative liver trauma is intra-abdominal abscesses (IAA). The objective of this study was to determine risk factors associated with postoperative IAA in surgical patients with major operative liver trauma.

Methods: A retrospective multi-institutional study was performed at 13 Level 1 and Level 2 trauma centers from 2012 to 2021.

The Emotional Impact of Educational Productivity Videos on YouTube: A Global, Cross-Sectional Survey.

Introduction YouTube is the most popular video-sharing website, and many students use it as a resource to find educational content. One type of video category is "productivity," in which the creator teaches viewers how to lead a more productive lifestyle by sharing ways to maximize studying, reshape daily habits, or set achievable goals. Little research has been conducted on whether these videos actually promote positive or negative feelings among viewers.

Low-dose Fosphenytoin for Aborting Acute Trigeminal Neuralgia Pain: A Case Report.

Introduction: While the typical treatment for trigeminal neuralgia is carbamazepine, the dose must be gradually titrated over time to achieve pain control, which makes the drug a less than ideal candidate for treatment for acute exacerbation of pain due to trigeminal neuralgia in the emergency department (ED) setting. The literature for other effective treatments for acute exacerbations of trigeminal neuralgia is currently lacking. We discuss a case where intravenous (IV) fosphenytoin was used for treatment of acute pain due to trigeminal neuralgia in the ED.

Systemic Lupus Erythematosus With Multi-System Involvement and Immunosuppression Presenting With a Rare Fungal Brain Abscess.

The fungal pathogen is a ubiquitous opportunistic pathogen found in soil and water that can cause severe infection in hosts with impaired immunity. Patients with systemic autoimmune diseases such as systemic lupus erythematosus (SLE) are already at risk for infections given their altered immunity. This can be exacerbated further in patients taking immune-suppressing medications to control their disease status.

Medical Students' Socioeconomic Status and Academic Performance in Medical School.

Background Students from lower socioeconomic groups tend to underestimate their chances of acceptance to medical school and their likelihood of success once admitted. Objective The objective of this study is to determine if socioeconomic disadvantage status is linked to lower medical college admission test (MCAT) scores and academic performance in medical school. Methods Using the Association of American Medical Colleges (AAMC) education/occupation (EO) indicator, we compared economically disadvantaged students to students with no financial disadvantage on the MCAT, Phase 1 National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE) Step 1, Phase 2 NBME, and USMLE Step 2 test scores.

A Systematic Review and Meta-Analysis: A Prior Appendectomy Does Not Increase the Risk of Severe Clostridioides difficile Infection or Recurrence.

Background And Objectives: There is conflicting evidence regarding the association between a prior appendectomy and severity of Clostridioides difficile infection. The aim of this study was to perform a systematic review and meta-analysis to evaluate this association.

Patients And Methods: Comprehensive review of multiple databases was performed up to May 2022.

Novel Device Therapies for Heart Failure.

Heart failure (HF) therapeutics have advanced significantly over the past few years [...

Internal Carotid Artery Pseudoaneurysm After Transsphenoidal Pituitary Tumor Resection: A Case Report.

Here, we present a case report on internal carotid artery pseudoaneurysm (ICAP) which highlights a rare but potentially life-threatening complication of transsphenoidal pituitary surgery. A 32-year-old male underwent resection of a pituitary tumor and developed a large cerebrospinal fluid (CSF) leak during surgery, which was reconstructed with a fat graft and nasoseptal flap. Postoperatively, he was recovering well and discharged without complications; however, eight days after surgery he returned with massive epistaxis and hematemesis.

Nasogastric Tube-Induced Catastrophic Airway Compromise Due to a Large Blood Clot.

Nasogastric and orogastric tube (NGT/OGT) insertion is a routine in-hospital procedure used in patients who need enteral feeding, medication administration, and gastric decompression in a patient unable to tolerate per oral administration. NGT insertion has a relatively low complication rate when performed adequately; however, previous studies demonstrate that associated complications range from delicate, simple nose bleeds to more severe conditions such as nasal mucosal bleeding, which can be easily aspirated in a patient with encephalopathy or other conditions associated with the inability to protect the airway. Here we present a case of traumatic NGT insertion causing nasal bleeding, leading to respiratory distress secondary to aspiration of blood clot obscuring the airway.

The interplay of inflammation, exosomes and Ca dynamics in diabetic cardiomyopathy.

Diabetes mellitus is one of the prime risk factors for cardiovascular complications and is linked with high morbidity and mortality. Diabetic cardiomyopathy (DCM) often manifests as reduced cardiac contractility, myocardial fibrosis, diastolic dysfunction, and chronic heart failure. Inflammation, changes in calcium (Ca) handling and cardiomyocyte loss are often implicated in the development and progression of DCM.