Utilization of parenteral nutrition in major gastrointestinal surgery: An opportunity for quality improvement.

Background & Aims: Parenteral nutrition (PN) is commonly utilized to support patients in the perioperative period of major gastrointestinal (GI) surgeries. This study sought to evaluate PN utilization based on malnutrition status and duration of PN use in a single academic institution to evaluate baseline ASPEN recommendation concordance and identify opportunities for quality improvement.

Methods: Patients who had undergone major GI surgical oncology operations and received PN were identified over six months.

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions.

Background: Spin - the misrepresentation of a study's results - has been identified in abstracts of studies focused on a variety of disorders from multiple fields of medicine.

Objectives: This study's primary objective was to evaluate the abstracts of systematic reviews and meta-analyses focused on the treatment of atopic dermatitis for the nine most severe forms of spin.

Methods: We systematically searched Embase and MEDLINE for systematic reviews of atopic dermatitis therapies.

The Palmaris Longus and Its Association with Carpal Tunnel Syndrome.

 The palmaris tendon inserts into the palmar fascia and is positioned in close association with the transverse carpal ligament. Loading of this tendon has been demonstrated to increase carpal tunnel pressures.  The purpose of this study was to determine if a relationship exists between the palmaris tendon, carpal tunnel syndrome (CTS), and handedness.

Does robotic-assisted transabdominal preperitoneal (R-TAPP) hernia repair facilitate contralateral investigation and repair without compromising patient morbidity?

Inguinal hernia repair (IHR) is performed through either an open or minimally invasive approach (MIS). MIS allows for exploration and potential repair of an occult contralateral hernia. The aim of this study is to evaluate complications associated with intraoperative contralateral exploration and repair through robotic-assisted (da Vinci) IHR.

Scurvy in 2017 in the USA.

Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and depression may make this disease difficult to diagnose until classical dermatological manifestations appear. Diagnosis mainly relies on clinical presentation, dietary history to identify risk factors, and dramatic recession of symptoms and signs following vitamin C therapy.

Microenvironmental agonists generate phenotypic resistance to combined ibrutinib plus venetoclax in CLL and MCL.

resistance and rapid recurrence often characterize responses of B-cell malignancies to ibrutinib (IBR), indicating a need to develop drug combinations that block compensatory survival signaling and give deeper, more durable responses. To identify such combinations, we previously performed a combinatorial drug screen and identified the Bcl-2 inhibitor venetoclax (VEN) as a promising partner for combination with IBR in Mantle Cell Lymphoma (MCL). We have opened a multi-institutional clinical trial to test this combination.

Wissler-Fanconi syndrome and related diagnoses: a case report.

Introduction: Wissler-Fanconi syndrome is a rare rheumatic syndrome that was first described during the 1940s in Europe. Since then, many papers have been written that cover all aspects of this syndrome, most of which are in French and German language, with only a very few in English (none of them recent). We report here a case that fulfils the criteria for Wissler-Fanconi syndrome.

Acute fibrinous and organising pneumonia following lung transplantation is associated with severe allograft dysfunction and poor outcome: a case series.

Acute fibrinous and organising pneumonia (AFOP) is a histopathologic variant of acute lung injury that has been associated with infection and inflammatory disorders and has been reported as a complication of lung transplantation. A retrospective chart review was performed for all patients transplanted at the University of Wisconsin Hospital and Clinics from January 1995 to December 2013 ( = 561). We identified 6 recipients whose clinical course was complicated by AFOP.

A multicenter study of initial experience with single-incision robotic cholecystectomies (SIRC) demonstrating a high success rate in 465 cases.

Background: Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC).

Methods: Medical records of consecutive patients who underwent SIRC were retrospectively reviewed.

Langerhan Cell Histiocytosis: A Rare Disorder With a Rare Presentation.

Langerhans cell histiocytosis (LCH) is a rare disorder most commonly seen in Caucasians of Northern European decent, male, children. The most common presentation is osteolytic bone lesions. A 44-year-old native American presents with diffuse erythematous, scaling lesions.

Obstructive Sleep Apnea Mimics Attention Deficit Disorder.

Attention deficit and hyperactivity are known possible symptoms or correlates of obstructive sleep apnea (OSA). However, these associations may be missed in children, because children often fail to report excessive daytime sleepiness, and attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are common primary diagnoses in themselves. We report on a 17-year-old, slender, non-snoring male who presented to his pediatrician with a prolonged history of four complaints: inattention, fidgeting, frequent sinusitis, and somnolence.

Failure at 50--alive at 55.

Author Dale Molesworth was fired from his job at the age of 50. In his article, Molesworth takes an honest (and sometimes biting) look at the emotions and consequences of such an event and how to get back on your feet afterwards.