Microsurgical Reconstruction of Complex Scalp Defects With Vastus Lateralis Free Flap.

Background: Scalp reconstruction is a challenging field for plastic surgeons. In case of large or complex defects, microsurgical-free flaps are usually required. Reconstructive failure can result in high morbidity and in some cases be life-threatening.

Assessment of safety and effectiveness after percutaneous closure for decannulation of Veno-Arterial Extracorporeal Membrane Oxygenation: A systematic review and meta-analysis.

Introduction: Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) has emerged as a crucial component of critical care medicine, mainly as a lifesaving intervention for patients experiencing refractory cardiac arrest and respiratory failure.

Background: In the past, VA-ECMO decannulation was surgical and often associated with a high rate of periprocedural complications, such as surgical site infection, bleeding, and patient mobilization costs. To reduce the rate of these adverse events, many percutaneous techniques utilizing suture-mediated closing devices have been adopted.

Integration of Apolipoprotein B into the SCORE2 Framework: Implications for Cardiovascular Risk Prediction.

Aim: To evaluate whether integrating Apolipoprotein B (ApoB) into the SCORE2 cardiovascular risk prediction framework improves its predictive accuracy and clinical applicability within the UK Biobank population.

Method: A 10-year prospective cohort study was conducted with 448,303 UK Biobank participants eligible for SCORE2 calculation. Three approaches were employed: (1) threshold analysis to determine the optimal ApoB cutoff for cardiovascular disease (CVD) risk prediction using Youden's Index, (2) assessment of the synergistic effect of SCORE2 and ApoB through concordant and discordant classifications, and (3) recalibration of the SCORE2 model by incorporating ApoB as an additional predictor.

Retinal oculomics and risk of incident aortic aneurysm and aortic adverse events: a population-based cohort study.

Background: The asymptomatic onset and extremely high mortality rate of aortic aneurysm (AA) highlight the urgency of early detection and timely intervention. The alteration of retinal vascular features (RVFs) can reflect the systemic vascular properties, and be widely used as the biomarker for cardiovascular disease risk prediction. Therefore, we aimed to investigate associations of RVFs with AA and its progression.

Impact of load and movement on arteriovenous fistula flow.

Introduction: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. Whether acute arm movement impacts arteriovenous fistula (AVF) blood flow is unknown.

Methods: In this cross-sectional analysis, we evaluated AVF blood flow using an ultrasound device at resting and after three muscle movements for proximal (elbow flexion, shoulder adduction and abduction) or distal AVF (fist extension and flexion, fingers squeeze), without and with a 2 kg load.

Evaluation of the comparative efficacy and safety of surgical strategies for long bone defects: a network meta-analysis.

Abstract: To evaluate the safety and efficacy of various surgical treatments for long bone defects. Despite numerous observational studies, randomized controlled trials (RCTs), and meta-analyses, the optimal surgical treatment for long bone defects remains undetermined.

Methods: A network meta-analysis (NMA) was conducted.

Expression of Plasma Levels of miRNA-181b and miRNA-21 in Patients With Abdominal Aortic Aneurysms and Their Effect on Clinical Outcome After Endovascular Treatment.

Introduction: Abdominal aortic aneurysms (AAA) are major causes of morbidity and mortality in the elderly population. Endovascular aneurysm repair (EVAR) is associated with lower complications rates than conventional treatment; however, rigorous follow-up with contrast imaging is required to confirm aneurysmal sac exclusion. The main objective of this study was to quantify and evaluate miRNA expression response to EVAR based on serum dosages at the 6-month follow-up.

The Impact of Surgeon Experience-Consultant Versus Supervised Trainees After Elective Infrarenal EVAR: Short-term to Mid-term Outcomes.

Introduction: Vascular trainees are required to have a comprehensive training program, encompassing the completion of clinical, surgical, and research tasks. To fulfill their surgical abilities and performance, sufficient supervised operating time is mandatory. After open vascular procedures, it has been observed that trainee involvement does not lead to detrimental outcomes.

Hallmarks of Quercetin Benefits as a Functional Supplementary in the Management of Diabetes Mellitus-Related Maladies: From Basic to Clinical Applications.

Quercetin (QE), a particular flavonoid, is well known for its medicinal effects, including anti-oxidant, hypoglycemic, and anti-inflammatory effects. In this review, the findings of QE effects on diabetes STZinduced, alloxan-induced, and its complications have been summarized with a particular focus on in vitro, in vivo, and clinical trials. Consequently, QE mediates several mechanisms, including ameliorating tumor necrosis factor (TNF)-α, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin (IL)-1β, IL-8, and IL-10 expression, increasing insulin glucose uptake to inhibit insulin resistance.

A Belgian physician-initiated trial investigating the LifeStream peripheral stent graft system for the treatment of complex TASC C and D iliac lesions.

Background: Due to the heterogeneity of literature findings, stent type selection for the endovascular treatment of complex aorto-iliac occlusive disease remains challenging. The BELSTREAM study, a physician-initiated, prospective, multicenter, single-arm study, aims to report the safety and efficacy of the balloon expandable LifeStream Peripheral Stent Graft System (BD, Tempe, Arizona, USA) for the treatment of complex TASC C and D aorto-iliac artery lesions.

Methods: Seventy patients and 133 lesions were included at six Belgian institutions.

Optimizing the life of vascular access during follow-up.

Optimizing the longevity of vascular access in hemodialysis patients remains a critical aspect of patient care, given the significant role of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) in enabling effective dialysis. Vascular access complications, such as stenosis, thrombosis, and cannulation-related damage, continue to challenge both the functionality and the sustainability of these access points. Recent advancements underscore the importance of a robust follow-up strategy, integrating clinical evaluations with diagnostic tools like color Doppler ultrasound (CDU) and emerging interventional approaches such as drug-coated balloon (DCB) angioplasty.

Clearing the path for whole-mount labeling and quantification of neuron- and vessel-density in adipose tissue.

White adipose tissue (WAT) comprises a plethora of cell types beyond adipocytes forming a regulatory network that ensures systemic energy homeostasis. Intertissue communication is facilitated by metabolites and signaling molecules that are spread by vasculature and nerves. Previous works indicated that WAT responds to environmental cues by adapting the abundance of these "communication routes", however, high intra-tissue heterogeneity questions the informative value of bulk or single cell analyses and underscores the necessity of whole-mount imaging.

PP2A Attenuates Thoracic Aneurysm and Dissection in Mouse Models of Marfan Syndrome.

Background: Recent studies show that hyperactivation of mTOR (mammalian target of rapamycin) signaling plays a causal role in the development of thoracic aortic aneurysm and dissection. Modulation of PP2A (protein phosphatase 2A) activity has been shown to be of significant therapeutic value. In light of the effects that PP2A can exert on the mTOR pathway, we hypothesized that PP2A activation by small-molecule activators of PP2A could mitigate AA progression in Marfan syndrome (MFS).

Causal association between matrix metalloproteinases and diabetic neuropathy: a two-sample Mendelian randomization study.

Objective: Diabetic neuropathy (DN), a common and debilitating complication of diabetes, significantly impairs the quality of life of affected individuals. While multiple studies have indicated changes in the expression of specific matrix metalloproteinases (MMPs) in patients with DN, and basic research has reported the impact of MMPs on DN, there is a lack of systematic research and the causal relationship remains unclear. The objective of this research is to investigate the casual relationship between MMPs and DN through two-sample Mendelian randomization (MR).

A case of bacteremia in a 38-year-old homeless male originating from a maggot-infested amputated foot.

() was first isolated from the larval stage of the fly vector It is a gram-negative, non-motile, strictly aerobic rod that thrives in temperatures between 28º C and 37º C. Its strong chitinase activity aids in metamorphosis, which suggests a symbiotic relationship with the fly. Although rare, has been implicated in human infections, like bacteremia and osteomyelitis, typically transmitted through fly larvae in skin wounds.

Machine learning prediction of hepatic encephalopathy for long-term survival after transjugular intrahepatic portosystemic shunt in acute variceal bleeding.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.

Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.

Advances in gastrointestinal vascular bleeding disorders: Successful sirolimus treatment in colonic angioectasia.

Background: Gastrointestinal (GI) vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment responses. Despite advancements in diagnostic and therapeutic techniques, optimal management strategies remain elusive, necessitating further research.

Aim: To assess research trends and clinical advancements in GI vascular bleeding disorders, highlighting key themes and therapeutic progress.

Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study.

Background: Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex.

Objectives: The purpose of this study was to explore sex-specific associations between AF subtypes and subsequent HF, identifying HF risk factors in participants with AF, and exploring the combined impact on mortality.

The Clinical Course of Portopulmonary Hypertension and Outcomes With Endothelin Receptor Antagonist Treatment: Observational Study of Data From the US Organ Procurement and Transplantation Network.

Background: Portopulmonary hypertension (PoPH) occurs in patients with advanced liver disease and can be a contraindication to liver transplant (LT). Improvement of hemodynamic parameters with pulmonary arterial hypertension (PAH) therapies (including endothelin receptor antagonists [ERAs]) may help some patients to become eligible for LT.

Methods: We conducted a retrospective secondary data analysis to describe the clinical course and management of PoPH in patients on a US registry LT waitlist and outcomes in patients receiving an ERA.

Endurance training and pyruvate dehydrogenase kinase 4 (PDK4) inhibition combination is superior to each one alone in attenuating hyperketonemia/ketoacidosis in diabetic rats.

Objectives: While ketone bodies are not the main heart fuel, exercise may increase their uptake. Objectives: This study aimed to investigate the effect of 6-week endurance training and Pyruvate dehydrogenase kinase 4 )PDK4( inhibition on ketone bodies metabolism in the heart of diabetic rats with emphasis on the role of Peroxisome proliferator-activated receptor-gamma coactivator PGC-1alpha (PGC-1α).

Materials And Methods: Sixty male Wistar rats were divided into eight groups: healthy control group (CONT), endurance training group (TRA), diabetic group (DM), DM + EX group, Dichloroacetate (DCA) group, DM + DCA group, TRA + DCA group, and DM + TRA + DCA group.

Symbiotic anti-oxidant, anti-glycation, and anti-inflammatory qualities of a combination of thiamine and niacin protected type-2 diabetic male rats against both macro and micro-vascular complications.

Objectives: Increased nuclear factor (NF-kβ) and carbonyl stress due to decreased glyoxalase-1 activity (Glo-I) contribute significantly to insulin resistance and vascular complications. Therefore, we aimed to study the impact of the combination of thiamine and niacin on hepatic NF-kβ signaling, metabolic profile, and Glo-I activity in male rats with type-2 diabetes (T2DM).

Materials And Methods: Forty male rats were divided equally into five groups: control, diabetic, diabetic treated with thiamine (180 mg/l in drinking water), niacin (180 mg/l), and a combination of both.

Assessment of Left Ventricular function and Aortic blood flow in children with Tetralogy of Fallot (TOF) attending two health institutions in Enugu Metropolis.

Background: Children with Tetralogy of Fallot (TOF) usually present with right heart abnormalities, however much is not known if these children presents with left ventricular dysfunction.

Objectives: This article is aimed to ascertain the left ventricular function of children with TOF compared with those without any congenital heart disease. It also elicits the correlation if any, between left ventricular mass and descending aorta blood flow.

Blood usage among orthopedic patients at the Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

Background: Blood transfusion holds a significant place in the practice of surgery, including orthopaedic surgeries. The aim of this study was to evaluate the intraoperative use of blood and blood products among orthopaedic patients operated at the Rivers State University Teaching Hospital from January 2021 to December 2021, focusing on the demographics of patients, number and type of surgeries needing a blood transfusion, and the number of blood transfusions.

Methodology: A retrospective observational study was carried out at the operating theatre of a referral tertiary hospital using a designed proforma to extract data from the registers of operated orthopaedic patients.