Notes

Entheseal participation within a number of psoriatic arthritis sufferers: The ultrasonographic study.
893, p < 0.001).

The ultrasound evaluation of ONSD has proven to be a reliable test for the diagnosis and non-invasive monitoring of intracranial hypertension.
The ultrasound evaluation of ONSD has proven to be a reliable test for the diagnosis and non-invasive monitoring of intracranial hypertension.
Bull-horn injuries (BHI) are unique and there is reduced published literature about it. We present an analysis of a 11-year BHI case series.

Study of 138 cases developed during a 11-year period with hospitalization admission greater than 24 hours with diagnosis of BHI/contusion. We classified patients in two groups group A, patients undergoing procedures under general anaesthesia and group B undergoing procedures under local anaesthesia. Variables age, sex, date, hospitalization length, main region affected, Comprehensive complication index (CCI, ISS, intensive care unit (ICU) admission, stay and mortality. Statistical analysis t-Student test, ANOVA, χ
and linear or logistic regression.

ISS was related to hospital stay, CCI, ICU admission and type of treatment applied. The comparative statistical analysis of variables between both groups determined a significant difference in age, ISS and hospitalization length, being greater in those belonging to group A. There is a more risk of undergoing surgery by increasing age, ISS and presenting the wounds in thorax-abdomen-pelvis area. CCI may be a good method of quantifying postoperatory morbidity in polytraumatized patients or in other areas besides the abdomen.
ISS was related to hospital stay, CCI, ICU admission and type of treatment applied. The comparative statistical analysis of variables between both groups determined a significant difference in age, ISS and hospitalization length, being greater in those belonging to group A. There is a more risk of undergoing surgery by increasing age, ISS and presenting the wounds in thorax-abdomen-pelvis area. CCI may be a good method of quantifying postoperatory morbidity in polytraumatized patients or in other areas besides the abdomen.
Sheehan's syndrome is a hypopituitarism secondary to necrosis of the pituitary gland caused by massive postpartum bleeding. The presentation is frequently amenorrhea and agalactia; hypoglycemia as a solitary presentation is uncommon.

68-year-old female with a history of postpartum hemorrhage 35 years ago. She had two episodes of hypoglycemia. During her hospital stay, panhypopituitarism was detected and the empty sella was confirmed by magnetic resonance imaging.

It is recommended that medical personnel suspect Sheehan´s syndrome in any woman with nonspecific hypoglycemia and no history of chronic degenerative disease.
It is recommended that medical personnel suspect Sheehan´s syndrome in any woman with nonspecific hypoglycemia and no history of chronic degenerative disease.Perioperative stroke is one of the complications that can occur during the surgical procedure and up to 30 days after it. A 52-year-old woman with no neurological symptoms and a diagnosis of intracardiac mass. She underwent cardiac surgery with resection of the tumor that was compatible with atrial myxoma. In the immediate postoperative, she presented neurological symptoms and was diagnosed with basal ganglia infarction of embolic etiology. Perioperative stroke appears most frequently in cardiovascular surgery but is rarely reported in heart tumor resection surgery.Gastrointestinal Stromal Sarcomas (GIST) are mesenchymal neoplasms whose incidence accounts for 1-2% of digestive tumors, being located in the stomach (55-60%) and small intestine (30%). The advances in its knowledge and management succeeded in the last years have being spectacular. This review aims to summarize the most important of them for surgeons. We identified four areas of interest molecular oncology, laparoscopic approach, management of GIST located at unusual locations, and management of advanced GIST. Advances in the field of molecular oncology lead to the discovery of new oncogenic mutations making the term Wil Type GIST obsolete. Moreover, these advances allow for the development of 2 new drugs Avapritinib and Ripretinib, that added to the previous 3 commercially available drugs (imatinib, sunitinib and regorafenib) make possible the management of GIST with resistant mutations. The principles of the surgical management of primary GIST are well stablished which laparoscopic approach must accomplish. This approach is limited by 2 main factors location and size. The diagnosis of GIST in unusual locations as esophagus, duodenum, rectum of out of the gastrointestinal tract (EGIST), implies an extraordinary therapeutic challenge, being imperative to manage them by surgeons and oncologist among others in the setting of a multidisciplinary team. The management of advanced/metastatic GIST has changed in a revolutionary fashion because surgery is now part of its treatment as adjuvant to tyrosine kinase inhibitors.Hemorrhagic liver rupture is a rare and deadly complication. The pathogenesis is unknown. This situation forces the multidisciplinary team, the immediate termination of pregnancy, the treatment and management of the patient in an intensive care unit (ICU). We report the results of two patients with spontaneous rupture of the liver during pregnancy and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, asymptomatic, during cesarean section, with management in ICU, poor evolution without adequate response; one died and the other leaves hospital. Liver rupture requires high suspicion and timely, aggressive multidisciplinary management in all cases and surgical intervention in those who develop liver ruptura, to improve survival.
Opioid-induced respiratory depression (OIRD) is common on the medical and surgical wards and is associated with increased morbidity and health care costs. While previous studies have investigated risk factors for OIRD, the role of race remains unclear. We aim to investigate the association between race and OIRD occurrence on the medical/surgical ward.

This is a post hoc analysis of the PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial; a prospective multinational observational blinded study of 1335 general ward patients who received parenteral opioids and underwent blinded capnography and oximetry monitoring to identify OIRD episodes. For this study, demographic and perioperative data, including race and comorbidities, were analyzed and assessed for potential associations with OIRD. Univariable χ 2 and Mann-Whitney U tests were used. Stepwise selection of all baseline and demographic characteristics was used in the multivariable logistic regression ansed OIRD incidence. Further study is required to elucidate its underlying mechanisms and develop targeted care pathways to reduce OIRD in susceptible populations.
This post hoc analysis of PRODIGY found a novel association between Asian race and increased OIRD incidence. Further study is required to elucidate its underlying mechanisms and develop targeted care pathways to reduce OIRD in susceptible populations.
To characterize vision-related malpractice litigation involving prisoners.

Retrospective legal database review using the Westlaw database was performed to identify vision-related malpractice lawsuits involving prisoners in the United States from 1914 to 2020. Main outcomes and measurements were allegations of malpractice, verdicts, and settlements.

Sixty-four vision-related malpractice lawsuits involving prisoners were identified. Mean defendant age was 49 years (range, 28-74 years). Fifty-seven percent of the defendants were ophthalmologists and 43% were optometrists. The cases were most commonly from the South and Midwest (n = 19 [30%] for each). Allegations of malpractice included inadequate medical care or treatment refusal (n = 21 [33%]), failure to treat fully leading to continued suffering (n = 18 [28%]), and delay in treatment or referral (n = 17 [27%]). Retina-related diagnoses were most common (n = 18 [28%]). Forty-six (72%) cases were closed, 14 (22%) were open, and four (6.3%) were partially closed. Only two (3.1%) cases were decided in favor of the plaintiff. The most common reason for an unsuccessful suit was lack of deliberate indifference by the eye care professional (n = 21 [46%]).

The most common reasons for vision-related malpractice brought forth by prisoners were inadequate or incomplete eye care and treatment refusal. Retina was the most commonly involved subspecialty. However, the success rate of these suits was extremely low.
The most common reasons for vision-related malpractice brought forth by prisoners were inadequate or incomplete eye care and treatment refusal. Retina was the most commonly involved subspecialty. However, the success rate of these suits was extremely low.
To investigate the prevalence of Gunn's dots (GDs) and associated systemic factors in adult Chinese.

A cross-sectional study enrolling participants older than 45 years from a community-based study. Gunn's dots were evaluated using fundus photography, and associated systemic factors were analyzed. Patients with any retinal or optic neuropathy were excluded.

The study included 4,118 participants (mean age 58.3 ± 9.9 years; male 1,699/41.3%). Gunn's dots were found in 931 participants, with a prevalence of 22.6 ± 0.8% (95% confidence interval [CI] 21.3-23.9). Systemic factors associated with a higher GD prevalence were younger age (odds ratio [OR] 0.92; 95% CI 0.91-0.93; P < 0.001), higher estimated glomerular filtration rate (eGFR) (OR 1.01; 95% CI 1.001-1.02; P = 0.022), and higher serum concentration of triglycerides (OR 1.08; 95% CI 1.004-1.16; P = 0.040). The GD prevalence was 3.5 (OR = 3.46; 95% CI 1.06-11.35) and 4.4 (OR = 4.37; 95% CI 1.27-15.09) times greater for participants with an eGFR of ≥90 mL/minute/1.73 m2 and an eGFR of ≥100 mL/minute/1.73 m2, respectively, as compared with participants with an eGFR of <60 mL/minute/1.73 m2.

The GD prevalence (mean 22.6%) was associated with younger age, higher eGFR, and higher serum triglyceride concentrations. The presence of GDs may serve as indicators of healthy renal function.
The GD prevalence (mean 22.6%) was associated with younger age, higher eGFR, and higher serum triglyceride concentrations. The presence of GDs may serve as indicators of healthy renal function.
To assess spectral domain optical coherence tomography biomarkers of short-term outcomes in eyes with diabetic macular edema treated with intravitreal bevacizumab.

In a prospective interventional case series, 66 eyes with diabetic macular edema underwent 3 monthly intravitreal bevacizumab injections. Best-corrected visual acuity measurement and spectral domain optical coherence tomography were performed at baseline and at 3 months. Multivariate regression analysis was performed to investigate the baseline spectral domain optical coherence tomography parameters as predictors of functional and anatomical outcomes.

Patients with diabetic nephropathy had greater subfoveal choroidal thickness (300.8 ± 35.54 vs. 253.0 ± 50.07 µm, P < 0.01) and were more likely to have subretinal fluid (r = 0.26, P = 0.03) at baseline. Multivariate analysis showed that the extent of external limiting membrane disruption (P = 0.03) and the extent of disorganization of retinal inner layers (P = 0.03) at baseline were predictors of best-corrected visual acuity at 3 months, whereas the extent of disorganization of retinal inner layers (P = 0.
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