Isr Med Assoc J
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Observational Study
Trephine Minimally Invasive Procedure for Pilonidal Sinus.
Pilonidal sinus is a chronic, inflammatory condition. Controversy exists regarding the best surgical management for pilonidal sinus, including the extent of excision and type of closure of the surgical wound. ⋯ The trephines technique has a significant long-term recurrence rate. Short-term advantages include low morbidity, enhanced recovery, and minimal to mild postoperative impairment to quality of life. The trephine procedure may be justified as a first treatment of pilonidal disease.
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Accuracy of the number and location of pathological lymph nodes (LNs) in the pathology report of a neck dissection (ND) is of vital importance. ⋯ At least 7.5% of ND reports were inaccurate in this investigation. The treating physician should be alert to red flags in the pathological report.
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Risk factors for severe coronavirus disease-2019 (COVID-19) infection include old age, chronic illness, and neurological conditions. In contrast, high vitamin D levels are known to augment immune activity and to reduce the severity of viral infections. Recently, a possible association between the likelihood of COVID-19 infection, COVID-19 severity, and vitamin D blood levels was reported. ⋯ Pre-existing vitamin D supplementation may reinforce immunity and reduce COVID-19 severity in elderly psychiatric inpatients.
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The diagnosis of atrial fibrillation (AFIB) related cardiomyopathy relies on ruling out other causes for heart failure and on recovery of left ventricular (LV) function following return to sinus rhythm (SR). The pathophysiology underlying this pathology is multifactorial and not as completely known as the factors associated with functional recovery following the restoration of SR. ⋯ Patients with worse LV function and larger left ventricle during AFIB are less likely to return their baseline LV function following the restoration of sinus rhythm.
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Achieving laparoscopic competency is challenging. Common laparoscopic simulators usually fall short in achieving true simulation. ⋯ Using a laparoscopic porcine model in a guided didactic course performing complete common laparoscopic procedures in simulated operating room surroundings was beneficial for surgical trainees. The porcine model mimics human abdominal anatomy and allows trainees to increase their comfort level in performing such procedures.