Two Cases of Mycotic Aneurysms Caused by Infection of Aortic Graft Material.

, a zoonotic pathogen, can affect multiple human organ systems causing various clinical manifestations. While aortoiliac involvement is rare worldwide, we report 2 cases of aortic brucellosis following abdominal aortic aneurysm repairs within a 9-year period at a single US institution in Georgia. One case was an infected aortic endograft, which may be the first reported.

ROTEM's utility in guiding resuscitation of traumatic lower extremity fracture patients.

Introduction: Rotational thromboelastometry (ROTEM) is a method for real-time detection of clotting derangements allowing for targeted blood product resuscitation. We sought to determine if coagulopathy profiles differed based on fracture location (comparing pelvic versus tibia and femur fractures), if ROTEM profiles correlated between both total hospital and intensive care unit length of stay (LOS), and if ROTEM profiles correlated with patients undergoing an immediate definitive fixation versus an early damage control approach to care.

Materials And Methods: A retrospective cohort study was performed using data from a level 1 trauma registry database.

Wound Healing in Older Adults after Major Lower Extremity Amputation.

Background: The higher prevalence of multiple chronic conditions and frailty among older adults may increase the physiologic demand required for wound healing after a major lower extremity amputation (LEA). After below knee amputations (BKA), patients generally have improved prosthetic fitting rates, postoperative ambulation, and quality of life compared to an above knee amputation (AKA). However, the benefit of a BKA must be weighed against the risk of wound complications.

Evaluating Receipt of Optimal Medical Therapy Among Structurally Disadvantaged Groups Undergoing Amputation.

Background: Optimal medical therapy (OMT) for peripheral artery disease (PAD) is associated with decreased major amputation and mortality. OMT has several components, including antiplatelet and high-intensity statin therapy, blood pressure control, etc. While there are disparities in receipt of OMT among PAD patients, it is unknown if patients from disadvantaged neighborhoods, measured by the area deprivation index (ADI), are less likely to be on OMT.

Prosthetic fitting and mortality after major lower extremity amputation.

Background: Studies suggest that ambulation after major lower extremity amputation (LEA) is low and mortality after LEA is high. Successful prosthetic fitting after LEA has a significant quality of life benefit; however, it is unclear if there are benefits in post-LEA mortality. Our objective was to examine a contemporary cohort of patients who underwent LEA and determine if there is an association between fitting for a prosthetic and mortality.

Arteriovenous fistula aneurysmorrhaphy is associated with improved patency and decreased vascular access abandonment.

Background: Upper extremity hemodialysis arteriovenous fistulas (AVFs) can become aneurysmal over time due to repeated cannulation and/or outflow steno-occlusive disease. The optimal surgical management of aneurysmal AVFs (aneurysmorrhaphy vs interposition graft) has remained unclear.

Methods: We performed a retrospective review in which current procedural terminology codes were used to screen for patients who had undergone surgical treatment of aneurysmal AVFs between 2016 and 2021 at a single hospital system.

Cardiovascular Health in Individuals with Exceptional Longevity Residing in Arkansas.

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas.