BACKGROUND Hip fractures in geriatric patients carry high morbidity and mortality due to advanced age, frailty, and multiple comorbidities. Accurate preoperative risk assessment is therefore essential. The hemoglobin-albumin-lymphocyte-platelet (HALP) score and prognostic nutritional index (PNI) are emerging immunonutritional biomarkers reflecting inflammatory and nutritional status. This study aimed to evaluate and compare the prognostic value of preoperative HALP and PNI scores for predicting 6-month mortality and postoperative complications in elderly hip fracture patients. MATERIAL AND METHODS This retrospective cohort included 549 patients aged≥³65 years who underwent surgical repair of proximal femoral fractures between January 2021 and July 2024. Demographic characteristics, comorbidities, fracture type, and preoperative laboratory data were analyzed. HALP and PNI scores were calculated from admission blood tests. Independent predictors of 6-month all-cause mortality were identified using Cox regression, and receiver-operating characteristic (ROC) analysis determined optimal cut-off values. RESULTS The mean age was 78±9 years, and 51.9% were female. Six-month mortality was 16.4%. Non-survivors had significantly lower HALP and PNI scores (P<0.001). In multivariate Cox analysis, coronary artery disease (HR 2.57, 95% CI 1.66-4.00), postoperative complications (HR 3.97, 95% CI 2.57-6.15), and lower HALP levels (HR 3.11, 95% CI 1.19-8.13) were independently associated with mortality. Additionally, ROC analysis identified a HALP cut-off value of 0.176 for predicting mortality. CONCLUSIONS The HALP score showed modest prognostic value for 6-month mortality and can complement established clinical predictors. Its use in preoperative evaluation could help identify higher-risk patients, but its discriminatory ability should be interpreted with caution.

Incisional hernia is a common postoperative complication, particularly following abdominal surgeries, and is frequently associated with recurrence and impaired healing due to postoperative infections. In this study, a dual-layered hernia repair biopatch was developed by integrating a 3D-printed polycaprolactone/gelatin (PCL/Ge) scaffold, providing mechanical support, with an electrospun nanofibrous layer composed of PCL/Ge/κ-carrageenan (κ-C) to promote wound healing. To impart antimicrobial functionality, the scaffolds were functionalized with eitherAgrimonia eupatoria(AE) extract or the clinically used antibiotic rifampicin (RIF). Commercial polypropylene (PP) meshes were employed as control groups in bothin vitroandin vivoevaluations. Mechanical testing demonstrated that the developed biopatches exhibited tensile strengths within a clinically relevant range, with values of 5.13 MPa and 2.49 MPa for the 3D-printed RIF-loaded and AE-loaded electrospun-coated scaffolds, respectively. Both AE- and RIF-loaded groups showed pronounced antibacterial activity againstS. aureus, a predominant pathogen associated with surgical site infections. Sustained and controlled release profiles were observed over 160 h, with cumulative release values of approximately 30%-35%.In vivoevaluation using a rat incisional hernia model revealed that AE exhibits strong potential as an alternative to conventional antibiotics, attributable to its phenolic-rich composition and associated anti-inflammatory and tissue-remodeling properties. Overall, these findings demonstrate that the proposed dual-layer biopatch, which integrates mechanical reinforcement with sustained antimicrobial activity, represents a promising and effective strategy for infection-resistant incisional hernia repair.

Since its introduction in 1974, the artificial urinary sphincter (AUS) has been considered the gold standard for treatment of moderate to severe male stress urinary incontinence. This article provides an overview of perioperative management and long-term outcomes, offering an evidence-based foundation for clinical practice. Current evidence on patient selection, preoperative diagnostics, surgical techniques, long-term outcomes, and management of complications was reviewed, based on recent studies, multicenter cohorts, and registry data. The implantation of an AUS generally results in high continence rates and substantial improvement in quality of life. Perioperative risk factors, including prior radiotherapy, diabetes mellitus, or previous urethral procedures, increase the likelihood of postoperative complications such as infections, urethral erosions, or mechanical failure. Specialized centers with extensive experience achieve better functional outcomes and lower revision rates. Despite potential complications, most patients report sustained satisfaction and an improved quality of life following AUS implantation. The AUS is an effective treatment option for moderate to severe stress urinary incontinence. Perioperative risk assessment, specialized implantation techniques, and treatment in experienced centers are crucial for therapeutic success. Prospective registry and multicenter data provide valuable guidance for evidence-based patient selection, complication management, and of long-term outcome optimization.

Surgical stress, such as hepatic ischemia-reperfusion (I/R) injury, induces excessive inflammation and adversely affects liver surgery outcomes. Regulatory T cells (Tregs) are crucial for immune homeostasis, yet their protective mechanisms against liver I/R injury remain unclear. In this study, we demonstrated that decreased hepatic Treg abundance correlates with increased liver injury in patients undergoing hepatic hemangioma resections. In murine models, Treg depletion worsened liver I/R injury. Bulk RNA-seq of hepatic Tregs showed enrichment of Toll-like receptor (TLR) signaling pathways, with flow cytometry identifying TLR4 as the most increased TLR after I/R. Treg-specific Tlr4 knockout mice (Treg-Tlr4-/- mice) exhibited exacerbated liver injury following I/R. Adoptive transfer of WT Tregs, but not Tlr4-deficient Tregs, alleviated liver injury in both Treg-depleted and Treg-Tlr4-/- mice. Transcriptomic analysis revealed that IL-10 production was impaired in Tlr4-deficient Tregs. Mechanistically, Tlr4-deficient Tregs showed reduced activation of the MyD88/ERK/CREB pathway, resulting in diminished IL-10 production. Myd88-/- and IL-10-/- Tregs failed to confer protection against liver I/R injury, whereas exogenous IL-10 administration rescued the hepatic dysfunction in Treg-Tlr4-/- mice. Our findings implicate the vital role of TLR4 in Tregs to mitigate liver I/R injury and offer a potential therapeutic option to reduce postoperative complications following liver surgery.

Serological risk factors associated with arthroplasty complications.

Cataract Surgery with IOL Implantation in Children with Chronic Anterior Uveitis Associated with Juvenile Idiopathic Arthritis (JIA) or Antinuclear Antibody (ANA)-Positive Uveitis: Mid-term Results and Predictors for Outcome.

Given the large incidence of uterovaginal prolapse among parous women and high utilization of obliterative surgical procedures among the elderly, a clear understanding of the risk profile associated with concomitant hysterectomy is critical to guide surgical decision making. The objective of this study was to compare 30-day postoperative complications between obliterative surgery with or without concomitant hysterectomy for the treatment of uterovaginal prolapse. This was a large retrospective cohort study, which identified patients undergoing an obliterative surgery with or without concurrent hysterectomy in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Database (2015-2022) using Current Procedural Terminology codes. The primary outcome was any 30-day complication, defined as a composite of any ACS NSQIP-tracked postoperative complication. Secondary outcomes included major complications, minor complications, readmission, and reoperation. A total of 4,040 patients were included in the analysis, with 3,497 (86.6%) undergoing LeFort colpocleisis and 543 (13.4%) undergoing obliterative surgery (colpocleisis or vaginectomy) with hysterectomy. LeFort colpocleisis patients were significantly older (76.7 vs 74.7y, P<0.001) and had lower body mass index (27.2 vs 28.2, P<0.001). The rate of 30-day complications was 6.9%, and the rate of major complications was 6.2%. The rate of any adverse event (postoperative complications, readmission, and reoperation) did not differ between groups. On multivariable logistic regression controlling for potential confounders, obliterative surgery with hysterectomy was not associated with increased odds of any postoperative complication compared with LeFort colpocleisis. The addition of hysterectomy to obliterative surgery for uterovaginal prolapse is not associated with increased odds of any postoperative complications within 30 days of surgery.

Masculinizing chest surgery outcomes by body mass index and American Society of Anesthesiologists class in ambulatory care.

Hemorrhagic and thrombotic complications following robotic-assisted prostatectomy (RALP) with risk-adapted antithrombotic prophylaxis: A retrospective study.

Intraoperative Hemodynamic Management During Esophagectomy and Implications for Postoperative Care.

Area Deprivation Index Relationship to Patterns of Revascularization Among Chronic Limb-Threatening Ischemia Patients Presenting for Major Amputation: A Vascular Quality Initiative Study.

McGrath videolaryngoscopy versus direct laryngoscopy for rapid sequence intubation: A multicenter randomized clinical trial.

Recurrence and reoperation rates as well as intraoperative and postoperative complications are much higher in the treatment of inguinal hernia recurrences than in the treatment of primary hernias and increase with each additional follow-up procedure. Is endoscopic treatment of endoscopically pre-operated patients an alternative technique? Retrospective case study analysis on the feasibility of treating recurrent inguinal hernias after initial endoscopic, i.e., total extraperitoneal patch (TEP) or transabdominal preperitoneal (TAPP) repair technique, pre-operation using the TEP technique (RE-TEP) based on data from our own patient collective. Since 2016 atotal of 79patients with recurrences after minimally invasive surgery (MIS) hernioplasty were operated on using the RE-TEP technique. In 30patients, perioperative data and the results of clinical and sonographic follow-up examinations were evaluated and analyzed, particularly with respect to the quality of life. Perioperative and postoperative data and results were comparable to those of primary hernia repair. There were no conversions, no intraoperative or postoperative complications, no re-operations or evidence of recurrence with good postoperative quality of life. We were thus able to demonstrate feasibility in alarger group and confirm the results of individual publications of smaller studies. The RE-TEP technique can be seen as an option for the treatment of recurrent inguinal hernias after primary MIS techniques.

To evaluate sociodemographic and clinical factors with postoperative complications after cataract surgery at academic medical centers in the United States. 16 U.S. academic medical centers contributing to the Sight Outcomes Research Collaborative (SOURCE) big data repository. Retrospective, multicenter cohort study. Adults undergoing cataract surgery between 2010 and 2023 were identified from the SOURCE database. Sociodemographic and clinical predictors including race, ethnicity, primary language, and prior intraocular surgery were assessed. Postoperative complications within 6 months were identified using Current Procedural Terminology/International Classification of Diseases codes. Multivariate cox regression estimated hazard ratios with 95% confidence intervals. 78 565 eyes were analyzed (mean age 70.8 ± 8.9 years, 59% female, 12.6% Black). At 6 months, 1.49% of eyes developed a complication and 0.10 developed a severe adverse complication. Independent predictors of any complication included male sex (hazard ratio [HR] 1.14; P < .01), Black race (HR 1.66; P < .01), complex surgery (HR 1.23; P < .01), combined intraocular procedures (HR 1.33; P < .01), prior intraocular surgery (HR 1.18; P < .01), and poorer preoperative vision (HR 1.10; P < .01). Severe adverse complications were more likely among men (HR 1.54; P = .02) and those with poorer vision (HR 1.62; P < .01), but less likely with increasing age (HR 0.95; P < .01), urban residence (HR 0.33; P < .01), and having 1 or more children in the household (HR 0.32; P = .03). Sociodemographic and clinical factors that increased risk of postoperative outcomes after cataract surgery included Black race, male sex, and poor preoperative vision. Older age, urban residence, and children in the household were protective. Incorporating social determinants of health into perioperative risk stratification may improve surgical equity and outcomes.

Detailed analysis of postoperative complications and oncological outcomes in pelvic exenteration: A propensity score weighted analysis based on Japanese multicenter cohort study.

Intrathoracic side-overlap vs circular stapled esophagogastrostomy for Siewert type I/II adenocarcinoma of the esophagogastric junction: a retrospective comparative study.

Prophylactic norepinephrine infusion to reduce severe hypotension during induction of anaesthesia in patients undergoing cardiac surgery: a randomised controlled single-centre clinical trial.

Outcomes following unilateral axillofemoral bypass versus crossover femorofemoral bypass in chronic limb-threatening ischemia patients.

Adenoidectomy with tympanostomy or with myringotomy alone: A systematic review of pediatric randomized controlled trials.

Microsurgical Clipping of Ruptured Posterior Fossa Aneurysms in the Semi-Sitting Position.