Search

Background Cholelithiasis is a common gallbladder finding leading to cholecystitis in 7% of cases. Sonographic imaging or computed tomography scans are commonly employed for the diagnosis of benign gallbladder disease. Air within the gallbladder might carry various diagnoses. As opposed to pathologic air in the gallbladder seen in emphysematous cholecystitis, gas-containing gallstones are no more pathological than the exclusive presence of gallstones. In the present report, we review the incidence, physiology, typical characteristics, and clinical significance of gas-containing gallstones within the gallbladder.Methods We performed an institutional review of all patients with benign gallbladder disease over the past 16 years (2005 to 2021) to identify patients with gas-containing gallstones in the gallbladder. We performed a review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) to identify all reported cases of patients with gas-containing biliary calculi within the gallbladder.Results Our institutional review identified 5 patients with gas-containing biliary calculi in 1252 consecutive cholecystectomies; 4 of which had cholecystitis, while 1 was an incidental finding. Our review of the literature identified 30 manuscripts documenting 54 unique patients with gas-containing biliary calculi. None of these patients had consequential pathology related to gas in the stones other than that caused by the gallstones (ie, biliary colic and cholecystitis).Conclusions Gas-containing biliary calculi are uncommon. How gas finds itself within gallstones within the gallbladder is not entirely clear. Gas-containing gallstones should not be interpreted as free gas within the gallbladder or within an abscess.

Major lower extremity amputation (LEA—above the ankle) carries a high rate of mortality. In the present study, we performed an institutional review of all patients submitting to LEAs at a Veteran Administration Hospital (between 2009 and 2021) accompanied with a review of the literature.For the past 12 years, 1042 LEAs were performed in 603 patients at our hospital. The 30-day, 1-year, and 5-year mortalities were 8.5%, 28.9%, and 53.0%, respectively. Age, hypoalbuminemia, and Clavien-Dindo Class were independent predictors of mortality in all the time intervals in the analysis. Cardiac disease was not an independent predictor of mortality. In 39 studies reviewed, the average 30-day, 1-year, and 5-year mortality was 14%, 36%, and 56%, respectively. There was no difference in mortality in multiple studies analyzed. No significant temporal variation was identified between 1950 and 2000 vs. 2001 and 2021. Predictors of mortality were not substantially different from our institutional experience.The mortality rate for LEAs remains constant over time. Increasing age and hypoalbuminemia are strong predictors of short- and long-term mortality.

A personal narrative is presented which explores the author's disagreement with religious means for her daughters treatment having intellectual disability.

A personal narrative is presented which explores the author's experience related to getting her three-month-old daughter diagnosed with chromosomal disorder and the events that followed, citing speaking inability of her daughter.

In this article the author focuses on the wet T-shirt contest which is held in Key West, Florida. She states that women participate in the contest not for alcohol or money but to have fun. She mentions that the contest doesn't tell that the women who will win it will not be wearing a T-shirt. She highlights that no one tells that there is way of winning the contest, which has not much to do with size of one's breasts.

A personal narrative is presented which explores the author's experience of visiting her boyfriend named Justin in October, the same month of his stepfather's death, when she realized that October has a beautiful weather.

Morbidity and mortality for major (above the ankle) lower extremity amputation (LEA) is high in veteran patients and age is a predictor of mortality. The Veteran Affair Surgical Quality Improvement Program (VASQIP) risk assessment tool has been validated for several operations but not for elderly patients undergoing LEA. The present study interrogated the accuracy for the VASQIP calculator for a medium/high-risk operation in a high-risk veteran population (octogenarians and nonagenarians).

The poem "To the Parent Who Says Her Child's Disability Isn't in “the Natural Order of Things"" by Heather Lanier is presented. First Line: I think of planets spinning apart in the blackness, Last Line: broke the natural order? You do, don't you.

In this article, the author discusses the reasons behind crying of infants. She mentions that first cry after a baby is born is from the phenomenon of apgar score, which is led from several physiological reasons including heart rate, muscle tone and reflex response. She highlights the first gasp of a baby which helps in signaling the entire circulatory system.

The poem "What She Calls Eternity" by Heather Kirn Lanier is presented. First Line: What's this, that each cell now aches; Last Line: what she calls eternity.

A personal narrative is presented which explores the author's experience of visiting to the office of a dentist who took advantage of her innocence.

The poem "Bed Rest," by Heather Kirn Lanier is presented. First Line: Cramps, I say, and the midwife; Last Line: dialing down as fast as this bean's lit up.

In this article, the author focuses on her little daughter who can not walk because of Down Syndrome and reflects on changes in U.S legislation which offers services to children with disabilities. Topics discussed include efforts made by therapists to assist her daughter to walk, positive consequences of therapy sessions that made her daughter to sit upright in her crib and loopholes of U.S legislation that prevented disabled children to gain knowledge in schools where normal children study.

The poem "Passing Notes" by Heather Kirn Lanier is presented. First Love: While we folded breaking news in light; Last Line: The tea had tasted like blah and I'd loved it.