S R Priolo

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A 29-year-old man with end-stage kidney disease received a living-donor kidney transplant using the da Vinci Xi robotic system, with the kidney introduced through a small incision and blood vessel connections made entirely inside the body. The surgery was uneventful, graft function was excellent at discharge, and creatinine normalized. This case report documents a step-by-step institutional technique for robot-assisted kidney transplantation, supporting its feasibility at centers with robotic surgical experience.

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The PROGRESS trial is a multicenter randomized controlled trial testing whether a four-week prehabilitation program—combining exercise, nutrition, and psychological support—reduces major postoperative complications in patients undergoing cancer surgery on the stomach or intestines. The trial targets 400 patients and hypothesizes that prehabilitation will cut the major complication rate from 40% to 25%. Results will clarify whether preparing patients' physical and mental condition before surgery improves their recovery.

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This paper argues that the anesthesiologist should play a central role in operating room management, acting as the integrating link between clinical care and organizational logistics rather than being treated as just one of many specialists. As digital tools and AI enter the operating room, this model positions the anesthesiologist to translate between patient-centered needs and efficiency-focused systems. The authors frame this as a shift away from both purely clinician-led and purely engineer-led OR management models.

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In 346 patients undergoing esophagectomy for cancer, adherence to Enhanced Recovery After Surgery protocols was analyzed against postoperative major complications. Complications occurred in 12.4% of patients overall and were more frequent after McKeown than Ivor Lewis surgery. Early soft diet intake and timely urinary catheter removal were independently associated with fewer complications after Ivor Lewis surgery, while organizational failures were the most common reason patients did not follow the protocol.

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The OSSIGENA trial is a multicenter randomized study testing whether high-flow nasal oxygen after esophagectomy reduces pulmonary complications compared to standard oxygen delivery. Patients are randomized at the end of surgery to receive high-flow nasal cannula or a Venturi mask for 48 hours after early extubation. Pulmonary complications occur in up to 40% of esophagectomy patients, making this comparison clinically important.

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Surgical program directors and an AI system were tested on their ability to distinguish AI-generated residency application personal statements from human-written ones. Human reviewers identified AI-authored statements with only 55% accuracy and poor inter-rater agreement, while perceiving human-written statements as seven times more likely to receive an interview offer. As AI writing tools become ubiquitous, residency programs need to reconsider how much weight personal statements carry in applicant evaluation.

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In 218 patients with essential thrombocythemia—a blood disorder with excess platelets—the study examined what determines how well once-daily aspirin inhibits platelet activity. Platelet count was the strongest predictor of incomplete inhibition, and cytoreductive therapy (drugs that lower platelet counts) largely compensated for this. Switching from once-daily to more frequent aspirin dosing restored adequate platelet inhibition across all patients regardless of cytoreductive treatment.

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Cost data from 71 esophagectomy patients treated under an Enhanced Recovery After Surgery protocol from 2014 to 2017 showed that costs fell significantly over time, driven primarily by increasing protocol compliance rather than calendar year. Patients who developed major complications saw costs rise to levels that erased the savings from compliance. Protocol compliance is the key cost driver in enhanced recovery programs, and preventing complications is more impactful than experience alone.

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This paper summarizes outcomes from a series of multistakeholder discussions (2013–2016) to produce a practical roadmap for involving patients in medicines research and development across all four stages of the drug development lifecycle. It addresses gaps in the structure and documentation of patient involvement activities. A clearer framework encourages consistent, meaningful patient participation rather than tokenistic consultation.

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Twenty-two patients undergoing esophageal cancer surgery under an Enhanced Recovery After Surgery protocol were compared prospectively to 17 historical controls under standard care. The ERAS group had earlier extubation, faster ICU discharge, earlier drain removal, and earlier oral feeding, with a median hospital stay of 9 versus 10 days. This early single-center experience showed that ERAS protocols are safe and feasible for esophageal surgery, supporting their broader adoption.

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Italian gastroenterology experts developed consensus guidelines for diagnosing and managing chronic pancreatitis using a modified Delphi process. The guidelines cover pain treatment, nutritional support, pancreatic function testing, endoscopic management, and surgical indications. They provide a practical reference for clinicians managing this complex condition, where treatment decisions often lack strong randomized evidence.

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Eighteen children who used both a cochlear implant and a hearing aid in opposite ears were evaluated on speech perception, sound localization, and functional hearing. Children experienced with binaural use showed comparable benefits to those newly fitted with a hearing aid after years without one. Children with residual hearing in the non-implanted ear should be encouraged to use a hearing aid alongside their cochlear implant, regardless of how long the ear has been without amplification.

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Chick eyes were fitted with different types of goggles to induce myopia or hyperopia, then lenses were harvested and optically analyzed. Induced refractive errors did not change lens size or average focal length, but did increase variability in focal length across the lens surface. Lens optical quality is influenced by the visual environment during development, not just by genetics, suggesting the lens participates in the eye's overall refractive adaptation.

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White Leghorn chicken lenses were examined across five age groups from hatch to five years old. As lenses grow through 34 weeks, focal length increases; beyond that, growth slows but focal length variability—a measure of optical quality degradation—continues rising with age. Structural changes including irregular fiber layering and shape changes in older lenses correspond directly to this measurable decline in optical quality.

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This paper argues that clinical research study designs (randomized trials, cohorts, case-controls) have direct structural equivalents in basic laboratory research, even though basic researchers rarely name their designs explicitly. Using examples from both fields, the author shows that parallel logic underlies both approaches. Adopting clinical design vocabulary in basic science papers could improve communication between laboratory and clinical researchers.

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A case report described a ureterocolic fistula—an abnormal connection between the ureter and colon—caused by diverticular disease of the colon rather than the more common cause of kidney stones. Review of the five reported cases showed the condition predominantly affects older women and is diagnosed late due to vague urinary symptoms. Surgical resection of the diseased bowel segment was curative in all cases, with no need to operate on the urinary system.

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A 48-year-old woman was found to have a gastrinoma—a hormone-secreting tumor—located in a lymph node rather than the pancreas or duodenum where these tumors are usually found. Preoperative imaging successfully identified and localized the lesion, allowing surgical resection. Lymph node gastrinomas have a favorable clinical course, supporting a conservative surgical approach rather than aggressive resection.

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A patient with lower gastrointestinal bleeding had arteriovenous malformations of the right colon—a condition called angiodysplasia—that was invisible on standard X-ray and endoscopy. Selective angiography identified the lesion and guided treatment. This case highlights angiography as an essential diagnostic tool when standard endoscopic and radiologic workup fails to identify the source of lower intestinal bleeding.

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Ten patients with essential hypertension were treated for four weeks with prizidilol, a blood pressure medication. Both systolic and diastolic pressure fell significantly through peripheral vasodilation, while cardiac output improved and standing heart rate decreased. Despite rises in stress hormones (noradrenaline and adrenaline), the drug effectively lowered blood pressure and improved cardiac performance over the treatment period.