A Novel Microsnare and Microwire Coil Retrieval Technique.

Coil migration during endovascular embolization is a complication that can result in thromboembolic occlusion leading to potentially large infarcts if not removed. Microsnares are commonly used to remove migrated coils. Current techniques, however, struggle in cases where the microsnare is unable to loop over and secure a free end of the coil. We present a case in which a microsnare combined with a microwire successfully removed a migrated coil in a patient with a bleeding hepatic pseudoaneurysm post-embolization. This technique proved beneficial when traditional methods were insufficient, especially in small vessels or coil packs that cannot be snared. The synergy of the microsnare and microwire technique presents a promising solution for challenging migrated coil retrievals.

Analysis of Research Productivity of Orthopedic Surgery Residency Applicants.

Background Orthopedic surgery has become an increasingly competitive specialty. With a pass-fail Step 1, an even greater emphasis on research has been placed to allow candidates to better distinguish themselves. This study analyzes the scholarly activity of accepted orthopedic residency applicants during medical school, assessing what factors, including the novel altmetric attention score, may be associated with greater research productivity. Methods A list of orthopedic residency programs was obtained from the Electronic Residency Application Service (ERAS). A total of 688 orthopedic residents from 180 programs who matriculated in 2020 from allopathic medical schools were identified. Resident demographic information and bibliometric data (total publications, orthopedic-related publications, h-index, and altmetric score) of publications published from July 1, 2016, to September 1, 2020, were collected. Descriptive statistics were calculated. Kruskal-Wallis tests analyzed the association between medical school characteristics and research productivity using Stata® 17.0 (StataCorp LLC, College Station, Texas). Results Postgraduate-Year-3 orthopedic residents (N=688) published 2,600 articles during medical school, averaging 3.8 articles per resident. The residents from a top 25 medical school for research had publication counts, altmetric scores, and h-indices, on average, that were higher than those from non-top 25 medical schools for research. Over 150 residents had no publications, and ~10 residents had more than 30 publications. Conclusions The results illustrate that medical school research status influences the research productivity of applicants. Also, given the average number of publications, most research listed on applications are abstracts and presentations. Utilization of the altmetric score may not yet be the best way of examining research experience because orthopedic applicants do not appear to use social networks for academic research.

Breastfeeding Practices of Women with HIV in Sub-Saharan Africa.

OBJECTIVE: To identify sociodemographic factors that could enhance breastfeeding uptake among women with HIV in sub-Saharan Africa. DESIGN: This was a secondary analysis from a retrospective cohort study using the Demographic Health Surveys (DHS) on women and HIV data from 14 sub-Saharan African countries during the period from 2010 to 2018. Our study sample encompassed women aged 15 to 49 years with HIV, with childbearing history within the 3 to 5 years preceding the survey, living in any of the countries in sub-Saharan Africa for whom breastfeeding information was available. We used an adjusted survey log binomial regression model to examine factors associated with breastfeeding among participants. SETTING: Sub-Saharan Africa. PARTICIPANTS: Breastfeeding women with HIV from 15 sub-Saharan African countries. RESULTS: Of 138,920 women with HIV in sub-Saharan Africa, 49,479 (35.6%) breastfed their infants. Young women, aged 15 to 19 years (90.5%, n = 2,422) were more likely to breastfeed than those aged 25 to 29 years (13.7%, n = 5,266). Breastfeeding was more common among women who lived in rural areas (38.1%, n = 26,000) than among those in urban areas (33.2%, n = 23,479) (p < .01). The wealthiest women (43.3%, n = 13,710) breastfed more than those with the lowest economic resources (30.8%, n = 4,750) (p < .01). CONCLUSION: Recognizing the breastfeeding issues in this individualized sub-Saharan population of women with HIV can influence the creation of more accessibility to education, resources, supplies, counseling, and support throughout the region and beyond through policy changes in health care.