Wyckoff Heights Medical Center is a 350-bed teaching hospital located in the Wyckoff Heights section of Bushwick, Brooklyn in New York City. The hospital is an academic affiliate of the NewYork-Presbyterian's Weill Cornell Medical College of Cornell University, the New York Medical College and New York Institute of Technology College of Osteopathic Medicine. The primary goal of the center is to train future physicians that are qualified medically and personably.
Dorsocervical fibro-lipodystrophy, commonly known as “buffalo hump,” presents a challenging deformity often associated with HIV-related lipodystrophy or idiopathic etiologies. Although various surgical techniques have been reported, a comprehensive evaluation of their safety, efficacy, and recurrence rates remains lacking. This systematic review and meta-analysis aimed to evaluate outcomes of surgical interventions, particularly suction-assisted lipectomy, in managing dorsocervical fibro-lipodystrophy. A systematic review with meta-analysis was conducted using PubMed and ScienceDirect. Eligible studies reported surgical outcomes of dorsocervical fibro-lipodystrophy managed with suction-assisted or excisional lipectomy. Meta-analyses used a random-effects model, with heterogeneity and publication bias assessed. Sensitivity analysis was performed. Twenty-two studies encompassing 218 patients were included. Most cases were associated with HIV-related lipodystrophy, and the average patient age was 47.4 years. Suction-assisted lipectomy was the most common approach. The pooled recurrence rate with liposuction was 10.6 www.springer.com/00266 .
Parastomal hernia (PSH) is a common complication after stoma creation and may present emergently with obstruction, incarceration, or ischemia. While minimally invasive surgery (MIS, laparoscopic or robotic) shows benefits in elective PSH repair, data in emergencies are limited. This study compared outcomes following open versus MIS emergent PSH repair. In this retrospective cohort using ACS-NSQIP, patients undergoing emergent open, laparoscopic, or robotic PSH repair were identified. Surgical approach was categorized as open or MIS. A 3:1 propensity score–matched analysis balanced demographic, comorbidity, physiologic, laboratory, and operative variables. Primary outcome was 30-day overall postoperative complications; secondary outcomes included wound, medical, and surgical complications, return to the operating room (OR), length of stay, and readmission. Multivariate logistic regression identified predictors of complications. Of 303 patients (249 open, 54 MIS), 192 were analyzed after matching (144 open, 48 MIS) with balanced baseline characteristics. MIS repair had lower overall complications than open repair (22.9
Parastomal hernias (PSHs) significantly impact the quality of life and pose risks including obstruction and stoma dysfunction. Minimally invasive approaches, particularly robotic surgery, are increasingly employed for elective PSH repairs, yet comparative outcomes remain insufficiently studied. This study evaluated short-term outcomes comparing robotic and open PSH repairs. A retrospective cohort analysis was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients undergoing elective open, laparoscopic, or robotic PSH repairs were identified. Propensity score matching was used to balance baseline characteristics, and multivariate logistic regression identified independent predictors of complications. Of 1,322 patients, 734 (55.5
Autoimmune hemolytic anemia (AIHA) is a rare and heterogeneous disorder characterized by immune-mediated red blood cell destruction, often posing diagnostic and therapeutic challenges, particularly in patients with multiple comorbid conditions. We report a complex case of recurrent mixed AIHA occurring in the setting of Evans syndrome, human immunodeficiency virus (HIV) infection, metastatic malignancy, and recent exposure to an immune checkpoint inhibitor. The patient presented with profound anemia and laboratory evidence of hemolysis, with a positive direct antiglobulin test demonstrating both IgG and complement (C3) involvement, consistent with mixed AIHA. The clinical course was marked by multiple relapses despite initial treatment with corticosteroids, intravenous immunoglobulin, and transfusion support, ultimately requiring escalation to rituximab for sustained hematologic stabilization. Notably, the disease course demonstrated discordant recovery patterns between hemoglobin and platelet counts, reflecting complex immune dysregulation. This case highlights the challenges in managing mixed AIHA with overlapping risk factors and underscores the potential role of immune checkpoint inhibitors and chronic immune activation in precipitating or exacerbating autoimmune cytopenias. It also emphasizes the importance of early recognition of high-risk features, including severe anemia and concomitant thrombocytopenia, which may warrant prompt escalation to second-line therapy. Further investigation is needed to better define optimal treatment strategies and the underlying mechanisms driving relapse in this population.
