Background: In the past few decades, there has been a gradual increase in breast reconstruction post mastectomy; however, there exists a conflict about whether race has an influence on reconstruction rates. Methods: We conducted an electronic search from MEDLINE and Cochrane CENTRAL from their inception to September 2022. Primary outcome was disparity in rates of Immediate Breast Reconstruction (IBR) in racial minorities. Odds ratios were pooled using a random-effects model. All statistical analyses were performed on the Review Manager. Quality of included studies was assessed using the Joanna Briggs Institute critical appraisal checklist. Results: Twenty studies ( n = 1 840 671) were identified. The pooled analysis of all the studies showed that subjects in racial minorities were significantly less likely to receive IBR as compared to White subjects (OR = 0.62, [95% confidence interval: 0.57-0.68; P < .01, I² = 97%]. Subgroup analyses revealed that Asian subjects were the least likely to undergo IBR among different minorities (OR = 0.43). Conclusion: There exists a significant disparity in rates of IBR in different racial minorities as compared to White subjects. Future studies are warranted to assess factors contributing to such disparities in provision of healthcare.

Purpose: Intramedullary spinal cord tumors (IMSCTs) account for 2–8% of all primary CNS tumors, with ependymal tumors astrocytic tumors and hemangioblastoma being the most prevalent. Due to scarcity of large-scale studies, we aim to provide insights into the long-term neurological and functional outcomes following their resection. Methods: A single-center study where retrospective review of all patients’ medical records with IMSCT resection between October 2001 and March 2023 was conducted. Data on demographic characteristics, clinical presentations, and surgical outcomes were collected and analyzed. Results: This study included 253 patients (57.7% male) with a mean age of 36.2 ± 19. The cohort comprised ependymal tumors (45.1%), astrocytic tumors (35.6%), hemangioblastoma (11.1%), and miscellaneous tumors (n = 21; 8.3%). Differences were observed in age at surgery (p < 0.001) and mortality (p = 0.002) across tumor types. Gross total resection was more frequently achieved in hemangioblastoma (96.4%) and ependymal tumors (82.5%) compared to astrocytic tumors (55.6%) (p < 0.001). Long-term postoperative improvements were significant, with reductions in numbness from 74.7% to 52.2%, pain from 42.2% to 25.7%, and bladder incontinence from 23.7% to 11.6%, particularly in ependymal tumors and astrocytic tumors. Kaplan–Meier analysis showed that patients with ependymal tumors had the highest overall survival rates (94.8% at 5 years, 86.7% at 10 years, 76.3% at 15 years, and 65.4% at 20 years) compared to hemangioblastoma (88.7% at 5 and 10 years, and 53.2% at 15 years) and astrocytic tumors (67.8% at 5 years, 58.1% at 10 and 15 years) (p = 0.001). Conclusions: This study highlights the differences in survival and long-term functional outcomes among patients with IMSCTs based on tumor histology and grade.

Prompt identification and aggressive intervention in Echis carinatus envenomation are paramount to avert life‐threatening complications such as venom‐induced consumptive coagulopathy (VICC), acute renal failure (ARF), and necrotizing fasciitis. Expeditious antivenom administration, coupled with a coordinated multidisciplinary approach, is imperative for optimizing clinical outcomes and mitigating mortality.

Nonroutine discharge (NRD) from the hospital carries considerable cost. We identified predictors of NRD after surgical treatment of ruptured intracranial aneurysms (IAs). The American College of Surgeons National Surgical Quality Improvement Program database was searched for patients with surgically treated ruptured IAs from 2016 through 2020. Demographics, clinical characteristics, preoperative comorbidities, procedural details, and 30-day morbidity and mortality were extracted. NRD risk factors were determined by multivariate logistic regression. Surgical outcomes and postoperative complications were compared by aneurysm complexity and location after propensity score matching. Among 671 patients, 277 (41%) had NRD, 591 (88%) underwent emergent surgery, and 466 (69%) had complex aneurysms. After matching, complex aneurysms were associated with higher frequencies of postoperative pneumonia (16% vs 10%, p=0.04), NRD (45% vs 32%, p=0.01), and 30-day reoperation (21% vs 13%, p=0.03). Aneurysms in the vertebrobasilar circulation were associated with a higher frequency of postoperative urinary tract infection (13% vs 5%, p=0.01) and organ/space surgical site infection (4% vs 0.7%, p=0.02). On multivariable analysis, NRD was associated with age ≥65 years (odds ratio [OR] 2.76), Black/African American (OR 1.86) or White (OR 2.16) race, preoperative immunosuppressive or steroid therapy (OR 4.46), complex aneurysms (OR 1.75), emergent surgery (OR 2.37), length of stay ≥21 days (OR 2.94), and postoperative pneumonia (OR 3.64) or sepsis (OR 5.64). Predictors of NRD after ruptured IA surgery included patient demographics, aneurysm characteristics, and postoperative complications. Early identification of high-risk patients and targeted discharge planning could reduce NRD rates.