There is increasing interest in understanding what role, if any, sex and sexual orientation play in body dissatisfaction, its correlates to distress, and its relationship to disordered eating. The goals of the present study were to examine: (a) differences in sex and sexual orientation in internalization of societal pressure to modify physical appearance, components of body image dissatisfaction, self-esteem, and eating disorder symptomatology and (b) whether the internalization-eating disorder symptomatology was mediated by the different components of body image dissatisfaction and low self-esteem. The present data support several key trends in the literature: men generally reported less body dissatisfaction, internalization of socio-cultural standards of beauty, drive for thinness, and disordered eating, but a greater drive for muscularity than women; results also indicated that different components of body image dissatisfaction and low self-esteem partially mediated the relationship between internalization and eating disorder symptomatology. Gay men reported significantly more body dissatisfaction, internalization, eating disorder symptomatology, drive for thinness, and drive for muscularity than heterosexual men. Compared to heterosexual women, lesbians reported increased drive for muscularity, lower self-esteem, and lower internalization; however, they did not significantly differ on body dissatisfaction, drive for thinness or disordered eating. Correlation coefficients between body shape dissatisfaction and several aspects of mental distress were significantly larger for gay men than heterosexual men; the same coefficients did not differ between lesbian women and heterosexual women. Results of path analyses indicated that the relationship between internalization and disordered eating differs for gay and heterosexual men but not for lesbian and heterosexual women. These results call attention to lesbians as a generally understudied population.

Background Increasing awareness of scientific misconduct has prompted various fields of medicine, including orthopedic surgery, neurosurgery, and dentistry to characterize the reasons for article retraction. The purpose of this review was to evaluate the reasons for and the rate of article retraction in the field of anesthesia within the last 30 years. Methods Based on a reproducible search strategy, two independent reviewers searched MEDLINE, EMBASE, and the Retraction Watch website to identify retracted anesthesiology articles. Extracted data included: author names, year of publication, year of the retracted article, journal name, journal five-year impact factor, research type (clinical, basic science, or review), reason for article retraction, number of citations, and presence of a watermark indicating article retraction. Results Three hundred and fifty articles were included for data extraction. Reasons for article retraction could be grouped into six broad categories. The most common reason for retraction was fraud (data fabrication or manipulation), which accounted for nearly half (49.4%) of all retractions, followed by lack of appropriate ethical approval (28%). Other reasons for retraction included publication issues (e.g., duplicate publications), plagiarism, and studies with methodologic or other non

Background We report a symptomatic carotid web successfully treated with carotid endarterectomy. A healthy 43-year-old woman presented with acute-onset left-sided weakness. Carotid web was evident on computed tomography angiography as a focal filling defect in the right common carotid artery. This right common carotid artery web extended into the ICA created an eddy resulting in turbulent flow. Subsequent acute embolus formation led to embolization and acute stroke. Method Review of the literature was performed using Medline Plus and PubMed databases. Result The patient underwent carotid endarterectomy with primary closure. Procedure was well tolerated and there was an uneventful recovery. Conclusion Arterial webs are a rare arteriopathy and a usual arrangement of fibromuscular intralumenal in-growth with unclear etiology. It is however, an important potential etiology of stroke in patients without traditional atherosclerotic risk factors. Carotid web and atypical carotid fibromuscular dysplasia should be considered in young, otherwise healthy patients presenting with stroke and without the typical risk factors for atherosclerotic carotid disease and stroke.

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Objectives: Failure of a femoropopliteal bypass often necessitates redo lower extremity surgery and is associated with increased mortality and morbidity. An alternative strategy is to perform endovascular revascularization of the superficial femoral artery (SFA) and avoid catheter-directed lysis or open surgery. The purpose of this retrospective study was to examine the outcomes of native SFA chronic total occlusion (CTO) recanalization compared with bypass after failed femoropopliteal bypass.Methods: Patients presenting with a symptomatic failed femoropopliteal bypass who underwent attempted CTO recannulization of the native SFA or a redo femoropopliteal bypass from 2000 to 2014 were included. Patients undergoing catheter-directed thrombolysis were excluded. Kaplan-Meier survival analyses were performed to assess time-dependent outcomes. Factor analyses were performed using a Cox proportional hazard model for time-dependent variables.Results: A total of 104 patients (69% male, average age 65 years) underwent native CTO recannulization (n ¼ 40) or redo bypass (n ¼ 64) after presentation with symptomatic occlusion of a previous femoropopliteal bypass graft (rest pain in 84% and life style-limiting claudication in 16%, 79% to the aboveknee popliteal), 81% of the lesions being TASC-II category D and 19% TASC-II category C. Tibial runoff was one tibial vessel in most patients (79%) and two-vessel runoff in the remainder. Lesions treated endovascularly underwent primary stenting with a median of three stents used. Sixty-nine percent of the bypasses were to the below-knee popliteal and remainder to the proximal tibials (68% of the patients has venous conduit). Overall, 30-day major adverse cardiac events were 5.6% and all-cause morbidity was 6.3%. 30-day major adverse limb events was 17% and 30-day amputation rate was 8% (Table). Overall amputation-free survival was 43% 6 9% and freedom from major adverse limb events was 28% 6 7% at 3 years (Table). Critical ischemia, TASC-II lesion (D), and onevessel tibial runoff were significant predictors of failure.Conclusions: In a high-risk cohort, bypass is superior to native CTO recannulization after failure of a femoropopliteal bypass. Shifting the paradigm offers no patient benefit.