For the first time, we find good evidence that at least three alternate versions of the SDMT are of equivalent difficulty in healthy adults. The forms are reliable, and can be implemented in clinical trials emphasizing cognitive outcomes.

Tension-free repairs have revolutionized the way we repair hernias. To help reduce undue tension when performing ventral hernia repair, multiple different techniques of myofascial releases have been described. The purpose of this project is to evaluate tension measurements for commonly performed myofascial releases in abdominal wall hernia repair. Patients undergoing myofascial release techniques for their ventral hernias were enrolled in a prospective Institutional Review Board-approved protocol to measure abdominal wall tension from June 1, 2011 to August 1, 2019. Abdominal wall tensions were measured using tensiometers before and after myofascial release techniques. Descriptive statistics were performed and data were analyzed. Thirty patients had tension measurements (5 anterior myofascial separation, 25 posterior myofascial separation with transversus abdominis release [TAR]). Average age was 60.1 years (range 29-81), 83% Caucasian, 53% female, and 42% recurrent hernias. The average hernia defect in patients undergoing anterior myofascial release was 117.3 cm2, and the average mesh size was 650 cm2. The reduction in tension after anterior release was 4.7 lbs (2.7 lbs vs 7.4 lbs). The average hernia defect in patients undergoing posterior myofascial release (TAR) was 183 cm2, and the average mesh size was 761.36 cm2. The reduction in tension after bilateral posterior rectus sheath incision was 2.55 lbs (5.01 lbs vs 7.56 lbs) with 0.66 lbs further reduction in tension after TAR (4.35 lbs vs 5.01). In this evaluation, abdominal wall tension measurements are shown to be a feasible adjunct during open hernia repair. Preliminary data show tension reductions associated with the different myofascial release techniques and, with further study, may be a useful intraoperative adjunct for decision making in hernia repair.

Major bronchial injury during blunt trauma is a life-threatening occurrence in children. We describe a 3-year-old female who presented with a near circumferential tear at the takeoff of the right upper lobe bronchus after an all-terrain vehicle accident. This is an unusual blunt traumatic injury in the pediatric population and highlights the need for evaluation when a large, persistent air leak occurs after chest tube placement.

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preoperative vein mapping use (P < .05 for all). Preoperative vein mapping was not independently associated with likelihood of AVG creation (odds ratio, 0.98; 95% confidence interval [CI], .81-1.17; P ¼ .8), but was independently associated with increased 30day patency (odds ratio, 2.23; 95% CI, 1.44-3.45; P < .001) and 1year patency (hazard ratio, 1.56; 95% CI, 1.19-2.04; P ¼ .001).Conclusions: Preoperative vein mapping was more likely to be performed in patients presenting with cardiovascular comorbidities and potential technical concerns. Vein mapping did not appear to minimize AVG creation; however, it was independently associated improved access patency in autogenous access. Although the majority of patients are receiving preoperative vein mapping, increasing its use may improve outcomes for hemodialysis patients.

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Tension pneumoperitoneum is a life-threatening complication of pneumatic reduction for intussusception if not immediately recognized and treated. We describe a 3-month-old woman who presented with intussusception, underwent attempted pneumatic reduction, and subsequently developed tension pneumoperitoneum with associated hemodynamic instability requiring emergent laparotomy. This is a known, rare complication of pneumatic reduction which highlights the need to have a high index of suspicion for early surgical management to obtain a positive outcome.