First robotic surgery performed at Surrey Memorial Hospital - Fraser Health

UVA Health is expanding its advanced cardiovascular care capabilities as the first healthcare system in Virginia to offer a dedicated robotic cardiac surgery program. Led by Michael Ibrahim, MD, director of robotic cardiac surgery at UVA Health, the program brings cutting-edge, minimally invasive options for valve patients right now across Virginia and beyond. While robotic heart surgery was once limited to simple procedures, the program at UVA Health covers a broad spectrum of complex valve conditions as well as atrial fibrillation and coronary artery disease. The team's inaugural procedure demonstrated the clinical value of bringing this advanced technology to UVA Health. Rather than facing a traditional open-chest operation, the patient successfully underwent a robotic mitral valve repair. "This first patient was somewhere kind of in the middle. She had complex valve disease and was considering a transcatheter therapy versus surgery, “ says Ibrahim. “Because we were able to use surgery without having to open the chest, that's what she went with. And surgery is generally more durable and more definitively corrective than transcatheter therapy," he notes.

A new AI-driven platform could allow people to interact with their medical devices by sending messages using a smartphone application and receiving feedback in real time. Participants in a proof-of-concept study undergoing monitoring for seizures could ask questions about their brain activity, receive personalized alerts, report symptoms and behaviors and help train the system to better recognize seizure-related patterns.

Acute hemorrhage within the thyroid gland is uncommon but can cause rapid neck swelling and, in severe cases, airway compromise. We report a 65-year-old woman with hypertension and a history of partial thyroidectomy performed more than 25 years earlier who presented with painful neck swelling that developed overnight. The swelling was associated with pain on swallowing, without shortness of breath, voice change, drooling, fever, or recent neck trauma. She was hemodynamically stable with an oxygen saturation of 99% on room air. Examination showed marked neck swelling, thyromegaly, thyroid tenderness, and left-sided neck induration. Contrast-enhanced computed tomography (CT) demonstrated a multinodular thyroid with a large heterogeneous mass in the left thyroid lobe causing mass effect and rightward tracheal deviation. Subsequent ultrasonography demonstrated a heterogeneous intrathyroidal collection consistent with hematoma. The patient remained clinically stable and was discharged after approximately five hours of observation. At otolaryngology follow-up 10 days later, repeat ultrasonography showed a progressively enlarging left thyroid nodule, and fine-needle aspiration cytology wa

Primary adrenal insufficiency in childhood is frequently associated with inherited disorders. Lipoid congenital adrenal hyperplasia due to steroidogenic acute regulatory protein (StAR) deficiency is a rare disorder characterized by impaired mitochondrial cholesterol transfer and deficient adrenal and gonadal steroidogenesis. We report a five-year-old child raised as a girl who had been diagnosed with primary adrenal insufficiency at three months of age and was receiving hydrocortisone and fludrocortisone. Physical examination showed female-appearing external genitalia without virilization and Tanner stage I development. Biochemical evaluation demonstrated markedly elevated adrenocorticotropic hormone with profoundly low morning cortisol and globally reduced steroidogenesis, including low 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone sulfate, and free testosterone. Karyotyping revealed 46,XY. Anti-Müllerian hormone and inhibin B concentrations were compatible with preserved Sertoli cell secretory activity and supported the presence of testicular tissue despite severely impaired androgen production. A contrast-enhanced abdominal and pelvic magnetic resonance imaging

Electrical storm following myocardial infarction (MI) can be difficult to control when antiarrhythmic drugs and cardioversion fail. We describe a 53-year-old man with hypertension and previously undiagnosed diabetes who presented with an inferolateral ST-segment elevation MI caused by total occlusion of the proximal left circumflex artery, which was treated with primary percutaneous coronary intervention and drug-eluting stent placement. He then developed marked leukocytosis with a systemic inflammatory response and acute kidney injury (peak creatinine, 4.03 mg/dL), which resolved with empirical antibiotic therapy and supportive renal care. On day 6, he experienced recurrent syncope associated with sustained monomorphic ventricular tachycardia (VT) that persisted despite intravenous amiodarone and lidocaine, electrolyte correction, and repeated cardioversion, necessitating sedation and mechanical ventilation. Repeat coronary angiography demonstrated a patent stent. VT ceased following an ultrasound-guided left stellate ganglion block (SGB) using 1% lidocaine and dexamethasone, which resulted in Horner syndrome. Antiarrhythmic therapy was continued, and the patient was extubated wit