Objective: Homocysteine and sepsis are both associated with inflammation and endothelial activation. Therefore this study was aimed to evaluate if the plasma homocystein level is related with the septic patient clinical severity. Methods: Severe sepsis or septic shock patients, with less than 48 hours from organ dysfunction start, were admitted to this prospective observational study. Homocysteine levels were determined by the time of study admission and then on the Days 3, 7 and 14. The homocysteine association with the Sequential Organ Failure Assessment (SOFA) score was evaluated using the Sperman test, and its association with mortality using the Mann-Whitney test. A p<0.05 value was considered statistically significant. Results: Twenty one patients were enrolled, and 60 blood samples were collected to measure total homocysteine [median 6.92 (5.27-9.74 μmol/L)]. The Sperman correlation test showed no association between homocysteine and SOFA (r=0.15 and p=0.26). Also no correlation was found for the homocysteine level by the study admission time and the difference between the Day 3 SOFA score versus by study admission (deltaSOFA) (r=0.04 and p=0.87). Homocysteine varia tion between the Day 3 and the study admission (deltaHmc) and SOFA score variation in the same period were not correlated (r=-0.11 and p=0.66). Homocysteine by the study admission was not correlated with death in intensive care unit rate (p= 0.46) or in-hospital death rate (p = 0.13). This was also true for deltaHmc (p=0.12 and p=0.99, respectively). Conclusion: Baseline homocysteine levels and its variations within the first dysfunction days were not related with septic patients' worsened organ function parameters or mortality.

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Objective: Vascular surgery integrated residencies were granted accreditation in 2007, and 60 positions were offered in 2018. Our goal was to determine the factors affecting the number of vascular surgery matches from each medical school and the factors affecting where students match. We hypothesized that the Vascular Annual Meeting (VAM) would play a role in the match.Methods: Public online match records of 140 U.S. medical schools from 2009 to 2018 were reviewed to determine the number of students from each medical school who matched into vascular surgery and where they matched. Factors reviewed included presence of an integrated program, fellowship, and vascular surgery interest group (VSIG). In addition, the number of representatives from each medical school at the VAM student breakfast program and the number of podium presentations from each medical school from 2015 to 2018 were also reviewed.Results: Of all U.S. medical students who matched into vascular surgery, 88% were identified. The median number of vascular surgery matches from a U.S. medical school was 2. The presence of an integrated residency program (odds ratio [OR 8.6]; P < .001) and VSIG (OR, 4.9; P < .001) strongly correlated with matching vascular surgery residents. There were six medical schools with at least five representatives at the VAM medical student breakfast program from 2015 to 2018. Students from those medical schools were more likely to match at one of the six affiliated residency programs (OR, 6.2; P < .001). Eleven medical schools had at least three representatives at the breakfast program. Those 11 schools matched more vascular residents (OR, 0.2; P ¼ .003) and their students were more likely to match at one of the 11 affiliated programs (OR, 4.8; P < .001). The number of podium presentations per institution at the VAM from 2015 to 2018 also positively correlated with matching vascular surgery residents from those affiliated medical schools (OR, 3.6; P ¼ .02).Conclusions: Medical schools with affiliated integrated residency programs and VSIGs provide opportunity for medical student exposure of vascular surgery and are correlated with producing more vascular surgery residents. Students from schools without integrated programs, VSIGs, or faculty actively involved in the VAM student program may be under-represented in the vascular match. The VAM student program provides critical exposure to vascular surgery programs and should be represented by a diverse group of medical schools to foster student interest from those without integrated residency programs or VSIGs.Objective: There is increasing interest in using endovascular simulation to assess, acquire, and translate technical skill into improved operative outcomes. The aim of this study was to review the literature regarding the validity evidence, methodology, and reporting quality of endovascular simulation research.Methods: A search strategy for studies pertaining to endovascular simulation was performed within MEDLINE, Embase, PubMed, Web of Science, PsychINFO, and Google Schol...