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Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Gynecol Obstet Invest 2021 May 12:1-13. Epub 2021 May 12.

Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Aim: This systematic and meta-analysis was conducted to evaluate the efficacy and safety of insulin, metformin, and glyburide on perinatal complications for gestational diabetes mellitus (GDM).

Methods: Medline (PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials [CENTRAL], and Cochrane Methodology Register), Web of Science (Science and Social Science Citation Index), and ClinicalTrials (Clinicaltrials.gov) were searched, as well as manual searching. Read More

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Effect of L-Arginine supplementation in pregnant women with chronic hypertension and previous placenta vascular disorders receiving Aspirin prophylaxis: a randomized control trial.

Minerva Obstet Gynecol 2021 May 12. Epub 2021 May 12.

Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy.

Background: The aim of the study is to evaluate the effects of supplementation with Arginine (L-Arg) 3g, (together with Magnesium (Mg) 350 mg and Salicilate (Sal) 100 mg) on maternal blood pressure (BP), uterine artery doppler PI and neonatal outcomes in women with high-risk pregnancy for chronic hypertension (CH) and other previous placenta vascular disorders (PVD) already treated with low dose of aspirin (LDA), as recommended by guidelines.

Methods: We enrolled women affected by CH and other previous PVD referred to the High-Risk Clinic of the Mother-Infant Department of the University of Modena and Reggio Emilia from September 2017 to June 2019. The study design was a controlled, randomized trial of oral supplementation of L-Arg 3g (together with Mg 350 mg and Sal extract 100 mg) + LDA 100 mg/die versus only LDA 100 mg/die. Read More

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Higher Cerebral Small Vessel Disease Burden is Associated with Smaller Hematoma Volume in Mixed-Location Intracerebral Hemorrhage.

Microcirculation 2021 May 12:e12705. Epub 2021 May 12.

Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, China.

Objective: To study the relationship between cerebral small vessel disease (CSVD) and hematoma volume in mixed-location intracerebral hemorrhage (ICH), and non-mixed ICH (hypertensive arteriopathy/cerebral amyloid angiopathy-related ICH).

Methods: We consecutively collected patients with primary ICH with MRI. Mixed-location ICH was defined as having ICH or cerebral microbleeds (CMBs) in both lobar and deep regions. Read More

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Impella RP Versus Pharmacologic Vasoactive Treatment in Profound Cardiogenic Shock due to Right Ventricular Failure.

J Cardiovasc Transl Res 2021 May 11. Epub 2021 May 11.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0. Read More

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Comparison of Behavioral Risk Factors and Cardiometabolic Comorbidities of Psoriatic Arthritis and Psoriasis: A Case-Control Study in Chinese Patients.

Ther Clin Risk Manag 2021 3;17:397-404. Epub 2021 May 3.

Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.

Purpose: Comparison of risk factors and comorbidities could help indicate the underlying mechanisms of diseases. This study aimed to compare behavioral factors and cardiometabolic comorbidities of PsA/psoriasis versus healthy controls to implicate the similarities and differences in potential pathogenic mechanisms for further research.

Patients And Methods: A case-control study in Chinese patients with PsA or psoriasis and healthy controls was conducted. Read More

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Examining the Effects of Postmastectomy Radiation Therapy in Prepectoral Versus Subpectoral Autologous Breast Reconstruction.

Ann Plast Surg 2021 May;86(5S Suppl 3):S390-S394

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.

Background: Postmastectomy radiation therapy (PMRT) is known to increase the risk of multiple adverse outcomes after breast reconstruction. In the context of delayed-immediate autologous breast reconstruction, PMRT is typically conducted after placement of subpectoral (SP) tissue expanders. With the re-emergence of prepectoral (PP) reconstruction, there are little data assessing the outcomes of PP reconstruction in breasts receiving PMRT. Read More

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Partial Gastrectomy is Associated with Improved Overall Survival in Signet-ring Cell Gastric Cancer.

J Surg Res 2021 May 8;266:27-34. Epub 2021 May 8.

Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. Electronic address:

Background: Signet-ring cell gastric cancer (SRGC) is a histological variant of gastric adenocarcinoma (GAC) with a worse prognosis compared to non-signet-ring cell gastric cancer (NSRGC). To our knowledge, the overall survival (OS) among patients with SRGC undergoing total/near-total (TG) versus partial gastrectomy (PG) has never been reported from a large-scale Western database.

Methods: We performed a retrospective analysis of patients with both SRGC and NSRGC using The National Cancer Database. Read More

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Anticoagulation Is Associated with Increased Mortality in Splenic Injuries.

J Surg Res 2021 May 8;266:1-5. Epub 2021 May 8.

Division of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, CT.

Introduction: Anticoagulation (AC) is associated with worse outcomes after trauma in some but not all studies. To further investigate the effect of AC on outcomes in patients with splenic injury, we analyzed the Trauma Quality Programs Participant Use File (PUF) METHODS: The 2017 PUF was used to identify adult (18+ y) with all mechanisms and grades of splenic injury. Demographics, comorbidities, hospital course and outcomes were compared between AC and non-AC patients. Read More

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Clinically Important Reductions in Physical Function and Quality of Life in Adults with Tumor Prostheses in the Hip and Knee: A Cross-sectional Study.

Clin Orthop Relat Res 2021 05 10. Epub 2021 May 10.

C. E. Holm, A. Villadsen, M. S. Sørensen, M. M. Petersen, Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark.

Background: Patients with a bone sarcoma who undergo limb-sparing surgery and reconstruction with a tumor prosthesis in the lower extremity have been shown to have reduced self-reported physical function and quality of life (QoL). To provide patients facing these operations with better expectations of future physical function and to better evaluate and improve upon postoperative interventions, data from objectively measured physical function have been suggested.

Questions/purposes: We sought to explore different aspects of physical function, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, by asking: (1) What are the differences between patients 2 to 12 years after a bone resection and reconstruction surgery of the hip and knee following resection of a bone sarcoma or giant cell tumor of bone and age-matched controls without walking limitations in ICF body functions (ROM, muscle strength, pain), ICF activity and participation (walking, getting up from a chair, daily tasks), and QoL? (2) Within the patient group, do ICF body functions and ICF activity and participation outcome scores correlate with QoL?

Methods: Between 2006 and 2016, we treated 72 patients for bone sarcoma or giant cell tumor of bone resulting in bone resection and reconstruction with a tumor prosthesis of the hip or knee. Read More

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Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery.

Indian J Gastroenterol 2021 May 11. Epub 2021 May 11.

Department of Gastroenterology, G B Pant Institute of Postgraduate Medical Education and Research, 1, J L N Marg, New Delhi, 110 002, India.

Background: Scope-induced duodenal perforation is a life-threatening complication and surgery remains the standard of care. With the advent of over-the-scope clip (OTSC), scope-induced perforations are increasingly managed conservatively, though there is no study comparing this form of non-surgical treatment with surgery. We aimed to compare OTSC and surgery in the management of scope-induced perforation of the duodenum. Read More

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Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study.

BMJ Open 2021 May 10;11(5):e039960. Epub 2021 May 10.

Paracelsus Medizinischen Privatuniversität für Geriatrie, Paracelsus Universitat Nurnberg, Nurnberg, Germany.

Objective: The aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.

Design: Cohort study recruiting patients between June 2015 and January 2017. Read More

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Outcomes of Total Hip Arthroplasty in Patients With Acetabular Protrusio.

J Am Acad Orthop Surg Glob Res Rev 2020 Jul;4(7):e2000121

From the Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA (Dr. Greig, Dr. Hsiue, Mr. Chen, Dr. Trikha, and Dr. Stavrakis), and the Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario (Dr. Khoshbin), Canada.

Background: Acetabular protrusio (AP) is associated with distorted anatomic landmarks and insufficient bone stock that increases complexity of total hip arthroplasty (THA). This study used a large national database to compare outcomes after THA in patients with and without AP.

Methods: The Nationwide Readmissions Database was used to identify patients with and without AP who underwent THA from 2010 to 2014. Read More

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Rate and impact on patient outcome and healthcare utilization of complications requiring surgical revision: subcutaneous versus transvenous implantable defibrillator therapy.

J Cardiovasc Electrophysiol 2021 May 9. Epub 2021 May 9.

Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi", Ancona, Italy.

Introduction: Comparison data on management of device-related complications and their impact on patient outcome and healthcare utilization between subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICS (TV-ICD) are lacking. We designed this prospective, multicentre, observational registry to compare the rate, the nature and the impact of long-term device-related complications requiring surgical revision on patient outcome and healthcare utilization between patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) or transvenous ICD (TV-ICD) implantation.

Methods And Results: A total of 1,099 consecutive patients who underwent S-ICD or TV-ICD implantation were enrolled. Read More

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Patient-reported Effects of Fedratinib, an Oral, Selective Inhibitor of Janus Kinase 2, on Myelofibrosis-related Symptoms and Health-related Quality of Life in the Randomized, Placebo-controlled, Phase III JAKARTA Trial.

Hemasphere 2021 May 29;5(5):e553. Epub 2021 Apr 29.

Guy's and St Thomas' Hospital, London, United Kingdom.

Patients with myelofibrosis (MF) experience an array of symptoms that impair health-related quality of life (HRQoL). Fedratinib, an oral, selective Janus-kinase 2 (JAK2) inhibitor, was investigated in the randomized, placebo-controlled, phase III JAKARTA study in adult patients with intermediate- or high-risk JAK-inhibitor-naïve MF. The effect of fedratinib 400 mg/d on patient-reported MF symptoms and HRQoL in JAKARTA was assessed. Read More

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Immune Checkpoint Inhibitor Associated Hepatotoxicity in Primary Liver Cancer Versus Other Cancers: A Systematic Review and Meta-Analysis.

Front Oncol 2021 21;11:650292. Epub 2021 Apr 21.

Thoracic and Gastrointestinal Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.

Background: Overall risks of hepatotoxicity with immune checkpoint inhibitors (ICIs) have yet to be compared in primary liver cancers to other solid tumors.

Methods: We reviewed data from the PubMed, Embase, and Scopus databases, and assessed the risk of hepatotoxicity associated with ICIs.

Results: A total of 117 trials were eligible for the meta-analysis, including 7 trials with primary liver cancers. Read More

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Assessment of Intraoperative Microbiological Culture in Patients with Empyema: Comparison with Preoperative Microbiological Culture.

Ann Thorac Cardiovasc Surg 2021 May 8. Epub 2021 May 8.

Department of Surgery, Saiseikai Karatsu Hospital, Karatsu, Saga, Japan.

Purpose: Assessing microbiological culture results is essential in the diagnosis of empyema and appropriate antibiotic selection; however, the guidelines for the management of empyema do not mention assessing microbiological culture intraoperatively. Therefore, we tested the hypothesis that intraoperative microbiological culture may improve the management of empyema.

Methods: We performed a retrospective analysis of 47 patients who underwent surgery for stage II/III empyema from January 2011 to May 2019. Read More

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Neonatal mortality among outborn versus inborn babies.

Pediatr Neonatol 2021 Apr 22. Epub 2021 Apr 22.

Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address:

Background: Most previous studies reported there were higher survival rates if low birth weight babies were born in tertiary perinatal centers (inborn) than elsewhere (outborn). The objective of this study is to examine whether the number and ratio of outborn babies decrease and the neonatal mortality differs between inborn and outborn babies.

Methods: We used the pooled data of the Taiwan Clinical Effectiveness Index for the years 2011-2016 obtained from the Joint Commission of Taiwan to study the outborn/inborn number and neonatal mortality rate. Read More

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Distribution of MICA alleles and haplotypes associated with HLA-B in Greek population.

Hum Immunol 2021 May 6. Epub 2021 May 6.

Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Introduction: The Major Histocompatibility Complex Class I-related chain A gene (MICA) is a highly polymorphic functional gene located close to the HLA-B locus. Certain MICA alleles have been related to inflammatory and autoimmune diseases while MICA antibodies have been implicated in organ allograft rejection or graft-versus-host disease (GVHD).

Aim: The aim of this study was to identify the frequencies of MICA alleles and MICA ~ HLA-B haplotypes in the Greek population since, as far as we know, these data are still limited. Read More

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Suture Tape Augmentation Improves the Biomechanical Performance of Bone-Patellar Tendon-Bone Grafts Used for Anterior Cruciate Ligament Reconstruction.

Arthroscopy 2021 May 5. Epub 2021 May 5.

Washington University Department of Orthopedic Surgery, St. Louis, MO.

Purpose: The purpose of this study was to investigate the time-zero biomechanical properties (stiffness, displacement and load at failure) of bone-patellar tendon-bone (BTB) grafts used for anterior cruciate ligament (ACL) reconstruction with and without suture tape augmentation as a means to determine the potential clinical benefit of this technique.

Methods: Eight juvenile porcine knees underwent ACL reconstruction with a human cadaveric BTB graft (control). These were compared to eight juvenile porcine knees that underwent ACL reconstruction with a BTB graft augmented with suture tape. Read More

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Immune adverse events (irAEs) with adjuvant ipilimumab in melanoma, use of immunosuppressants and association with outcome: ECOG-ACRIN E1609 study analysis.

J Immunother Cancer 2021 May;9(5)

UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA.

Background: The impact of immune-related adverse events (irAEs) occurring from adjuvant use of immunotherapy and of their management on relapse-free survival (RFS) and overall survival (OS) outcomes is currently not well understood.

Patients And Methods: E1609 enrolled 1673 patients with resected high-risk melanoma and evaluated adjuvant ipilimumab 3 mg/kg (ipi3) and 10 mg/kg (ipi10) versus interferon-α. We investigated the association of irAEs and of use of immunosuppressants with RFS and OS for patients treated with ipilimumab (n=1034). Read More

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Pulse wave velocity is decreased in acromegaly compared to non-acromegaly study participants with similar cardiovascular risk profile.

Growth Horm IGF Res 2021 Apr 29;57-58:101395. Epub 2021 Apr 29.

Almazov National Medical Research Centre, Ulica Akkuratova 2, St. Petersburg 197341, Russia.

Objective: Acromegaly patients were reported to have an increased arterial stiffness that could contribute to the frequent cardiovascular complications in this population. The chronic excess of GH and IGF-1 may lead to arterial stiffening via different mechanisms, including hypertension, impaired glucose tolerance and dyslipidemia, however, it is not known whether the activation of GH/IGF-1 axis might influence arterial stiffening independently of cardiovascular risk factors. The objective of this prospective case-control study was to compare arterial stiffness assessed with pulse-wave velocity (PWV) in acromegaly versus non-acromegaly group with similar cardiovascular risk profile. Read More

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First-line immune-checkpoint inhibitor combination therapy for chemotherapy-eligible patients with metastatic urothelial carcinoma: A systematic review and meta-analysis.

Eur J Cancer 2021 May 4;151:35-48. Epub 2021 May 4.

Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; European Association of Urology Research Foundation, Arnhem, Netherlands. Electronic address:

Introduction: Platinum-based combination chemotherapy is the standard treatment for patients with chemotherapy-eligible metastatic urothelial carcinoma (mUC). Immune-checkpoint inhibitors (ICIs) are currently assessed in this setting. This review aimed to assess the role of ICIs alone or in combination as first-line treatment in chemotherapy-eligible patients with mUC. Read More

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Effect of supraphysiological estrogen levels on arterial stiffness and hemodynamic parameters.

Anatol J Cardiol 2021 May;25(5):346-351

Department of Obstetrics and Gynecology, Faculty of Medicine, Ondokuz Mayıs University; Samsun-Turkey.

Objective: The present study evaluates the arterial stiffness and hemodynamic parameters in patients with a supraphysiological estrogen level due to in vitro fertilization (IVF) with controlled ovarian hyperstimulation (COH).

Methods: A total of 82 female patients aged 24-45 years were included. Their arterial stiffness parameters were analyzed before and after the appropriate COH protocol involving arteriography using Mobil-O-Graph NG (IEM GmbH, Stolberg, Germany) 24-hour ambulatory blood pressure monitor. Read More

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Histopathology of myopic cobblestones.

Acta Ophthalmol 2021 May 6. Epub 2021 May 6.

Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.

Purpose: To search for the histological correlate of peripheral 'cobblestones' in highly myopic eyes.

Methods: The histomorphometric investigation included histologic sections of enucleated eyes of Caucasian patients. Using light microscopy, we measured the thickness of the retina, Bruch's membrane (BM) and choriocapillaris. Read More

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Reliability of supraspinatus intramuscular fatty infiltration estimates on T1-weighted MRI in potential candidates for rotator cuff repair surgery: full-thickness tear versus high-grade partial-thickness tear.

Skeletal Radiol 2021 May 6. Epub 2021 May 6.

Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.

Objective: Patients with supraspinatus high-grade partial-thickness tear or full-thickness tear are potential candidates for rotator cuff repair surgery. We sought (1) to compare supraspinatus intramuscular fatty infiltration between these groups by Goutallier grade, fuzzy C-means and an orthopaedic surgeon visible percentage estimate, (2) and to determine the reliability of each method.

Materials And Methods: We performed a retrospective cross-sectional study of supraspinatus intramuscular fatty infiltration on T1-weighted MR images for 93 shoulders with either supraspinatus partial-thickness tear > 50% tendon thickness or full-thickness tear by Goutallier grade, fuzzy C-means and an orthopaedic surgeon visible percentage estimate, by two observers for each method. Read More

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Haemodialysis and peritoneal dialysis patients have severely impaired post-occlusive skin forearm vasodilatory response assessed with laser speckle contrast imaging.

Clin Kidney J 2021 May 21;14(5):1419-1427. Epub 2020 Oct 21.

Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Endothelial dysfunction is associated with cardiovascular events and mortality in various disease states, including end-stage renal disease (ESRD). Novel technological approaches have emerged for real-time assessment of endothelial reactivity. This study examined skin microcirculation using laser speckle contrast imaging (LSCI) before and after arterial occlusion in ESRD patients undergoing haemodialysis (HD) or peritoneal dialysis (PD). Read More

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Microvascular Dysfunction in Patients with Critical COVID-19, A Pilot Study.

Shock 2021 May 4. Epub 2021 May 4.

Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Division of Internal medicine and Infectious diseases, Stockholm, Sweden.

Background: Endothelial and microvascular dysfunction may be a key pathogenic feature of severe COVID-19. The aim of this study was to investigate endothelial-dependent and endothelial-independent skin microvascular reactivity in patients with critical COVID-19.

Methods: Twelve patients with COVID-19 treated with non-invasive or invasive mechanical ventilation were included in the study. Read More

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Permanent Pacemaker Implantation Following Valve-in-Valve Transcatheter Aortic Valve Replacement: VIVID Registry.

J Am Coll Cardiol 2021 May;77(18):2263-2273

Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.

Background: Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs).

Objectives: The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures.

Methods: Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. Read More

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Efficacy and Safety of Transarterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma Associated with Bile Duct Tumor Thrombus: A Real-World Retrospective Cohort Study.

Cancer Manag Res 2021 28;13:3551-3560. Epub 2021 Apr 28.

Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, People's Republic of China.

Background: The occurrence of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of the study was to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) for patients with unresectable HCC with BDTT.

Methods: This retrospective study was conducted on newly diagnosed HCC and BDTT patients who were initially treated with TACE or conservative management (CM) from 2009 to 2018. Read More

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Reduction of Inhospital Mortality of Patient Admissions to Cardiac Intensive Care Units During the COVID-19 Pandemic in Hunan, China.

Int Heart J 2021 May 1. Epub 2021 May 1.

Department of Cardiology, Cardiac Intensive Care Units, The Second Xiangya Hospital of Central South University.

This study aims to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on patient admissions to Hunan's cardiac intensive care units (CCUs).We conducted a retrospective, single-center study. Data were collected from patients who were confirmed to have critical cardiovascular disease and admitted to the CCU of the Second Xiangya Hospital of Central South University, Hunan, from January 23 to April 23, 2020. Read More

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