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Safety of a Protective Funnel in Primary Breast Augmentation: A Retrospective Analysis of 380 Multicenter Cases in the United States.

Aesthet Surg J 2021 Apr 17. Epub 2021 Apr 17.

Background: Protective funnels devices are commonly used to deliver implants in primary breast augmentation (BA) yet there is a paucity of evidence-based data describing their safety in the literature.

Objectives: The purpose of the study was to assess the safety of protective funnels in primary BA within the first 30-days postoperatively.

Methods: This multi-center, Level 3 study retrospectively reviewed the surgical records of 380 consecutive patients (760 breasts) who underwent primary BA by nine board-certified plastic surgeons using the iNPLANT Funnel (Proximate Concepts LLC, Allendale, NJ, USA) for implant delivery between November 2019 and December 2020. Read More

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Upper airway stimulation: Fewer complications, ED presentations, readmissions, and increased surgical success.

Am J Otolaryngol 2021 Apr 7;42(5):103035. Epub 2021 Apr 7.

Thomas Jefferson University Hospital, Department of Otolaryngology - Head and Neck Surgery, 925 Chestnut St, Philadelphia, PA 19107, United States of America.

Objectives: Evaluate the rate of complications, readmissions, emergency department presentations, and surgical success rates amongst three standard surgical treatment options for obstructive sleep apnea: upper airway stimulation, transoral robotic surgery, and expansion sphincter pharyngoplasty.

Study Design: Retrospective cohort.

Setting: Tertiary care center. Read More

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Gastric remnant mesentero-axial volvulus following Roux-en-Y esophagojejunostomy: A rare complication.

Int J Surg Case Rep 2021 Apr 7;82:105873. Epub 2021 Apr 7.

Esophageal Institute, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address:

Introduction: Acute gastric volvulus is a surgical emergency with a mortality as high as 15-20%. The rarity of gastric volvulus requires high index of clinical suspicion especially in the patients with altered anatomy, to allow immediate surgical intervention and reduce the morbidity and mortality.

Presentation Of Case: We present an unusual case of gastric remnant volvulus several months following Roux-en-Y esophagojejunostomy performed in an obese patient for severe, recurrent gastroesophageal reflux disease (GERD) and failed prior fundoplication. Read More

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Diabetic retinopathy, oxidative stress and sirtuins: an in depth look in enzymatic patterns and new therapeutic horizons.

Surv Ophthalmol 2021 Apr 14. Epub 2021 Apr 14.

Department of Sense Organs, Faculty of Medicine and Odontology, Policlinico Umberto I. Sapienza University of Rome, v. le del Policlinico 155, 00161 Rome, Italy.

Diabetic retinopathy (DR) is one of the leading causes of blindness in the world. DR represents the most common microvascular complication of diabetes, and its incidence is constantly rising. The complex interactions between inflammation, oxidative stress, and the production of free oxygen radicals caused by prolonged exposure to hyperglycemia determine the development of DR. Read More

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Modulation of autophagy and transient receptor potential vanilloid 4 channels by montelukast in a rat model of hemorrhagic cystitis.

Life Sci 2021 Apr 14:119507. Epub 2021 Apr 14.

Histology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.

Aims: Hemorrhagic cystitis (HC) is a major urotoxic complication of cyclophosphamide (CPA) therapy. This study investigated the uroprotective effect of montelukast on CPA-induced HC, compared to the efficacy of 2-mercaptoethane sulfonate sodium (MESNA).

Main Methods: Male albino rats were pretreated with MESNA (40 mg/kg/day, IP) or montelukast (10 mg/kg/day, orally) for three days then received a single dose of CPA (200 mg/kg, IP), 1 h after the last dose, and compared to CPA-treated rats receiving drug vehicle. Read More

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Impact of refeeding syndrome on short- and medium-term all-cause mortality: a systematic review and meta-analysis.

Am J Med 2021 Apr 15. Epub 2021 Apr 15.

Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.

Background: The refeeding syndrome has been described as a potentially life-threatening complication of re-nutrition. However, moving from single reports to larger population studies, the real impact of refeeding syndrome on all-cause mortality is still unknown.

Methods: PubMed/Medline, EMBASE, Cochrane library and CINAHL databases were systematically searched until September 2020 for studies reporting mortality rates in patients who developed the syndrome at re-nutrition, compared to those who did not develop it. Read More

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Risk Factors for Perioperative Morbidity in Adults Undergoing Cardiac Surgery at Children's Hospitals.

Ann Thorac Surg 2021 Apr 14. Epub 2021 Apr 14.

Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Increasing numbers of adult with congenital heart disease (ACHD) undergo cardiac surgery in children's hospitals, yet surgical outcomes data are limited. We sought to better understand the impact of preoperative risk factors on postoperative complications and cardiac intensive care unit (CICU) length of stay (LOS).

Methods: Surgical CICU admissions for patients > 18 years in the Pediatric Cardiac Critical Care Consortium registry (8/2014-1/2019; 34 hospitals) were included. Read More

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Surgery after a previous SARS-CoV-19 infection: data, answers and questions.

Anaesthesia 2021 Apr 17. Epub 2021 Apr 17.

Department of Surgery, Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton, AB, Canada.

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Surgiflo embolism during pelvic surgery: a rare but potentially life-threatening complication.

ANZ J Surg 2021 Apr 17. Epub 2021 Apr 17.

Colorectal Surgery Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

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Skin microvascular function and renal hemodynamics in overweight patients with type 2 diabetes: a cross-sectional study.

Microcirculation 2021 Apr 17:e12700. Epub 2021 Apr 17.

Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands.

Objective: Diabetic kidney disease is a microvascular complication of diabetes Here we assessed the association between skin microvascular function and renal hemodynamic function in a cohort of well-phenotyped adults with type 2 diabetes (T2D).

Methods: We included 81 overweight/obese adults (age: 62±8 years; BMI: 32±4 kg/m ) with well-controlled T2D and no renal impairment. Skin microvascular function was assessed by nailfold capillary density in rest and after arterial occlusion (i. Read More

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Augmentation in patients with restless legs syndrome receiving pramipexole therapy: a retrospective study in a single center from China.

Sleep Breath 2021 Apr 16. Epub 2021 Apr 16.

Center for Sleep Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Rd East Qingchun, Zhejiang Province, 310016, Hangzhou, China.

Purpose: Augmentation is a major complication of long-term pramipexole treatment of restless legs syndrome (RLS). However, there have been no studies on augmentation in Chinese patients with RLS. We therefore investigated the clinical characteristics of augmentation in RLS patients treated with pramipexole in a real-world Chinese setting. Read More

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Focal seizures with impaired awareness as long-term neurological complication of COVID-19: a case report.

Neurol Sci 2021 Apr 16. Epub 2021 Apr 16.

Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10126, Turin, Italy.

We report here the first case of a young individual otherwise healthy, who presented with frequent focal seizures with impaired awareness as a possible long-term complication of severe acute respiratory syndrome coronavirus-2 infection. Seizures were documented by electroencephalography and responded clinically and neuro-physiologically to antiseizure therapy. The patient underwent an extensive investigation including cerebrospinal fluid examination, conventional and quantitative brain magnetic resonance imaging, and 18-FDG positron emission tomography. Read More

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Craniofrontonasal dysplasia: hypertelorism correction in late presenting patients.

Childs Nerv Syst 2021 Apr 16. Epub 2021 Apr 16.

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.

Background: Craniofrontonasal dysplasia (CFND) is a rare congenital craniofacial syndrome characterized by single suture synostosis, hypertelorism, other clinical facial features, and abnormalities in the upper extremities. There are only a few studies in the applicable literature that address hypertelorism management for CFND patients and outcomes and complication rates.

Methods: A retrospective study was performed on consecutive late presenting CFND patients referred to our hospital with substantially completed craniofacial skeleton growth, who underwent hypertelorism correction between 2007 and 2019 following intracranial pressure screening, and who received at least 1 year of follow-up care. Read More

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Prevalence of acid gastroesophageal reflux disease in infants with esophageal atresia/tracheoesophageal fistula.

Pediatr Res 2021 Apr 16. Epub 2021 Apr 16.

Univ. Lille, CHU Lille, INSERM U1286, Reference Center for Congenital Abnormalities of the Esophagus, Lille, France.

Background: Given the high prevalence and complication risks of acid gastroesophageal reflux (GERD) in the first months of life in infants with esophageal atresia, the ESPGHAN/NASPGHAN consensus statement recommends systematic treatment with proton pump inhibitors (PPIs) until the age of 1 year and checking for acid GERD thereafter. However, these recommendations have not been evaluated.

Methods: This prospective study was conducted from 2007 to 2016. Read More

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Mesenteric Tear Can Be Caused by Abdominal Counter-Pressure Applied During Colonoscopy.

Am J Case Rep 2021 Apr 17;22:e928889. Epub 2021 Apr 17.

5G Law Firm, PLLC, Woodward, OK, USA.

BACKGROUND We report the case of a patient undergoing a colonoscopy during which pressure applied on the abdomen by a nurse assisting in the procedure caused an extraluminal mesenteric tear. Mesenteric tears can be life-threating and need to be managed appropriately. This is the first case reported in the literature describing abdominal counter-pressure applied in the endoscopic procedure room as the cause of traumatic bowel injury. Read More

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Contemporary use of excimer laser in percutaneous coronary intervention with indications, procedural characteristics, complications and outcomes in a university teaching hospital.

Open Heart 2021 Apr;8(1)

Department of interventional cardiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK

Background: Excimer laser coronary atherectomy (ELCA) can be used as an adjunctive percutaneous coronary intervention treatment for challenging, heavily calcified lesions. Although previous studies have documented high rates of complication and restenosis, these predate the introduction of the smaller 0.9 mm laser catheter. Read More

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Colocutaneous fistula following infection managed as an 'autocolostomy': a novel approach to a recognised complication.

BMJ Case Rep 2021 Apr 16;14(4). Epub 2021 Apr 16.

General Surgery, The Dudley Group NHS Foundation Trust, Dudley, UK

Colocutaneous fistula is a rare entity in colorectal disease. We present a case of colocutaneous fistula in a patient whose postoperative course following a laparoscopic anterior resection for sigmoid cancer was complicated by colitis. During the follow-up period, it was found that his bowel contents were preferentially discharging through this fistula which had taken up the role of an 'autocolostomy'. Read More

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Feeding disorders in children with oesophageal atresia: a cross-sectional study.

Arch Dis Child 2021 Apr 16. Epub 2021 Apr 16.

AP-HP, Service des Maladies Digestives de l'Enfant, Hôpital Universitaire Mère-enfant Robert-Debré, Paris, France.

Introduction: With advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. Read More

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A potentially catastrophic complication of transapical mitral neochordoplasty.

Rev Esp Cardiol (Engl Ed) 2021 Apr 13. Epub 2021 Apr 13.

Cardiothoracic Surgery Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal.

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Effect of the COVID-19 pandemic on surgical treatment of acute appendicitis: A single-center retrospective study.

Asian J Surg 2021 Apr 13. Epub 2021 Apr 13.

Division of Coloproctology, Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.

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Use of Three-dimensional Titanium Trusses for Arthrodesis Procedures in Foot and Ankle Surgery: A Retrospective Case Series.

J Foot Ankle Surg 2020 Aug 15. Epub 2020 Aug 15.

Program Director, Foot & Ankle Residency Training Program, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Periarticular osseous defects pose a challenge when considering arthrodesis. Failure to restore the cubic content of bone can result in shortening and malalignment, as well as subsequent biomechanical issues. This study reports on 12 patients treated with patient-specific 3-D printed (7) and prefabricated titanium trusses (5). Read More

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Amount of blood during the subacute phase and clot clearance rate as prognostic factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

J Clin Neurosci 2021 May 11;87:74-79. Epub 2021 Mar 11.

Service de réanimation neurologique, Hôpital neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69 bld Pinel, 69650 BRON Cedex, France.

Delayed cerebral ischemia (DCI) is a poorly predictable complication occurring after aneurysmal subarachnoid hemorrhage (SAH) that can have dramatic functional consequences. Identifying the patients with the highest risk of DCI may help to institute more suitable monitoring and therapy. Early brain injuries and aneurysm-securing procedure complications could be regarded as confounding factors leading to severity misjudgment. Read More

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Bioinformatic analysis identifies potential biomarkers and therapeutic targets of septic-shock-associated acute kidney injury.

Hereditas 2021 Apr 16;158(1):13. Epub 2021 Apr 16.

Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277, Jiefang Avenue, Wuhan, 430022, China.

Background: Sepsis and septic shock are life-threatening diseases with high mortality rate in intensive care unit (ICU). Acute kidney injury (AKI) is a common complication of sepsis, and its occurrence is a poor prognostic sign to septic patients. We analyzed co-differentially expressed genes (co-DEGs) to explore relationships between septic shock and AKI and reveal potential biomarkers and therapeutic targets of septic-shock-associated AKI (SSAKI). Read More

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Abdominal aortic aneurysm and acute appendicitis: a case report and review of the literature.

J Med Case Rep 2021 Apr 17;15(1):203. Epub 2021 Apr 17.

Servicio de Angiología y Cirugía Vascular, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Paseo de San Vicente 139, 37007, Salamanca, Spain.

Background: Abdominal aortic aneurysm and acute appendicitis occur relatively frequently in elderly patients. However, the co-occurrence of the two pathologies is very rare and serious.

Case Presentation: We present the case of an elderly Caucasian patient who was aware of having an abdominal aortic aneurysm but refused treatment and was subsequently admitted to the hospital's emergency department with acute abdominal symptoms. Read More

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Fast track sacrospinous ligament fixation: subjective and objective outcomes at 6 months.

BMC Womens Health 2021 Apr 16;21(1):154. Epub 2021 Apr 16.

Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.

Background: Sacrospinous ligament fixation (SSLF) is a widely used vaginal procedure for correction of apical vaginal prolapse. The objective of this study was to evaluate subjective and objective outcomes of SSLF performed in a fast-track setting.

Methods: This was a prospective cohort study of sacrospinous ligament fixation performed using local anesthesia and light sedation in a fast-track setting at Aarhus University Hospital between April 2016 and December 2017. Read More

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Bilateral neck fracture in bimodular femoral stem after primary total hip arthroplasty: a case report.

BMC Musculoskelet Disord 2021 Apr 16;22(1):356. Epub 2021 Apr 16.

Department of Orthopaedic Surgery, University Medical Centre, 5 Ljubljanska street, SLO-2000, Maribor, Slovenia.

Background: Bi-modular stems were introduced in primary total hip arthroplasty (THA) to enable better control of the femoral offset, leg length, and hip stability. Despite numerous reports on modular femoral neck fractures, some designs are still marketed worldwide. While the risk factors for the sudden failure are multifactorial and mostly known, the timing of this new THA complication is not predictable by any means. Read More

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Eye pain and blurred vision as main complaints in a new case with MDPL syndrome.

Eur J Ophthalmol 2021 Apr 16:11206721211009179. Epub 2021 Apr 16.

Department of ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Introduction: We report a novel phenotype of mandibular hypoplasia, deafness, and progeroid features with lipodystrophy (MDPL) syndrome with mutation in a Chinese girl.

Case Description: Diabetic retinopathy was detected as the primary manifestation in a Chinese girl with MDPL syndrome carrying a known mutation (c.1812_1814delCTC, p. Read More

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[Liposuction with consequences: what to consider when using prilocaine].

Handchir Mikrochir Plast Chir 2021 Apr 16. Epub 2021 Apr 16.

Spital Thurgau AG, Hand- und Plastische Chirurgie.

Aetiologically, prilocaine-induced methaemoglobinaemia is a rare form of acquired methaemoglobinaemia, which occurs rarely in the first place. The following report highlights a potentially dangerous complication arising after application of prilocaine during liposuction.A young female visited the Accident and Emergency Department following a pre-syncopal fall. Read More

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Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery.

Neurosurgery 2021 Apr 16. Epub 2021 Apr 16.

Pacific Northwest University of Health Sciences, Yakima, Washington, USA.

Background: Preoperative depression is a risk factor for poor outcomes after spine surgery.

Objective: To understand effects of depression on spine surgery outcomes and healthcare resource utilization.

Methods: Using IBM's MarketScan Database, we identified 52 480 patients who underwent spinal fusion. Read More

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Awake CT-guided percutaneous stylomastoid foramen puncture and radiofrequency ablation of facial nerve for treatment of hemifacial spasm.

J Neurosurg 2021 Apr 16:1-7. Epub 2021 Apr 16.

2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California.

Objective: Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA) of the facial nerve for treatment of HFS, and they examine its clinical efficacy. Read More

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