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Closed loop small bowel obstruction due to herniation through silastic ring after bariatric surgery.

BMJ Case Rep 2022 May 26;15(5). Epub 2022 May 26.

Department of General Surgery, St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia.

Bariatric surgery is an effective treatment for obesity and obesity-related complications. Weight regain after surgery plagues all methods of bariatric procedures including the minigastric bypass. The use of a 'silastic ring' around the gastric pouch has been shown to reduce weight regain. Read More

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Surgical outcomes in dogs with tracheal collapse treated with a novel cross-and-hook braided endoluminal stent.

J Vet Sci 2022 May;23(3):e46

Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan.

Background: Stenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs. Read More

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Trans-inguinal pelvic lymphadenectomy in vulvar cancer patients: TRIPLE pilot study.

Int J Gynecol Cancer 2022 May 26. Epub 2022 May 26.

Dipartimento Universitario Scienze della Vita e Sanità Pubblica - Sezione di Ginecologia ed Ostetricia - Università Cattolica del Sacro Cuore, Rome, Italy.

Objective: The goal of this study was to assess the feasibility and safety of a retrograde extraperitoneal trans-inguinal novel approach to pelvic lymphadenectomy in vulvar cancer patients. The secondary objectives were to assess complications (early and late) and oncological outcomes.

Methods: In this pilot study, all patients referred to our institution from November 2019 to May 2021 were evaluated. Read More

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Association between thoracic epidural block and major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia.

Reg Anesth Pain Med 2022 May 20. Epub 2022 May 20.

Department of Anesthesiology and Pain Medicine, Hyogo Medical University, School of Medicine, Nishinomiya, Hyogo, Japan

Introduction: A curative-intent surgical procedure, pleurectomy/decortication, for malignant pleural mesothelioma is accompanied by a high incidence of major postoperative complications. Although epidural block, which suppresses nociception during and after surgery, reportedly has both benefits and disadvantages in terms of outcomes after thoracic surgery for other diseases, the effects of epidural block on major complications after pleurectomy/decortication have not been evaluated. The aim of this study was to evaluate the association between epidural block and major postoperative complications following pleurectomy/decortication. Read More

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Microvascular reactivity as a predictor of major adverse events in patients with on-pump cardiac surgery.

Korean J Anesthesiol 2022 May 27. Epub 2022 May 27.

Department of Anesthesia and Pain Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Background: Microcirculatory disturbance occurs most seriously during cardiopulmonary bypass (CPB) in cardiac surgery. If microvascular reactivity compensates for microcirculatory disturbance during CPB, tissue hypoxemia may be minimized. The primary aim of this study was to assess whether microvascular reactivity during CPB can predict major adverse events (MAE) after cardiac surgery. Read More

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Transcriptome sequencing of 3,3',4,4',5-Pentachlorobiphenyl (PCB126)-treated human preadipocytes demonstrates progressive changes in pathways associated with inflammation and diabetes.

Toxicol In Vitro 2022 May 23:105396. Epub 2022 May 23.

Department of Microbiology and Immunology, University of Iowa, Iowa City, IA, USA; Fraternal Order of Eagles Diabetes Research Center, Iowa City, IA, USA. Electronic address:

Polychlorinated biphenyls (PCBs) are persistent organic pollutants that accumulate in adipose tissue and have been associated with cardiometabolic disease. We have previously demonstrated that exposure of human preadipocytes to the dioxin-like PCB126 disrupts adipogenesis via the aryl hydrocarbon receptor (AhR). To further understand how PCB126 disrupts adipose tissue cells, we performed RNAseq analysis of PCB126-treated human preadipocytes over a 3-day time course. Read More

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Umbilical incisional hernias (M3): are trocar-site hernias different? Comparative analysis of the EVEREG registry.

Cir Esp (Engl Ed) 2022 May 23. Epub 2022 May 23.

Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, Spain. Electronic address:

Background: Incisional hernia (HI), in open and laparoscopic surgery, is a very frequent complication. HI located in the umbilical region are called M3. The main aim of this study is to compare HI produced by the placement of an umbilical laparoscopic trocar (M3T) with those located in M3 in open surgery (M3O) in terms of basal characteristics, complications and recurrences; and secondarily the identification of risk factors. Read More

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Access Site Complications Are Uncommon with Vascular Closure Devices or Manual Compression after Lower Extremity Revascularization.

J Vasc Surg 2022 May 23. Epub 2022 May 23.

Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA. Electronic address:

Objective: Vascular closure devices (VCD) and manual compression (MC) are used to achieve hemostasis following peripheral vascular interventions (PVI). We sought to compare perioperative outcomes between MC and four VCDs following PVI in a multicenter setting.

Methods: The Vascular Quality Initiative was queried for all lower extremity (LE) PVIs with common femoral artery access performed from 2010-2020. Read More

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Comparison of Cold Snare and Hot Snare Polypectomy for the Resection of Sporadic Non-Ampullary Duodenal Adenomas.

Gastrointest Endosc 2022 May 23. Epub 2022 May 23.

San Diego Veterans Affairs Healthcare System; San Diego, CA; University of California San Diego; San Diego, CA.

Background And Aims: Non-ampullary duodenal adenomas can undergo malignant transformation, making endoscopic resection, often by hot snare (HSP) or cold snare polypectomy (CSP), necessary. While CSP has been shown to be safer for removal of colon polyps, there is limited data comparing these techniques for the resection of duodenal adenomas. Our aim was to compare the safety and efficacy of CSP and HSP for the removal of non-ampullary duodenal adenomas. Read More

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Osteo-odonto-keratoprosthesis according to Strampelli original technique: A retrospective study with up to 30 years of follow-up.

Am J Ophthalmol 2022 May 23. Epub 2022 May 23.

Department of Odontostomatologic and Maxillofacial Sciences, Head and Neck Department, Sapienza University of Rome, Italy.

Purpose: To describe clinical, anatomical, and visual outcomes obtained from a long-term follow-up of 59 patients who underwent osteo-odonto-keratoprosthesis (OOKP) using the original Strampelli technique.

Design: retrospective clinical cohort study.

Methods: 82 eyes of 59 patients who underwent OOKP surgery between 1969 and 2011 were included. Read More

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Evidence construction of Huangkui capsule against chronic glomerulonephritis: A systematic review and network pharmacology.

Phytomedicine 2022 May 20;102:154189. Epub 2022 May 20.

State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China. Electronic address:

Background: Chronic glomerulonephritis (CGN) is a relatively common primary glomerular disease. Huangkui capsule (HKC) combined with angiotensin receptor blocker (ARB) for CGN is frequently used in clinical practice, however, there is still lack of high-quality evidence-based evidence and network pharmacology to clarify the therapeutic efficacy and pharmacological mechanisms.

Purpose: Integrating evidence-based medicine and network pharmacology to explain the therapeutic efficacy and pharmacological mechanisms of ARB combined with HKC for CGN. Read More

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Association between the timing of antibiotics administration and outcome of neonatal sepsis.

J Infect Public Health 2022 May 17;15(6):643-647. Epub 2022 May 17.

Children Hospital, King Fahad Medical City, P.O.BOX: 59046, Riyadh 11525, Saudi Arabia. Electronic address:

Background: Sepsis is a life-threatening condition that requires aggressive and rapid intervention. However, data on the association between antibiotic administration timing in neonatal sepsis and neonatal outcomes is limited, particularly in the gulf area.

Objective: This study aimed to evaluate the association between the timing of antibiotic administration and the outcome of neonatal sepsis. Read More

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Diabetes mellitus and diabetic foot ulcer: Etiology, biochemical and molecular based treatment strategies via gene and nanotherapy.

Biomed Pharmacother 2022 May 23;151:113134. Epub 2022 May 23.

Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hallym University, College of Medicine, Hwaseong, Republic of Korea. Electronic address:

Diabetes mellitus (DM) is a collection of metabolic and pathophysiological disorders manifested with high glucose levels in the blood due to the inability of β-pancreatic cells to secrete an adequate amount of insulin or insensitivity of insulin towards receptor to oxidize blood glucose. Nevertheless, the preceding definition is only applicable to people who do not have inherited or metabolic disorders. Suppose a person who has been diagnosed with Type 1 or Type 2DM sustains an injury and the treatment of the damage is complicated and prolonged. Read More

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Comparison of absolute immature platelet count to the PLASMIC score at presentation in predicting ADAMTS13 deficiency in suspected thrombotic thrombocytopenic purpura.

Thromb Res 2022 May 20;215:30-36. Epub 2022 May 20.

University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, United States of America. Electronic address:

Introduction: Thrombotic thrombocytopenic purpura (TTP) demands rapid initiation of therapeutic plasma exchange to avoid severe complications associated with it. ADAMTS13 activity <10% defines TTP, however, this is a send-out test at most institutions. We have previously reported our experience looking at absolute immature platelet counts (A-IPC) in TTP patients. Read More

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Partial Replacement of High-Fat Diet with Beef Tallow Attenuates Dyslipidemia and Endoplasmic Reticulum Stress in / Mice.

J Med Food 2022 May 26. Epub 2022 May 26.

Department of Food Science and Nutrition, Dankook University, Cheonan, Korea.

High-fat diet (HFD) consumption is closely associated with an increased risk of metabolic syndromes (MetS), such as obesity, type 2 diabetes, and cardiovascular diseases (CVDs). Therefore, the consumption of alternative and functional fatty acids to replace saturated fatty acids and/or -fatty acids with polyunsaturated fatty acids has become an important dietary strategy for the prevention of MetS. Consumption of omega-3 fatty acids (-3) reduces various physiological complications, including CVDs, nonalcoholic fatty liver disease, and insulin resistance, related to inflammatory responses. Read More

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Regional Anesthesia for Spine Surgery.

J Am Acad Orthop Surg 2022 May 25. Epub 2022 May 25.

From the Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India (Garg), the Department of Spine Surgery, Indraprastha Apollo Hospital, New Delhi, India (Ahuja), and WESTMED Spine Center, Yonkers, NY (Sharan).

Current advancements in spine surgery have led to a recent interest in regional anesthesia for spine surgery. Spinal anesthesia, epidural anesthesia, and their combination are commonly used modalities for regional anesthesia in spine surgeries. The successful use of regional anesthesia has led to the emergence of several new concepts such as awake spinal fusion and outpatient spinal surgery. Read More

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Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Education Program for Critical Care Nurses.

Kimberly Bagley

Dimens Crit Care Nurs 2022 Jul-Aug 01;41(4):182-189

Kimberly Bagley, DNP, RN, AGPCNP-BC, AGACNP-BC, CCRN, has worked in critical care first as a critical care nurse in both specialized (cardiothoracic) and nonspecialized (medical-surgical) intensive care units and currently as a critical care nurse practitioner in the medical-surgical intensive care unit at Duke Raleigh Hospital. She obtained her master of science in nursing from the University of North Carolina at Chapel Hill, her postgraduate certificate in acute care from Duke University, and her doctor of nursing practice from Duke University.

Background: Ultrasound-guided (US-guided) peripheral intravenous (PIV) insertion is a skill used by specially trained nurses for patients with difficult vascular access. It can result in potential complications such as occlusive thrombus, phlebitis, infiltration, and pain. Complications can be prevented or minimized with clinical training to achieve competency. Read More

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Improving Helmet CPAP Use During COVID-19 Pandemic: A Multidisciplinary Approach in the Emergency Department.

Dimens Crit Care Nurs 2022 Jul-Aug 01;41(4):178-181

Daniele Privitera, MSN, CCRN, RN, Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. Annamaria Mazzone, RN, Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.Paolo Vailati, RN, CCRN, Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. Raffaela Amato, RN, CEN, Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. Nicolò Capsoni, MD, Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

The aim of this article is to describe the importance of a multidisciplinary team dedicated to noninvasive ventilation training of the emergency department's staff. In our experience, the presence of a medical and nursing "noninvasive ventilation group" made it possible to quickly teach expertise on the management of noninvasive ventilation of COVID-19 patients among emergency department doctors and nurses. This allowed improving a standardized approach regarding the identification and ventilatory assistance of patients with SARS-CoV-2 pneumonia needing ventilatory support, the correct use of the devices, and quick identification and reduction of the complications associated with noninvasive ventilation. Read More

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An overview of esophageal atresia and tracheoesophageal fistula.

JAAPA 2022 Jun;35(6):34-37

At the time this article was written, Nathan A. McGowan was a student in the PA program at Marietta (Ohio) College. He now practices at Ascension Texas Spine and Scoliosis in Austin, Tex. John Grosel is a radiologist at Lucid Health Riverside Radiology and Interventional Associates, Inc., based in Columbus, Ohio, and the McCoy associate professor in the PA program at Marietta College. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Abstract: Esophageal atresia and tracheoesophageal fistula are often-concomitant pathologies that primarily afflict neonates. The complications of these anomalies may lead to increased morbidity and mortality, and clinicians should be familiar with the diagnosis and management of these pathologies. Clinicians can improve patient outcomes by having a thorough understanding of the signs and symptoms, classification systems, diagnostic workup, and surgical intervention options for these patients. Read More

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Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey.

Global Spine J 2022 May 26:21925682221095470. Epub 2022 May 26.

Department of Orthopedic Surgery, Graduate School of Medical Sciences, 38305Kyushu University, Fukuoka, Japan.

Study Design: Retrospective Cohort Study.

Objective: The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors.

Methods: We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Read More

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The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women.

J Perinat Med 2022 May 27. Epub 2022 May 27.

Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: Preterm birth (PTB) is the common cause of neonatal mortality nationwide. The present study aimed to evaluate the efficacy of different doses of aspirin in preventing PTB in high-risk pregnant women. As secondary outcomes, other perinatal complications were compared. Read More

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Evolution in caesarean section practices in North Kivu: Impact of caregiver training.

PLoS One 2022 26;17(5):e0264251. Epub 2022 May 26.

School of Public Health, Center for Research in Epidemiology, Biostatistics and Clinical Research, Free University of Brussels, Brussels, Belgium.

Introduction: A caesarean section is a major obstetric procedure that can save the life of mother and child. Its purpose is to protect the mother's health from the complications of childbirth and to protect the baby's health. In sub-Saharan Africa (SSA), there are major inequalities in access to caesarean sections and significant variations in practices to determine the indications for the procedure. Read More

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Placenta Accreta Spectrum - a single-center retrospective observational cohort study of multidisciplinary management over time.

Int J Gynaecol Obstet 2022 May 26. Epub 2022 May 26.

University of Gothenburg, Institute of Clinical Sciences, Sahlgrenska Academy, Department of Obstetrics and Gynecology, Gothenburg, Sweden.

Objective: A prior study has shown a decrease in blood loss and transfusions with a multidisciplinary approach including a fixed team when delivering women diagnosed with placenta accreta spectrum at Sahlgrenska University Hospital. Our primary aim was to evaluate if these results were kept low throughout time, secondary, to investigate hospital stay and maternal and neonatal complications during a time period with varying team structure compared to previous periods.

Methods: A retrospective observational cohort study with data from medical records including three cohorts of women diagnosed with placenta accreta spectrum between October 2003 - December 2020 were compared. Read More

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Seizure- or Epilepsy-Related Emergency Department Visits Before and During the COVID-19 Pandemic - United States, 2019-2021.

MMWR Morb Mortal Wkly Rep 2022 May 27;71(21):703-708. Epub 2022 May 27.

Seizures, transient signs or symptoms caused by abnormal surges of electrical activity in the brain, can result from epilepsy, a neurologic disorder characterized by abnormal electrical brain activity causing recurrent, unprovoked seizures, or from other inciting causes, such as high fever or substance abuse (1). Seizures generally account for approximately 1% of all emergency department (ED) visits (2,3). Persons of any age can experience seizures, and outcomes might range from no complications for those with a single seizure to increased risk for injury, comorbidity, impaired quality of life, and early mortality for those with epilepsy (4). Read More

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Predictors of mortality and nephrectomy in emphysematous pyelonephritis: a tertiary care centre study.

Ann R Coll Surg Engl 2022 May 26. Epub 2022 May 26.

Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: Emphysematous pyelonephritis (EPN) is a deadly disease due to its associated morbidity and mortality. Attempts have been made to identify predictors of severity, mortality and need for nephrectomy in EPN with little success.

Methods: We conducted an ambispective study of EPN patients between March 2014 and September 2019. Read More

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Endocrine Emergencies in the Medical Intensive Care Unit.

Crit Care Nurs Q 2022 Jul-Sep 01;45(3):266-284

Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs Nasrullah, Azharuddin, Young, and Dumont); and Department of Nursing, Allegheny Health Network, Pittsburgh, Pennsylvania (Ms Kejas).

Endocrine emergencies are underdiagnosed and often overlooked amid the management of severe multisystem pathologies in critically ill patients in the medical intensive care unit (ICU). In an appropriate clinical scenario, a low threshold of suspicion should be kept to investigate for various life-threatening, yet completely treatable, endocrinopathies. Prompt identification and treatment of endocrine emergencies such as diabetic ketoacidosis, myxedema coma, thyroid storm, and/or adrenal insufficiency leads to fewer complications, shorter ICU and hospital stay, and improved survival. Read More

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Acute Renal Failure and Its Complications, Indications for Emergent Dialysis, and Dialysis Modalities.

Crit Care Nurs Q 2022 Jul-Sep 01;45(3):258-265

Divisions of Nephrology and Hypertension (Drs Muaddi and Nashar) and Pulmonary, Critical Care Medicine (Drs Muaddi, Ledgerwood, and Dumont and Ms Sheridan), Allegheny Health Network, Pittsburgh, Pennsylvania.

Acute kidney injury or acute renal failure is commonly observed in the critically ill patient with hemodynamic compromise. Dialysis is frequently used in the intensive care units as part of the critical care management of metabolic derangements fluid status and electrolyte issues. It is imperative that the bedside critical care nurse is able to identify acute kidney injury and is familiar with the modalities used to manage the metabolic consequences of renal failure, particularly important as the bedside nurse is operating the continuous renal replacement machine at the bedside. Read More

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Acute Respiratory Failure.

Crit Care Nurs Q 2022 Jul-Sep 01;45(3):233-247

Division of Pulmonary and Critical Care Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs Villgran, Nasrullah, Abalos, Bihler, and Alhajhusain); and Department of Nursing, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania (Ms Lyons).

Respiratory failure is one of the most common reasons for hospitalization and intensive care unit (ICU) admissions, and a diverse range of etiologies can precipitate it. Respiratory failure can result from various mechanisms such as hypoventilation, diffusion impairment, shunting, ventilation-perfusion mismatch, or a combination of those mentioned earlier. Hence, an accurate understanding of different pathophysiologic mechanisms is required for appropriate patient care. Read More

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Delays in Presentation of New Onset Diabetes at the Start of the COVID-19 Pandemic.

R I Med J (2013) 2022 Jun 1;105(5):46-50. Epub 2022 Jun 1.

Division of Pediatric Endocrinology, Hasbro Children's Hospital, Department of Pediatrics, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Rhode Island Hospital.

Objective: To compare the frequency, severity of presentation and initial presentations of new onset diabetes mellitus (DM) in youth in Rhode Island during the early phase of the COVID-19 pandemic compared to the same time frame in 2018 and 2019.

Methods: A retrospective cohort study of youth treated for new onset DM at Hasbro Children's Hospital between March 1 and May 15, 2020, compared to those diagnosed in the same period in 2018 and 2019.

Results: Fewer youth were diagnosed with new onset DM in Spring 2020 and the percentage of youth with DKA at time of DM diagnosis was higher in Spring 2020 compared to prior years (p=0. Read More

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Revascularization of Left Subclavian to Common Carotid Artery Prepares for Covered Stent Implantation in Patients With Complex Aortic Coarctation.

Innovations (Phila) 2022 May 26:15569845221099298. Epub 2022 May 26.

Center for Congenital Heart Disease/Pediatric Cardiology, Heart and Diabetes Center NRW, University Clinic of Ruhr University Bochum, Bad Oeynhausen, Germany.

Seven adult patients underwent a two-stage treatment of complex coarctation (CoA), including surgical revascularization of the left subclavian artery (LSA) to left common carotid artery (LCCA), followed by transcatheter covered stent implantation. The majority of patients (5 of 7, 71%) received 1 covered stent (covered Cheatham Platinum stent: 8 zig/45 mm [ = 2], 10 zig/60 mm [ = 1], 10 zig/65 mm [ = 1]; BeGraft: 24/48 mm [ = 2]). In 1 patient (14%), the implantation of 2 covered stents (BeGraft 20/48 mm) was necessary. Read More

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