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Determination of reference intervals for knee motor functions specific to patients undergoing knee arthroplasty.

PLoS One 2021 14;16(4):e0249564. Epub 2021 Apr 14.

Department of Rehabilitation, Hoshasen Daiichi Hospital, Imabari, Japan.

Background: In patients with knee osteoarthritis (KOA) undergoing knee arthroplasty (KA), lower-limb motor function tests are commonly measured during peri-surgical rehabilitation. To clarify their sources of variation and determine reference intervals (RIs), a multicenter study was performed in Japan.

Methods: We enrolled 545 KOA patients (127 men; 418 women; mean age 74. Read More

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Staging and Classification of Primary Musculoskeletal Bone and Soft Tissue Tumors Based on the 2020 WHO Update, From the Special Series on Cancer Staging.

AJR Am J Roentgenol 2021 Apr 14. Epub 2021 Apr 14.

Professor of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota and Consultant, Department of Radiology, Mayo Clinic, Phoenix, Arizona.

Staging of primary musculoskeletal bone and soft tissue tumors is most commonly performed using the AJCC and the Enneking or Musculoskeletal Tumor Society (MSTS) staging systems. Radiologic imaging is integral in achieving adequate musculoskeletal neoplastic staging by defining lesion extent and identifying regional lymph node involvement and distant metastatic disease. Additional important features in surgical planning, though not distinct components of the staging systems, include cortical involvement, joint invasion, and neurovascular encasement; these features are optimally evaluated by MRI. Read More

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Tracheostomy decannulation to noninvasive positive pressure ventilation in congenital central hypoventilation syndrome.

Sleep Breath 2021 Apr 14. Epub 2021 Apr 14.

Division of Pediatric Pulmonology and Sleep Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, 1400 Tullie Road NE, Atlanta, GA, 30329, USA.

Purpose: Noninvasive positive pressure ventilation (NPPV) may permit tracheostomy decannulation (TD) in patients with congenital central hypoventilation syndrome (CCHS) requiring nocturnal positive pressure ventilation via tracheostomy (PPV-T). There is limited evidence on optimal strategies for transitioning patients from PPV-T to NPPV. This study aimed to describe the clinical course and outcome of children with CCHS who underwent TD and transitioned from PPV-T to NPPV. Read More

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Severe herpes virus 6 interstitial pneumonia in an infant with three variants in genes predisposing to lung disease.

J Med Virol 2021 Apr 14. Epub 2021 Apr 14.

Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.

Background: Infections due to Human herpes virus 6 (HHV-6) are frequent during early childhood. Usually they have a favorable clinical course. Conversely HHV-6 congenital infections occur in about 1% of neonates and may present with more severe clinical pictures. Read More

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Malignant gastrointestinal neuroectodermal tumor-A case report.

Indian J Pathol Microbiol 2021 Apr-Jun;64(2):373-375

Department of Surgical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.

Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare neoplasm with unknown etiology. It was previously referred to as Clear cell sarcoma of gastrointestinal tract. This tumor is characterized by a higher rate of local recurrence and metastasis. Read More

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He Wānanga Whakarite: preparing Māori for surgical selection interviews.

ANZ J Surg 2021 Apr 13. Epub 2021 Apr 13.

Ear, Nose and Throat Department, Wellington Hospital, 49 Riddiford Street, 49 Riddiford Street, Wellington, 6021, New Zealand.

Background: Māori are significantly under-represented in the surgical workforce in Aotearoa New Zealand. There needs to be more effort and initiative action to address this lack of diversity in order to ultimately achieve proportionality so that more Māori surgeons are available to help treat and care for their communities.

Methods: An independent kaupapa Māori wānanga (course) initiative, using a 'by Māori, for Māori' approach, and adhering to tīkanga Māori (Māori lore and protocols) was developed to support and prepare Māori Non-Training Surgical Registrars for the Royal Australasian College of Surgeons Surgical Education and Training (SET) interviews. Read More

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Leiomyosarcoma of the scrotum: a case report and literature review.

Transl Androl Urol 2021 Mar;10(3):1342-1346

Department of Urology, University of Arizona College of Medicine, Tucson, AZ, USA.

Leiomyosarcoma (LMS) is one of the most common forms of soft tissue sarcoma with approximately 2,500 cases per year in the United States. The symptoms LMS vary depending upon the location, size, and spread of the tumor. In early stages, it may not be associated with any obvious symptoms so diagnosis and treatment may be delayed. Read More

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Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement.

J Arrhythm 2021 Apr 19;37(2):418-425. Epub 2021 Jan 19.

Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan.

Background: The peri-outflow tract region could be the origin of ventricular tachycardia (VT) after aortic valve replacement (AVR). However, the clinical characteristics of outflow tract ventricular tachycardias (OTVTs) after AVR are yet to be clarified. This study investigated the incidence, risk factors, and clinical characteristics of patients with OTVTs after AVR. Read More

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Surgical resection of arteriovenous fistula at the cauda equina.

Spinal Cord Ser Cases 2021 Apr 13;7(1):29. Epub 2021 Apr 13.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Introduction: Although spinal arteriovenous fistula (AVF) has been reported widely, AVF at the cauda equina is quite rare. We described a case of AVF at the cauda equina that was fed by the distal radicular artery (DRA).

Case Presentation: A 50-year-old woman presented with sudden weakness of the lower extremities. Read More

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Primary pancreatic hydatid cyst: a case report and literature review.

BMC Gastroenterol 2021 Apr 13;21(1):164. Epub 2021 Apr 13.

The Second Department of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.

Background: Hydatid cysts are parasitic zoonoses that often occur in the liver. Pancreatic hydatid cysts are very rare and are usually misdiagnosed as pancreatic cystadenomas. At present, surgical resection combined with albendazole administration is the standard treatment for pancreatic hydatid cysts. Read More

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Hepatic artery resection and reconstruction using the right gastroepiploic artery during pancreaticoduodenectomy in advanced pancreatic cancer.

Langenbecks Arch Surg 2021 Apr 13. Epub 2021 Apr 13.

Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.

Purpose: Surgical resection is the only curative treatment for pancreatic cancer. Arterial resection and reconstruction during pancreaticoduodenectomy for advanced pancreatic cancer remain controversial due to a high rate of complications.

Methods: We report two cases of pancreatic cancer with hepatic artery resection and reconstruction using the right gastroepiploic artery during pancreaticoduodenectomy after neoadjuvant therapy. Read More

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[Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: 5 years of experience in Italy].

G Ital Cardiol (Rome) 2021 Mar;22(3):5-11

U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, Bologna - Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna.

Background: Balloon pulmonary angioplasty (BPA) represents a therapeutic option for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in patients who are not eligible for surgical pulmonary endarterectomy (PEA) or with persistent/recurrent symptomatic pulmonary arterial hypertension after PEA. This study evaluated the safety of BPA during 5 years of experience of the only Italian center systematically performing this procedure.

Methods: The BPA program was activated at the S. Read More

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Neurocognitive disorders in the elderly: altered functional resting-state hyperconnectivities in postoperative delirium patients.

Transl Psychiatry 2021 Apr 12;11(1):213. Epub 2021 Apr 12.

Department of Anesthesiology, Charité (CVK, CCM)-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Postoperative delirium (POD) represents a confusional state during days/weeks after surgery and is particularly frequent in elderly patients. Hardly any fMRI studies were conducted to understand the underlying pathophysiology of POD patients. This prospective observational cohort study aims to examine changes of specific resting-state functional connectivity networks across different time points (pre- and 3-5 months postoperatively) in delirious patients compared to no-POD patients. Read More

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Acute colonic pseudo-obstruction and rapid septic progression after transabdominal preperitoneal hernia repair: a case report.

BMC Surg 2021 Apr 12;21(1):191. Epub 2021 Apr 12.

Division of Surgery, Kenpoku Medical Center, Takahagi Kyodo Hospital, 1006-9, Agehocho, Kamitezuna, Takahagi, Ibaraki, Japan.

Background: Acute colonic pseudo-obstruction (ACPO) is a rare condition observed in patients with some underlying medical or surgical conditions. To the best of our knowledge, this is the first case report of a patient with ACPO development and rapid septic progression after laparoscopic inguinal hernia repair.

Case Presentation: A 78-year-old man who underwent transabdominal preperitoneal hernia repair (TAPP) for right inguinal hernia presented with difficulty in defecation and abdominal distension. Read More

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Health Care Utilization and Associated Economic Burden of Postoperative Surgical Site Infection after Spinal Surgery with Follow-Up of 24 Months.

J Neurol Surg A Cent Eur Neurosurg 2021 Apr 12. Epub 2021 Apr 12.

Department of Neurosurgery, University of Louisville, Louisville, Kentucky, United States.

Background:  Surgical site infection (SSI) may lead to vertebral osteomyelitis, diskitis, paraspinal musculoskeletal infection, and abscess, and remains a significant concern in postoperative management of spinal surgery. SSI is associated with greater postoperative morbidity and increased health care payments.

Methods:  We conducted a retrospective analysis using MarketScan to identify health care utilization payments and risk factors associated with SSI that occurs postoperatively. Read More

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[Removal of an infected gastric cyanoacrylate plug. Report of one case].

Rev Med Chil 2020 Nov;148(11):1674-1678

Grupo Medicina Hospitalaria, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

In patients with actively bleeding gastric varices, the treatment of choice is the endoscopic use of sclerosing agents such as cyanoacrylate. We report a 69-year-old man who, after being treated with cyanoacrylate, suffered from recurrent febrile episodes. After an extensive study and broad-spectrum antibiotic treatment, discarding other presumably infectious focus, the superinfection of the cyanoacrylate plug was suspected, and its surgical removal was decided. Read More

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November 2020

Exploring the potential of rapid evaporative ionization mass spectrometry (Intelligent Knife) for point-of-care testing in aortic surgery.

Eur J Cardiothorac Surg 2021 Apr 11. Epub 2021 Apr 11.

Liverpool Centre for Cardiovascular Science, Liverpool, UK.

Objectives: Many intraoperative decisions regarding the extent of thoracic aortic surgery are subjective and are based on the appearance of the aorta, perceived surgical risks and likelihood of early recurrent disease. Our objective in this work was to carry out a cross-sectional study to demonstrate that rapid evaporative ionization mass spectrometry (REIMS) of electrosurgical aerosol is able to empirically discriminate ex vivo aneurysmal human thoracic aorta from normal aorta, thus providing supportive evidence for the development of the technique as a point-of-care test guiding intraoperative surgical decision-making.

Methods: Human aortic tissue was obtained from patients undergoing surgery for thoracic aortic aneurysms (n = 44). Read More

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An 83-year-old-male with bronchopleural fistula and empyema successfully treated with multidisciplinary management of thoracostomy, endoscopic, and surgical treatment: a case report.

Ann Transl Med 2021 Mar;9(5):427

Division of Endocrinology and Metabolism, Department of Medicine, Zhejiang University Medical School Second Affiliated Hospital, Hangzhou, China.

Bronchopleural fistula (BPF) with empyema is a severe complication in patients undergoing lobectomy or pneumonectomy and is associated with high morbidity and mortality rates. Although a wide variety of treatment options exist, refractory cases with larger fistulas are still difficult to cure, especially in elderly patients. Here, we report a case of an 83-year-old man with stage I squamous cell lung carcinoma who underwent minimally invasive right lower lobectomy. Read More

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Case Report: Epiglottitis in the setting of COVID-19.

IDCases 2021 Apr 7:e01116. Epub 2021 Apr 7.

Staten Island University Hospital, Staten Island, NY, USA.

Epiglottitis is an uncommon, potentially fatal infection of the epiglottis that can lead to complete upper airway obstruction. Isolated pathogens are usually nasopharyngeal bacteria, most commonly type b (Hib). While the incidence of epiglottitis has diminished significantly over the years due to widespread vaccination against Hib, the proportion of epiglottitis caused by other pathogens has increased. Read More

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Tuberculosis Septic Arthritis of the Elbow: A Case Report and Literature Review.

Cureus 2021 Mar 8;13(3):e13765. Epub 2021 Mar 8.

Department of Orthopedics, Prince of Songkhla University, Songkhla, THA.

Tuberculosis (TB) infections of the musculoskeletal system are rare. A 77-year-old female with chronic left elbow pain for five months was treated by irrigation and debridement of the elbow for a presumed diagnosis of septic arthritis. Her pain and wound condition did not improve, and she was referred to our institution. Read More

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Remote Teamwork Management of NORSE During the COVID-19 Lockdown.

Neurol Clin Pract 2021 Apr;11(2):e170-e173

Child Neuropsychiatry (FD, TLB, FD, GC), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona; Clinical and Experimental Medicine PhD Program (TLB), University of Modena and Reggio Emilia; Child Neuropsychiatry Unit (FD, E. Fontana, E. Fiorini, MM, GC), and Pediatric Intensive Care Unit (PB), University-Hospital of Verona; and Center for Research on Epilepsies in Pediatric Age (CREP) (BDB), Verona, Italy.

New-onset refractory status epilepticus (NORSE) is rare condition, and sharing knowledge is vital in its management, based on strict collaboration between multiple specialists, continuous EEG (c-EEG) monitoring, and prompt therapy modification. The coronavirus disease 2019 (COVID-19) pandemic challenged many of these established practices because of "social distancing" measures, making it necessary to work around physical restrictions. We report a case of a 10-year-old with NORSE admitted in a pediatric intensive-care unit and monitored with c-EEG and amplitude-integrated EEG. Read More

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Utilization of a training portfolio in thoracic and cardiovascular surgery: the example of the French platform-EPIFORM.

J Thorac Dis 2021 Mar;13(3):2054-2057

Department of Thoracic Surgery, Strasbourg University Hospital, Strasbourg, France.

Thoracic and cardiovascular surgery requires learning both theoretical knowledge and technical skills. In this surgical field, several disparities exist between the different training programs around the world. This report describes the implementation of a portfolio in the teaching and assessment of French trainees in Thoracic and Cardiovascular surgery, following an electronic logbook model, aiming to improve the training program. Read More

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From McKeown to Ivor Lewis, the learning curve for thoracic lymphadenectomy over the first 100 robotic esophagectomy cases: a retrospective study.

J Thorac Dis 2021 Mar;13(3):1543-1552

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.

Background: Lymphadenectomy is an essential but challenging part of the surgical treatment for esophageal cancer. However, the previously reported learning curve for robotic esophagectomy primarily focused on only one surgical approach (McKeown or Ivor Lewis). However, both approaches must be mastered by a mature robotic surgical team to deal with different clinical conditions and satisfy patients' needs. Read More

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Deposition of Immune Complexes in Gingival Tissues in the Presence of Periodontitis and Systemic Lupus Erythematosus.

Front Immunol 2021 25;12:591236. Epub 2021 Mar 25.

Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil.

Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease characterized by tissue damage and widespread inflammation in response to environmental challenges. Deposition of immune complexes in kidneys glomeruli are associated with lupus nephritis, determining SLE diagnosis. Periodontitis is a chronic inflammatory disease characterized by clinical attachment and bone loss, caused by a microbial challenge - host response interaction. Read More

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[A case of poorly differentiated pancreatic adenocarcinoma with spontaneous regression wherein retrospective rim enhancement findings were important for diagnosis].

Nihon Shokakibyo Gakkai Zasshi 2021 ;118(4):358-365

Department of Pathology, Shizuoka General Hospital.

A 66-year-old man with epigastric pain was admitted to our hospital for further evaluation of a pancreatic mass, as indicated on transabdominal ultrasonography performed by his family doctor. Using various imaging modalities, the 22-mm tumor was diagnosed as a cystic tumor with hemorrhagic necrosis. The tumor diameter reduced to 11mm over the course of 1 month. Read More

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Laparoscopic treatment for renal paratransplant hernia: A case report.

Int J Surg Case Rep 2021 Apr 1;82:105849. Epub 2021 Apr 1.

Department of Surgery, Shonan Kamakura General Hospital, Kanagawa, Japan.

Introduction: There are limited reports regarding renal paratransplant hernia (RPH), which is a rare type of internal hernia. Herein, we report a case of successful laparoscopic treatment of RPH.

Presentation Of Case: A kidney transplant recipient presented to our emergency department with a 6-h history of abdominal pain and vomiting. Read More

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Invasive Aortic Valve Endocarditis: Clinical and Tissue Findings from a Prospective Investigation.

Ann Thorac Surg 2021 Apr 8. Epub 2021 Apr 8.

Department of Thoracic and Cardiovascular Surgery, Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Advanced aortic valve infective endocarditis (IE) with progression and destruction beyond the valve cusps-invasive IE-is incompletely characterized. We aimed to further characterize invasive disease extent, location, and stage and correlate macroscopic operative findings with microscopic disease patterns and progression.

Methods: Forty-three patients with invasive aortic valve IE were prospectively enrolled from 8/2017 to 7/2018. Read More

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Marine Penetrating Injury to the Shoulder of Uncertain Origin.

Wilderness Environ Med 2021 Apr 7. Epub 2021 Apr 7.

Department of Orthopaedics, St John of God Subiaco, Nedlands, Australia.

Penetrating injuries from marine animals are rare events; however, published case reports have detailed critical injuries including death occurring as a result of such incidents. We present a case of a marine penetrating injury to the right posterolateral shoulder of a 10-y-old boy. The patient underwent open surgical debridement and a course of oral antibiotics before returning to normal function. Read More

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Ultrasound-guided percutaneous needle tenotomy using Tenex system for refractory lateral epicondylitis; short and long-term effectiveness and contributing factors.

Skeletal Radiol 2021 Apr 10. Epub 2021 Apr 10.

Department of Radiology, Musculoskeletal Imaging and Intervention, University of Virginia Health System, Charlottesville, VA, USA.

Background: Ultrasound-guided percutaneous needle tenotomy (USPNT) has been proposed as an alternative treatment to surgical intervention for lateral epicondylitis (LE). The Tenex system (Tenex Health Inc., Lake Forest, CA, USA) for USPNT is an ultrasonic device involving a needle which oscillates at high frequency to debride and aspirate diseased tendon under ultrasound image guidance. Read More

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[Refractive surgery for hyperopia].

J Fr Ophtalmol 2021 Apr 6. Epub 2021 Apr 6.

Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France.

Hyperopia is a refractive error in which light is focused behind, instead of on, the retina. Clear vision can be obtained by accommodation, but in the long run, this results in eye strain. Hyperopia can be classified as low [≤2. Read More

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