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Medium-term safety outcomes in patients undergoing tension free vaginal tape obturator for stress urinary incontinence in Murcia, Spain. Historical cohort

Rev Colomb Obstet Ginecol 2021 03 30;72(1):43-52. Epub 2021 Mar 30.

Hospital General Universitario Reina Sofía de Murcia, Murcia (Spain)..

Objective: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery.

Materials And Methods: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Read More

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No association of both serum pro-brain-derived neurotrophic factor (proBDNF) and BDNF concentrations with depressive state in community-dwelling elderly people.

Psychogeriatrics 2021 Apr 20. Epub 2021 Apr 20.

Department of Psychiatry, Faculty of Medicine, Saga University, Saga, Japan.

Background: Brain-derived neurotrophic factor (BDNF) is involved in emotional and cognitive function. Low-BDNF levels occur in patients with depression, while proBDNF, a precursor of BDNF with the opposite physiological function, increases in major depression. However, it is unclear whether BDNF and proBDNF are associated with depression in the elderly. Read More

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General anaesthesia in end-of-life care: extending the indications for anaesthesia beyond surgery.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

In this article, we describe an extension of general anaesthesia - beyond facilitating surgery - to the relief of suffering during dying. Some refractory symptoms at the end of life (pain, delirium, distress, dyspnoea) might be managed by analgesia, but in high doses, adverse effects (e.g. Read More

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Failure of the Ottawa Score to Predict the Risk of Recurrent Venous Thromboembolism in Cancer Patients: The Prospective PREDICARE Cohort Study.

Thromb Haemost 2021 Apr 20. Epub 2021 Apr 20.

Georges Pompidou European Hosp, Paris, France.

Introduction: Recurrent venous thromboembolism (VTE) despite curative anticoagulation is frequent in patients with cancer. Identifying patients with a high risk of recurrence could have therapeutic implications. A prospective study was designed to validate the Ottawa risk score of recurrent VTE in cancer patients. Read More

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Local and Regional Blocks for Complex Facial Wound Repair.

Authors:
Joy Obokhare

Facial Plast Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, Texas.

The location, severity, and associated injuries of the head and neck trauma dictate the type and treatment location needed for that particular patient. An in-depth knowledge of local and regional block options is vital to the proper management of facial wounds at the bedside, decreasing need for general anesthesia, anesthesia-related complication, length of hospital stay, and overall hospital costs. This article will discuss local and regional block options for the upper-face, midface, and lower face including dentition; complications of local and regional blocks and how to prevent them; and recent advances in local anesthesia. Read More

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Distinct Prognostic Factors in Sporadic and Multiple Endocrine Neoplasia Type 1-Related Pancreatic Neuroendocrine Tumors.

Horm Metab Res 2021 Apr 20. Epub 2021 Apr 20.

Division of Endocrinology and Metabolism, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel.

Pancreatic neuroendocrine tumors (PNET) may develop sporadically or in the context of hereditary syndromes. In patients with multiple endocrine neoplasia type 1 (MEN1), PNET is the leading cause of death. Our aim was to compare the mortality risk in sporadic and MEN1-related PNETs and identify high-risk populations. Read More

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Tranexamic Acid Treatment for Trauma Victims.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Worldwide, traumatic injury is responsible for over 5 million deaths per year, the majority due to exsanguination and head injury. The antifibrinolytic drug tranexamic acid is the only drug proven to reduce deaths after traumatic injury. Several large randomized controlled trials have provided high-quality evidence of its effectiveness and safety in trauma patients. Read More

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Fibrinolytic Alterations in Sepsis: Biomarkers and Future Treatment Targets.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Thrombosis and Haemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Sepsis is a life-threatening condition which develops as a dysregulated immune response in the face of infection and which is associated with profound hemostatic disturbances and in the most extreme cases disseminated intravascular coagulation (DIC). In addition, the fibrinolytic system is subject to alterations during infection and sepsis, and impaired fibrinolysis is currently considered a key player in sepsis-related microthrombus formation and DIC. However, we still lack reliable biomarkers to assess fibrinolysis in the clinical setting. Read More

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Fibrinolysis and Remote Ischemic Conditioning: Mechanisms and Treatment Perspectives in Stroke.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Department of Neurology, Danish Stroke Center, Aarhus University Hospital, Aarhus, Denmark.

Stroke is a leading cause of death and disability. Intravenous thrombolysis and mechanical thrombectomy have greatly improved outcomes in acute ischemic stroke (AIS). However, only a minority of patients receive reperfusion therapies, highlighting the need for novel neuroprotective therapies. Read More

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Altered Fibrinolysis during and after Surgery.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Anaesthesia and Critical Care Department, Bellvitge University Hospital, L'Hospitalet de LLobregat, Barcelona, Spain.

Major surgery induces hemostatic changes related to surgical stress, tissue destruction, and inflammatory reactions. These changes involve a shift of volume from extravascular space to intravascular and interstitial spaces, a "physiologic" hemodilution of coagulation proteins, and an increase of plasmatic fibrinogen concentration and platelets. Increases in fibrinogen and platelets together with a simultaneous dilution of pro- and anticoagulant factors and development of a hypofibrinolytic status result in a postoperative hypercoagulable state. Read More

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Impaired Fibrinolysis in the Antiphospholipid Syndrome.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.

The pathogenesis of the antiphospholipid syndrome (APS) is complex and involves the persistent presence of antiphospholipid antibodies (aPL) in the bloodstream causing a prothrombotic condition. aPL induce excessive activation of the endothelium, monocytes, and platelets in consort with aberrations in hemostasis/clotting, fibrinolytic system, and complement activation. Impaired fibrinolysis has been found in APS patients with thrombotic as well as obstetric manifestations. Read More

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Fibrinolysis in Traumatic Brain Injury: Diagnosis, Management, and Clinical Considerations.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Department of Surgery, Duke University Medical Center, Durham, North Carolina.

Posttraumatic coagulopathy involves disruption of both the coagulation and fibrinolytic pathways secondary to tissue damage, hypotension, and inflammatory upregulation. This phenomenon contributes to delayed complications after traumatic brain injury (TBI), including intracranial hemorrhage progression and systemic disseminated intravascular coagulopathy. Development of an early hyperfibrinolytic state may result in uncontrolled bleeding and is associated with increased mortality in patients with TBI. Read More

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Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Division of Maternal-Fetal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York.

Objective:  This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19.

Study Design:  This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. Read More

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A Randomized Controlled Trial on the Effect of Standardized Video Education on Prenatal Genetic Testing Choices: Uptake of Genetic Testing.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, California.

Objective:  This study aimed to assess the use of a standardized prenatal genetic testing educational video and its effects on patient uptake of prenatal testing, patient knowledge, decisional conflict, and decisional regret.

Study Design:  This was an IRB-approved randomized controlled trial. Patients were randomized to intervention (standardized video education) or control (no video education). Read More

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Improving Postpartum Attendance among Women with Gestational Diabetes Using the Medical Home Model of Care.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective:  Poor attendance at the 6-week postpartum (PP) visit has been well reported. Attendance at this visit is crucial to identify women who have persistent diabetes mellitus (DM) following pregnancies affected by gestational DM (GDM). The medical home model has eliminated barriers to care in various other settings. Read More

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Effects of Different Onset Times of Early Caffeine Treatment on Mesenteric Tissue Oxygenation and Necrotizing Enterocolitis: A Prospective, Randomized Study.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Division of Neonatology, Department of Pediatrics, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.

Objective:  Caffeine treatment is routinely used in premature infants to prevent development of apnea and bronchopulmonary dysplasia. Although a limited number of studies have reported that early caffeine treatment may cause development of necrotizing enterocolitis (NEC) by reducing mesenteric blood flow, this issue is still under discussion. The aim of this study is to investigate the possible effect of different onset times of early caffeine treatment on mesenteric tissue oxygen saturation and NEC development in premature infants. Read More

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Disparities in Trial of Labor among Women with Twin Gestations in the United States.

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Objective:  The aim of the study is to examine clinical and demographic factors associated with trial of labor (TOL) among women with twin gestations eligible for a vaginal delivery.

Study Design:  This was a population-based cohort study of women giving birth to twin gestations in the United States (2012-2014). Inclusion criteria for the analysis included live births greater than 23 weeks' gestation and a cephalic presenting twin. Read More

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The Effect of Prandial Insulin Applied for Fat Protein Units on Postprandial Glucose Excursions in Type 1 Diabetes Patients with Insulin Pump Therapy: Results of a Randomized, Controlled, Cross-Over Study.

Exp Clin Endocrinol Diabetes 2021 Apr 20. Epub 2021 Apr 20.

FIDAM - Research Institute Diabetes Academy, Mergentheim, Gemany.

Objective: This randomized cross-over study aimed to compare different algorithms for calculating prandial insulin considering the fat and protein content of a standardized meal in type 1 diabetes patients using insulin pump therapy (CSII).

Methods: Twenty-six patients received a standardized evening meal for three consecutive days using different algorithms for insulin dose adjustment: A) exclusive consideration of carbohydrate content without considering fat-protein content, B) high-dose algorithm considering additional insulin for fat protein units (FPUs) with the same factor as for carbohydrates, and C) low-dose algorithm considering additional insulin for FPUs with half the factor as for carbohydrates. The primary outcome was the proportion of interstitial glucose values in the target range (≥ 70 to ≤ 180 mg/dl) during the post-prandial 12-hour follow-up period. Read More

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Validity of the 6-Minute Walk Test in Patients with End-Stage Lung Diseases Wearing an Oronasal Surgical Mask in Times of the COVID-19 Pandemic.

Respiration 2021 Apr 20:1-6. Epub 2021 Apr 20.

Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Background And Objectives: The 6-minute walk test (6MWT), as a clinical assessment tool for functional exercise capacity, is an integral component of lung allocation scores (LASs). In times of the coronavirus disease (COVID-19) pandemic, patients underwent 6MWTs wearing a surgical mask in ambulatory care. We investigated the impact of wearing a mask on 6-minute walk distances (6MWDs). Read More

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