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Prediction of Nonunion After Nonoperative Treatment of a Proximal Humeral Fracture.

J Bone Joint Surg Am 2021 Apr;103(8):668-680

The Edinburgh Shoulder Clinic, New Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.

Background: The prevalence of nonunion after a proximal humeral fracture (PHF) and the risk factors for its occurrence are poorly defined. We aimed to estimate the rate of nonunion in nonoperatively treated patients and to produce a clinical model for its prediction.

Methods: Two thousand two hundred and thirty adult patients (median age, 72 years [range, 18 to 103 years]; 75. Read More

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Adrenal surgery: Review of 35 years experience in a single centre.

Surg Oncol 2021 Apr 2;37:101554. Epub 2021 Apr 2.

Department of Surgery, Endocrine Surgery Unit, Veneto Institute of Oncology, IOV-IRCSS, Padua, Italy.

Introduction: The rate of adrenal disease diagnosed is progressively increasing due to the diagnostic tools improvement. We analysed patients that underwent to adrenalectomy in our centre for different adrenal pathologies and we tried to established guidelines for the surgical therapy.

Methods: Demographic and clinical data were prospectively entered in a computerized endocrine surgery registry for all patients who underwent surgery for adrenal lesions at our institution over a 35-year period and statistical analyses was performed. Read More

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Surgical Decision Making in Pancreatic Ductal Adenocarcinoma: Modeling Prognosis Following Pancreatectomy in the Era of Induction and Neoadjuvant Chemotherapy.

Ann Surg 2021 Apr 9. Epub 2021 Apr 9.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America Department of Surgery, New York University School of Medicine and NYU-Langone Medical Center, New York, New York, United States of America.

Objective: To develop a predictive model of oncologic outcomes for patients with pancreatic ductal adenocarcinoma (PDAC) undergoing resection after neoadjuvant or induction chemotherapy use.

Background: Early recurrence following surgical resection for PDAC is common. The use of neoadjuvant chemotherapy prior to resection may increase the likelihood of long-term systemic disease control. Read More

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Preoperative coronary artery calcifications in veterans predict higher all-cause mortality in early-stage lung cancer: a cohort study.

J Thorac Dis 2021 Mar;13(3):1427-1433

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: Lung cancer patients often have comorbidities that may impact survival. This observational cohort study examines whether coronary artery calcifications (CAC) impact all-cause mortality in patients with resected stage I non-small cell lung cancer (NSCLC).

Methods: Veterans with stage I NSCLC who underwent resection at a single institution between 2005 and 2018 were selected from a prospectively collected database. Read More

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Monocyte-based inflammatory indices predict outcomes following aneurysmal subarachnoid hemorrhage.

Neurosurg Rev 2021 Apr 10. Epub 2021 Apr 10.

Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building, Suite 102, Baltimore, MD, 21287, USA.

The contribution of specific immune cell populations to the post-hemorrhagic inflammatory response in aneurysmal subarachnoid hemorrhage (aSAH) and correlations with clinical outcomes, such as vasospasm and functional status, remains unclear. We aimed to compare the predictive value of leukocyte ratios that include monocytes as compared to the neutrophil-to-lymphocyte ratio (NLR) in aSAH. A prospectively accrued database of consecutive patients presenting to our institution with aSAH between January 2013 and December 2018 was used. Read More

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Discharge Disposition Following Hematopoietic Cell Transplantation: Predicting the Need for Rehabilitation and Association with Survival.

Transplant Cell Ther 2021 Apr 17;27(4):337.e1-337.e7. Epub 2020 Dec 17.

Division of Hematology, The Ohio State University, Columbus, Ohio.

Many hematopoietic cell transplantation (HCT) recipients require rehabilitation due to deconditioning following intensive conditioning regimens and immune reconstitution. HCT recipients are preferentially discharged to home to avoid the risk of exposure to healthcare-associated infection in a rehabilitation facility (RF), with a caregiver who has been provided specific education about the complexity of post-HCT care. This study was conducted to determine the incidence of discharge to an RF following HCT, identify pre-HCT and peri-HCT risk factors for discharge to an RF, and estimate the effect of discharge disposition on overall survival (OS). Read More

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Mortality and functional outcome after pediatric intracerebral hemorrhage: cohort study and meta-analysis.

J Neurosurg Pediatr 2021 Apr 9:1-7. Epub 2021 Apr 9.

1Service d'imagerie Morphologique et Fonctionnelle, GHU Paris Psychiatrie et Neurosciences, Hospitalier Sainte Anne, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, INSERM, Université de Paris.

Objective: The clinical outcome of pediatric intracerebral hemorrhage (pICH) is rarely reported in a comprehensive way. In this cohort study, systematic review, and meta-analysis of patients with pICH, the authors aimed to describe the basic clinical outcomes of pICH.

Methods: Children who received treatment for pICH at the authors' institution were prospectively enrolled in the cohort in 2008; data since 2000 were retrospectively included, and data through October 2019 were analyzed. Read More

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Thoracic Endovascular Aortic Repair With Additional Distal Bare Stents in Type B Aortic Dissection Does Not Prevent Long-Term Aneurysmal Degeneration.

J Endovasc Ther 2021 Apr 9:15266028211007459. Epub 2021 Apr 9.

Vascular Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Purpose: TEVAR (thoracic endovascular aortic repair) + PETTICOAT (Provisional ExTension to Induce COmplete ATtachment) technique has been selectively employed since 2005 at our institution during endovascular treatment of type B aortic dissection (TBD). The aim of this study is to evaluate the long-term (>5 years) clinical results and the evolution of aortic volume.

Materials And Methods: All the patients receiving an endovascular treatment for TBD with the PETTICOAT technique were collected in a prospectively maintained database and follow-up computed tomography scan were retrospectively analyzed. Read More

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Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years.

BMC Musculoskelet Disord 2021 Apr 7;22(1):336. Epub 2021 Apr 7.

Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, Tampere University, Niveltie 4, 33520, Tampere, Finland.

Background: The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design.

Methods: Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). Read More

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Hemorrhage Following Complete Arteriovenous Malformation Resection With No Detectable Recurrence: Insights From a Twenty-Seven-Year Registry.

Neurosurgery 2021 Apr 7. Epub 2021 Apr 7.

Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Background: Although recurrence and de novo formation of arteriovenous malformations (AVMs) have been reported following complete resection, the occurrence of hemorrhage in the same location of an AVM with no detectable lesion (lesion-negative hemorrhage) has not been described after microsurgery.

Objective: To characterize the incidence and properties of lesion-negative hemorrhage following complete microsurgical resection.

Methods: A prospectively maintained registry of AVM patients seen at our institution between 1990 and 2017 was used. Read More

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Transabdominal Ultrasound for Follow-Up of Incidentally Detected Low-Risk Pancreatic Cysts: A Prospective Multicenter Study.

AJR Am J Roentgenol 2021 Apr 7:1-9. Epub 2021 Apr 7.

Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea.

The purpose of this study is to investigate the detection rate of transabdominal ultrasound (TAUS) for pancreatic cysts incidentally detected on CT or MRI as well as the factors that influence detection rates. Fifty-seven patients with low-risk pancreatic cysts ( = 77; cyst size, 5 mm to 3 cm) that were incidentally detected on CT or MRI were prospectively enrolled at five institutions. At each institution, TAUS was independently performed by two radiologists who assessed detection of cysts, cyst location and size, and the diameter of the main pancreatic duct (MPD). Read More

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Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay.

J Am Geriatr Soc 2021 Apr 7. Epub 2021 Apr 7.

Department of Surgery, Rocky Mountain Regional Veterans Affairs Medical Center, VA Eastern Colorado Health Care System, Aurora, Colorado, United States.

Objectives/background: The Geriatric Surgery Verification (GSV) Program promotes clinical standards aimed to optimize the quality of surgical care delivered to older adults. The purpose of this study was to determine if preliminary implementation of the GSV Program standards improves surgical outcomes.

Design: Prospective study with cohort matching. Read More

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Transient delayed gastric emptying following laparoscopic Nissen fundoplication for gastroesophageal reflux disease.

Langenbecks Arch Surg 2021 Apr 6. Epub 2021 Apr 6.

The Nutrition Department, Suining Central Hospital, Sichuan, China.

Purpose: Although laparoscopic Nissen fundoplication (LNF) is a kind of minimally invasive surgery, some transition time may still be required to allow the fundoplicated stomach to adapt to the new anatomical position. We observed transient delayed gastric emptying (DGE) post-LNF in our preliminary study. This study aimed to investigate the occurrence rate and development of transient DGE post-LNF. Read More

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Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers-A Prospective Observational Study.

Can J Gastroenterol Hepatol 2021 22;2021:6643595. Epub 2021 Mar 22.

Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

Background: Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP.

Methods: Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. Read More

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The impact of body mass index on outcomes in robotic colorectal surgery: a single-centre experience.

J Robot Surg 2021 Apr 3. Epub 2021 Apr 3.

Department of Colorectal Surgery, University Hospital Limerick, St Nessan's Road, Dooradoyle Co, Limerick, Ireland.

Obesity is an independent risk factor for postoperative morbidity and mortality in laparoscopic colorectal surgery (LCRS). The technological advantages of robotic colorectal surgery (RCRS) may allow surgeons to overcome the limitations of LCRS in obese patients, but it is largely unknown if this translates to superior outcomes. The aim of this study was to compare perioperative, postoperative and short-term oncological outcomes in obese (BMI ≥ 30. Read More

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Evaluation of cardiac function and systolic dyssynchrony of fetuses exposed to maternal autoimmune diseases using speckle tracking echocardiography.

Clin Rheumatol 2021 Apr 4. Epub 2021 Apr 4.

Department of Rheumatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China.

Objectives: To compare cardiac function and systolic dyssynchrony of fetuses not exposed to and those exposed to maternal autoimmune antibodies using two-dimensional speckle tracking echocardiography (2DSTE).

Methods: An observational study of 52 fetuses, 18 from mothers with autoimmune antibodies (anti-SSA/Ro60, anti-Ro52 or/and anti-SSB/La) and 34 from healthy mothers without antibodies, was conducted. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data were prospectively collected. Read More

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Evaluation of Iterative Denoising 3-Dimensional T2-Weighted Turbo Spin Echo for the Diagnosis of Deep Infiltrating Endometriosis.

Invest Radiol 2021 Apr 1. Epub 2021 Apr 1.

From the Centre imagerie du Nord, Clinique du Landy, radiology departement, Ramsay-Générale de Santé, Saint-Ouen, France Siemens Healthcare France, Saint-Denis, France Department of Radiology, Hôpital Tenon, Paris, France Siemens Healthcare GmbH, Erlangen, Germany Sorbonne University, APHP, Hôpital la Pitié-Salpêtrière, Urology and renal transplantation department, Paris, France.

Objectives: The primary end point of this study was to evaluate the image quality and reliability of a highly accelerated 3-dimensional T2 turbo spin echo (3D-T2-TSE) sequence with prototype iterative denoising (ID) reconstruction compared with conventional 2D T2 sequences for the diagnosis of deep infiltrating endometriosis (DIE). The secondary end point was to demonstrate the 3D-T2-TSE sequence image quality improvement using ID reconstruction.

Material And Methods: Patients were prospectively enrolled to our institution for pelvis magnetic resonance imaging because of a suspicion of endometriosis over a 4-month period. Read More

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Prospective Validation of Pentraxin-3 as a Novel Serum Biomarker to Predict the Risk of Prostate Cancer in Patients Scheduled for Prostate Biopsy.

Cancers (Basel) 2021 Mar 31;13(7). Epub 2021 Mar 31.

Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy.

Purpose: To test and internally validate serum Pentraxin-3 (PTX3) levels as a potential PCa biomarker to predict prostate biopsy (PBx) results.

Materials And Methods: Serum PSA and serum PTX3 were prospectively assessed in patients scheduled for PBx at our Institution due to increased serum PSA levels or abnormal digital rectal examination. Uni- and multivariable logistic regression analysis, area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA), were used to test the accuracy of serum PTX3 in predicting anyPCa and clinically significant PCa (csPCa) defined as Gleason Grade (GG) ≥ 2. Read More

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Self-Expandable Metal Stents for Left Sided Colon Obstruction from Diverticulitis. A Single Center Retrospective Series.

Medicina (Kaunas) 2021 Mar 23;57(3). Epub 2021 Mar 23.

Department of Surgery "Pietro Valdoni", Sapienza, University of Rome, 00161 Rome, Italy.

: The incidence of diverticulitis is increasing in western countries. Complicated diverticulitis is defined as diverticulitis associated with localized or generalized perforation, localized or distant abscess, fistula, stricture or obstruction. Colonic symptomatic strictures are often treated with segmental colectomy. Read More

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Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part-II, Strengthening the Health System: A Mixed-Methods Study Protocol.

Int J Environ Res Public Health 2021 Mar 25;18(7). Epub 2021 Mar 25.

Department of Public Health, Universidad Miguel Hernández, Sant Joan d'Alacant, 03550 Alicante, Spain.

Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings in Ecuador and to stimulate context-led health systems innovations to improve diabetes care and reduce inequity. The mixed-methods approach includes a 24-month retrospective study to assess the current level of implementation of comprehensive diabetes care and participants will be followed up prospectively for two years to assess changes in healthcare and clinical outcomes from the outset of the research. Read More

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A Canadian Prospective Study of Linkage of Randomized Clinical Trial to Cancer and Mortality Registry Data.

Curr Oncol 2021 03 8;28(2):1153-1160. Epub 2021 Mar 8.

Canadian Cancer Trials Group, Queen's University, Kingston, ON K7L 3N6, Canada.

In a prospective study, we sought to determine acceptability of linkage of administrative and clinical trial data among Canadian patients and Research Ethics Boards (REBs). The goal is to develop a more harmonized approach to data, with potential to improve clinical trial conduct through enhanced data quality collected at reduced cost and inconvenience for patients. On completion of the original LY. Read More

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Application of unruptured aneurysm scoring systems to a cohort of ruptured aneurysms: are we underestimating rupture risk?

Neurosurg Rev 2021 Apr 2. Epub 2021 Apr 2.

Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower 6115C, Baltimore, MD, 21287, USA.

The predictive values of current risk stratification scales such as the Unruptured Intracranial Aneurysm Treatment Score (UIATS) and the PHASES score are debatable. We evaluated these scores using a cohort of ruptured intracranial aneurysms to simulate their management recommendations had the exact same patients presented prior to rupture. A prospectively maintained database of ruptured saccular aneurysm patients presenting to our institution was used. Read More

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Efficacy of Anti-inflammatory Treatment Versus Rescue Analgesia After Arthroscopic Partial Meniscectomy in Nonarthritic Knees: A 3-Arm Controlled Study.

Orthop J Sports Med 2021 Mar 19;9(3):2325967121991545. Epub 2021 Mar 19.

Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach Tikva, Israel.

Background: There is currently no consensus regarding the appropriate treatment for postoperative pain after arthroscopic partial meniscectomy (APM). Prescribing a mild non-anti-inflammatory protocol of rescue analgesia may be sufficient to avoid the side effects of opioids or anti-inflammatories.

Purpose/hypothesis: The purpose was to compare the efficacy of pain reduction after APM in nonarthritic knees using betamethasone or celecoxib as anti-inflammatory analgesics versus acetaminophen or tramadol as rescue analgesics. Read More

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