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Prognostic value of tumor mutational burden in patients with oral cavity squamous cell carcinoma treated with upfront surgery.

ESMO Open 2021 Jun 9;6(4):100178. Epub 2021 Jun 9.

Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France. Electronic address:

Background: Oral cavity is the most prevalent site of head and neck squamous cell carcinomas (HNSCCs). Most often diagnosed at a locally advanced stage, treatment is multimodal with surgery as the cornerstone. The aim of this study was to explore the molecular landscape of a homogenous cohort of oral cavity squamous cell carcinomas (OCSCCs), and to assess the prognostic value of tumor mutational burden (TMB), along with classical molecular and clinical parameters. Read More

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A rare case of large left internal maxillary artery pseudoaneurysm secondary to mandibular fracture: A case report and review of the literature.

Int J Surg Case Rep 2021 Jun 9;84:106072. Epub 2021 Jun 9.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Introduction And Importance: Pseudoaneurysms secondary to traumatic vessel wall disruption are a rare but potentially fatal complication after traumatic injury. The majority of the cases are found incidentally.

Case Presentation: An 80-year-old woman was brought into our Level 1 Trauma Center after sustaining a ground-level fall with significant facial swelling. Read More

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Does Loss of Spondylolisthesis Reduction Impact Clinical and Radiographic Outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Spine J 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA; Weill Cornell Medical College, 1300 York Ave, New York, NY, 10065, USA. Electronic address:

Background Context: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is a common operative approach to address degenerative lumbar stenosis and spondylolisthesis which has failed nonoperative care. Compared to open TLIF, MI-TLIF relies to a greater extent on indirect decompression resulting in a heightened awareness of spondylolisthesis reduction among MI surgeons. To what extent intraoperative reduction is achieved as well as the rate and clinical impact of loss or reduction and slip recurrence remain unknown. Read More

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Ultrasound-guided erector spinae plane block for open inguinal hernia repair: a randomized controlled trial.

Braz J Anesthesiol 2021 Jun 9. Epub 2021 Jun 9.

SIANEST/Hospital Florianópolis, Unidade de Anestesiologia, Florianópolis, SC, Brazil; Universidade do Sul de Santa Catarina (UNISUL), Florianópolis, SC, Brazil; TSA, Sociedade Brasileira de Anestesiologia, Brazil.

Introduction And Objectives: Inguinal hernia repair is associated with significant postoperative pain. We assessed the analgesia efficacy of unilateral Erector Spinae Plane block (ESP) performed under ultrasound guidance in patients submitted to open unilateral inguinal hernia repair, comparing ESP to spinal anesthesia administered with or without opioid.

Method: Forty-five patients with ages ranging from 27 to 83 years were randomly allocated into three groups: control group receiving spinal anesthesia (n = 14), ESP group receiving ESP block combined with spinal anesthesia (n = 16), and spinal morphine group receiving spinal anesthesia with morphine 1 mcg. Read More

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Defining the rate of, and factors influencing, radiographic progression of osteoarthritis of the canine hip joint.

Vet Rec 2021 Jun 12:e516. Epub 2021 Jun 12.

Translational Research in Pain (TRiP), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

Background: This study aimed to define the rate of progression of radiographic osteoarthritis (OA) of the canine hip joint and to describe factors affecting this progression.

Methods: Dogs that underwent unilateral total hip replacement (THR) were reviewed for the evaluation of radiographic appearance of the non-operated hip joint over time. Standard extended ventrodorsal hip radiographs were taken preoperatively and postoperatively. Read More

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Emergent valve replacement after circular mapping catheter entrapment in mitral valve apparatus.

Interact Cardiovasc Thorac Surg 2021 Jun 12. Epub 2021 Jun 12.

Department of Advanced Cardiovascular Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center-Houston, Houston, TX, USA.

We present the case of a 47-year-old male patient with a history of symptomatic paroxysmal atrial fibrillation who failed guideline-directed medical treatment and cardioversion. Electrical mapping was attempted and complicated with catheter entrapping in the mitral valve (MV) apparatus, and multiple attempts for retrieval were unsuccessful and caused severe valvular dysfunction. Emergent valve replacement was required secondary to the extensive disruption of the valvular apparatus and posterior annulus. Read More

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Perioperative platelet reduction after sutureless or stented valve implantation: results from the PERSIST-AVR controlled randomized trial.

Eur J Cardiothorac Surg 2021 Jun 12. Epub 2021 Jun 12.

Klinikum Nürnberg, Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany.

Objectives: Platelet count reduction is a common but not fully understood phenomenon after aortic valve replacement (AVR) with bioprosthesis implantation. The aim of the present study was to investigate the occurrence and the clinical impact of platelet count reduction in patients receiving the Perceval bioprosthesis compared to those receiving standard sutured stented bioprosthetic aortic valve in a randomized, controlled AVR study.

Methods: PERceval Sutureless Implant versus STandard Aortic Valve Replacement is a prospective, randomized, adaptive, open-label trial. Read More

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Efficacy and safety of TAS-115, a novel oral multi-kinase inhibitor, in osteosarcoma: an expansion cohort of a phase I study.

Invest New Drugs 2021 Jun 12. Epub 2021 Jun 12.

Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Background osteosarcoma is a rare, primary malignant bone tumour with limited available treatments for advanced or recurrent disease, resulting in a poor prognosis for patients. TAS-115 is a novel tyrosine kinase inhibitor under investigation in a phase I study in patients with solid tumours. We report data of osteosarcoma patients in the expansion cohort of this ongoing study. Read More

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Open, laparoscopic, and robotic inguinal hernia repair: more options, more questions.

S Huerta

Hernia 2021 Jun 12. Epub 2021 Jun 12.

VA North Texas Health Care System, Department of Surgery, University of Texas Southwestern Medical Center, 4500 S. Lancaster Road, Dallas, TX, 75216, USA.

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Identification of key genes in the tumor microenvironment of lung adenocarcinoma.

Med Oncol 2021 Jun 12;38(7):83. Epub 2021 Jun 12.

Key Laboratory of Medical Imaging and Artifical Intelligence of Hunan Province, 423000, Chenzhou, P. R. China.

The tumor microenvironment plays an important role in tumor development and progression, but the role of immune and stromal cells in this environment has not been sufficiently studied. In this study, we aimed to identify key genes associated with the microenvironment of lung adenocarcinoma (LUAD). Raw data for stromal and immune cells in malignant tumors were downloaded from The Cancer Genome Atlas (TCGA). Read More

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The instep flap for anterior ankle coverage with bone and hardware exposure.

Eur J Orthop Surg Traumatol 2021 Jun 12. Epub 2021 Jun 12.

Division of Orthopaedic and Trauma Surgery, Sahel General Hospital, University Medical Centre, PO Box 99/25., Ghoubeiry, Beirut, Lebanon.

Purpose: The instep medial plantar flap is a well-known flap based on the medial plantar artery of the foot and usually used for coverage of soft tissue defects of the heel area. It has seldom been reported for coverage of anterior ankle area with exposure of the bone and metallic hardware after open reduction and internal fixation of distal tibial fractures. The primary purpose of this study is to evaluate the feasibility and viability of this flap as well as its reliability saving the internal fixation devices and efficiency protecting bone healing; the secondary purpose is to assess the condition of the flap and its cosmetic appearance, as well as occurrence of complications related to its harvesting. Read More

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Both arthroscopic and open posterior knee capsulotomy are effective in terms of extension recovery and functional improvement-systematic review.

Knee Surg Sports Traumatol Arthrosc 2021 Jun 12. Epub 2021 Jun 12.

Artromedical Orthopaedic Clinic, Antracytowa 1, 97-400, Belchatow, Poland.

Purpose: To assess the recovery of extension and improvement in functional scores after an arthroscopic or open posterior knee capsulotomy in the setting of an extension deficit.

Methods: A systematic search of articles published between 1980 and 2020 was performed in the MEDLINE/PubMed database, EMBASE/Ovid database and Web of Science database. The inclusion criteria consisted of patients with primary extension deficits > 5° who underwent an arthroscopic or open posterior knee capsulotomy. Read More

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Calcaneal fractures: 3D-printing model to assist spatial weaving of percutaneous screws versus conventional open fixation-a retrospective cohort study.

Int Orthop 2021 Jun 11. Epub 2021 Jun 11.

Department of Foot and Ankle Surgery, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.

Purpose: This study compared the clinical effectiveness and wound complications of a three-dimensional model-assisted spatial weaving screw fixation (3D-SWSF) versus open reduction and internal fixation (ORIF) via an L-shaped extensile lateral approach for calcaneal fractures.

Methods: This single-centre retrospective cohort study was conducted with two cohort groups in which patients with Sanders II and III calcaneal fractures underwent 3D-SWSF or conventional ORIF. The clinical outcome measures included operation duration, time to operation, wound complications, blood loss volume, hospital stays, American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, and visual analog scale (VAS) score. Read More

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Staged endovascular treatment of aneurysmal progressive development of an intercostal arteries island reimplanted with the loop-graft technique.

Eur J Cardiothorac Surg 2021 Jun 12. Epub 2021 Jun 12.

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

A staged endovascular strategy was used to treat the aneurysmal evolution of the aortic island including intercostal arteries reimplanted in a loop-graft, following thoraco-abdominal aortic open repair in a young patient diagnosed with Marfan syndrome. First, selective coil embolization of patent intercostal arteries was performed in 2 separate sessions, to minimize the risk of spinal cord ischaemia. Then, the aneurysm was successfully excluded occluding the loop graft with 2 PTFE-membrane vascular plugs. Read More

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A Game of Adaptability: Reflecting on the Highlights & Challenges of Applying for Surgical Residency During the COVID-19 Pandemic.

Ann Surg 2021 Jun 11. Epub 2021 Jun 11.

Johns Hopkins University School of Medicine, Baltimore, MD University of Virginia School of Medicine, Charlottesville, VA Indiana University School of Medicine, Indianapolis, IN.

Virtual recruitment of candidates applying into General Surgery residency during the COVID-19 pandemic presented a number of benefits and challenges. Notable benefits for candidates included financial and resource cost savings, the ability to conduct multiple interviews within short time frame, and the ability to meet more faculty members on virtual interview day. Challenges included technological difficulties, difficulty assessing culture and authenticity of in-program relationships, zoom fatigue, and inability to form relationships with co-applicants. Read More

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Survival Comparison Between Open and Thoracoscopic Upfront Esophagectomy in Patients with Esophageal Squamous Cell Carcinoma.

Ann Surg 2021 Jun 10. Epub 2021 Jun 10.

Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Taiwan School of Medicine, Chung Shan Medical University, Taichung, Taiwan School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan Center for General Education, Ming Dao University, Changhua, Taiwan Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Taiwan Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan Department of Health Care Administration, Chang Jung Christian University.

Background: The survival outcomes of patients with esophageal squamous cell carcinoma (ESCC) after open or thoracoscopic upfront esophagectomy remained unclear.

Objective: The aim of this retrospective study was to compare overall survival between open and thoracoscopic esophagectomy for ESCC patients without neoadjuvant CRT.

Methods: The Taiwan Cancer Registry was investigated for ESCC cases from 2008-2016. Read More

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Statin therapy for patients with aortic stenosis who underwent transcatheter aortic valve implantation: a report from a Japanese multicentre registry.

BMJ Open 2021 Jun 11;11(6):e044319. Epub 2021 Jun 11.

Department of Cardiology, Keio University School of Medicine, Shinjuku-ku, Japan.

Objective: Data on statin for patients with aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI) are limited. The present study aimed to evaluate the impact of statin on midterm mortality of TAVI patients.

Design: Observational study. Read More

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Resuming cataract surgery in a high-risk COVID-19 population.

BMJ Open Qual 2021 Jun;10(2)

Ophthalmology Department, Central Middlesex Hospital, London North West University Healthcare NHS Trust, London, UK

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Castration Complications: A Review of Castration Techniques and How to Manage Complications.

Vet Clin North Am Equine Pract 2021 Jun 8. Epub 2021 Jun 8.

Department of Medicine and Epidemiology, UC Davis School of Veterinary Medicine, One Shields Avenue, Davis, CA 95616, USA.

Castration is one of the most common surgical procedures performed in equine practice. Open, closed, and semiclosed techniques are described for castration of horses, and the procedure may be performed in a standing, sedated animal or in a recumbent animal under general anesthesia. Although a relatively routine procedure, complications can occur, with reported complication rates ranging from 10. Read More

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Probabilistic forecasts of COVID-19 deaths with the progression rate from pneumonia to ARDS: An open-data-based global study.

J Formos Med Assoc 2021 May 31. Epub 2021 May 31.

Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan. Electronic address:

Background: Cumulative data of case-fatality rates (CFR) of COVID-19 varied across countries. A forecasting model generated based on detailed information from three countries during the initial phase of pandemic showed that progression rates from pneumonia to ARDS (PRPA) varied by country and were highly associated with CFR. We aim to elucidate the impact of the PRPA on COVID-19 deaths in different periods of pandemic. Read More

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Trends in Operative Treatment of Pediatric and Adolescent Forearm Fractures Among American Board of Orthopaedic Surgery Part II Candidates.

J Pediatr Orthop 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedic Surgery, Brown University/Warren Alpert School of Medicine Warren Alpert School of Medicine at Brown University Brown University, Providence, RI Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.

Background: Pediatric and adolescent forearm fractures are among the most common injuries treated by orthopaedic surgeons. Recent literature shows that there has been an increased interest in operative management for these injuries. The purpose of the current study was to examine the trends in case volume, patient age, surgeon fellowship training, and postoperative complications of surgically treated pediatric forearm fractures over >15-year period of American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination candidates. Read More

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Clinical management of patients with thymic epithelial tumors: the recommendations endorsed by the Italian Association of Medical Oncology (AIOM).

ESMO Open 2021 Jun 8;6(4):100188. Epub 2021 Jun 8.

Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, Istituto Europeo di Oncologia, IRCCS, Milan, Italy.

The Italian Association of Medical Oncology recommendations on thymic epithelial tumors, which have been drawn up for the first time in 2020 through an evidence-based approach, report indications on all the main aspects of clinical management of this group of rare diseases, from diagnosis and staging, to new available systemic treatments, such as targeted therapies and immunotherapies. A summary of key recommendations is presented here and complete recommendations are reported as Supplementary Materials, available at https://doi.org/10. Read More

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Consensus Statement on the Treatment of Massive Irreparable Rotator Cuff Tears - A Delphi Approach by the Neer Circle of the American Shoulder and Elbow Surgeons.

J Shoulder Elbow Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopedic Surgery, Mayo Clinic Arizona, Scottsdale, AZ, USA.

Background: Management of massive irreparable rotator cuff tears (MIRCTs) remains controversial due to variability in patient features and outcomes contributing to a lack of unanimity in treatment recommendations. The purpose of this study was to implement the Delphi process using experts from the Neer Circle of the American Shoulder and Elbow Surgeons (ASES) to determine areas of consensus regarding treatment options for a variety of MIRCTs.

Methods: A panel of 120 shoulder surgeons were sent a survey regarding MIRCT treatments including: arthroscopic débridement and partial cuff repair, graft augmentation, reverse shoulder arthroplasty (RSA), superior capsular reconstruction (SCR), and tendon transfers. Read More

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Treatment with edaravone improves the structure and functional changes in the hippocampus after chronic cerebral hypoperfusion in rat.

Brain Res Bull 2021 Jun 8. Epub 2021 Jun 8.

Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

This study aimed to find out cellular and electrophysiological effects of the edaravone (EDR) administration following induction of vascular dementia (VaD) via bilateral-carotid vessel occlusion (2VO). The rats were randomly divided into control, sham, 2VO + V (vehicle), and 2VO + EDR groups. EDR was administered once a day from day 0-28 after surgery. Read More

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"We're Moving in the Right Direction. Still a Long Way to Go": Experiences and Perceptions of the Climate for LGBTQ+ Employees at a Pediatric Hospital.

J Homosex 2021 Jun 11:1-19. Epub 2021 Jun 11.

Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.

A positive LGBTQ+ (lesbian, gay, bisexual, transgender/nonbinary, queer) workplace climate is critical for healthcare employee satisfaction, productivity, and patient care. The current study assessed LGBTQ+ workplace climate among 791 employees from a large urban pediatric hospital. Several workplace climate domains were assessed in an online survey: employee attitudes, training, experiences related to working with LGBTQ+ colleagues, patients and families, and LGBTQ+-specific experiences. Read More

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Functional Ankle Range of Motion but Not Peak Achilles Tendon Force Diminished With Heel-Rise and Jumping Tasks After Achilles Tendon Repair.

Am J Sports Med 2021 Jun 11:3635465211019436. Epub 2021 Jun 11.

Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.

Background: Deficits in sporting performance after Achilles tendon repair may be due to changes in musculotendinous unit structure, including tendon elongation and muscle fascicle shortening.

Purpose/hypothesis: The purpose was to discern whether Achilles tendon rupture reduces triceps surae muscle force generation, alters functional ankle range of motion, or both during sports-related tasks. We hypothesized that individuals who have undergone Achilles tendon repair lack the functional ankle range of motion needed to complete sports-related tasks. Read More

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Treatment of High-Energy Intra-Articular Fractures of Tibia with Ilizarov External Fixator in Adults: A Tertiary Center Experience.

Int J Clin Pract 2021 Jun 11:e14488. Epub 2021 Jun 11.

Dow University of Health Sciences, Karachi, Pakistan.

Objective: To evaluate the clinical and radiological outcomes of the Ilizarov fixator in the proximal and distal fractures of the tibia.

Materials And Methodology: This retrospective study reviewed 59 patients having high-energy intra-articular proximal and distal tibia fractures associated with severe soft-tissue injury, who were managed surgically with an Ilizarov fixator. The functional outcome was evaluated by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and the Association for the Study and Application of the Method of Ilizarov (ASAMI) Italy scoring system for tibial plateau and plafond fractures respectively. Read More

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Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized With COVID-19.

JAMA Netw Open 2021 Jun 1;4(6):e2111788. Epub 2021 Jun 1.

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor.

Importance: Venous thromboembolism (VTE) is a common complication of COVID-19. It is not well understood how hospitals have managed VTE prevention and the effect of prevention strategies on mortality.

Objective: To characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality. Read More

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