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Endoscopic Management of Staple Line Leak after Bariatric Surgery: Surgeon's Perspective.

Clin Endosc 2021 May 12. Epub 2021 May 12.

Bariatric and Metabolic Surgery Center, H+ Yangji Hospital, Seoul, Korea.

Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early 2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverse event and occurs in approximately 1%-6% of patients. Read More

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Unicommissural Unicuspid Aortic Valve, Ascending Aortic Aneurysm, and Bovine Arch: A Rare Case Report.

World J Pediatr Congenit Heart Surg 2021 May 6:2150135120965201. Epub 2021 May 6.

Banner University Medical Center, Phoenix, AZ, USA.

A 24-year-old man presented with rapidly progressive dyspnea due to mixed aortic stenosis and insufficiency. Unicommissural unicuspid aortic valve, ascending aortic aneurysm, and a bovine arch were identified on computed tomography angiography. Uncomplicated surgical mechanical valve replacement and ascending aortic graft placement improved his symptoms. Read More

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Using Waterless Alcohol-based Antiseptic for Skin Preparation and Active Thermal Support in Laboratory Rats.

J Am Assoc Lab Anim Sci 2021 May 4. Epub 2021 May 4.

Rodents are frequently used for models that require surgical procedures. At our institution, laboratory rats are increasingly preferred for investigations of neurologic disorders, cardiovascular interventions, and assessment and treatment of addictive and depressive behaviors. For these types of studies, surgical preparations of the head and neck areas are necessary for catheterization and instrumentation. Read More

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Sensor-Embedded Automatic Grasping Forceps for Precise Corneal Suture in Penetrating Keratoplasty.

Micromachines (Basel) 2021 Apr 23;12(5). Epub 2021 Apr 23.

Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 37673, Korea.

In penetrating keratoplasty (PKP), the proper corneal suture placement is very important for successful transplantation and restoring functional vision. Generating sutures with accurate depth is difficult for the surgeon because of the tissue's softness, lack of depth information, and hand tremors. In this paper, an automatic cornea grasping device is proposed, which detects when the device reaches the target suture depth. Read More

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Identification of intracranial hemorrhage progression by transcranial point-of-care ultrasound in a patient with prior hemicraniectomy: a case report.

J Ultrasound 2021 Apr 28. Epub 2021 Apr 28.

Department of Emergency Medicine, Medical University of South Carolina, 169 Ashley Avenue, MSC 300, Charleston, SC, 29425, USA.

Transcranial ultrasound has been described as a tool to identify intracranial pathology, however, it is seldom used in the adult patient population due to poor imaging windows and rapid availability of more advanced imaging such as CT and MRI. We report a unique population in which transcranial ultrasound may be beneficial: those with a history of hemicraniectomy. We present a case of a 65-year-old male with a history of hemicraniectomy who suffered head trauma after a fall from his wheelchair. Read More

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Students' Perspectives on Learning Practical Nursing Skills: A Focus Group Study in Norway.

Nurs Res Pract 2021 9;2021:8870394. Epub 2021 Apr 9.

Department of Health and Welfare, Ostfold University College, Postal Box Code 700, 1757 Halden, Norway.

Practical nursing skills are complex and involve technical, theoretical, and practical aspects, caring perspectives adjusted to both patient and circumstances, as well as ethical and moral considerations. Patients' length of stay in hospitals is decreasing, and more advanced patient treatment is conducted in primary healthcare settings. Hence, education and nursing skills need adjustment in line with the rapidly evolving field of practice. Read More

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Life and Limb: Current Concepts in Endovascular Treatment of Extremity Trauma.

Semin Intervent Radiol 2021 Mar 15;38(1):64-74. Epub 2021 Apr 15.

Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington.

Traumatic injury is the leading cause of death worldwide in younger patient populations and extremity trauma with associated vascular injury accounts for many trauma-related deaths. Iatrogenic injury is also a common cause of extremity vascular trauma and the incidence of iatrogenic injury will likely increase as endovascular techniques continue to become more ubiquitous. For many vascular injuries involving the extremities, surgical repair is viewed as the standard of care. Read More

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[Current robotic ventral hernia surgery exemplified by 50 consecutive patients].

Chirurg 2021 Apr 19. Epub 2021 Apr 19.

Abteilung für Allgemein‑, Viszeral‑, Thorax- und Kinderchirurgie, Klinikum Kempten, Klinikverbund Allgäu, Robert-Weixler-Str. 50, 87439, Kempten, Deutschland.

Background: In recent years there has been a rise in robotic techniques and approaches regarding hernia repair with extraperitoneal mesh placement.

Methods: A retrospective analysis of the first 50 patients who underwent robotic ventral hernia repair between May 2019 and November 2020 at the department of general surgery of the Kempten Clinic was performed.

Results: This case series consisted of 36 incisional hernias, 12 primary hernias (8 umbilical and 3 epigastric hernias in combination with a diastasis recti abdominis as well as 1 Spigelian hernia) and 2 parastomal hernias. Read More

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Cannulation of the popliteal vein as an intraoperative emergency access in prone position: A case report.

J Vasc Access 2021 Apr 8:11297298211008091. Epub 2021 Apr 8.

Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany.

Many surgeries have to be performed in the prone position. Access to central vessels is very limited in this position. This requires forward planning with regard to the placement of a central venous catheter. Read More

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Augmented and virtual reality in spine surgery, current applications and future potentials.

Spine J 2021 Mar 25. Epub 2021 Mar 25.

Spine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA; Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.

Background Context: The field of Artificial Intelligence (AI) is rapidly advancing, especially with recent improvements in deep learning (DL) techniques. Augmented (AR) and virtual reality (VR) are finding their place in healthcare, and spine surgery is no exception. The unique capabilities and advantages of AR and VR devices include their low cost, flexible integration with other technologies, user-friendly features and their application in navigation systems, which makes them beneficial across different aspects of spine surgery. Read More

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Histiocytic Sarcoma Arising From a Long Bone: Report of Two Cases.

Int J Surg Pathol 2021 Mar 22:1066896921996464. Epub 2021 Mar 22.

6923University of Rochester Medical Center, Rochester, USA.

Histiocytic sarcoma is a rare, but aggressive malignant neoplasm of monocyte/macrophage lineage with a wide age distribution. Bone involvement is exceedingly rarer compared to the lymph node, skin, and soft tissue, and no long bone involvement has been reported in the English literature. We here report 2 cases of histiocytic sarcoma involving the long bone: one from the femur of a 77-year-old female, status post the placement of an intramedullary nail for subtrochanteric hip fracture; the other from the radius of a 3-year-old female with no significant medical history. Read More

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A rare cause of cervicomediastinal cellulitis: Oesophageal perforation case report.

Ann Med Surg (Lond) 2021 Apr 8;64:102195. Epub 2021 Mar 8.

Department of Otolaryngology, Head and Neck Surgery, 20 August 1953 Hospital, Casablanca, Morocco.

Esophageal perforation following an impacted foreign body (FB) is a rare and potentially life-threatening condition. Early clinical suspicion and imaging are important for a targeted management to achieve a good outcome. Endoscopic extraction of esophageal FB is a good and safe treatment alternative while the surgical procedure remains a necessary option for many patients. Read More

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Unusual Presentation of a Rapidly Progressive Coronary Artery Pseudoaneurysm after Drug Eluting Stent Placement.

Cureus 2021 Feb 12;13(2):e13305. Epub 2021 Feb 12.

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, IND.

Infected coronary artery aneurysm (CAA) is a rare complication of percutaneous coronary intervention (PCI) and is associated with high morbidity and mortality. The management of infected CAA is unclear and is based on the clinical and imaging features. We report an interesting case of a giant infected right CAA secondary to Pseudomonas aeruginosa within four weeks of a drug eluting stent (DES) implantation. Read More

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February 2021

Diuretic-Resistant Ascites Following Laparoscopic Surgery in a Patient With Chronic Myeloid Leukemia on Imatinib Therapy.

Cureus 2021 Feb 4;13(2):e13127. Epub 2021 Feb 4.

Internal Medicine, Sismanoglio-A. Fleming General Hospital, Athens, GRC.

Imatinib mesylate is a tyrosine kinase inhibitor with high efficacy in the treatment of chronic myeloid leukemia (CML). Although fluid retention is a common adverse effect of imatinib, it rarely necessitates discontinuation of therapy. Isolated ascites has not been reported as a complication of imatinib therapy in patients with CML. Read More

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February 2021

Nucleation and growth dynamics of graphene grown by radio frequency plasma-enhanced chemical vapor deposition.

Sci Rep 2021 Mar 16;11(1):6007. Epub 2021 Mar 16.

Key Laboratory of Advanced Corrosion and Protection for Aviation Materials, Beijing Institute of Aeronautical Materials, Aero Engine Corporation of China, Beijing, 10095, China.

We investigated the nucleation and grain growth of graphene grown on Cu through radio frequency plasma-enhanced chemical vapor deposition (RF-PECVD) at different temperatures. A reasonable shielding method for the placement of copper was employed to achieve graphene by RF-PECVD. The nucleation and growth of graphene grains during PECVD were strongly temperature dependent. Read More

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Recurrent thrombosis of an arteriovenous fistula as a complication of COVID-19 in a chronic hemodialysis patient: A case report.

J Vasc Access 2021 Mar 16:11297298211000881. Epub 2021 Mar 16.

Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.

Patients with end-stage kidney disease are at increased risk of death from coronavirus disease 2019 (COVID-19). In addition, severe COVID-19 has been associated with an increased risk of arterial and venous thromboses. In this report, we describe the case of a hemodialysis patient who developed an otherwise-unexplained thrombosis of an arteriovenous fistula during a symptomatic COVID-19 infection. Read More

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Circumferential esophageal perforation resulting in tension hydropneumothorax in a patient with septic shock.

Acute Crit Care 2021 Mar 11. Epub 2021 Mar 11.

Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.

Esophageal perforations occur traumatically or spontaneously and are typically associated with high mortality rates. Early recognition and prompt management are essential. We present the case of a 76-year-old man who was admitted to the medical intensive care unit with fulminant Clostridium difficile colitis, shock, and multi-organ failure. Read More

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Modeling Tool for Rapid Virtual Planning of the Intracardiac Baffle in Double Outlet Right Ventricle.

Ann Thorac Surg 2021 Mar 6. Epub 2021 Mar 6.

Children's Hospital of Philadelphia, Department of Anesthesia and Critical Care, Philadelphia, PA; Children's Hospital of Philadelphia, Division of Pediatric Cardiology, Philadelphia, PA. Electronic address:

Purpose: Biventricular repair of double outlet right ventricle (DORV) necessitates the creation of a complex intracardiac baffle. Creation of the optimal baffle design and placement thereof can be challenging to conceptualize, even with 2-dimensional and 3-dimensional images. We describe a newly developed methodology for creating virtual baffles to inform intraoperative repair. Read More

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Line days as a determinant of central line-associated bloodstream infections in pediatric patients with tunneled femoral peripherally inserted central catheters.

Pediatr Radiol 2021 Mar 6. Epub 2021 Mar 6.

Division of Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.

Background: Ultrasound (US)-guided tunneled femoral peripherally inserted central catheters (PICCs) are a safe central venous access option in infants and neonates. Studies have shown, however, that femoral central venous access has the potential for high central line-associated bloodstream infection (CLABSI) rates with a significant increase in risk around line day 30, though no studies have evaluated these risks exclusively for tunneled femoral PICCs.

Objective: The primary purpose of this study was to evaluate the relationship between line duration and the risk of CLABSI in tunneled femoral PICCs in children. Read More

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PF-3845, a Fatty Acid Amide Hydrolase Inhibitor, Directly Suppresses Osteoclastogenesis through ERK and NF-κB Pathways In Vitro and Alveolar Bone Loss In Vivo.

Int J Mol Sci 2021 Feb 15;22(4). Epub 2021 Feb 15.

Department of Oral Pathology and Regenerative Medicine, School of Dentistry, IHBR, Kyungpook National University, Daegu 41940, Korea.

Alveolar bone loss, the major feature of periodontitis, results from the activation of osteoclasts, which can consequently cause teeth to become loose and fall out; the development of drugs capable of suppressing excessive osteoclast differentiation and function is beneficial for periodontal disease patients. Given the difficulties associated with drug discovery, drug repurposing is an efficient approach for identifying alternative uses of commercially available compounds. Here, we examined the effects of PF-3845, a selective fatty acid amide hydrolase (FAAH) inhibitor, on receptor activator of nuclear factor kappa B ligand (RANKL)-mediated osteoclastogenesis, its function, and the therapeutic potential for the treatment of alveolar bone destruction in experimental periodontitis. Read More

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February 2021

Humanized Anti-DNABII Fab Fragments Plus Ofloxacin Eradicated Biofilms in Experimental Otitis Media.

Laryngoscope 2021 Mar 5. Epub 2021 Mar 5.

Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.

Objectives/hypothesis: To evaluate the ability of humanized monoclonal antibody fragments directed against a bacterial DNABII protein plus ofloxacin delivered directly into the chinchilla middle ear via tympanostomy tube (TT) to enhance the ability of ofloxacin to eradicate biofilms formed by nontypeable Haemophilus influenzae (NTHI).

Study Design: A blinded pre-clinical study of comparative efficacy of single versus combinatorial treatment strategies.

Methods: NTHI was allowed to form biofilms in the middle ears of chinchillas prior to TT placement. Read More

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Transitioning Child Health Clinical Content From Direct Care to Online Instruction.

J Nurs Educ 2021 Mar;60(3):177-179

Background: The global pandemic of 2020 forced preli-censure nursing degree programs to rapidly reevaluate clinical teaching methodologies. To maintain high educational standards with minimal anxiety and disruption for students, a child health teaching team developed an innovative revised plan for facilitation of clinical experiences within the virtual learning environment.

Method: Experienced faculty employed a series of clinical learning activities in the online environment using existing virtual simulations, along with new innovations including a digital escape room, unfolding case studies, and blended prioritization simulations. Read More

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Distant large acute epidural hematoma after closed cerebrospinal fluid tapping through the anterior fontanelle: A case report and its pathogenesis.

Surg Neurol Int 2021 17;12:59. Epub 2021 Feb 17.

Department of Neurosurgery, Cairo University, Cairo, Egypt.

Background: Cerebrospinal fluid (CSF) infection is one of the most common and serious complications of shunt placement. The CSF shunt infections are preferably treated with intravenous antibiotics, infected shunt removal, repeated tapping (infants) or placement of an external ventricular drainage (EVD) device, and placement of a new shunt once the CSF is sterile. The tapping through the anterior fontanelle is commonly used instead of the EVD in developing countries to manage CSF infection in open anterior fontanelle patients. Read More

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February 2021

DEBISim: A simulation pipeline for dual energy CT-based baggage inspection systems1.

J Xray Sci Technol 2021 ;29(2):259-285

School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA.

Background: Materials characterization made possible by dual energy CT (DECT) scanners is expected to considerably improve automatic detection of hazardous objects in checked and carry-on luggage at our airports. Training a computer to identify the hazardous items from DECT scans however implies training on a baggage dataset that can represent all the possible ways a threat item can packed inside a bag. Practically, however, generating such data is made challenging by the logistics (and the permissions) related to the handling of the hazardous materials. Read More

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January 2021

Use of Point-of-Care Ultrasound to Confirm Central Venous Catheter Placement and Evaluate for Postprocedural Complications.

J Emerg Med 2021 Feb 24. Epub 2021 Feb 24.

San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.

Background: Central venous catheter (CVC) placement is commonly performed in the emergency department (ED), but traditional confirmation of placement includes chest radiograph.

Objective: This manuscript details the use of point-of-care ultrasound (POCUS) to confirm placement of a CVC and evaluate for postprocedural complications.

Discussion: CVC access in the ED setting is an important procedure. Read More

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February 2021

Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences?

Digit Health 2021 Jan-Dec;7:2055207620985396. Epub 2021 Feb 11.

Department of Psychology, University of Bath, Bath, UK.

Objectives: Digital practice in psychological services is a rapidly expanding and innovative area which is supporting continuation of clinical provision during the COVID-19 pandemic. Training the workforce to deliver safe and effective online psychological provision is key to service success and relies on accurate mapping of competences and current training needs. This paper discusses the initial stage for developing the first digital mental health competence framework for applied psychology in the UK. Read More

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February 2021

Ultrasonography-guided post-pyloric feeding tube insertion in medical intensive care unit patients.

J Clin Monit Comput 2021 Feb 18. Epub 2021 Feb 18.

Division of Critical Care Medicine, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.

In this study, we investigated placement rate, complication rate and time spent of successful post-pyloric enteral feeding (PPEF) tube insertion procedure guided by ultrasonography (USG). The patients who required enteral nutrition and who admitted to medical intensive care unit (MICU) of Gazi University Hospital were included to this single-center, prospective, cohort study. It was aimed to insert the enteral feeding tube into the proximal duodenum as the post-pyloric area by ultrasonography guidance. Read More

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February 2021

Benchtop plasma treatment of titanium surfaces enhances cell response.

Dent Mater 2021 04 13;37(4):690-700. Epub 2021 Feb 13.

Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA; Department of Periodontology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. Electronic address:

Objective: Modifications to implant surface properties, including topography, chemistry, and wettability, alter immune response, osteoblast differentiation of bone marrow stromal cells (MSCs), and implant integration in vivo. Dielectric barrier discharge (DBD) plasma treatment has been used to sterilize surfaces and remove adsorbed carbon, improving wettability. However, unless it is used immediately prior to placement, ambient atmospheric hydrocarbons rapidly adhere to the surface, thereby reducing its hydrophilicity. Read More

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Speed of electroconvulsive therapy for depression: Effects of electrode placement.

Acta Psychiatr Scand 2021 May 18;143(5):444-452. Epub 2021 Feb 18.

Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland.

Objective: Electroconvulsive therapy (ECT) is a rapidly effective treatment for severe depression. Treatment with right unilateral (RUL) or bitemporal (BT) ECT may explain individual differences in speed of ECT effectiveness. There is limited evidence for demographic and clinical factors that predict speed of response and remission with ECT. Read More

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Stent placement combined with intraluminal radiofrequency ablation and hepatic arterial infusion chemotherapy for advanced biliary tract cancers with biliary obstruction: a multicentre, retrospective, controlled study.

Eur Radiol 2021 Feb 13. Epub 2021 Feb 13.

Department of Interventional Therapy, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, 106 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China.

Objective: To evaluate the efficacy and safety of stent placement combined with intraluminal radiofrequency ablation (intra-RFA) and hepatic arterial infusion chemotherapy (HAIC) for patients with advanced biliary tract cancers (Ad-BTCs) and biliary obstruction (BO).

Methods: We retrospectively reviewed data for patients with Ad-BTCs and BO who underwent stent placement with or without intra-RFA and HAIC in three centres between November 2013 and November 2018. The stent patency time (SPT), overall survival (OS), and adverse events (AEs) were analysed. Read More

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February 2021