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Demographic characteristics, treatment, and outcome of patients with Kaposi sarcoma: Ten-year follow-up results of a single center.

J Cosmet Dermatol 2021 Sep 15. Epub 2021 Sep 15.

Department of Dermatology and Venereology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

Background: Clinical features, types of Kaposi sarcoma, and treatment outcomes have not been well-defined in Turkey. In this study, we reviewed records of the patients who had been diagnosed with Kaposi sarcoma in the last decade in a single center and evaluated treatment results.

Methods: Medical records of the Kaposi sarcoma patients seen in the last decade in a single tertiary center were evaluated in detail. Read More

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September 2021

Comparing Different Techniques in Children With or Without a Simultaneous Fundoplication: Does the Gastrostomy Technique Matter?

J Laparoendosc Adv Surg Tech A 2021 Sep 12;31(9):1067-1072. Epub 2021 Jul 12.

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Ondokuz Mayıs University Medical School, Samsun, Turkey.

To evaluate the results of different gastrostomy techniques and the impact of simultaneous fundoplication. The patients who underwent a gastrostomy procedure between 2009 and 2019 in a single tertiary center were evaluated retrospectively. The patients are divided into groups depending on the gastrostomy techniques as open gastrostomy (OG), laparoscopic gastrostomy (LG), percutaneous endoscopic gastrostomy (PEG), and laparoscopy-assisted PEG (LAPEG). Read More

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September 2021

Establishing Benchmarks for Antimicrobial Use in Canadian Children's Hospitals: Results From 2 National Point Prevalence Surveys.

Pediatr Infect Dis J 2021 Oct;40(10):899-905

Division of Infectious Diseases, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.

Background: Point prevalence surveys (PPS) are potentially useful to measure antimicrobial use across institutions. The objectives of the study were to describe and compare antimicrobial use between pediatric hospitals in Canada.

Methods: Fifteen pediatric hospitals all with pediatric infectious diseases service participated in 2 single-day PPS in 2018/19. Read More

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October 2021

Assessment of the Diagnostic Performance of Endoscopic Ultrasonography After Conventional Endoscopy for the Evaluation of Esophageal Squamous Cell Carcinoma Invasion Depth.

JAMA Netw Open 2021 Sep 1;4(9):e2125317. Epub 2021 Sep 1.

Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Importance: Distinguishing between mucosal and submucosal cancers is important for selecting the optimal treatment for patients with esophageal squamous cell carcinoma (ESCC); however, standard procedures for diagnosing cancer invasion depth have not yet been determined.

Objective: To evaluate the diagnostic performance of endoscopic ultrasonography (EUS) after conventional endoscopy for the evaluation of ESCC invasion depth.

Design, Setting, And Participants: This prospective single-arm confirmatory diagnostic study comprising 372 patients with T1 esophageal cancer was conducted at 41 secondary or tertiary hospitals in Japan. Read More

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September 2021

Universal features in the lifetime distribution of clusters in hydrogen-bonding liquids.

Phys Chem Chem Phys 2021 Sep 15;23(35):19537-19546. Epub 2021 Sep 15.

Sorbonne Université, Laboratoire de Physique Théorique de la Matière Condensée (UMR CNRS 7600), 4 Place Jussieu, F75252, Paris cedex 05, France.

Hydrogen-bonding liquids, typically water and alcohols, are known to form labile structures (network, chains, ); hence, the lifetime of these structures is an important microscopic parameter, which can be calculated computer simulations. Since these cluster entities are mostly statistical in nature, one would expect that, in the short-timescale regime, their lifetime distribution would be a broad Gaussian-like function of time, with a single maximum representing their mean lifetime, and be weakly dependent on criteria such as the bonding distance and angle, much similar to non-hydrogen-bonding simple liquids, while the long-timescale regime is known to have some power law dependence. Unexpectedly, all the hydrogen-bonding liquids studied herein, namely water and alcohols, display three highly hierarchical specific lifetimes, in the sub-picosecond range 0-0. Read More

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September 2021

A randomised double-blind comparison of phenylephrine and norepinephrine for the management of postspinal hypotension in pre-eclamptic patients undergoing caesarean section.

Eur J Anaesthesiol 2021 Oct;38(10):1077-1084

From the Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital (MM, LR, GTC), Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital (RA), Delhi Cancer Registry, Dr BRA IRCH, All India Institute of Medical Sciences, Delhi, India (RKM).

Background: Studies comparing phenylephrine and norepinephrine for the treatment of postspinal hypotension in pre-eclamptic patients are limited.

Objective: To compare bolus doses of phenylephrine and norepinephrine for treating hypotension in pre-eclamptic mothers undergoing caesarean section under spinal anaesthesia. It was hypothesised that norepinephrine and phenylephrine use would be associated with similar neonatal outcome. Read More

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October 2021

Incidence And Predictors Of Textbook Outcome After Simultaneous Liver And Rectal Surgeries For Stage Iv Rectal Cancer.

Colorectal Dis 2021 Sep 15. Epub 2021 Sep 15.

Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.

Aim: Textbook outcome [TO] is a new surgical quality measure that combines structure, process, and surgical outcomes into a single element. Our study aimed to determine the incidence of TO after simultaneous rectal and liver surgery and to use the achievement of TO as a tool to identify the best candidates for these complex procedures.

Methods: In total, 256 patients who underwent simultaneous liver and rectal surgery for stage IV rectal cancer between January 2004 and August 2019 at five tertiary centers were enrolled. Read More

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September 2021

Onset and progression of puberty in Klinefelter syndrome.

Clin Endocrinol (Oxf) 2021 Sep 14. Epub 2021 Sep 14.

New Children's Hospital, Pediatric Research Center, Helsinki University Hospital, Helsinki, Finland.

Objective: Klinefelter syndrome (KS) (47,XXY and variants, KS) is the most common sex chromosome disorder in humans. However, little is known about the onset and progression of puberty in patients with KS. In this study, we describe the onset and progression of puberty in a large series of boys with KS in a single tertiary centre. Read More

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September 2021

Antibiotic prescribing practices in general surgery: a mixed methods quality improvement project.

Infect Prev Pract 2021 Sep 20;3(3):100166. Epub 2021 Aug 20.

Imperial College Healthcare NHS Trust, London, UK.

Background: A single pre-operative antibiotic dose provides optimal prophylaxis against surgical site infection (SSI), but significant variability persists in adherence to prophylaxis guidelines. We describe a quality improvement project aiming to improve guideline-driven antibiotic prescribing within surgical teams at a tertiary hospital.

Methods: Face-to-face interviews with surgical teams and anonymous surveys of senior surgeons and anaesthetists were used to collect qualitative data on the perceptions and attitudes of prescribers. Read More

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September 2021

Gonadotropin releasing hormone analogue treatment of central precocious puberty is not associated with altered prevalence of polycystic ovary syndrome: a single center cohort study.

Clin Diabetes Endocrinol 2021 Sep 15;7(1):14. Epub 2021 Sep 15.

Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, 91120, PO Box 12000, Jerusalem, Israel.

Background: There is conflicting evidence regarding an association between gonadotropin releasing hormone analogue (GnRHa) therapy and polycystic ovary syndrome (PCOS). This study aimed to compare the prevalence of endocrine disorders, primarily PCOS, between women who had been treated with GnRHa for central precocious puberty (CPP) and those who were not treated.

Methods: This was a retrospective cohort study, including women diagnosed with central precocious puberty between 1989 and 2011 in a university affiliated tertiary medical center. Read More

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September 2021

Perioperative outcomes for patients on chronic buprenorphine undergoing spine surgery: A case series.

J Opioid Manag 2021 ;17(7):171-177

Department of Anesthesia and Perioperative Care, University of California, San Francisco.

Objective: Pain management following spine surgery can be challenging as patients routinely suffer from chronic pain and opioid tolerance. The increasing popularity of buprenorphine use for pain management in this population may further complicate perioperative pain management due to the limited efficacy of other opioids in the presence of buprenorphine. This study describes perioperative management and outcomes in patients on chronic buprenorphine who underwent elective inpatient spine surgery. Read More

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January 2021

An approach to giant neonatal hydrocolpos with normally sited anus - Diagnosis and management including a novel one stage operation.

J Pediatr Urol 2021 Aug 8. Epub 2021 Aug 8.

Department of Paediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamilnadu, India.

Introduction: Giant non cloacal neonatal hydrocolpos is a rare entity where early recognition of the underlying cause and drainage of the distended vagina is paramount. Conventionally, immediate management has been by abdominal tube vaginostomy or, in urogenital sinus by vaginal clean intermittent catheterisation (CIC). Though effective in providing temporary relief, the abdominal tube vaginostomy is replete with complications, making it imperative to search for alternatives. Read More

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Rotational Thromboelastometry-Guided Transfusion Protocol to Reduce Allogeneic Blood Transfusion in Proximal Aortic Surgery With Deep Hypothermic Circulatory Arrest.

J Cardiothorac Vasc Anesth 2021 Aug 19. Epub 2021 Aug 19.

Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address:

Objectives: To determine the impact of a rotational thromboelastometry (ROTEM)-guided transfusion protocol on the use of blood products, patient outcomes, coagulation factor concentrates, and costs.

Design: A single-center retrospective cohort study.

Setting: A tertiary university hospital. Read More

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Evaluation of Patients with Rheumatic Diseases Admitted at Emergency Department: Five-Year Analysis in a Single Center.

Int J Clin Pract 2021 Sep 13:e14837. Epub 2021 Sep 13.

Department of Emergency Medicine, School of Medicine, Düzce University, Düzce, Turkey.

Background: Chronic inflammatory diseases can lead to emergency admissions with various acute complications.Unfortunately,there is limited data on emergency admissions due to rheumatologic diseases.

Objectives: To evaluate the patients with rheumatic diseases presenting to the ED. Read More

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September 2021

Why are neurosurgeons sued? A single-center, half-decade review.

Br J Neurosurg 2021 Sep 11:1-4. Epub 2021 Sep 11.

Department of Neurosurgery, Atkinson Morley Wing, St George's Hospital, London, UK.

The burden of medicolegal claims in neurosurgery is increasing in the UK. Trepidation associated with malpractice claims has the potential to negatively impact surgical practice and patient safety. What are the causes of these claims and can we address them? The aim of this study was to identify the incidence and total burden of litigation claims related to neurosurgery in a London tertiary center. Read More

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September 2021

Does Early Secondary Alveolar Bone Grafting Influence Need for Additional Maxillary Advancement Procedures in Cleft Lip and Palate?

Cleft Palate Craniofac J 2021 Sep 13:10556656211042789. Epub 2021 Sep 13.

School of Dentistry, 83488University of Alabama at Birmingham, Birmingham, AL, USA.

Objective: To determine if secondary alveolar bone grafting (SABG) timing in patients with cleft lip and palate (CLP) influences the future need for additional maxillary advancement procedures, particularly Le Fort I osteotomy with rigid external distraction (RED).

Design: Retrospective cohort study. Groups were separated by SABG timing: early mixed dentition (ages 68 years) or late mixed dentition (ages 9-11 years). Read More

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September 2021

Reduction in post-operative pancreatic fistula with polyethylene glycol and recombinant human albumin sealant following stapled distal pancreatectomy.

ANZ J Surg 2021 Sep 13. Epub 2021 Sep 13.

The University of Melbourne Department of Surgery, Austin Health, Heidelberg, Victoria, Australia.

Background: Postoperative pancreatic fistula (POPF) remains a significant cause of morbidity in patients undergoing distal pancreatectomy (DP). The use of polyethylene glycol (PEG) and recombinant human albumin sealant gel applied to the transected pancreatic margin in DP may reduce POPF rates and was assessed.

Methods: A retrospective single centre cohort study of patient undergoing DP at an Australian high volume tertiary institution between January 2015 and January 2021. Read More

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September 2021

Clinical Characteristics, Management, and Outcomes of Cancer Patients With Coronavirus Disease 2019 Admitted to the ICU.

Crit Care Explor 2021 Sep 7;3(9):e0535. Epub 2021 Sep 7.

All authors: Critical Care Center, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

Adult patients with cancer have a greater likelihood of developing severe illness and death from coronavirus disease 2019 compared with patients without cancer. We sought to characterize the clinical characteristics and outcomes of cancer patients who tested positive for severe acute respiratory syndrome coronavirus 2 and were admitted to the ICU at the peak of the first wave of the pandemic in the United States.

Design: A single-center retrospective cohort study. Read More

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September 2021

Argatroban for Anticoagulation in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019.

Crit Care Explor 2021 Sep 7;3(9):e0530. Epub 2021 Sep 7.

Trauma & Critical Care Service, Department of Surgery, Brooke Army Medical Center, San Antonio, TX.

A significant proportion of patients with coronavirus disease 2019 requiring venovenous extracorporeal membrane oxygenation at our institution demonstrated heparin resistance, which in combination with a heparin shortage resulted in the transition to argatroban with or without aspirin as an alternative anticoagulation strategy. The optimal anticoagulation strategy for coronavirus disease 2019 patients requiring venovenous extracorporeal membrane oxygenation is unknown, and therefore, we sought to evaluate the efficacy and safety of argatroban with or without aspirin as an alternative anticoagulation strategy in this patient population.

Design: Retrospective cohort. Read More

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September 2021

Surgical Experience in Prevention of Postoperative CSF Leaks Using Abdominal Fat Grafts in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenomas.

J Neurol Surg B Skull Base 2021 Oct 20;82(5):522-527. Epub 2020 Aug 20.

Department of Neurosurgery, The Catholic University of Korea, Seoul St. Mary's Hospital, College of Medicine, Seoul, Republic of Korea.

 Cerebrospinal fluid (CSF) leaks are the most common complication during endonasal endoscopic transsphenoidal approach (EETSA) and prevention of postoperative CSF leaks is critical. In this study, we report a single surgeon's experience of sellar floor reconstruction using abdominal fat grafts for prevention of postoperative CSF leaks in EETSA for pituitary adenomas.  This study is presented as case series with retrospective chart review. Read More

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October 2021

Risk Factors of Biochemical Failure in Locally Advanced Carcinoma Prostate Treated With Definitive External Beam Radiotherapy and Androgen Deprivation Therapy: Experience From Tertiary Care Center in North India.

Cureus 2021 Aug 4;13(8):e16895. Epub 2021 Aug 4.

Oncology, Dayanand Medical College & Hospital (DMCH), Ludhiana, IND.

Background Locally advanced prostate cancer (LACAP), despite external beam radiotherapy (EBRT) along with antiandrogen therapy (ADT) has risk of prostate-specific antigen (PSA) progression. Furthermore, number of studies have emphasized on different prognostic factors. The purpose of our study is to analyze risk factors for biochemical failure (BF) in these patients treated at our institute. Read More

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Single-cell profiling of infiltrating B cells and tertiary lymphoid structures in the TME of gastric adenocarcinomas.

Oncoimmunology 2021 6;10(1):1969767. Epub 2021 Sep 6.

Department of Pharmaceutical Engineering, School of Engineering, China Pharmaceutical University, Nanjing, China.

The occurrence and development of gastric adenocarcinoma (gADC) is closely related to the interaction between tumor cells and immune cells in the tumor microenvironment (TME). Our objective was to characterize the repertoire of immune cells in the TME of gADC. To analyze the transcriptomic, immune, and spatial information of TME in gADC, we constructed single-cell RNA sequencing, 10 × Genomics V(D)J analysis, multiple immunofluorescence techniques, and OSCmap analysis of 49,765 single cells in seven samples from four gADC patients. Read More

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September 2021

Clinical Outcomes and Prevalence of Intravascular Ultrasound Use at a Tertiary Care Hospital in a South Asian Country.

J Clin Imaging Sci 2021 9;11:42. Epub 2021 Aug 9.

Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan.

Objectives: Intravascular ultrasound (IVUS) plays a pivotal role in the current era of coronary interventions. We aimed to determine the prevalence of IVUS use and clinical outcomes of IVUS-guided percutaneous treatment of coronary arteries lesions in a South Asian country.

Material And Methods: It is a retrospective observational study, a total of 134 consecutive patients having done IVUS, was enrolled from January 2013 to March 2020 at a single center. Read More

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Traumatic acute subdural hematoma and coma: retrospective cohort of surgically treated patients.

Surg Neurol Int 2021 24;12:424. Epub 2021 Aug 24.

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Sao Paulo, Brazil.

Background: A subdural hematoma is defined as clot formation in the subdural space after vessel rupture or brain parenchyma damage. Several demographic and tomographic factors were associated to poor prognosis, although some debate according to their specific roles still remains.

Methods: Retrospective cohort study of comatose patients admitted to a single-institution, tertiary hospital center, between the years 2013 and 2019 with traumatic acute subdural hematoma requiring surgical evacuation were studied. Read More

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Impact of COVID-19 on presentation, management, and outcomes of acute care surgery for gallbladder disease and acute appendicitis.

World J Gastrointest Surg 2021 Aug;13(8):859-870

Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, United States.

Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted both elective and acute medical care. Data from the early months suggest that acute care patient populations deferred presenting to the emergency department (ED), portending more severe disease at the time of presentation. Additionally, care for this patient population trended towards initial non-operative management. Read More

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Two-point compression ultrasonography: Enough to rule out lower extremity deep venous thrombosis?

World J Emerg Med 2021 ;12(4):268-273

Department of Emergency Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.

Background: Deep venous thrombosis (DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department (ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT. Read More

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January 2021

Challenges to Early Discharge of Patients with Upper Urinary Tract Infections by ESBL Producers: TMP/SMX as a Step-Down Therapy for Shorter Hospitalization and Lower Costs.

Infect Drug Resist 2021 2;14:3589-3597. Epub 2021 Sep 2.

Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Background: Urinary tract infections (UTIs) caused by extended spectrum beta-lactamase (ESBL) producing pathogens have increased and are treated with carbapenem in general. Carbapenem use is associated with prolonged hospitalization or daily outpatient visit. The aim of this study was to investigate patients with UTIs by ESBL-producing pathogens for early discharge using an old oral antibiotic, trimethoprim-sulfamethoxazole (TMP-SMX), which is susceptible to ESBL-producing pathogens. Read More

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September 2021

Knowledge, Attitude and Practice of Sudanese Health Care Providers toward Ebola Virus Outbreak.

Acta Med Okayama 2021 Aug;75(4):487-493

Department of Microbiology and Parasitology, Faculty of Medicine, University of Khartoum.

Ebola virus disease (EVD) is a highly contagious and fatal disease in humans. Healthcare providers (HCPs) are often at the frontline of epidemics and can thus be in jeopardy of contracting EVD. Sudan is at a great risk of an EVD outbreak, as it borders countries that experienced EVD outbreaks. Read More

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Developmental dysplasia of the hip: Beyond the screening. Physical exam is our pending subject.

An Pediatr (Engl Ed) 2021 Sep 10. Epub 2021 Sep 10.

Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.

Introduction: Developmental dysplasia of the hip is a common cause of disability among children. Early detection leads to better prognosis. There are some risk factors that increase the possibility of developing a dysplasia. Read More

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September 2021

The risk factors of polymicrobial periprosthetic joint infection: a single-center retrospective cohort study.

BMC Musculoskelet Disord 2021 Sep 12;22(1):780. Epub 2021 Sep 12.

Department of Orthopedic Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, People's Republic of China.

Background: Periprosthetic joint infection is a serious complication after total joint arthroplasty and polymicrobial PJI which compose a subtype of PJI often indicate worse outcomes compared to monomicrobial periprosthetic joint infection. However, a literature review suggested that there were limited number studies evaluating the risk factors of polymicrobial PJI.

Materials And Methods: Between 2015 January and 2019 December, a total of 64 polymicrobial PJI patients and 158 monomicrobial PJI patients in a tertiary center were included in this study and corresponding medical records were scrutinized. Read More

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September 2021