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Prevalence of sarcopenic obesity and association with metabolic syndrome in an adult Iranian cohort: The Fasa PERSIAN cohort study.

Clin Obes 2021 May 4:e12459. Epub 2021 May 4.

Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Sarcopenic obesity (SO) is characterised by a concomitant high fat mass (FM) and low fat free mass (FFM) leading to an increased cardio-metabolic risk. This analysis aims to estimate the SO prevalence in Iranian adults and evaluate the association of SO with metabolic syndrome (MetS) risk. This cross-sectional analysis included 4296 subjects (age 35-70 years, 55. Read More

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Single-Dose del Nido Cardioplegia Compared With Standard Cardioplegia During Coronary Artery Bypass Grafting at a Veterans Affairs Hospital.

Tex Heart Inst J 2021 Jan;48(1)

Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas.

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85. Read More

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January 2021

Evaluating Quality in Adult Cardiac Surgery.

Tex Heart Inst J 2021 Jan;48(1)

Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah.

National and institutional quality initiatives provide benchmarks for evaluating the effectiveness of medical care. However, the dramatic growth in the number and type of medical and organizational quality-improvement standards creates a challenge to identify and understand those that most accurately determine quality in cardiac surgery. It is important that surgeons have knowledge and insight into valid, useful indicators for comparison and improvement. Read More

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January 2021

Mitral Surgery after Transcatheter Edge-to-Edge Repair: Society of Thoracic Surgeons Database Analysis.

J Am Coll Cardiol 2021 Apr 27. Epub 2021 Apr 27.

Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Transcatheter edge-to-edge (TEER) mitral repair may be complicated by residual or recurrent mitral regurgitation. Increasing need for surgical reintervention has been reported but operative outcomes are ill-defined.

Objectives: This study evaluated national outcomes of mitral surgery after TEER. Read More

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Cardiac Surgery Outcomes: A Case for Increased Screening and Treatment of Obstructive Sleep Apnea.

Ann Thorac Surg 2021 May 1. Epub 2021 May 1.

Department of Surgery, Section of Cardiac Surgery, University of Vermont Medical Center, Burlington, VT.

Background: Due to the limited published information on complications that obstructive sleep apnea (OSA) patients experience during and after cardiac surgery, we are investigating OSA as a risk factor for post-operative outcomes.

Methods: This project utilized the Northern New England Cardiovascular Disease Study Group's data collected between 2011 and 2017 based on the Society of Thoracic Surgeons Adult Cardiac Surgery Database Data Collections form. A retrospective analysis of 1,555 patients with OSA and 10,450 patients without OSA, across 5 medical centers undergoing isolated CABG, isolated valve, combined CABG valve surgery was conducted. Read More

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A prospective observational study of preoperative natriuretic peptide testing in adult non-cardiac surgical patients in hospitals in Western Cape Province, South Africa.

S Afr Med J 2021 03 31;111(4):338-342. Epub 2021 Mar 31.

Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

Background: International guidelines recommend risk stratification to identify high-risk non-cardiac surgical patients. It is also recommended that all patients aged ≥45 years with significant cardiovascular disease should have preoperative natriuretic peptide (NP) testing. Abnormal preoperative B-type NPs have a strong association with postoperative cardiac complications. Read More

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Tricuspid valve in congenital heart disease: multimodality imaging and electrophysiological considerations.

Minerva Cardiol Angiol 2021 May 4. Epub 2021 May 4.

Department of Women's and Children's Health, University of Padua, Padua, Italy -

The tricuspid valve (TV) has been neglected for many years. Only recently, new studies demonstrated the prognostic role of the tricuspid valve lesions. In addition to that, new interventional approaches offer the possibility to non-invasively treat tricuspid valve disease. Read More

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Surveillance Cultures and Infection in 230 Pacemaker and Defibrillator Generator Changes in Pediatric and Adult Congenital Patients.

World J Pediatr Congenit Heart Surg 2021 May;12(3):331-336

Section of Pediatric Cardiovascular Surgery, Cincinnati Children's, 177468UK HealthCare Kentucky Children's Hospital, Lexington, KY, USA.

Background: Postoperative infections can occur during surgical replacement of pulse generators for pacemakers and implantable cardioverter-defibrillators. The incidence of infection is poorly documented in children and patients with adult congenital heart disease. The utility of surveillance cultures obtained from device pocket swabs is unknown in this group. Read More

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Current Management of Anomalous Aortic Origin of a Coronary Artery: A Pan-Canadian Survey.

World J Pediatr Congenit Heart Surg 2021 May;12(3):387-393

Faculty of Medicine, 5620McGill University, Montreal, Canada.

Background: Anomalous aortic origin of a coronary artery (AAOCA) is a significant cause of sudden cardiac death (SCD) in children and adolescents. The natural history of AAOCA and the pathophysiology of AAOCA-related SCD are poorly understood. Therefore, the evaluation and management of AAOCA remain controversial. Read More

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Two cases of tuberculous retropharyngeal abscess in adults.

Xiaofeng Xu Xue Hu

J Int Med Res 2021 May;49(5):3000605211011972

Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Integrated Traditional and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China. Currently working in Hangzhou Occupational Disease Prevention Hospital.

Retropharyngeal abscess (RPA) is an acute or chronic deep neck tissue infection. Tuberculous RPA is chronic and extremely rare in adults. A 20-year-old female patient visited the local hospital due to cough and sputum. Read More

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Reproductive Health Risks and Clinician Practices with Gender Diverse Adolescents and Young Adults.

Andrology 2021 May 4. Epub 2021 May 4.

Department of Pediatrics, The Ohio State University College of Medicine, Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA.

Background: Reproductive health counseling is essential for adolescents and young adults (AYAs). Transgender and gender diverse (TGD) AYAs would benefit from tailored counseling given concerns about iatrogenic infertility and sexual dysfunction, and high rates of interpersonal violence, unplanned pregnancies and sexually transmitted infections, yet there are multiple obstacles to providing this care at the patient/family and clinician levels.

Objectives: This narrative review summarizes the literature on reproductive health considerations for TGD AYAs, current practices, and clinician barriers and facilitators to providing culturally sensitive reproductive care for TGD AYAs. Read More

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Perioperative Safety of Tofacitinib in Surgical Ulcerative Colitis Patients.

Colorectal Dis 2021 May 3. Epub 2021 May 3.

Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Background: Literature regarding monoclonal antibodies and increased postoperative complications in inflammatory bowel disease remains controversial. No study has investigated tofacitinib. We sought to determine preoperative exposure to small molecule inhibitors, tofacitinib, and postoperative outcomes. Read More

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Microglia-mediated phagocytosis of apoptotic nuclei is impaired in the adult murine hippocampus after stroke.

Glia 2021 May 4. Epub 2021 May 4.

Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany.

Following stroke, neuronal death takes place both in the infarct region and in brain areas distal to the lesion site including the hippocampus. The hippocampus is critically involved in learning and memory processes and continuously generates new neurons. Dysregulation of adult neurogenesis may be associated with cognitive decline after a stroke lesion. Read More

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Quality assurance audit in adult cardiac anaesthesia.

J Pak Med Assoc 2021 Feb;71(2(B)):704-707

Department of Anaesthesia, Tabba Heart Institute, Karachi, Pakistan.

Objective: To assess different anaesthesia-related quality indicators during adult cardiac surgery.

Methods: The prospective clinical audit was conducted at the Aga Khan University Hospital, Karachi, from October 2016 to March 2017, and comprised all adult patients scheduled for cardiac surgery. Different anaesthesia-related quality indicators were observed during the pre-induction phase, before the cardiopulmonary bypass, during the procedure, and post-surgery till the transfer from the operating room to the cardiac intensive care unit. Read More

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February 2021

Lack of association of HFE gene polymorphism with high body iron status in Pakistani patients with type 2 diabetes mellitus.

J Pak Med Assoc 2021 Feb;71(2(B)):608-613

Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.

Objective: The Aim of this study was to investigate the relationship of 3 common polymorphisms in the HFE gene (C282Y, H63D and S65C) with high body iron status in a population of Pakistani subjects with type 2 diabetes mellitus (DM) and to explore if there is any novel mutation in HFE gene in a sample of Pakistani subjects with type 2 DM.

Methods: In a case-control design, 200 healthy controls and 200 consecutive adult subjects with type 2 DM (both gender; age range of 30-70 years) were enrolled with informed consent. Their serum samples were analyzed for body iron status (ratio of concentration of soluble transferrin receptor to ferritin concentration). Read More

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February 2021

Location Matters: Type of Hospital Unit Can Influence Medicine Patients' Satisfaction with Physician Communication.

Am J Med Qual 2021 May-Jun 01;36(3):180-184

Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI.

Payors hold hospitals accountable for patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The objective was to determine if hospital unit (medicine versus nonmedicine [ie, cardiology, oncology, urology, physical medicine and rehabilitation, and surgery]) influences HCAHPS scores when care is given by the same providers on different units. This retrospective analysis of adult inpatient data (n = 845), included overall hospital satisfaction, staff communication, care and communication from physicians, and discharge communication. Read More

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Aquablation versus holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia in medium-to-large-sized prostates (ATHLETE): protocol of a prospective randomised trial.

BMJ Open 2021 May 3;11(5):e046973. Epub 2021 May 3.

Department of Urology, School of Medicine, University of St. Gallen, St Gallen, Switzerland.

Introduction: A novel method for the surgical treatment of benign prostatic hyperplasia (BPH) called Aquablation has become commercially available. Previous studies have been able to show similar functional results when compared with transurethral resection of the prostate and a high efficacy has been demonstrated when this approach is applied to patients with a prostate size of 80-150 cm.Holmium laser enucleation of the prostate (HoLEP) is a well-established procedure in the surgical treatment of BPH in prostate glands larger than 30 mL and a first-line therapy in glands over 80 mL. Read More

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Fatigue in newly diagnosed acute myeloid leukaemia: general population comparison and predictive factors.

BMJ Support Palliat Care 2021 May 3. Epub 2021 May 3.

Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

Objectives: This study compared the burden of fatigue between treatment-naïve patients with newly diagnosed acute myeloid leukaemia (AML) and the general population and investigated patient factors associated with fatigue severity.

Methods: Pretreatment patient-reported fatigue was assessed with the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire in a sample of 463 newly diagnosed patients with AML who were enrolled in a clinical trial. Multivariable linear regression models were used to estimate the adjusted mean differences in fatigue between patients with AML and adults from the general population (n=847) by AML disease risk categories. Read More

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Influence of body mass index on the management and outcomes of acute myocardial infarction-cardiogenic shock in the United States, 2008-2017.

Cardiovasc Revasc Med 2021 Apr 30. Epub 2021 Apr 30.

Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America. Electronic address:

Background: There are limited data on influence of body mass index (BMI) on outcomes of acute myocardial infarction-cardiogenic shock (AMI-CS).

Methods: Adult AMI-CS admissions from 2008 to 2017 were identified from the National Inpatient Sample and stratified by BMI into underweight (<19.9 kg/m), normal-BMI (19. Read More

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A clinicoradiological classification and a treatment algorithm for traumatic triceps tendon avulsion in adults.

Chin J Traumatol 2021 Feb 27. Epub 2021 Feb 27.

Department of Orthopedics, Govt. Medical College, Kozhikkode, 673008, Kerala, India; Department of Arthroscopy, Ganga Hospital, Coimbatore, Tamilnadu, India.

Purpose: Triceps tendon avulsion (TTA) is an uncommon injury, and there are no classifications or treatment guidelines available. This study aims to describe a clinicoradiological classification and treatment algorithm for traumatic TTA in adults. The functional outcome of surgical repair has been evaluated too. Read More

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February 2021

The association between residual neuromuscular blockade (RNMB) and critical respiratory events: a prospective cohort study.

Perioper Med (Lond) 2021 May 4;10(1):14. Epub 2021 May 4.

Anesthesia Technology Program, College of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Inadequate neuromuscular recovery might impair pulmonary function among adult patients who undergo general anaesthesia and might thus contribute to critical respiratory events in the post-anaesthesia care unit (PACU). The pilot study aims to understand the baseline incidence of residual neuromuscular blockade (RNMB) and postoperative critical respiratory events (CREs), which are described in a modified Murphy's criteria in the PACU.

Method: This is a prospective cohort study from January to March 2017 from a tertiary hospital in Saudi Arabia with thirty adult patients over 18 years old scheduled for elective surgery under general anaesthesia with neuromuscular blocking drugs (NMBDs) who were enrolled in the study. Read More

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Incidence and profile of acute intoxication among adult population in Najran, Saudi Arabia: A retrospective study.

Sci Prog 2021 Apr-Jun;104(2):368504211011339

Regional Laboratory, Ministry of Health, Najran, Saudi Arabia.

Acute poisoning is considered one of the most important medical emergencies, resulting in severe morbidity and mortality, and is an economic burden on governments. This study aimed to determine the extent of acute adult intoxication among the population located in the Najran area, Saudi Arabia, over the last 3 years (from January 2017 to December 2019). The study is a hospital-based retrospective observational study. Read More

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Midterm Outcome of Subtalar Joint Revision Arthrodesis.

Foot Ankle Int 2021 May 3:1071100721995187. Epub 2021 May 3.

Orthopoint, Vienna, Austria.

Background: The outcomes of revision subtalar arthrodesis have received relatively little focus in research compared with primary subtalar arthrodesis outcomes. This study aimed to assess the midterm clinical and radiologic results of subtalar joint revision arthrodesis and to analyze the risk factors that might influence the outcome of this procedure.

Methods: We performed a retrospective review of 20 patients after subtalar joint revision arthrodesis for malunion, using interposition of iliac crest bone graft. Read More

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Long Noncoding RNA Fos Downstream Transcript Is Developmentally Dispensable but Vital for Shaping the Poststroke Functional Outcome.

Stroke 2021 May 4:STROKEAHA120033547. Epub 2021 May 4.

Department of Neurological Surgery (S.L.M., A.K.C., T.K., S.B., B.C., K.C.M.-B., R.V.).

Background And Purpose: Stroke induces the expression of several long noncoding RNAs in the brain. However, their functional significance in poststroke outcome is poorly understood. We recently observed that a brain-specific long noncoding RNA called Fos downstream transcript (FosDT) is induced rapidly in the rodent brain following focal ischemia. Read More

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Coronal Plane Gap Increases Postoperative Pseudoarthrosis after Lateral Interbody Fusion for Adult Spinal Deformity.

Asian Spine J 2021 May 6. Epub 2021 May 6.

Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Japan.

Study Design: This is a retrospective study.

Purpose: This study aims to evaluate the risk factor associated with pseudoarthrosis after placement of lateral interbody fusion (LIF) cages for adult spinal deformity (ASD) treatment.

Overview Of Literature: LIF technique is widely used for ASD correction. Read More

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Posterior Fossa Decompression and Duraplasty with and without Arachnoid Preservation for the Treatment of Adult Chiari Malformation Type 1 : A Systematic Review and Meta-Analysis.

World Neurosurg 2021 Apr 30. Epub 2021 Apr 30.

Birmingham Women's and Children's Hospital NHS Foundation Trust, Steelhouse Lane, Birmingham, B4 6NH.

Background: The best surgical treatment for adult Chiari-1 malformation still remains widely debated.

Objectives: This study aimed to assess the efficacy of posterior fossa decompression and duraplasty with arachnoid preservation compared to arachnoid dissection for the treatment of adult Chiari-1 malformation.

Methods: Two reviewers (MOG and MA) performed a PubMed, Medline and Embase literature search using the following terms: ("Chiari" OR "Chiari 1") AND ("duraplasty" OR "arachnoid preservation" OR "arachnoid spar*" OR "posterior fossa surgery" OR "posterior fossa decompression" OR "foramen magnum decompression"). Read More

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Race is an Independent Predictor for Non-Routine Discharges after Spine Surgery for Spinal Intradural/Cord Tumors.

World Neurosurg 2021 Apr 30. Epub 2021 Apr 30.

Department of Neurosurgery, John Hopkins School of Medicine, Baltimore, MD.

Objective: The aim of this study was to determine if race was an independent predictor of extended length of stay (LOS), non-routine discharge, and increased healthcare costs following surgery for spinal intradural/cord tumors.

Methods: A retrospective cohort study was performed using National Inpatient Sample (NIS) database from 2016 through 2017. All adult (>18 years-old) inpatients who underwent surgical intervention for a benign or malignant spinal intradural/cord tumor were identified using ICD-10-CM diagnosis and procedural coding systems. Read More

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Traumatic Femoral Artery Injuries and Predictors of Compartment Syndrome: A Nationwide Analysis.

J Surg Res 2021 Apr 30;265:159-167. Epub 2021 Apr 30.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona. Electronic address:

Background: The femoral artery is commonly injured following lower extremity trauma. If not identified early and addressed properly, it can lead to compartment syndrome (CS) and limb amputation. The aim of this study is to examine traumatic femoral artery injuries and identify risk factors for the development of lower extremity CS. Read More

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A New Cross-Linked Hyaluronic Acid Gel for Preventing Adhesion After Thyroid Surgery: An Animal Study.

J Surg Res 2021 Apr 30;265:147-152. Epub 2021 Apr 30.

Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey.

Background: Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. Read More

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Trends and impact on cold ischemia time and clinical outcomes using virtual crossmatch for deceased donor kidney transplantation in the United States.

Kidney Int 2021 Apr 30. Epub 2021 Apr 30.

Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, USA.

For assessing human leukocyte antigen compatibility in deceased donor kidney transplantation, virtual crossmatch is used as an alternative to physical crossmatch and has potential to reduce cold ischemia time. The 2014 United States kidney allocation system prioritized highly sensitized candidates but led to increased shipping of kidneys. Using data from the Scientific Registry of Transplant Recipients, we evaluated changes in virtual crossmatch use with the new allocation policy and the impact of virtual crossmatch use on cold ischemia time and transplant outcomes. Read More

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