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Dental and maxillofacial manifestations of Steinert's myotonic dystrophy: a retrospective case series and therapeutic investigation.

J Stomatol Oral Maxillofac Surg 2022 Jun 22. Epub 2022 Jun 22.

Department and Maxillo-Facial Surgery, CHU Salengro, Rue Emile Laisne, 59037 Lille, France.

This retrospective study was performed to analyse the facial features and occlusal anomalies in 18 patients with Steinert's myotonic dystrophy (MD1). Medical and surgical management issues noted in this study may contribute to clinical decision-making. This series included 18 patients with MD1 who presented for maxillofacial consultations. Read More

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Amyloidosis Tissue Confirmation for Tafamidis Eligibility Using Transverse Carpal Ligament and Tenosynovium Biopsy.

Can J Cardiol 2022 Jun 22. Epub 2022 Jun 22.

Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address:

In most Canadian provinces, eligibility criteria for public reimbursement coverage for tafamidis for treatment of transthyretin amyloidosis cardiomyopathy (ATTR-CM) include tissue biopsy confirmation of amyloidosis. Carpal tunnel syndrome requiring surgical release is common in ATTR-CM. We report our experience performing simultaneous transverse carpal ligament and tenosynovium biopsy during CTR, with all patients positive for amyloidosis, facilitating initiation of tafamidis. Read More

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Supplementary Motor Area Syndrome after Brain Tumor Surgery: A Systematic Review.

World Neurosurg 2022 Jun 22. Epub 2022 Jun 22.

Department of Neurological Surgery, Northwell Health, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, New York, NY, USA.

Background: Supplementary motor area syndrome (SMAS) may occur after frontal tumor surgery, with variable presentation and outcomes. We reviewed the literature on postoperative SMAS following brain tumor resection.

Methods: PubMed, Web-of-Science, Scopus, and Cochrane were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to include studies reporting SMAS after brain tumor resection. Read More

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Transfusion Guidelines in Brain Tumor Surgery: A Systematic Review and Critical Summary of Currently Available Evidence.

World Neurosurg 2022 Jun 22. Epub 2022 Jun 22.

University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, TX, USA.

Objective: Red blood cell (RBC) transfusion is commonly indicated in brain tumor surgery due to risk of blood loss. Current transfusion guidelines are based on evidence derived from critically ill patients and may not be optimal for brain tumor surgeries. Our study is the first to synthesize available evidence to suggest RBC transfusion thresholds in brain tumor patients undergoing surgery. Read More

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Postoperative Complication Rates after One-Level Cervical Spine Surgery in Patients with Parkinson's Disease: A Database Study.

World Neurosurg 2022 Jun 22. Epub 2022 Jun 22.

Department of Neurosurgery, University of Southern California, Keck School of Medicine, Los Angeles, California; Department of Orthopedic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California.

Objective: Parkinson's Disease (PD) is a risk factor for worse surgical outcomes. The degree to which Parkinson's affects outcomes in cervical spine surgery is not well understood. Therefore, we characterize rates of postoperative complications among patients with PD who undergo cervical spine surgery. Read More

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Diagnostic performance of ultrasound in assessing the extension of disease in advanced ovarian cancer.

Am J Obstet Gynecol 2022 Jun 22. Epub 2022 Jun 22.

Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy. Electronic address:

Background: Surgical exploration remains the gold standard to evaluate the extension of disease and predict resectability. A laparoscopy-based scoring model was developed by Fagotti and colleagues in 2006 and updated in 2015, based on the intraoperative presence or absence of some specific cancer features. The model proved an overall accuracy rate of 77-100% and is considered the reference test to assess resectability in our Institution. Read More

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Percutaneous/mini-laparotomy fetoscopic repair of open spina bifida: a novel surgical technique.

Am J Obstet Gynecol 2022 Jun 22. Epub 2022 Jun 22.

The Fetal Institute, Miami, FL; The USFetus Research Consortium, Miami, FL-Los Angeles, CA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wertheim School of Medicine, Florida International University, Miami, FL.

Open spina bifida (OSB) is the most common congenital anomaly of the central nervous system compatible with life. Prenatal repair of open spina bifida via open maternal-fetal surgery has been shown to improve postnatal neurological outcomes, including reducing the need for ventriculoperitoneal shunting and improving lower neuromotor function. Fetoscopic repair of OSB minimizes the maternal risks while providing similar neurosurgical outcomes to the fetus. Read More

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Expectant versus medical management for retained products of conception after medical termination of pregnancy: A randomized controlled study.

Am J Obstet Gynecol 2022 Jun 22. Epub 2022 Jun 22.

Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Despite the rise of medical treatments for the termination of pregnancy, to-date no prospective trial has evaluated the efficacy of misoprostol in treating retained products of conception after induced termination of pregnancy.

Objective: To compare medical management with misoprostol with expectant management for retained products of conception after first trimester medical termination of pregnancy.

Study Design: An open-label randomized controlled trial conducted at a university-affiliated tertiary medical center. Read More

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Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: A study of 20.6 million records from the USA.

Int J Cardiol 2022 Jun 22. Epub 2022 Jun 22.

Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, UK; Department of Cardiology, Thomas Jefferson University Philadelphia, PA, USA; Institute of Population Health, University of Manchester, UK. Electronic address:

Background: there is limited data on Emergency department (ED) cardiovascular disease (CVD) presentations and outcomes amongst cancer patients.

Objectives: The present study aimed to describe the clinical characteristics, prevalence, and clinical outcomes of the most common cardiovascular ED admissions in patients with cancer.

Methods: All ED encounters with a primary CVD diagnosis from the US Nationwide Emergency Department Sample between January 2016 to December 2018 were stratified by cancer type as well as metastatic status. Read More

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The Optimal Cesarean Skin Incision in Patients with Super Obesity.

Am J Perinatol 2022 Jun 25. Epub 2022 Jun 25.

Department of Obstetrics and Gynecology and Reproductive Sciences, University of Maryland Medical Center, Baltimore, United States.

Objective To evaluate if supraumbilical midline vertical incision performed in patients with a hanging pannus (umbilicus at the level of the pubic bone) is a reasonable alternative to Pfannenstiel in patients with Body Mass Index (BMI) ≥ 50 kg/m2 undergoing cesarean delivery. Methods Retrospective cohort study in patients with BMI ≥50 kg/m2 undergoing cesarean delivery at a single center from 2016 to 2020. Study groups were Pfannenstiel VS supraumbilical vertical skin incision. Read More

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"Nurturing future leaders in aesthetics: Now is the time".

Facial Plast Surg 2022 Jun 25. Epub 2022 Jun 25.

Plastic Surgery, Plastic Surgery, Thessaloniki, Greece.

There is a need for a specialist pathway or progression in aesthetic medicine for aesthetic physicians. A structured program for specialised training in non-surgical facial aesthetics to empower physicians is the need of the hour. The pharmaceutical companies currently provide training sessions, taking considerable initiatives to train aesthetic professionals. Read More

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Prognostic impact of postoperative radiotherapy in patients with breast cancer and with pT1-2 and 1-3 lymph node metastases: A retrospective cohort study based on the Japanese Breast Cancer Registry.

Eur J Cancer 2022 Jun 22;172:31-40. Epub 2022 Jun 22.

Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ward, Tokyo, 173-8606, Japan. Electronic address:

Aim: Postmastectomy radiotherapy (PMRT) is the standard treatment for locally advanced breast cancer. However, the effectiveness of PMRT in patients with pT1-2 and N1 tumours remains controversial. Therefore, this study aimed to determine the prognostic impact of PMRT in patients with breast cancer and with pT1-2 and 1-3 lymph node metastases. Read More

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Trochleoplasty for severe trochlear dysplasia significantly improves the quality of life of patients with symptomatic patellar instability.

Knee 2022 Jun 22;37:95-102. Epub 2022 Jun 22.

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry SY10 7AG, United Kingdom. Electronic address:

Background: Trochleoplasty is a recognized surgical technique to address severe trochlear dysplasia. The clinical and radiological outcomes of trochleoplasty surgery in trochlear dysplasia have been well reported. There is a paucity in literature regarding the correlation between trochleoplasty and quality of life (QoL). Read More

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Development of bony range of motion (B-ROM) boundary for total hip replacement planning.

Comput Methods Programs Biomed 2022 Jun 8;222:106937. Epub 2022 Jun 8.

WMG, The University of Warwick, Coventry CV4 7AL, UK.

Background And Objective: Pre-operative surgical planning using computer simulation is increasingly standard practice before Total Hip Arthroplasty (THA), in order to determine the optimal implant positions, and thereby minimise post-operative complications such as dislocation, wear and leg length discrepancy. One of the limitations of current methods, however, is the lack of information on the subject-specific reference range of motion (ROM) that could be used as targets for surgical planning. Only a limited number of hip motions are considered, which are neither subject-specific, nor representative of all the hip motions associated with all the activities of daily livings (ADLs). Read More

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Weakly supervised deep learning for prediction of treatment effectiveness on ovarian cancer from histopathology images.

Comput Med Imaging Graph 2022 Jun 16;99:102093. Epub 2022 Jun 16.

Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan; Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan. Electronic address:

Despite the progress made during the last two decades in the surgery and chemotherapy of ovarian cancer, more than 70 % of advanced patients are with recurrent cancer and decease. Surgical debulking of tumors following chemotherapy is the conventional treatment for advanced carcinoma, but patients with such treatment remain at great risk for recurrence and developing drug resistance, and only about 30 % of the women affected will be cured. Bevacizumab is a humanized monoclonal antibody, which blocks VEGF signaling in cancer, inhibits angiogenesis and causes tumor shrinkage, and has been recently approved by FDA as a monotherapy for advanced ovarian cancer in combination with chemotherapy. Read More

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A fatal perforation of the distal ileum from an ingested fish bone: A case report.

Int J Surg Case Rep 2022 Jun 21;96:107331. Epub 2022 Jun 21.

Department of Surgery, District General Hospital, Mannar, Sri Lanka.

Introduction And Importance: Foreign body-induced perforations of the ileum are rare consequences among adults.

Presentation Of Case: This is a case report of a delayed presentation of an ileal perforation and concurrent faecal peritonitis presented as an acute abdomen, resultant from an ingested fishbone, which led to fatality despite urgent laparotomy.

Clinical Discussion: Perforations following ingested foreign bodies are frequently unanticipated clinically, and diagnosed during advanced imaging studies or surgical interventions. Read More

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Extensor mechanism reconstruction and joint preservation surgery following a tibial tuberosity fracture in giant cell tumor of bone: A case report.

Int J Surg Case Rep 2022 Jun 20;96:107326. Epub 2022 Jun 20.

Eric Williams Medical Sciences Complex, University of the West Indies, Champ Fleur, Trinidad, West Indies.

Introduction And Importance: Pathologic fractures of the tibial tuberosity secondary to giant cell tumor of bone are rare injuries. While there are several well-described methods in the literature to reattach the tibial tuberosity, these techniques rely on good quality bone. However, in the presence of diseased and weak bone, additional factors have to be considered. Read More

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Imaging biomarkers of breast cancers originating from the major lactiferous ducts: Ductal adenocarcinoma of the breast, DAB.

Eur J Radiol 2022 Jun 4;154:110394. Epub 2022 Jun 4.

School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Wuxing Street, Taipei 110, Taiwan.

Purpose: As we have previously demonstrated, breast cancers originating in the major lactiferous ducts and propagating through the process of neoductgenesis are a distinct subtype of invasive breast cancers, although by current practice they are placed within the group termed ductal carcinoma in situ (DCIS) and are consequently underdiagnosed and undertreated. Imaging biomarkers provide a reliable indication of the site of origin of this breast cancer subtype (Ductal Adenocarcinoma of the breast, DAB) and have excellent concordance with long-term patient outcome. In the present paper, the imaging biomarkers of DAB are described in detail to encourage and facilitate its recognition as a distinct, invasive breast cancer subtype. Read More

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Diagnostic accuracy of different ultrasound signs for detecting adnexal torsion: systematic review and meta-analysis.

Ultrasound Obstet Gynecol 2022 Jun 25. Epub 2022 Jun 25.

Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain.

Objective: To evaluate the diagnostic accuracy of different ultrasound signs for diagnosing adnexal torsion (AT), using surgery as the reference standard.

Methods: A search was performed in PubMed/MEDLINE, CINAHL, Scopus, Cochrane, ClinicalTrials.gov and Web of Science databases (January 1990 to November 2021) for studies evaluating the presence of ovarian edema, an adnexal mass, Doppler flow findings and the whirlpool sign as ultrasound signs (index tests) for detecting AT, using surgical findings as reference standard. Read More

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A Retrospective Study of Parietal Lobe Epilepsy: Functional Anatomy and Surgical Treatment.

Altern Ther Health Med 2022 Jun 24. Epub 2022 Jun 24.

Context: Parietal lobe epilepsy (PLE) accounts for approximately 5% of all focal epilepsies worldwide,1 and few PLE patients have undergone epilepsy surgery in the past. With the introduction of functional neuroimaging methods, such as interictal fluorodeoxyglucose-positron emission tomography (FDG-PET), stereotactic electroencephalograms (SEEGs), and high-resolution magnetic resonance imaging (MRI), more patients with intractable neocortical epilepsy have been considered for surgical treatment.

Objective: The study intended to characterize the clinical features, aura, and presurgical evaluations of patients with PLE, by investigating their demographic and clinical characteristics, and to evaluate the prognostic value of the four diagnostic modalities-MRI, FDG-PET, scalp EEG, and SEEG-in terms of the localization of epileptogenic area. Read More

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Clinical Effects of Simultaneous Implant Placement in Hydraulic Maxillary Sinus Lift Without Bone Grafting.

Altern Ther Health Med 2022 Jun 24. Epub 2022 Jun 24.

Context: Tooth absence is a pervasive oral condition and mostly occurs as maxillary tooth absence. The only way to treat tooth absence in adults is prosthesis implantation, and implant therapy usually requires repair of the maxillary sinus to its original state using a maxillary sinus lift (MSL). MSL has usually included bone augmentation with bone grafting simultaneously with the placement of the dental implant. Read More

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Short-term kidney transplant outcomes from SARS-CoV-2 lower respiratory tract positive donors.

Transpl Infect Dis 2022 Jun 25. Epub 2022 Jun 25.

Division of Surgical Transplantation, University of Texas Southwestern Medical Center, Dallas, TX.

Goal: In this study we aim to assess short-term allograft outcomes following deceased donor kidney transplantation from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) lower respiratory tract (LRT) nucleic acid testing (NAT) positive donors.

Methods: From September to December 2021, SARS-CoV-2 NAT positive organ donors, whose solid abdominal organs were transplanted at our academic medical center were identified. Donors were stratified into having tested positive for SARS-CoV-2 in an upper respiratory tract (URT) or LRT sample. Read More

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Serum calcium levels are associated with cognitive function in hypoparathyroidism: a neuropsychological and biochemical study in an Italian cohort of patients with chronic post-surgical hypoparathyroidism.

J Endocrinol Invest 2022 Jun 25. Epub 2022 Jun 25.

University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy.

Purpose: Hypoparathyroidism (HypoPT) is a rare endocrine disease and conventional therapy is based on calcium and vitamin D analogues. Conventional therapy does not restore calcium homeostasis and patients complain with neuropsychological symptoms, which have been evaluated with nonspecific self-administered questionnaires. This study aims to evaluate cognitive functions of patients with chronic post-surgical (PS)-HypoPT compared to a control population, using a standardized neuropsychological approach and evaluating the relationship with serum calcium (Alb-Ca). Read More

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Adrenalectomy improves blood pressure control in nonfunctioning adrenal incidentalomas and glycemic and lipid control in patients with autonomous cortisol secretion.

Endocrine 2022 Jun 25. Epub 2022 Jun 25.

Endocrinology & Nutrition Department, Ramón y Cajal University Hospital, Madrid, Spain.

Purpose: To compare the evolution of the cardiometabolic parameters in patients with nonfunctioning adrenal incidentalomas (NFAI) and autonomous cortisol secretion (ACS) who underwent adrenalectomy and those who were conservatively managed.

Methods: A retrospective study of all patients with NFAI and ACS submitted to surgery or in follow-up in our center between January 2011-October 2020. NFAI was defined as an adrenal incidentaloma with cortisol post-dexamethasone suppression test (DST) ≤ 50 nmol/L and ACS as values >50 nmol/L without specific clinical signs of overt Cushing´s syndrome. Read More

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Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma.

Endocrine 2022 Jun 25. Epub 2022 Jun 25.

Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.

Background: Somatostatin receptor (SSTR) positron emission tomography/computed tomography (PET/CT) is increasingly deployed in the diagnostic algorithm of patients affected with medullary thyroid carcinoma (MTC). We aimed to assess the role of SSTR-PET/CT for therapeutic decision making upon restaging.

Methods: 23 pretreated MTC patients underwent SSTR-PET/CT and were discussed in our interdisciplinary tumor board. Read More

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Randomized, controlled trial of two tranexamic acid dosing protocols in adult spinal deformity surgery.

Spine Deform 2022 Jun 25. Epub 2022 Jun 25.

Rady Children's Hospital, University of California, 3020 Children's Way, San Diego, CA, 92123, USA.

Background: Tranexamic acid (TXA) is an anti-fibrinolytic effective in reducing blood loss in orthopedic surgery. The appropriate dosing protocol for adult spinal deformity (ASD) surgery is not known. The purpose of this study was to evaluate two TXA protocols [low dose (L): 10 mg/kg bolus, 1 mg/kg/hr infusion; high dose (H): 50 mg/kg, 5 mg/kg/hr] in complex ASD surgery. Read More

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Ultrasound Cyclo Plasty After Failed Glaucoma Surgery: Outcomes and Complications.

Ophthalmol Ther 2022 Jun 25. Epub 2022 Jun 25.

Department of Ophthalmology, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia.

Introduction: The purpose of this study is to report the outcomes and complications of ultrasound cyclo plasty (UCP) after failed glaucoma surgery.

Methods: A retrospective case series included patients with previously failed glaucoma surgery who underwent UCP at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, between 2016 and 2021. The main outcome measures were: intraocular pressure (IOP), number of antiglaucoma medications and presence of vision-threatening complications. Read More

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Fractionated pre-operative stereotactic radiotherapy for patients with brain metastases: a multi-institutional analysis.

J Neurooncol 2022 Jun 25. Epub 2022 Jun 25.

Department of Radiation Oncology, The Ohio State University Wexner Medical Center, 460 W. 10th Avenue, Columbus, OH, 43210, USA.

Background: The current standard of care for patients with a large brain metastasis and limited intracranial disease burden is surgical resection and post-operative single fraction stereotactic radiosurgery (SRS). However, post-operative SRS can still lead to substantial rates of local failure (LF), radiation necrosis (RN), and meningeal disease (MD). Pre-operative SRS may reduce the risk of RN and MD, while fractionated treatments may improve local control by allowing delivery of higher biological effective dose. Read More

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Effects of medical staff's turning movement on dispersion of airborne particles under large air supply diffuser during operative surgeries.

Environ Sci Pollut Res Int 2022 Jun 25. Epub 2022 Jun 25.

School of Health Science, Universiti Sains Malaysia, Penang, Kelantan, Malaysia.

The present study examines the effect of medical staff's turning movements on particle concentration in the surgical zone and settlement on the patient under single large diffuser (SLD) ventilation. A computational domain representing the operating room (OR) was constructed using computer-aided design (CAD) software. The airflow and particle models were validated against the published data before conducting the case studies. Read More

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Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations.

J Artif Organs 2022 Jun 25. Epub 2022 Jun 25.

Division of Cardiovascular Surgery, Department of Surgery, The Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Silverstein, Philadelphia, PA, 19104, USA.

Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Read More

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