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The Efficacy of Liposomal Bupivacaine for Opioid and Pain Reduction: A Systematic Review of Randomized Clinical Trials.

J Surg Res 2021 Apr 13;264:510-533. Epub 2021 Apr 13.

Harvard Medical School, General and Endocrine Surgery, Massachusetts General Hospital, Boston, MA.

Background The opioid crisis has prompted surgeons to search for alternative postoperative methods of analgesia. Liposomal bupivacaine is a long-acting local anesthetic formulation used for pain, potentially reducing opioid use. Evaluation of liposomal bupivacaine as a viable alternative for pain management is needed. Read More

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Diagnostic accuracy of LAMP versus PCR over the course of SARS-CoV-2 infection.

Int J Infect Dis 2021 Apr 13. Epub 2021 Apr 13.

Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Objective: Reverse transcription loop-mediated isothermal amplification (RT-LAMP) has been validated for diagnosis of several viral infections. However, its diagnostic accuracy in detecting SARS-CoV-2 in real-life clinical settings remains unclear. The aim of this study was to determine the diagnostic sensitivity and specificity of RT-LAMP compared to reverse transcription-quantitative polymerase chain reaction (RT-qPCR) over the disease course of COVID-19. Read More

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Comparable outcome for autografts and allografts in primary medial patellofemoral ligament reconstruction for patellofemoral instability: systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 16. Epub 2021 Apr 16.

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.

Purpose: This study updates the current evidence on the role of allografts versus autografts for medial patellofemoral ligament (MPFL) reconstruction in patients with patellofemoral instability.

Methods: The study was performed according to the PRISMA guidelines. In March 2021, a literature search in the main online databases was performed. Read More

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Comparison of Alternative Lipid Emulsions on Morbidities in Very-Low-Birth-Weight Preterms.

Indian J Pediatr 2021 Apr 16. Epub 2021 Apr 16.

Medical Faculty, Neonatal Intensive Care Unit, Istanbul Biruni University, Istanbul, Turkey.

Objective: To compare clinical outcomes of using different alternative lipid emulsions for longer durations in babies who are at high risk for preterm morbidities.

Methods: Preterm infants born ≤ 30 wk receiving SMOFlipid versus Clinoleic with longer durations (≥ 14 d) were included in this retrospective study. The authors compared demographic features, clinical applications, and morbidities between epochs: epoch 1 (Clinoleic, July 2017-June 2018) versus epoch 2 (SMOFlipid, July 2018-June 2019). Read More

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Breath holding and tidal breathing nasal NO to screen children for Primary Ciliary Dyskinesia.

Pediatr Pulmonol 2021 Apr 16. Epub 2021 Apr 16.

INSERM U934, Centre de Recherche Saint Antoine, Paris, France.

Nasal Nitric Oxide (nNO) measurement is recommended to screen for Primary Ciliary Dyskinesia (PCD) in subjects with suggestive history and symptoms. Clinical use of alternative methods (ie breath hold (BH), tidal breathing (TB)) in children unable to perform the gold standard slow Exhalation against a Resistance (ER) method has not been sufficiently evaluated. We extracted retrospectively (2013-2019) 454 files (374 subjects) containing nNO results. Read More

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Endoscopic full-thickness resection versus endoscopic submucosal dissection in the treatment of colonic neoplastic lesions ≤ 30 mm-a single-center experience.

Surg Endosc 2021 Apr 15. Epub 2021 Apr 15.

University Hospital and Faculty of Medicine, 2nd Department of Internal Medicine, Gastroenterology and Geriatrics, Palacký University, Olomouc, Czech Republic.

Endoscopic full-thickness resection (FTR) is a novel technique of endoscopic treatment of colorectal neoplastic lesions not suitable for endoscopic polypectomy or mucosal resection. FTR appears to be a reasonable alternative to technically demanding endoscopic submucosal dissection (ESD) for lesions ≤ 30 mm. However, comparison between FTR and ESD has not been published yet and their mutual positioning in the treatment algorithm is still unclear. Read More

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Similarities and differences between study designs in short- and long-term outcomes of laparoscopic versus open low anterior resection for rectal cancer: A systematic review and meta-analysis of randomized, case-matched, and cohort studies.

Ann Gastroenterol Surg 2021 Mar 21;5(2):183-193. Epub 2020 Nov 21.

Department of Surgery Kyoto University Graduate School of Medicine Kyoto Japan.

Aim: Randomized controlled trials (RCT) are the gold standard in surgical research, and case-matched studies, such as studies with propensity score matching, are expected to serve as an alternative to RCT. Both study designs have been used to investigate the potential superiority of laparoscopic surgery to open surgery for rectal cancer, but it remains unclear whether there are any differences in the findings obtained using these study designs. We aimed to examine similarities and differences between findings from different study designs regarding laparoscopic surgery for rectal cancer. Read More

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Non-vitamin K antagonist oral anticoagulation versus left atrial appendage occlusion for primary and secondary stroke prevention after cardioembolic stroke.

Rev Port Cardiol 2021 Apr 12. Epub 2021 Apr 12.

Serviço de Neurologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.

Introduction: This study aimed to evaluate the performance of non-vitamin K antagonist oral anticoagulation (NOAC) in patients with previous stroke and non-valvular atrial fibrillation (AF) compared with left atrial appendage occlusion (LAAO) in primary and secondary stroke prevention settings.

Methods: This was a prospective, single-center, non-randomized cohort study of 302 consecutive patients with non-valvular AF and at high risk for stroke. Two treatment strategies were compared: LAAO (n=91) and long-term treatment with NOAC (n=149). Read More

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Cost-effectiveness analysis of defibrotide in the treatment of patients with severe veno-occlusive disease/sinusoidal obstructive syndrome with multiorgan dysfunction following hematopoietic cell transplantation in Spain.

J Med Econ 2021 Apr 15. Epub 2021 Apr 15.

Hygeia Consulting, S.L., Madrid, Spain.

Aims: This study evaluated cost-effectiveness of defibrotide versus best supportive care (BSC) for the treatment of hepatic veno-occlusive disease/sinusoidal obstructive syndrome (VOD/SOS) with multiorgan dysfunction (MOD) post-hematopoietic cell transplantation (HCT) in Spain.

Materials And Methods: A two-phase Markov model, comprising a one-year acute phase with daily cycles and a lifetime long-term phase with annual cycles, was adapted to the Spanish setting. The model included a cohort of patients with severe VOD/SOS (defined as VOD/SOS with MOD) post-HCT. Read More

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Cost-effectiveness of Baloxavir Marboxil compared with Laninamivir for the treatment of influenza in patients at high risk for complications in Japan.

Curr Med Res Opin 2021 Apr 15. Epub 2021 Apr 15.

Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, Tokyo, Japan.

Baloxavir marboxil (baloxavir) is a single-dose antiviral which was previously found to be a cost-effective alternative to laninamivir in otherwise healthy adults in Japan. This study aimed at investigating the cost-effectiveness of baloxavir versus laninamivir in patients with influenza at high risk for complications. A decision tree was utilized to estimate costs and health gains associated with the use of antivirals. Read More

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Outcomes of Sleep Apnea Surgery in Outpatient and Inpatient Settings.

Anesth Analg 2021 May;132(5):1215-1222

From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Upper airway surgery is an alternative treatment for patients with severe obstructive sleep apnea (OSA). However, there is controversy regarding selection criteria for outpatient versus inpatient settings for these surgical procedures. The aim of this retrospective study was to compare postoperative outcomes of patients undergoing airway surgery in outpatient and inpatient settings based on length of stay at the facility. Read More

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Induction chemotherapy with lobaplatin and fluorouracil versus cisplatin and fluorouracil followed by chemoradiotherapy in patients with stage III-IVB nasopharyngeal carcinoma: an open-label, non-inferiority, randomised, controlled, phase 3 trial.

Lancet Oncol 2021 Apr 12. Epub 2021 Apr 12.

Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China. Electronic address:

Background: Cisplatin-based induction chemotherapy plus concurrent chemoradiotherapy in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma has been recommended in the National Comprehensive Cancer Network Guidelines. However, cisplatin is associated with poor patient compliance and has notable side-effects. Lobaplatin, a third-generation platinum drug, has shown promising antitumour activity against several malignancies with less toxicity. Read More

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The Cost-Effectiveness of Empagliflozin Versus Liraglutide Treatment in People with Type 2 Diabetes and Established Cardiovascular Disease.

Diabetes Ther 2021 Apr 15. Epub 2021 Apr 15.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Introduction: The increasing financial burden associated with diabetes treatment presents a challenge to healthcare systems worldwide. Recently, clinical guidelines have focussed on patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD) and recommend a sodium-glucose co-transporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist as second-line treatment after metformin or independently of baseline glycated haemogloblin A1c (HbA1c). In Danish clinical guidelines, empagliflozin and liraglutide are highlighted owing to their positive impact on mortality. Read More

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Excellent overall and chronic graft-versus-host-disease-free event-free survival in Fanconi anaemia patients undergoing matched related- and unrelated-donor bone marrow transplantation using alemtuzumab-Flu-Cy: the UK experience.

Br J Haematol 2021 Apr 14. Epub 2021 Apr 14.

Department of Bone Marrow Transplant and Haematology, Great Ormond Street Hospital for Children, London, UK.

Haematopoietic stem cell transplantation (HSCT) remains the only curative option in Fanconi anaemia (FA). We analysed the outcome of children transplanted for FA between 1999 and 2018 in the UK. A total of 94 transplants were performed in 82 patients. Read More

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Metallic Co Nanoarray Catalyzes Selective NH Production from Electrochemical Nitrate Reduction at Current Densities Exceeding 2 A cm.

Adv Sci (Weinh) 2021 Apr 1;8(7):2004523. Epub 2021 Feb 1.

Shenzhen Key Laboratory of Polymer Science and Technology Guangdong Research Center for Interfacial Engineering of Functional Materials College of Materials Science and Engineering Shenzhen University Shenzhen 518061 China.

Electrochemical nitrate reduction (NITRR) offers a promising alternative toward nitrogen recycling and ammonia production under ambient conditions, for which highly active and selective electrocatalyst is desired. In this study, metallic cobalt nanoarrays as facilely prepared from the electrochemical reduction of Co(OH) nanoarrays (NAs) are demonstrated to exhibit unprecedented NH producing capability from catalyzing NITRR. Benefitting from the high intrinsic activity of Co, intimate contact between active species and conductive substrate and the nanostructure which exposes large number of active sites, the Co-NAs electrode exhibits current density of -2. Read More

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Retention Sutures and Negative Pressure Wound Therapy for Delayed Primary Closure of Fasciotomy Wounds.

Plast Reconstr Surg Glob Open 2021 Apr 8;9(4):e3530. Epub 2021 Apr 8.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C.

Achieving primary closure of lower extremity fasciotomy wounds is difficult. Surgeons are faced with the option of waiting potentially long periods of time for edema to reside, in order to attempt delayed primary closure (DPC) versus closing at an earlier time with a split thickness skin graft. DPC offers superior aesthetic outcomes than split thickness skin grafts but traditionally cannot occur until later in the clinical course once excessive edema has subsided. Read More

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Sodium-glucose cotransporter-2 inhibitors and risk for genitourinary infections in older adults with type 2 diabetes.

Ther Adv Drug Saf 2021 29;12:2042098621997703. Epub 2021 Mar 29.

University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd., Campus Box C238, Room V20-1127A, Aurora, CO 80045, USA.

Background And Aims: Although landmark clinical trials have demonstrated an increased risk for genitourinary infection (GUI) after initiation of sodium-glucose cotransporter-2 inhibitor (SGLT2i) therapy that led to an FDA label warning, real world findings have been inconsistent and evidence specifically in older adults is lacking. The objective of the study was to examine the incidence of GUI in patients aged 65 years or older initiated on SGLT2i compared with glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy at a large academic health system.

Methods: A retrospective population-based cohort study was conducted using electronic health records of patients aged 65 years and older with a diagnosis of type 2 diabetes mellitus. Read More

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Moving somatic gene editing to the clinic: routes to market access and reimbursement in Europe.

Eur J Hum Genet 2021 Apr 14. Epub 2021 Apr 14.

Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Genetics, Section Community Genetics, Amsterdam Public Health research institute, Amsterdam, the Netherlands.

Somatic gene editing (SGE) holds great promise for making genetic therapy possible for many monogenic conditions very soon. Is our current system of European market authorization and reimbursement ready for the expected tsunami of gene therapies? At a recent workshop of the Netherlands ZonMw consortium on ethical, legal, and social implications of personalized medicine, we discussed the current possibilities for bringing new gene therapies to the clinic. In Europe, it is not yet clear whether the route via the European medicines agency as an advanced therapy medicinal product is the most appropriate for evaluation of highly personalized SGE applications, although this may optimally guarantee safety and effectiveness. Read More

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Intrinsic Electrical Remodeling Underlies Atrioventricular Block in Athletes.

Circ Res 2021 Apr 14. Epub 2021 Apr 14.

Cardiovascular Sciences, University of Manchester, UNITED KINGDOM.

Athletes present with atrioventricular node (AV node) dysfunction manifesting as AV block. This can necessitate electronic pacemaker implantation, known to be more frequent in athletes with a long training history. AV block in athletes is attributed to high vagal tone. Read More

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Comparison of interfragmentary pinning versus the extension block technique for acute Doyle type 4c mallet finger.

Hand Surg Rehabil 2021 Apr 10. Epub 2021 Apr 10.

Department of Orthopaedics and Traumatology, Gaziosmanpasa University Tokat, Mah. Muhittin Fisunoğlu Cad. Ali Şevki Erek Yerleşkesi Merkez/Tokat, Turkey.

The aim of this study was to compare the closed reduction interfragmentary pinning method (IPM) with the extension block technique (EBT) for bony mallet finger. Patients who underwent mallet finger operations were screened retrospectively for the following inclusion criteria: Doyle type 4c, age between 18 and 75 years, less than 4 weeks to surgery, and more than 1 year of follow-up time. Group I underwent a closed reduction IPM, and group II underwent the EBT. Read More

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Peroral endoscopic myotomy is equally safe and highly effective treatment option in achalasia patients with both lower and higher ASA classification status.

Esophagus 2021 Apr 13. Epub 2021 Apr 13.

Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Introduction: The American Society of Anesthesiologists (ASA) physical status classification system was developed as a simple categorization of patients' physiological status that predicts the operative risk. Peroral endoscopic myotomy (POEM) is a less invasive alternative to surgical myotomy in achalasia. As such, POEM seems to be an appealing option for high-risk patients with achalasia. Read More

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A method for estimating the time of initiating correct categorization in mouse-tracking.

Behav Res Methods 2021 Apr 12. Epub 2021 Apr 12.

Department of Psychology, University of Tennessee, Knoxville, TN, 37996, USA.

Mouse-tracking facilitates exploration of the mental processes underlying decision-making. As the cognitive system works to settle on a decision, response competition manifests in the motor movements of the hand, bringing the mouse relatively closer to one alternative versus the other. Many metrics provide insight into decision-making processes by indexing the shape or complexity of the mouse trajectory. Read More

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Syndesmotic Stabilization: Syndesmotic Screw Versus Flexible Fixation. "A Systematic Review".

J Foot Ankle Surg 2021 Mar 6. Epub 2021 Mar 6.

Department of Orthopaedic Surgery, Banha School of Medicine, Banha, Egypt.

Syndesmotic injuries are common injuries that occur in isolation or associated with ankle fractures. The suture button device fixation (SBDF) has become increasingly attractive to orthopedic surgeons as an alternative to metallic screw fixation (MSF) for syndesmotic fixation. This review involved the highest-quality clinical biomechanical and cost analysis studies to provide a comprehensive review. Read More

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A comparative study of postoperative outcomes between minimally invasive living donor hepatectomy and open living donor hepatectomy: The Korean organ transplantation registry.

Surgery 2021 Apr 10. Epub 2021 Apr 10.

Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea. Electronic address:

Background: This study evaluated the safety and effectiveness of minimally invasive living donor hepatectomy in comparison with the open procedure, using Korean Organ Transplantation Registry data.

Methods: We reviewed the prospectively collected data of all 1,694 living liver donors (1,071 men, 623 women) who underwent donor hepatectomy between April 2014 and December 2017. The donors were grouped on the basis of procedure type to the minimally invasive procedure group (n = 304) or to the open procedure group (n = 1,390) and analyzed the relationships between clinical data and complications. Read More

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Microdiscectomy compared with transforaminal epidural steroid injection for persistent radicular pain caused by prolapsed intervertebral disc: the NERVES RCT.

Health Technol Assess 2021 Apr;25(24):1-86

Liverpool Clinical Trials Centre, University of Liverpool (member of Liverpool Health Partners), Liverpool, UK.

Background: Sciatica is a common condition reported to affect > 3% of the UK population at any time and is most often caused by a prolapsed intervertebral disc. Currently, there is no uniformly adopted treatment strategy. Invasive treatments, such as surgery (i. Read More

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Alloplastic or Autologous? Bone Chips versus PEEK Cage for Lumbar Interbody Fusion in Degenerative Spondylolisthesis.

J Neurol Surg A Cent Eur Neurosurg 2021 Apr 12. Epub 2021 Apr 12.

Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany.

Introduction:  This study was conducted to compare bone-filled intervertebral cages with autologous bone chips for instrumented lumbar interbody fusion in patients with spinal stenosis and degenerative spondylolisthesis.

Methods:  Surgery consisted of posterior instrumentation and decompression, diskectomy, and intervertebral fusion using a polyetheretherketone (PEEK) cage surrounded and filled with spongious bone chips (group 1,  = 57) or spongious bone chips alone (group 2,  = 37). The choice of method was left to the discretion of the surgeon. Read More

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Economic Viability and Efficacy of Day Case Versus Inpatient Tonsillectomy in Southern Iran.

Value Health Reg Issues 2021 Apr 9;24:193-198. Epub 2021 Apr 9.

Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Objectives: Day case tonsillectomy compared with inpatient tonsillectomy has increasingly become a trend for many patients undergoing elective surgeries. Unjustified stays of tonsillectomy can be avoided by day case surgery, which consequently reduces treatment costs. The aim of this study was therefore to determine the cost and effectiveness of day case tonsillectomy compared with inpatient tonsillectomy. Read More

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[Cost-effectiveness of ceftazidime/avibactam versus colistin + meropenem for treatment of carbapenemic-resistant enterobacteria infections in Chile].

Rev Chilena Infectol 2021 Feb;38(1):7-14

Pfizer Chile S.A. laboratorio fabricante del principio activo ceftazidima/avibactam, Chile.

Background: Ceftazidime-avibactam (C/A), has shown reduction in mortality rates and risk of nephrotoxicity, compared to colistin, conventional therapy.

Aim: To estimate the cost-effectiveness of C/A versus colistin + meropenem in the treatment of infections due to carbapenem-resistant Enterobacteriaceae (CRE) in Chile.

Methods: An economic decision tree type model was adapted. Read More

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February 2021

Laparoscopic versus robotic-assisted Heller myotomy for the treatment of achalasia: A systematic review with meta-analysis.

Int J Med Robot 2021 Mar 24:e2253. Epub 2021 Mar 24.

Division of General, Minimally Invasive & Robotic Surgery, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA.

Background: Robotic-assisted laparoscopic Heller myotomy has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia. This systematic review aims to compare the safety and post-operative outcomes of the two procedures.

Methods: Systematic literature search was performed in MEDLINE through Ovid, Scopus and Cochrane to identify clinical trials and retrospective analyses. Read More

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Cosmetic outcomes following wide local excision of impalpable breast cancer: is radioguided occult lesion localization using iodine-125 seeds better than hookwire localization?

ANZ J Surg 2021 Apr 12. Epub 2021 Apr 12.

Division of Surgery, Medical School, University of Western Australia, Crawley, Perth, Western Australia, Australia.

Background: Hookwire localization (HWL) is the gold standard for localizing impalpable tumours for breast conserving surgery. An alternative technique, radioguided occult lesion localization using iodine-125 seeds (ROLLIS), has been associated with lower re-excision rates. This paper investigates if cosmetic outcomes differ in women undergoing breast conserving surgery with HWL or ROLLIS. Read More

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