Early Thrombolysis and Outcomes in Central Retinal Artery Occlusion: An Individual Participant Data Meta-Analysis.

Background: This individual participant data meta-analysis aimed to determine whether time to treatment influences the effect of intraarterial thrombolysis (IAT), intravenous thrombolysis, and conservative standard therapy on visual outcomes in nonarteritic central retinal artery occlusion.

Methods: We searched MEDLINE, CENTRAL, and Embase up to June 2023 for studies reporting treatment modality and peri-treatment best-corrected visual acuity (BCVA) for ≥5 participants, excluding patients with nonsevere vision loss (BCVA <1.0 logarithm of the minimum angle of resolution [logMAR]) or treated after 24 hours of symptom onset.

High-volume hospitals do not perform better than low-volume hospitals in septic and aseptic revision total hip arthroplasty: an analysis of re-revision risk and mortality based on the Dutch Arthroplasty Register.

Background And Purpose:  Revision total hip arthroplasty (rTHA) is a complex procedure that may benefit from centralization. We examined the association between annual hospital volume of rTHA and re-revision risk and mortality.

Methods:  We included all rTHAs between 2007 and 2022 in general hospitals, registered in the Dutch Arthroplasty Register (LROI; n = 12,515).

Unintentional amitriptyline overdose leading to coma and cardiac conduction impairment in an older adult: A case report.

Elderly patients are particularly vulnerable to look-alike/sound-alike medication errors due to physiological differences that alter medication pharmacokinetics and pharmacodynamics. This report presents the case of a 70-year-old woman admitted to the emergency department in an unconscious state. The information provided by the patient's family suggested a potential unintentional amitriptyline overdose due to confusion with berberine-a plant-derived over-the-counter antidiarrheal medication of similar appearance and packaging.

What is the patient-reported outcome, complication rate and conversion to total knee arthroplasty in patients with tibial plateau fractures caused by high-energy compared to low-energy mechanisms of injury?

Purpose: Despite varying impact of high- and low-energy traumas, research comparing patient and fracture characteristics as well as patient-reported functional outcomes following these trauma mechanisms is limited. From a patient, doctor, and legal perspective, assessing the association between trauma mechanism and clinical outcome is important for managing expectations.

Methods: A multicenter cross-sectional study was performed including 1066 patients treated for a tibial plateau fracture between 2003 and 2019.

Multi-Institutional Comparison of Quality of Life Between Open Versus Endoscopic Skull Base Approaches.

Objectives: The primary objective of this prospective review was to compare quality of life between patients undergoing endoscopic and open skull base approaches.

Study Type And Design: Prospective Review.

Methods: Five centers recruited consecutive patients treated surgically for skull base neoplasms between 2012 to 2018.

Combined MRI, high-resolution manometry and a randomised trial of bisacodyl versus hyoscine show the significance of an enlarged colon in constipation: the RECLAIM study.

Background: Colonic motility in constipation can be assessed non-invasively using MRI.

Objective: To compare MRI with high-resolution colonic manometry (HRCM) for predicting treatment response.

Design: Part 1: 44 healthy volunteers (HVs), 43 patients with irritable bowel syndrome with constipation (IBS-C) and 37 with functional constipation (FC) completed stool diaries and questionnaires and underwent oral macrogol (500-1000 mL) challenge.

Short-term Outcomes in Infants after General Anesthesia with Low-dose Sevoflurane/Dexmedetomidine/Remifentanil versus Standard-dose Sevoflurane (the TREX Trial).

Background: The Trial Remifentanil DEXmedetomidine (TREX) trial aimed to determine whether, in children less than 2 yr old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard-dose sevoflurane anesthesia in terms of global cognitive function at 3 yr of age. The aim of the current secondary analyses was to compare incidence of intraoperative hypotension and bradycardia, postoperative pain, time to recovery, need for treatment of intraoperative hypotension and bradycardia, incidence of light anesthesia and need for treatment, need for postoperative pain medications, and morbidity and mortality outcomes at 5 days between the two arms.

Methods: This phase III randomized active controlled, parallel group, assessor blinded, multicenter, superiority trial was performed in 20 centers in Australia, Italy, and the United States.

Fecundity and Nutrient Deficiency Following Obesity Treatment: Implications for Young-Onset Cancer Risk in Offspring.

Young-onset adult cancers have been an emerging problem over the last three decades in Australia [...

Optical coherence tomography assessment of the impact of colchicine on non-culprit coronary plaque composition after myocardial infarction.

Aims: Low-dose colchicine reduces the risk of cardiovascular events after myocardial infarction (MI). The purpose of this study was to assess the effect of colchicine post-MI on coronary plaque morphology in non-culprit segments by optical coherence tomography (OCT).

Methods And Results: COCOMO-ACS was a double-blind, placebo-controlled trial that randomized 64 patients (median age 61.

Can we "prehabilitate" pancreatic cancer patients prior to surgery? A critical appraisal of the literature.

Background: Enhancing a patient's functional capacity to withstand the surgical stress by means of multimodal (combined exercise, nutrition and psychological interventions) prehabilitation may potentially lead to improved outcomes in pancreatic cancer surgery.

Methodology: A systematic review was undertaken searching PubMed, Google Scholar and Cochrane Library databases, exploring the impact of prehabilitation in pancreatic surgery. Outcomes of interest were adherence to the prehabilitation, functional capacity, overall complications and post-operative length of stay.

Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization.

Background: Atrial fibrillation (AF) and ventricular fibrillation (VF) episodes exhibit varying durations, with some spontaneously ending quickly while others persist. A quantitative framework to explain episode durations remains elusive. We hypothesized that observable self-terminating AF and VF episode lengths, whereby durations are known, would conform with a power law based on the ratio of system size and correlation length ([Formula: see text].

REDISCOVER guidelines for borderline-resectable and locally advanced pancreatic cancer: management algorithm, unanswered questions, and future perspectives.

The REDISCOVER guidelines present 34 recommendations for the selection and perioperative care of borderline-resectable (BR-PDAC) and locally advanced ductal adenocarcinoma of the pancreas (LA-PDAC). These guidelines represent a significant shift from previous approaches, prioritizing tumor biology over anatomical features as the primary indication for resection. Condensed herein, they provide a practical management algorithm for clinical practice.

An infratentorial dural arteriovenous fistula mimicking cervical myelopathy: A case report.

Dural arteriovenous fistulas may have insidious clinical presentations and are often challenging to diagnose. A small number of cases have been associated with perimedullary venous congestion and cord oedema, mimicking common pathologies, such as cervical myelopathy. We describe a case report of a patient presenting with a constellation of symptoms and radiological signs mimicking C5/6 cervical myelopathy secondary to disc herniation.

The burden of young-onset pancreatic cancer and its risk factors from 1990 to 2019: A systematic analysis of the global burden of disease study 2019.

Objective: To investigate worldwide incidence, deaths, disability-adjusted life years (DALYs) and risk factors for young-onset pancreatic cancer (YOPC) using the Global Burden of Disease Study 2019-20 data.

Methods: We queried the Global Health Data Exchange tool for "pancreatic cancer" and "incidence", "deaths" as the "measure", and "DALYs" as the "cause" for the age group of 15-49 years to determine global, regional, and national trends in the incidence, deaths, and DALYs of YOPC. Sociodemographic index (SDI) was used to evaluate the associations between socioeconomic development and YOPC.

Ten technical aspects of baseplate fixation in reverse total shoulder arthroplasty for patients without glenoid bone loss: a systematic review.

The aim of this systematic review was to collect evidence on the following 10 technical aspects of glenoid baseplate fixation in reverse total shoulder arthroplasty (rTSA): screw insertion angles; screw orientation; screw quantity; screw length; screw type; baseplate tilt; baseplate position; baseplate version and rotation; baseplate design; and anatomical safe zones. Five literature libraries were searched for eligible clinical, cadaver, biomechanical, virtual planning, and finite element analysis studies. Studies including patients >16 years old in which at least one of the ten abovementioned technical aspects was assessed were suitable for analysis.

Global Perceptions on ERAS in Pancreatoduodenectomy.

Background: Uptake of ERAS pathways for pancreatic surgery have been slow and impacted by low compliance.

Objective: To explore global awareness, perceptions and practice of ERAS peri-pancreatoduodenectomy (PD).

Methods: A structured, web-based survey (EPSILON) was administered through the ERAS society and IHPBA membership.

Active surveillance should not be routinely considered in ISUP grade group 2 prostate cancer.

Active surveillance has been proposed as a therapeutic option in selected intermediate risk patients with biopsy grade group 2 prostate cancer. However, its oncologic safety in this setting is debated. Therefore, we conducted a non-systematic literature research of contemporary surveillance protocols including patients with grade group 2 disease to collect the most recent evidence in this setting.

Factors Influencing Outcome of Orbital Floor Reconstruction.

 Orbital floor fractures are routinely encountered in facial trauma. Many factors influence the final outcome of the orbital floor surgery, time interval and the extent of other facial bone fractures are the two factors which can significantly influence the postoperative outcome following orbital floor reconstruction. Our study aims to find the ideal time for intervention and the association of other factors in the final outcome of orbital floor reconstruction.

Plasma Cetuximab Concentrations Correlate With Survival in Patients With Advanced KRAS Wild Type Colorectal Cancer.

Background: Cetuximab is a standard of care therapy for patients with RAS wild-type (WT) advanced colorectal cancer. Limited data suggest a wide variation in cetuximab plasma concentrations after standard dosing regimens. We correlated cetuximab plasma concentrations with survival and toxicity.

Travel burden for patients with multimorbidity - Proof of concept study in a Dutch tertiary care center.

Objectives: To explore travel burden in patients with multimorbidity and analyze patients with high travel burden, to stimulate actions towards adequate access and (remote) care coordination for these patients.

Design: A retrospective, cross-sectional, explorative proof of concept study.

Setting And Participants: Electronic health record data of all patients who visited our academic hospital in 2017 were used.

Fluid resuscitation in the early management of acute pancreatitis - evidence from a systematic review and meta-analysis.

Background: Third space fluid loss is one of the hallmarks of the pathophysiology of acute pancreatitis (AP) contributing to complications, including organ failure and death. We conducted a systematic review of literature to determine the ideal fluid resuscitation in the early management of AP, primarily comparing aggressive versus moderate intravenous fluid resuscitation (AIR vs MIR).

Methods: A systematic review of major reference databases was undertaken.

A New Global Definition of Acute Respiratory Distress Syndrome.

Since publication of the 2012 Berlin definition of acute respiratory distress syndrome (ARDS), several developments have supported the need for an expansion of the definition, including the use of high-flow nasal oxygen, the expansion of the use of pulse oximetry in place of arterial blood gases, the use of ultrasound for chest imaging, and the need for applicability in resource-limited settings. A consensus conference of 32 critical care ARDS experts was convened, had six virtual meetings (June 2021 to March 2022), and subsequently obtained input from members of several critical care societies. The goal was to develop a definition that would ) identify patients with the currently accepted conceptual framework for ARDS, ) facilitate rapid ARDS diagnosis for clinical care and research, ) be applicable in resource-limited settings, ) be useful for testing specific therapies, and ) be practical for communication to patients and caregivers.