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Oncologic Outcomes of Incidental Versus Biopsy-diagnosed Grade Group 1 Prostate Cancer : A Multi-institutional Study

Background and objective: Patients diagnosed with grade group (GG) 1 prostate cancer (PCa) following treatment for benign disease (“incidental” PCa) are typically managed with active surveillance (AS). It is not known how their outcomes compare with those observed in patients diagnosed with GG1 on biopsy. We aimed at determining whether long-term oncologic outcomes of AS for patients with GG1 PCa

Laparoscopic lavage vs primary resection for acute perforated diverticulitis : The SCANDIV randomized clinical trial

IMPORTANCE: Perforated colonic diverticulitis usually requires surgical resection, which is associated with significant morbidity. Cohort studies have suggested that laparoscopic lavage may treat perforated diverticulitis with less morbidity than resection procedures. OBJECTIVE: To compare the outcomes from laparoscopic lavage with those for colon resection for perforated diverticulitis. DESIGN, S

Structured diabetes care routines in cardiac rehabilitation are associated with increased diabetes detection and improved treatment after myocardial infarction : a nationwide observational study

BACKGROUND: Despite the detrimental impact of abnormal glucose metabolism on cardiovascular prognosis after myocardial infarction (MI), diabetes is both underdiagnosed and undertreated. We investigated associations between structured diabetes care routines in cardiac rehabilitation (CR) and detection and treatment of diabetes at one-year post-MI.METHODS: Center-level data was derived from the Perf

Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study

Background: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study ass

Transatlantic multicenter study on the use of a modified preloaded delivery system for fenestrated endovascular aortic repair

Objective: Analyze the outcomes of endovascular complex abdominal and thoracoabdominal aortic aneurysm repair using the Cook fenestrated device with the modified preloaded delivery system (MPDS) with a biport handle and preloaded catheters. Methods: A multicenter retrospective single arm cohort study was performed, including all consecutive patients with complex abdominal aortic aneurysm repair an

Treatment for Acute Anterior Cruciate Ligament Tear in Young Active Adults

BACKGROUND Anterior cruciate ligament (ACL) injury of the knee is common in young active adults and often has severe and sometimes lifelong consequences. The clinical management of this injury remains debated. A prior trial of early versus delayed optional ACL repair showed no differences in outcomes at 2 years. METHODS We present the 11-year follow-up of a randomized clinical trial involving 121

Coronary Artery Lesion Lipid Content and Plaque Burden in Diabetic and Nondiabetic Patients : PROSPECT II

BACKGROUND: Patients with diabetes have increased rates of major adverse cardiac events (MACEs). We hypothesized that this is explained by diabetes-associated differences in coronary plaque morphology and lipid content. METHODS: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), 898 patients with acute myocardial infarction with or without ST-segme

Evaluating effect modification by HIV testing history to understand the mechanisms behind the impact of announcing HIV self-testing availability in a clinic system in Kenya

Background: In sub-Saharan Africa, truckers and female sex workers (FSWs) have high HIV risk and face challenges accessing HIV testing. Adding HIV self-testing (HIVST) to standard of care (SOC) programs increases testing rates. However, the underlying mechanisms are not fully understood. HIVST may decrease barriers (inconvenient clinic hours, confidentiality concerns) and thus we would expect a gr

Low levels of selenoprotein P associate with cognitive impairment in patients hospitalized for heart failure

BackgroundSelenoprotein P (SELENOP) is a transporter for selenium and has been shown to protect selenium status maintenance in brain against deficiency, supporting neuronal development, neurogenesis and neurocognitive function. Selenium deficiency has previously been associated with cognitive impairment in various populations, but no studies have been carried out in subjects with heart failure (HF

Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age : Extremely Preterm Infants in Sweden Study (EXPRESS)

Importance: This follow-up study of extremely preterm (EPT) children (<27 weeks' gestational age [GA] at birth) revealed major eye and visual problems in 37.9% (147 of 388) of all EPT infants and in 55.4% (67 of 121) of the most immature subgroups at 6.5 years of age. These major eye and visual problems were strongly associated with treatment-requiring retinopathy of prematurity (ROP).Objectives:

The semi-quantitative cardiac arrest brain ischemia (CABI) score for magnetic resonance imaging predicts functional outcome after cardiac arrest

Background: Magnetic resonance imaging (MRI) is recommended by guidelines to evaluate the severity of brain ischemia after cardiac arrest for functional outcome prediction. However, standardized assessment criteria are lacking. We have developed a semi-quantitative Cardiac Arrest Brain Ischemia (CABI) score to assess the extension of brain ischemia on MRI. Objectives: To evaluate the prognostic pe

Sedation and analgesia in post-cardiac arrest care : a post hoc analysis of the TTM2 trial

Background: The routine use of sedation and analgesia during post-cardiac arrest care and its association with clinical outcomes remain unclear. This study aimed to describe the use of sedatives and analgesics in post-cardiac arrest care, and evaluate associations with good functional outcome, survival, clinical seizures, and late awakening. Methods: This was a post hoc analysis of the TTM2-trial,

Caesarean section rates in public vs private hospitals in Europe : a systematic review and meta-analysis using the Robson ten group classification system

INTRODUCTION: Since the last two decades, there has been a dramatic rise in caesarean sections (CS) throughout the world. This increase has been seen even in Europe, where rates vary significantly from 17% in Northern Europe to 56% in the South. Although, CS can be a lifesaving intervention when medically necessary, non-essential CS are associated with short- and long-term complications for both t

Clinical aspects of molecular profiles in metastatic malignant melanoma

Malignant melanoma is a heterogeneous, malignant neoplastic disease, most often originating in the skin. Melanoma is characterized by a high mutational load and has a vastly variable prognosis, depending on disease stage. Genetic aberrations in the mitogen-activating protein kinase (MAPK) pathway are important in melanoma, of which mutations in BRAF and NRAS are the most common. Additionally, recu

High-resolution postmortem 7 tesla MRI yields localized atrophy measures that are more sensitive to tau pathology and neuronal loss in Alzheimer’s disease than corresponding measures on antemortem 3 tesla MRI

BACKGROUND: Postmortem MRI has opened-up avenues to study brain structure at ultra high-resolution revealing details not possible to observe with in vivo MRI. Here, we present a novel package (purple-mri) which performs tissue segmentation, anatomical parcellation and spatial normalization of postmortem MRI. Additionally, we provide a framework to perform point-wise surface-based group-level studi

Native T1-mapping using cardiovascular magnetic resonance detects myocardium at risk during the first week following myocardial infarction in a swine model and in patients - comparison to contrast-enhanced cine steady-state free precession

Background: Myocardium at risk (MaR) can be evaluated by cardiovascular magnetic resonance (CMR) imaging using contrast-enhanced steady state free precession (CE-SSFP) in patients after ST-elevation myocardial infarction (STEMI). However, CE-SSFP utilizes gadolinium contrast, which is contraindicated in patients with severe renal insufficiency. Native T1-mapping is a non-contrast CMR method which

Total and anatomically contextualized quantitative 18F-DCFPyL PET at biochemical recurrence to predict subsequent biochemical progression-free survival in patients with prostate cancer.

33Background: PSMA PET has been shown to detect more metastasis and alter management at biochemical recurrence (BCR), but it remains to be determined that it changes oncologic outcome. We assessed the quantitative parameters on 18F-DCFPyL PET at BCR and evaluated their association with tumor volume, metastatic locations with the subsequent biochemical progression free survival (bPFS). Methods: Thi

Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study

Background: Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of