Multi-Institutional Analysis of Pancreatoduodenectomy for Nonfamilial Periampullary Adenoma: A Novel Risk Score to Guide Shared Decision-Making.

Introduction: Pancreatoduodenectomy (PD) may occasionally be indicated for complete removal of periampullary (duodenal and ampullary) adenomas (PAs). As compared with malignant indications, PD for benign or pre-malignant disease is often associated with increased morbidity. While the Spigelman classification assesses malignancy risk for familial adenomatous polyposis (FAP)-related duodenal adenomas, no malignancy risk score (MRS) exists for non-FAP related PAs.

Incidence of bleeding during and after two non-surgical periodontal therapy schemes in patients with recent acute coronary syndrome on dual antiplatelet therapy: A pilot study.

Background: This study aimed to compare the incidence of bleeding using two periodontal treatment protocols in patients with recent Acute Coronary Syndrome (ACS).

Material And Methods: This is an interim analysis of a double-blind controlled clinical trial evaluating two periodontal treatment schemes in patients with recent ACS treated with different dual antiplatelet regimens: Clopidogrel+ASA, Prasugrel+ASA and Ticagrelor+ASA. After randomisation six patients (22 quadrants) were treated with Scheme A (scaling and root planning-SRP) and six patients (21 quadrants) with Scheme B (ultrasonic scaling-US).

Floodplain forests drive fruit-eating fish diversity at the Amazon Basin-scale.

Unlike most rivers globally, nearly all lowland Amazonian rivers have unregulated flow, supporting seasonally flooded floodplain forests. Floodplain forests harbor a unique tree species assemblage adapted to flooding and specialized fauna, including fruit-eating fish that migrate seasonally into floodplains, favoring expansive floodplain areas. Frugivorous fish are forest-dependent fauna critical to forest regeneration via seed dispersal and support commercial and artisanal fisheries.