Combined Open Surgery and CO Laser for Giant Supraglottic Hemangioma in an Adult: A Case Report.

Laryngeal hemangiomas are rare vascular tumors, mainly in children, and less common in adults. Giant lesions typically require multiple endoscopic procedures and temporary tracheostomy. Open surgery allows single-procedure removal with fewer complications.

Echocardiographic Evidence of Cardiac Atrophy in the Critically Ill.

Unlabelled: The purpose of this explorative study is to determine if critically ill patients experience cardiac atrophy that can be quantified as a loss of left ventricular mass (LVM) and thus detected by echocardiography.

Design: Retrospective single-center cohort study.

Setting: Patients admitted to a tertiary medical center in Boston, MA.

Multidisciplinary Heart Failure Care Program: An Experience From Colombia.

The prevalence of Heart Failure is growing alarmingly; its treatment consumes health resources and affects the quality of life of patients. To describe the changes in NYHA functional Class, ejection fraction, hospitalizations, and mortality after 8 years of follow up in a multidisciplinary heart failure program in Colombia as a model for lower and middle income countries. An observational study was performed with the retrospective analysis of the information.

X-linked myotubular myopathy associated with an MTM1 variant in a Maine coon cat.

Objective: Describe the clinical course and diagnostic and genetic findings in a cat with X-linked myotubular myopathy.

Case Summary: A 7-month-old male Maine coon was evaluated for progressively worsening gait abnormalities and generalized weakness. Neurolocalization was to the neuromuscular system.

Mechanical Thrombectomy for Acute Ischemic Stroke Due to Large Vessel Occlusion in Argentina: An Economic Analysis.

Objectives: Mechanical thrombectomy (MT) after intravenous thrombolysis (IV-tPA) is an effective and cost-saving treatment for stroke due to large vessel occlusion. However, rates of MT use are low in Argentina. This study was designed to estimate the economic value and the budget impact of incorporating MT after thrombolysis, simulating scenarios from Argentinian compulsory social health insurance (Obras Sociales) and private insurances (Empresas de Medicina Prepaga).

Intraoperative Oxygen Practices in Cardiac Surgery: A National Survey.

Objective: To describe the current nationwide perspectives and practice regarding intraoperative oxygen titration in cardiac surgery.

Design: Prospective, observational survey.

Setting: Hospitals across the United States.

Effectiveness and Safety of Palbociclib plus Endocrine Therapy in Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: Real-World Results.

Background: Real-world data are critical to demonstrate the reproducibility of evidence and the external generalizability of randomized clinical trials. Palbociclib is an oral small-molecule inhibitor of cyclin-dependent kinases 4/6 that has been shown to improve progression-free survival when combined with letrozole or fulvestrant in phase 3 clinical trials.

Objective: To evaluate real-world outcomes in patients with metastatic breast cancer who received palbociclib in combination with endocrine therapy in routine clinical practice.

Treatment Options for COVID-19-Related Guillain-Barré Syndrome: A Systematic Review of Literature.

Background: Central nervous system complications are reported in an increasing number of patients with Coronavirus Disease 2019 (COVID-19). COVID-19-related Guillain-Barré syndrome (GBS) is of particular importance given its association with higher mortality rates and prolonged respiratory failure.

Review Summary: We conducted a systematic review of published cases for COVID-19-related GBS, and provide a summary of clinical management strategies for these cases.

High frequency of ocular toxoplasmosis in Quindío, Colombia and risk factors related to the infection.

Objectives: To determine the frequency of retinochoroidal lesions by ocular toxoplasmosis and their relationships with risk factors, in residents of two districts with high exposure to in Armenia-Quindío, Colombia.

Methods: Cross-sectional analyses of fundoscopy screening, serological tests, and questionnaires were performed to determine risk factors associated with ocular toxoplasmosis retinochoroidal lesions. Differences in proportions were analyzed using the chi-squared test.

Comparison of cost-effectiveness of implantable cardioverter defibrillator therapy in patients for primary prevention in Latin America: an analysis using the Improve SCA study.

Objective: The mortality benefit of implantable cardioverter defibrillators (ICDs) for primary prevention (PP) of sudden cardiac arrest (SCA) has been well-established, but ICD therapy remains globally underutilized. The results of the Improve SCA study showed a 49% relative risk reduction in all-cause mortality among ICD patients with 1.5 primary prevention (1.

Anesthetic management of unruptured intracranial aneurysms: a qualitative systematic review.

Intracranial aneurysms (IA) occur in 3-5% of the general population and may require surgical or endovascular obliteration if the patient is symptomatic or has an increased risk of rupture. These procedures carry an inherent risk of neurological complications, and the outcome can be influenced by the physiological and pharmacological effects of the administered anesthetics. Despite the critical role of anesthetic agents, however, there are no current studies to systematically assess the intraoperative anesthetic risks, benefits, and outcome effects in this population.

Microcirculatory dysfunction and dead-space ventilation in early ARDS: a hypothesis-generating observational study.

Background: Ventilation/perfusion inequalities impair gas exchange in acute respiratory distress syndrome (ARDS). Although increased dead-space ventilation (V/V) has been described in ARDS, its mechanism is not clearly understood. We sought to evaluate the relationships between dynamic variations in V/V and extra-pulmonary microcirculatory blood flow detected at sublingual mucosa hypothesizing that an altered microcirculation, which is a generalized phenomenon during severe inflammatory conditions, could influence ventilation/perfusion mismatching manifested by increases in V/V fraction during early stages of ARDS.

Cost-effectiveness of the use of the continuous subcutaneous insulin infusion pump versus daily multiple injections in type 1 diabetes adult patients at the Mexican Institute of Social Security.

Background: To estimate the incremental cost-effectiveness ratio (ICER) of the use of continuous subcutaneous insulin infusion (CSII) therapy versus multiple daily injections (MDI) therapy in adult patients with type 1 diabetes (T1D) at the Mexican Institute of Social Security (IMSS).

Methods: An analysis was developed using the internationally validated Core Diabetes Model (CDM) with which the incidence and progression of acute and chronic complications and the mortality of T1D was simulated throughout life. The baseline characteristics of the simulated cohorts were obtained from Mexican T1D adult patients aged ≥ 18 years that received care at two national IMSS medical centres in 2016.

POEM in Latin America: The Rise of a New Standard.

Background: Per-oral endoscopic myotomy (POEM) has become the preferred alternative treatment to standard Heller myotomy for patients with esophageal achalasia, in Latin American countries. The aim of our study was to evaluate the efficacy and safety of a POEM in the management of achalasia with and without Chagas disease in patients receiving POEM.

Methods: Patients who underwent POEM from tertiary centers in Latin America were included in a dedicated registry.

Socio-demographic and clinical characteristics of type 1 diabetes patients associated with emergency room visits and hospitalizations in Mexico.

Background: To describe the demographic and clinical characteristics of Type 1 diabetes (T1D) patients affiliated with the Mexican Institute of Social Security (IMSS) and ascertain the socio-demographic and clinical risk factors associated with emergency room (ER) visits and diabetes-related hospitalizations.

Methods: We conducted secondary data analysis of a cross-sectional study. The study included T1D patients 18 years of age and older who in 2016 attended follow-up visits at the endocrinology department of two IMSS tertiary care hospitals in Mexico City.

Microcirculatory blood flow derangements during severe preeclampsia and HELLP syndrome.

Objective: To evaluate the microcirculatory blood flow in severe preeclampsia and compare it with healthy pregnant and non-pregnant women controls, using a portable intravital-microscopy technique.

Methods: Using a side-stream dark field (SDF) device, we prospectively evaluated the sublingual microcirculatory blood flow before placental delivery in 40 women with severe preeclampsia (PE-group) complicated (n=8) or not (n=32) with HELLP syndrome, 40 healthy pregnant women (HP-group) matched by gestational and chronological age, and 20 healthy non-pregnant women (NP-group). Microvessels were classified as large or small using a cutoff value of 20μm and those with continuous flow were considered as normal while sluggish, intermittent and stopped flows were considered as abnormal.

Effects of dobutamine on intestinal microvascular blood flow heterogeneity and O extraction during septic shock.

Derangements of microvascular blood flow distribution might contribute to disturbing O extraction by peripheral tissues. We evaluated the dynamic relationships between the mesenteric O extraction ratio ([Formula: see text]) and the heterogeneity of microvascular blood flow at the gut and sublingual mucosa during the development and resuscitation of septic shock in a swine model of fecal peritonitis. Jejunal-villi and sublingual microcirculation were evaluated using a portable intravital-microscopy technique.

Clinical and economic benefits of integrated pump/CGM technology therapy in patients with type 1 diabetes in Colombia.

Objective: To assess the long-term clinical and economic impact of integrated pump/CGM technology therapy as compared to multiple daily injections (MDI), for the treatment of type 1 diabetes (T1D) in Colombia.

Methods: The CORE Diabetes Model was used to simulate a hypothetical cohort of patients with T1D. Mean baseline characteristics were taken from a clinical study conducted in Colombia and a healthcare payer perspective was adopted, with a 5% annual discount rate applied to both costs and outcomes.

Can venous-to-arterial carbon dioxide differences reflect microcirculatory alterations in patients with septic shock?

Purpose: Septic shock has been associated with microvascular alterations and these in turn with the development of organ dysfunction. Despite advances in video microscopic techniques, evaluation of microcirculation at the bedside is still limited. Venous-to-arterial carbon dioxide difference (Pv-aCO2) may be increased even when venous O2 saturation (SvO2) and cardiac output look normal, which could suggests microvascular derangements.

[An adapted model of cost-effectiveness analysis for the drug entecavir vs pegylated interferon in Venezuela].

Objective: In order to compare the cost and to find the cost-effectiveness ratio of 0.5 mg/day entecavir versus pegylated interferon in the suppression of the viral replication and the quality of life of chronic hepatitis B patients based on a previously developed economic evaluation by Spackman y Veenstra, we performed, previous data transferability analysis, an adaptation of the model to the Venezuelan reality.

Methods: To adapt the economic evaluation, we assumed the probabilities of transition between states, in accordance with the effectiveness reported in the original evaluation.

Tumors of the coracoid process: clinical evaluation of twenty-one patients.

Objective: We present the incidence and management of bone tumors of the coracoid process and discuss the related clinical and imaging findings and treatment.

Materials And Methods: We present 21 patients (7 males and 14 females; mean age, 39 years) treated for bone tumors of the coracoid process from 1900 to 2010. Mean follow-up was 44 months (range, 12-132 months).