Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study.

Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR).

Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study.

Background: Insertable cardiac monitors (ICMs) are small subcutaneously implanted devices that detect changes in R-wave amplitudes (RWAs), effective in arrhythmia-monitoring. Although ICMs have proven to be immensely successful, electrical artefacts are frequent and can lead to misdiagnosis. Thus, there is a growing need to sustain and increase efficacy in detection rates by gaining insight into various patient-specific factors such as body postures and activities.

R-wave amplitude changes with posture and physical activity over time in an insertable cardiac monitor.

Background: Insertable cardiac monitors (ICMs) are accepted tools in cardiac arrhythmia management. Consistent R-wave amplitude (RWA) is essential for optimal detection.

Objectives: Assess RWAs with posture/activities at insertion and at 30 days.

Sex differences in Cardiac electronic device implantation: Outcomes from an Australian multi-centre clinical quality registry.

Background: There is uncertainty regarding whether outcomes after Cardiac Implantable Electronic Devices (CIED) differ between women and men. There are no prospectively collected data regarding Australian CIED outcomes. This study aimed to determine whether the characteristics and outcomes of Australian patients undergoing CIED implantation differ by sex.

Pyelonephritis in Pediatric Uropathic Patients: Differences from Community-Acquired Ones and Therapeutic Protocol Considerations. A 10-Year Single-Center Retrospective Study.

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020.

Miniaturized implantable cardiac monitor with a long sensing vector (BIOMONITOR III): Insertion procedure assessment, sensing performance, and home monitoring transmission success.

Background: Implantable Cardiac Monitors (ICMs) are used for long-term monitoring of arrhythmias. BIOMONITOR III is a novel ICM with a miniaturized profile, long sensing vector due to a flexible antenna, simplified implantation with a dedicated insertion tool for pocket formation and ICM placement in a single step, and daily automatic Home Monitoring (HM) function.

Methods: In 47 patients undergoing BIOMONITOR III insertion for any ICM indication, 16 investigators at 10 Australian sites assessed handling characteristics of the insertion tool, R-wave amplitudes, noise burden, P-wave visibility, and HM transmission success.

Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series.

Objective: The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD).

Methods: This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms.

"Double N": Evolution of the Surgical Technique for Laparoscopic Herniorrhaphy After 10-Year Experience in a Single Center.

Introduction: We describe our experience with the use of a modified technique for laparoscopic internal inguinal ring closure (peritoneal incision and double "N" stitch placement). We evaluate the technique in terms of feasibility, efficacy, and safety.

Materials And Methods: From November 2003 to March 2014 we performed 1700 herniorraphies by laparoscopy.

Laparoscopic patch repair of recurrent anterior diaphragmatic hernia in a child with SMA.

An anterior congenital diaphragmatic hernia (CDH) is a diaphragmatic defect that allows the passage of abdominal organs into the thorax. It is typically asymptomatic (the diagnosis is incidental) and it requires surgical correction. In this paper we present a 6 year-old girl affected by spinal muscular atrophy (SMA) who was diagnosed with anterior CDH.

Measuring the design of empathetic buildings: a review of universal design evaluation methods.

Purpose: Universal design (UD) provides an explanation of good design based on the user perspective, which are outlined through its principles, goals, and related frameworks. The aim of this paper is to provide an overview of the frameworks and methods for UD building evaluations and to describe how close they have come to describing what a universally designed building is.

Methods: Evaluation approaches are reviewed from the existing literature across a number of spatial disciplines, including UD, human geography and urban studies.

Sparing-lung surgery for the treatment of congenital lung malformations.

Purpose: Congenital lung malformations (CLM) are traditionally treated by pulmonary lobectomy. The foremost indication for surgery is that these lesions predispose to respiratory tract infections and to malignancy. Owing to the improvement of prenatal diagnosis, most patients are operated in a timely manner and prophylactically.

Congenital colonic stenosis: a case of late-onset.

Purpose: Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 1.8%-15% of intestinal atresias occur in the colon.

Predictive factors for child behaviour in the dental environment.

Aim: This was to evaluate the potential factors that influence behaviour in the paediatric dentistry environment of children aged 48 to 68 months who have never before been to a dentist.

Study Design: Cross sectional.

Methods: Child behaviour was evaluated using the Frankl scale during both clinical examination procedures and prophylaxis.

Use of different catheter ablation technologies for treatment of typical atrial flutter: acute results and long-term follow-up.

Objectives: We report the acute success and long-term follow-up in consecutive patients undergoing catheter ablation of typical right atrial flutter (AFL) using different ablation technologies.

Methods: One hundred and two patients presenting for treatment of AFL to our laboratory were included in the study. Based on availability and physician preference, ablation was performed with either a cooled-tip catheter (39 patients, group I), an 8- or 10-mm tip catheter connected to a high-power radiofrequency (RF) generator (25 patients, group II), or a 4- or 5-mm tip catheter (38 patients, group III).

Matching approved "nondedicated" hardware to obtain biventricular pacing and defibrillation: feasibility and troubleshooting.

Biventricular ICDs may offer increased benefit for patients with severe congestive heart failure and ventricular arrhythmia. Currently there are no approved dedicated biventricular ICDs available. Twenty-one consecutive patients who had approved nondedicated hardware implanted for biventricular pacing and defibrillation were included in this study.

Circular mapping and ablation of the pulmonary vein for treatment of atrial fibrillation: impact of different catheter technologies.

Objectives: We conducted this study to compare the efficacy and safety of different catheter ablation technologies and of distal versus ostial pulmonary veins (PV) isolation using the circular mapping technique.

Background: Electrical isolation of the PVs in patients with atrial fibrillation (AF) remains a technical challenge.

Methods: Two hundred eleven patients (163 men; mean age 53 +/- 11 years) with symptomatic AF were included in this study.

Nonexcitatory stimulus delivery improves left ventricular function in hearts with left bundle branch block.

Introduction: Preliminary data in a heart failure animal model and isolated muscle preparation have suggested that nonexcitatory stimulation (NES) improves left ventricular (LV) function.

Methods And Results: We compared biventricular (BV) pacing with NES in an animal model with left bundle branch block (LBBB). The left bundle branch (LBB) was ablated in eight normal heart pigs and led to >50% increase in QRS duration (mean 100 +/- 15 msec).

Empirical pulmonary vein isolation in patients with chronic atrial fibrillation using a three-dimensional nonfluoroscopic mapping system: long-term follow-up.

The purpose of this study was to assess the feasibility and long-term results of empirical isolation of both superior pulmonary veins in patients with chronic AF. Although localizing and ablating the focal triggers of AF has been proven an effective approach, this strategy is time consuming, often requires multiple procedures, and carries the risk of pulmonary vein stenosis. Whether ostial electrical isolation of the superior pulmonary veins, without initial detailed mapping, is a more efficient approach is not known.

Biventricular pacing for heart failure.

The completed trials of biventricular pacing in congestive cardiac failure are impressively encouraging as a novel therapy for the symptoms of a most devastating disease. The actual delivery of the LV pacing hardware and final patient selection criteria require further refinement, as it is clear that not all patients with heart failure respond favorably. What is clear is that all patients should be prescribed maximally tolerated, proven medical therapy before assessment as to the feasibility of biventricular pacing therapy.

Ascorbate attenuates atrial pacing-induced peroxynitrite formation and electrical remodeling and decreases the incidence of postoperative atrial fibrillation.

Atrial fibrillation (AF), the most common chronic arrhythmia, increases the risk of stroke and is an independent predictor of mortality. Available pharmacological treatments have limited efficacy. Once initiated, AF tends to self-perpetuate, owing in part to electrophysiological remodeling in the atria; however, the fundamental mechanisms underlying this process are still unclear.

Usefulness of midodrine in patients with severely symptomatic neurocardiogenic syncope: a randomized control study.

Introduction: The efficacy of midodrine for the management of patients with neurocardiogenic syncope was assessed prospectively in a randomized control study.

Methods And Results: Patients who had at least monthly occurrences of syncope and a positive tilt-table test were included in the study. A total of 61 patients were randomly allocated to treatment either with midodrine or with fluid, salt tablets, and counseling.

Ventricular tachycardias arising from the aortic sinus of valsalva: an under-recognized variant of left outflow tract ventricular tachycardia.

Objectives: To describe a normal heart left bundle branch block, inferior axis ventricular tachycardia (VT), that could not be ablated from the right or left ventricular outflow tracts.

Background: Whether these VTs are epicardial and can be identified by a specific electrocardiographic pattern is unclear.

Methods: Twelve patients with normal heart left bundle branch block, inferior axis VT and previously failed ablation were included in this study.

Preventing sudden death in coronary cardiomyopathy: implantable defibrillators lead the way.

The Multicenter Unsustained Tachycardia Trial (MUSTT) demonstrated that electrophysiologic testing (EP)-guided therapy significantly reduces arrhythmic death and cardiac arrest in patients with coronary artery disease, a left ventricular ejection fraction of 40% or less, nonsustained ventricular tachycardia, and inducible ventricular arrhythmia on EP testing-but only if the therapy includes an implantable defibrillator. All patients who meet the MUSTT inclusion criteria should undergo an EP test and if positive, should undergo defibrillator implantation.

The management of surgical complications of pacemaker and implantable cardioverter-defibrillators.

The rate of implantation of pacemakers and implantable cardioverter-defibrillators (ICDs) is ever-increasing. The relative ease of device implantation utilizing a relatively simple, expeditious, percutaneous approach, without the requirement for general anesthesia or long recuperation times, has fueled enthusiasm for implantation. However, the complication risk is ever-present and forms the subject of this pragmatic review, which is limited to the management of only the surgical complications of device implantation.