High And Intermediate-High Risk Pulmonary Embolism Management: A 5-Year Intensive Care Unit Casuistic Review.

Background And Objectives: The optimal management of high-risk and intermediate-high-risk Pulmonary Embolism (PE) is a matter of ongoing debate. This paper aims to assess the short and long-term clinical outcomes associated with different treatment approaches for high-risk and intermediate-high-risk PE within an Intensive Care Unit (ICU) and identify potential areas for improvement.

Methods: We conducted a retrospective analysis of patients admitted to an ICU with high and intermediate-high-risk PE between January 2018 and December 2023.

Comparison of management options for spontaneous bleeding into soft tissues in patients with COVID-19.

Spontaneous bleeding into soft tissues was a common complication of anticoagulant therapy among critically ill patients during the COVID-19 pandemic. This study sought to evaluate the impact of different treatment methods on survival among COVID-19 patients with active or self-resolved spontaneous bleeding into soft tissues. Methods used to treat CT-confirmed spontaneous hematomas in COVID-19 patients included nonoperative management (NOM), angiography (AG) with transarterial embolization (TAE) and open surgery (OS).

S8 Navigation system combined with an ultrasonic osteotome for three-dimensional real-time dynamic visualization decompression to reduce postoperative neurological deterioration in thoracic ossification of the ligamentum flavum.

Background: Posterior laminectomy is a standard treatment for thoracic ossification of the ligamentum flavum (TOLF), but it often leads to neurological deterioration during surgery. This study aimed to reduce iatrogenic neurological deterioration by using an S8 navigation system combined with an ultrasonic osteotome for three-dimensional real-time dynamic visualization decompression.

Methods: A retrospective analysis was conducted on patients who underwent laminectomy and internal fixation for TOLF in our centre from January 2016 to January 2023.

Prognostic relevance of CT-defined body composition in patients with acute bleeding undergoing endovascular embolization.

Objectives: Body composition assessment includes the parameter skeletal muscle mass, subcutaneous and visceral adipose tissue (SAT and VAT). The purpose of this study was to elucidate associations of body composition parameters with mortality in patients with acute bleeding undergoing transarterial embolization (TAE).

Methods: A mixed cohort of patients from 2018 to 2022 with acute bleeding requiring treatment with a TAE was retrospectively evaluated.

Postnatal management of preterm infants with congenital diaphragmatic hernia.

Introduction: Congenital diaphragmatic hernia (CDH) in the preterm population is increasingly common in the current era of fetal endoluminal tracheal occlusion (FETO) therapy. There remains a lack of clinical guidance for clinicians and surgeons regarding optimal management strategies for such infants. We aimed to describe our experience in managing preterm CDH in a single quaternary neonatal intensive care unit (NICU).

Endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries: a systematic review and clinical practice guideline update.

Purpose: Our aim was to update evidence-based and consensus-based recommendations for the inhospital endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.

Methods: MEDLINE and Embase were systematically searched to June 2021.

Amelioration of a von Willebrand disease type 2B phenotype in vivo upon treatment with allele-selective siRNAs.

Treatment options for the bleeding disorder von Willebrand disease type 2B (VWD2B) are insufficient and fail to address the negative effects of circulating mutant von Willebrand factor (VWF). The dominant-negative nature of VWD2B makes functionally defective VWF an interesting therapeutic target. Previous in vitro studies have demonstrated the feasibility of allele-selective silencing of mutant VWF using small interfering RNAs (siRNAs) targeting common single nucleotide polymorphisms (SNPs) in the human VWF gene, an approach that can be applied irrespective of the disease-causing VWF mutation.

Adverse effect of Henle fiber layer hemorrhage due to retinal arterial macroaneurysm rupture on retinal sensitivity.

Purpose: To investigate the effect of Henle fiber layer hemorrhage (HFLh) on retinal sensitivity (RS) before and after displacement of the submacular hemorrhage (SMH) caused by retinal arterial macroaneurysm (RAM) rupture.

Methods: This retrospective study included 31 eyes undergoing vitrectomy for SMH. Eyes were grouped based on the presence or absence of HFLh (HFLh [+/-] group).

Untreated and uncontrolled hypertension in Japanese patients with spontaneous intracerebral hemorrhage.

Hypertension (HT) is the most attributable and modifiable risk factor for spontaneous intracerebral hemorrhage (SICH). However, epidemiological data on blood pressure (BP) control before SICH and its relationship to patient lifestyles are lacking. This study prospectively enrolled patients with acute SICH from six stroke centers in Tochigi, Japan.

Can 3 Stages Forehead Flap Provide Longer Flap Length?

This article discusses the use of the forehead flap technique in nasal reconstruction, specifically examining the effect of the 3-stage forehead flap procedure in providing longer flap length. Traditionally performed in 2 stages, the forehead flap technique often requires additional operations due to the thickness of the forehead skin. The 3-stage procedure, however, allows for better control of the flap thickness and improved reconstruction of nasal subunits.

Prothrombin prevents fatal T cell-dependent anemia during chronic virus infection of mice.

Thrombin promotes the proliferation and function of CD8+ T cells. To test if thrombin prevents exhaustion and sustains antiviral T cell activity during chronic viral infection, we depleted the thrombin-precursor prothrombin to 10% of normal levels in mice prior to infection with the clone 13 strain of lymphocytic choriomeningitis virus. Unexpectedly, prothrombin insufficiency resulted in 100% mortality after infection that was prevented by depletion of CD8+ T cells, suggesting that reduced availability of prothrombin enhances virus-induced immunopathology.

Development and external validation of the SMASHERS risk prediction model for aneurysmal subarachnoid haemorrhage in the general population: a population-based prospective cohort study.

Objectives: Aneurysmal subarachnoid haemorrhage (ASAH) is a severe stroke type, preventable by screening for intracranial aneurysms followed by treatment in high-risk individuals. We aimed to develop and validate a risk prediction model for ASAH in the general population to identify high-risk individuals.

Design: We used the population-based prospective cohort studies of the United Kingdom (UK) Biobank for model development and the Trøndelag Health (HUNT) Study for model validation.

Cervical Neuroendocrine Carcinoma Presenting as Isolated Large Ovarian Metastasis: A Case Report.

BACKGROUND Neuroendocrine carcinoma (NEC) of the cervix is rare and has high mortality and recurrence rates. The clinical symptoms of cervical NEC, such as abnormal vaginal bleeding and discharge, are similar to those of other cervical cancers. Here, we describe a case involving a 42-year-old woman with cervical NEC accompanied by an isolated large ovarian metastasis.

A fusion model of manually extracted visual features and deep learning features for rebleeding risk stratification in peptic ulcers.

Objectives: We propose a multi-feature fusion model based on manually extracted features and deep learning features from endoscopic images for grading rebleeding risk of peptic ulcers.

Methods: Based on the endoscopic appearance of peptic ulcers, color features were extracted to distinguish active bleeding (Forrest I) from non-bleeding ulcers (Forrest II and III). The edge and texture features were used to describe the morphology and appearance of the ulcers in different grades.

Haematobiochemical alterations and lesion characterization induced by haemonchosis in slaughtered sheep at Gondar ELFORA abattoir, Ethiopia.

Haemonchosis is a major gastrointestinal parasitic infection in sheep caused by H. contortus. An abattoir-based cross-sectional study was conducted from January to September 2024 to assess the haematobiochemical alterations and lesion characterization induced by haemonchosis in slaughtered sheep at Gondar ELFORA abattoir.

Examining the etiology and pregnancy outcomes of 152 critically ill pregnant patients in the Intensive Care Unit.

Background: Collaborative multidisciplinary approaches in obstetrics, particularly in conjunction with Intensive Care Units (ICUs), offer innovative treatment strategies for critically ill pregnant women. This study aimed to assess pregnancy outcomes and mortality in critically ill pregnant women in the Intensive Care Unit (ICU) and to provide valuable clinical insights for improving the management of obstetric emergency care, reducing maternal and neonatal adverse outcomes, and improving the level of obstetric care.

Methods: This study retrospectively included 152 critically ill pregnant women admitted to the ICU.

The predictive value of optic nerve sheath diameter measurement via ultrasound for intracerebral hemorrhage complicated by cerebral-cardiac syndrome.

Objective: This study aims to evaluate the clinical significance of ultrasound-based measurement of optic nerve sheath diameter (ONSD) in predicting intracerebral hemorrhage (ICH) complicated by cerebral-cardiac syndrome (CCS).

Methods: Patients with ICH and who were treated in the intensive care unit (ICU) at Shijiazhuang People's Hospital between October 2021 and November 2022 were included in this study. Participants were divided into two groups: those with CCS and those without.

Purse string suture for rapid access hemostasis after removal of large-caliber femoral venous delivery sheaths in children with atrial septal defects.

Objectives: To evaluate the efficacy and safety of purse-string sutures (PSS) compared with manual compression for access hemostasis in children with atrial septal defects (ASDs) after large-caliber venous delivery sheaths removal.

Methods: We conducted a retrospective clinical data review of 271 children with ASDs who underwent transcatheter device closure through large-caliber venous delivery sheaths (≥ 8 Fr) at our institution from January 2018 to January 2023. The PSS group (n = 144) was compared to the control group (n = 127), which underwent manual compression for femoral venous hemostasis after sheath removal, focusing on hemostatic time, limb braking time, bed rest time, hospital stay, and vascular access complications.

Comparison of integrated versus parallel continuous renal replacement therapy combined with veno-venous extracorporeal membrane oxygenation in patients with COVID-19 ARDS.

Introduction: Acute kidney injury (AKI) is a common complication of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) in patients receiving extracorporeal membrane oxygenation (ECMO) support, leading to requirement of continuous renal replacement therapy (CRRT) in 70% of ECMO patients. Parallel arrangement of CRRT and ECMO circuits is common in adult patients. However, CRRT may also be integrated directly into the ECMO circuit.

Decision model to evaluate the cost of clinical events associated with switching from Apixaban to Rivaroxaban among patients with non-valvular atrial fibrillation in the United States and Germany.

Aims: Direct-acting oral anticoagulants (DOACs) have emerged as the preferred treatment for nonvalvular atrial fibrillation (NVAF). However, evidence concerning the economic outcomes of DOAC switching remains limited. This study aimed to assess the economic outcomes of DOAC switching in the US and Germany, two countries with a high AF prevalence and DOAC utilization.

The effects of admission hyperglycemia and diabetes mellitus on mechanical thrombectomy outcomes: A systematic review and meta-analysis.

Background: The impact of certain comorbidities on mechanical thrombectomy (MT) outcomes remains largely unexplored. Diabetes mellitus (DM) and admission hyperglycemia have been associated with poor clinical outcomes for patients treated with MT. In this study, we sought to investigate the effects of DM and admission hyperglycemia on MT outcomes.

Effects of blood pressure lowering in patients treated with intravenous thrombolysis before endovascular thrombectomy.

Background: The effects of blood pressure (BP) lowering in patients treated with intravenous tissue plasminogen activator (IV tPA) before endovascular thrombectomy (EVT) are unclear.

Aims: This study aims to investigate whether intensive and conventional BP management affect outcomes differently, depending on IV tPA administration before EVT.

Methods: In this subgroup analysis of the Outcome in Patients Treated with Intra-Arterial Thrombectomy-Optimal Blood Pressure Control (OPTIMAL-BP; ClinicalTrials.

Transoral robotic surgery in otolaryngology practice: a single institutional experience.

Background: Transoral robotic surgery (TORS) has emerged as a minimally invasive technique for managing head and neck pathologies, offering reduced morbidity and improved surgical precision. Despite its growing popularity, institutional experiences with TORS remain limited.

Objectives: This study aimed to evaluate the outcomes of TORS for oncological and obstructive sleep apnoea syndrome (OSAS) cases, focusing on efficacy, safety and complications.

Association of endovascular thrombectomy volume and outcomes in acute ischemic stroke: A National Inpatient Sample Study.

Background: Previous studies suggest a positive relationship between higher hospital endovascular thrombectomy (EVT) volume and improved outcomes. We investigated this association using the National Inpatient Sample (NIS) database from 2016 to 2020.

Methods: A cross-sectional analysis of the NIS examined the relationship between hospital EVT volume and outcomes.