Antibiotic exposure for culture-negative early-onset sepsis in late-preterm and term newborns: an international study.

Background: Early-life antibiotic exposure is disproportionately high compared to the burden of culture-proven early-onset sepsis (CP-EOS). We assessed the contribution of culture-negative cases to the overall antibiotic exposure in the first postnatal week.

Methods: We conducted a retrospective analysis across eleven countries in Europe, North America, and Australia.

Effect of opioid-free opioid-based strategies during multimodal anaesthesia on postoperative morphine consumption after bariatric surgery: a randomised double-blind clinical trial.

Background: The efficacy and safety of opioid-free anaesthesia during bariatric surgery remain debated, particularly when administering multimodal analgesia. As multimodal analgesia has become the standard of care in many centres, we aimed to determine if such a strategy coupled with either dexmedetomidine (opioid-free anaesthesia) or remifentanil with a morphine transition (opioid-based anaesthesia), would reduce postoperative morphine requirements and opioid-related adverse events.

Methods: In this prospective double-blind study, 172 class III obese patients having laparoscopic gastric bypass surgery were randomly allocated to receive either sevoflurane-dexmedetomidine anaesthesia with a continuous infusion of lidocaine and ketamine (opioid-free group) or sevoflurane-remifentanil anaesthesia with a morphine transition (opioid-based group).

Socio-familial environment influence on cognitive and language development in very preterm children.

Background: Preterm children are at increased risk of cognitive and language delay compared with term-born children. While many perinatal factors associated with prematurity are well established, there is limited research concerning the influence of the socio-familial environment on the development of preterm children. This study aims to assess the relative impact of perinatal and socio-familial risk factors on cognitive and language development at 2 years corrected age (CA).

Proximal Tibiofibular Synostosis: Report of 2 Cases and New Surgical Technique.

Proximal tibiofibular synostosis is a rare condition. It is often misdiagnosed or difficult to diagnose and its treatment is not widely known. There is no surgical procedure clearly reported in the literature.

Tight control of mean arterial pressure using a closed loop system for norepinephrine infusion after high-risk abdominal surgery: a randomized controlled trial.

Intensive care unit (ICU) nurses frequently manually titrate norepinephrine to maintain a predefined mean arterial pressure (MAP) target after high-risk surgery. However, achieving this task is often suboptimal. We have developed a closed-loop vasopressor (CLV) controller to better maintain MAP within a narrow range.

Doxapram versus placebo in preterm newborns: a study protocol for an international double blinded multicentre randomized controlled trial (DOXA-trial).

Background: Apnoea of prematurity (AOP) is one of the most common diagnoses among preterm infants. AOP often leads to hypoxemia and bradycardia which are associated with an increased risk of death or disability. In addition to caffeine therapy and non-invasive respiratory support, doxapram might be used to reduce hypoxemic episodes and the need for invasive mechanical ventilation in preterm infants, thereby possibly improving their long-term outcome.

Subtalar Arthrodesis in Patients With Prior Tibiotalar Arthrodesis for Posttraumatic Osteoarthritis.

Background: The tibiotalar arthrodesis for end-stage ankle osteoarthritis is a surgical procedure that leads to a modification of the kinematics of the adjacent joints and may result in the development of secondary osteoarthritic degeneration of the subtalar joint. It has previously been observed that subtalar arthrodesis in this context shows a lower fusion rate than isolated subtalar arthrodesis. This retrospective study reports the results of subtalar joint arthrodesis with previous ipsilateral tibiotalar arthrodesis and suggests some factors that may compromise the fusion of the joint.

Concomitant Triceps Surae Lengthening in Total Ankle Arthroplasty Affects the Mechanical Work at the Ankle Joint.

Background: Previous studies have examined the effect of concomitant triceps surae lengthening on ankle dorsiflexion motion at the time of total ankle arthroplasty (TAA). As plantarflexor muscle-tendon structures are important for producing positive ankle work during the propulsive phase of gait, caution should be exercised when lengthening triceps surae, as it may decrease plantarflexion strength. In order to develop an understanding of the work of the anatomical structures crossing the ankle during propulsion, joint work must be measured.

Neorectal prolapse following proctectomy: a novel application of mesh sacral pexy.

Neorectal prolapse following proctectomy for cancer has seldom been reported and treatment has mostly consisted in the resection of the prolapse via a perineal approach. Management of a patient with neorectal J-pouch prolapse using mesh sacral pexy via an abdominal approach is reported. By analogy with native rectal prolapse due to pelvic static disorders, laparoscopic mesh sacral pexy is likely to afford the same advantages of low morbidity and durability when applied to neorectal prolapse following rectal cancer surgery.

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study.

Background: Although considerable literature can be found on the outcome of total ankle replacement (TAR), only a few studies have reported the results of the fixed-bearing Cadence prosthesis. This noninventor study reports a consecutive series of 60 Cadence TAR systems with a mean of 2.9 years' follow-up, focusing on clinical and radiographic outcomes and early complications.

Analysis of Antibiotic Exposure and Early-Onset Neonatal Sepsis in Europe, North America, and Australia.

Importance: Appropriate use of antibiotics is life-saving in neonatal early-onset sepsis (EOS), but overuse of antibiotics is associated with antimicrobial resistance and long-term adverse outcomes. Large international studies quantifying early-life antibiotic exposure along with EOS incidence are needed to provide a basis for future interventions aimed at safely reducing neonatal antibiotic exposure.

Objective: To compare early postnatal exposure to antibiotics, incidence of EOS, and mortality among different networks in high-income countries.

Viral clade is associated with severity of symptomatic genotype 3 hepatitis E virus infections in Belgium, 2010-2018.

Background & Aims: HEV genotype (gt) 3 infections are prevalent in high-income countries and display a wide spectrum of clinical presentations. Host - but not viral - factors are reported to be associated with worse clinical outcomes.

Methods: Demographic, clinical, and biochemical data laboratory-confirmed HEV infections (by PCR and/or a combination of IgM and IgG serology) at the Belgian National Reference Centre between January 2010 and June 2018 were collected using standardised case report forms.

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement.

Background: The success of total ankle replacement (TAR) must be based on restoring reasonable mechanical balance with anatomical structures that can produce mechanical joint work through elastic (eg, tendons, fascia) or viscoelastic (eg, heel pad) mechanisms, or by active muscle contractions. Yet, quantifying the work distribution across the affected joint and the neighboring foot joints after TAR is lacking. Therefore, the objective of this study was to investigate if there is a change in the joint work distribution across the Ankle, Chopart, Lisfranc and Metatarsophalangeal joints during level walking before and after patients undergo TAR.

Single Anastomosis Jejuno-ileal (SAJI): a New Model of Malabsorptive Revisional Procedure for Insufficient Weight Loss or Weight Regain After Roux-en-Y Gastric Bypass.

Background: In case of insufficient weight loss or weight regain or relapse of weight-related comorbidities after Roux-en-Y gastric bypass (RYGB), other procedures such as reduction of a large gastric pouch and stoma, lengthening of the Roux limb, conversion to sleeve gastrectomy and/or bilio-pancreatic diversion with duodenal switch have been advocated. Single anastomosis jejuno-ileal (SAJI) is a new revisional simple operation performed after RYGB failure which adds malabsorption to the previous gastric bypass.

Methods: SAJI includes a single jejuno-ileal anastomosis specifically joining the ileum 250-300 cm proximal to the ileo-caecal valve and the jejunum 30 cm below the gastro-jejunal anastomosis on the Roux limb of the previous RYGB.

Pulmonary rehabilitation in Lebanon "What do we have"? A national survey among chest physicians.

Background: Pulmonary rehabilitation (PR) is not very often used by physicians in Lebanon despite evidence on its positive effects on health-related quality of life.

Aim: This study assesses the knowledge, attitudes and practices of PR among physicians in Lebanon. In addition, the study identifies the main barriers to access to PR according to chest physicians.

IFSO Update Position Statement on One Anastomosis Gastric Bypass (OAGB).

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued a position statement on the role of one anastomosis gastric bypass (OAGB) in the field of bariatric/metabolic surgery in 2018 De Luca et al. (Obes Surg. 28(5):1188-206, 2018).

Post-sprain versus post-fracture post-traumatic ankle osteoarthritis: Impact on foot and ankle kinematics and kinetics.

Background: Common etiologies for post-traumatic ankle osteoarthritis are ankle fractures and chronic ankle instability. As the nature of trauma is different for these two etiologies, it might be expected that the two subtypes of post-traumatic ankle osteoarthritis would display different foot mechanics during gait.

Research Question: The objective of this exploratory cross-sectional study was to compare the foot kinematics and kinetics of patients suffering from post-fracture ankle osteoarthritis with those of patients suffering from post-sprain ankle osteoarthritis.

Perceptions of homeopathy in supportive cancer care among oncologists and general practitioners in France.

Objectives: In France, homeopathy is the most frequently used complementary therapy in supportive care in oncology (SCO); its use is steadily increasing. However, data is limited about the perception and relevance of homeopathy by oncologists and general practitioners (GPs) both with and without homeopathic training (HGPs and NHGPs, respectively). Our aim was to evaluate French physicians' perceptions of homeopathy to clarify its place in SCO through two original observation survey-based studies.

Bariatric-Metabolic Surgery Utilisation in Patients With and Without Diabetes: Data from the IFSO Global Registry 2015-2018.

Background: Comparative international practice of patients undergoing bariatric-metabolic surgery for type 2 diabetes mellitus (T2DM) is unknown. We aimed to ascertain baseline age, sex, body mass index (BMI) and types of operations performed for patients with T2DM submitted to the IFSO Global Registry.

Materials And Methods: Cross-sectional analysis of patients having primary surgery in 2015-2018 for countries with ≥90% T2DM data completion and ≥ 1000 submitted records.

The IFSO Worldwide One Anastomosis Gastric Bypass Survey: Techniques and Outcomes?

Introduction: One anastomosis gastric bypass (OAGB) has become one of the most commonly performed gastric bypass procedures in some countries.

Objectives: To assess how surgeons viewed the OAGB, perceptions, indications, techniques, and outcomes, as well as the incidence of short- and long-term complications and how they were managed worldwide.

Methods: A questionnaire was sent to all IFSO members in all 5 chapters to study the pattern of practice and outcomes of OAGB.

The first modified Delphi consensus statement on sleeve gastrectomy.

Introduction: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG.