Predictors of Mortality in Venoarterial Extracorporeal Membrane Oxygenation Regardless of Early Left Ventricular Unloading: A National Experience.

Objective: The use of an intra-aortic balloon pump (IABP) has been suggested to unload the left ventricle while on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS), leading to possibly improved in-hospital mortality. However, the predictors of mortality on dual mechanical circulatory support have not yet been evaluated, especially in real-world clinical settings. Therefore, a case-control study was conducted to determine the rate of all-cause mortality associated with VA-ECMO use regardless of left ventricular (LV) unloading, and with early LV unloading in the setting of CS, and to identify the predictors of mortality associated with VA-ECMO, with concurrent early LV unloading.

Extracorporeal Life Support Organization 2024 Guideline for Early Rehabilitation or Mobilization of Adult Patients on Extracorporeal Membrane Oxygenation.

This Extracorporeal Life Support Organization guideline describes early rehabilitation or mobilization of patients on extracorporeal membrane oxygenation (ECMO). The guideline describes useful and safe practices put together by an international interprofessional team with extensive experience in the field of ECMO and ECMO rehabilitation or mobilization. The guideline is not intended to define the delivery of care or substitute sound clinical judgment.

Serious lower limb injuries following car gearbox explosion: A rare case report.

Car Gearbox explosion-related injuries are very rare but could be serious. We reported a 43-year-old female patient who sustained severe bilateral lower limb injuries following an explosion of the gearbox in her private car while waiting at a traffic signal. The patient suffered from a left open tibia shaft fracture and severely macerated soft tissues, along with an open wound on the right leg.

A descriptive analysis of nurses' self-reported mental health symptoms during the COVID-19 pandemic: An international study.

Aim: To describe the self-reported mental health of nurses from 35 countries who worked during the COVID-19 pandemic.

Background: There is little occupationally specific data about nurses' mental health worldwide. Studies have documented the impact on nurses' mental health of the COVID-19 pandemic, but few have baseline referents.

Abdominopelvic imaging in the follow-up of testicular germ-cell tumors in adults: recommendations of the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology.

Objectives: The Scrotal and Penile Imaging Working Group (SPIWG) of the European Society of Urogenital Radiology (ESUR) aimed to formulate recommendations on the imaging modalities and minimal technical requirements for abdominopelvic imaging in the follow-up of adult patients treated for testicular germ-cell tumors (TGCT).

Methods: The SPIWG members performed an extensive literature search, reviewed the current clinical practice, and reached a consensus based on the opinions of experts in the field.

Results: Recurrence in patients treated for TGCT mainly occurs in retroperitoneal lymph nodes (LNs).

Understanding the Spectrum of Mild Clinical Outcomes and Novel Findings in Arterial Tortuosity Syndrome Among Qatari Patients: Implications of SLC2A10 Mutation.

/: Arterial Tortuosity Syndrome (ATS) is a rare, autosomal recessive connective tissue disorder characterized by arterial twists, abnormal bulges, constriction, and tears. Patients have distinctive features and disease manifestations. The syndrome's full clinical spectrum and course remain incompletely understood.

Delayed Aneurysm Rupture Following Endovascular Treatment with Contour Device: A Case Report.

Delayed rupture of intracranial aneurysms after endovascular treatment is a rare but serious complication. We report the first documented case of late aneurysmal rupture following treatment with a Contour intrasaccular device. A patient in their 60s with a basilar tip aneurysm underwent endovascular treatment using a 14-mm Contour device.

The learning curve for the Shouldice Repair: a pilot analysis of post-training specialized surgeons at the Shouldice Hospital.

Purpose: The aim of the study was to evaluate operative time and postoperative complications of 4 post-training specialized surgeons.

Methods: This was a pilot retrospective chart review to determine the learning curve of a Shouldice primary inguinal hernia repair (Shouldice Repair) of 4 post-training specialized surgeons, at the Shouldice Hospital. The first 300 Shouldice Repairs (early learning block) were compared to their 900-1,000 repairs as the primary operating surgeon (late learning block).

The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation.

Background: Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) application on recovery time and airway complications in pediatric patients with subglottic stenosis undergoing balloon dilatation.

Methods: A prospective, double-blinded, parallel-group, randomized controlled study was conducted at Health Sciences University Ümraniye Training and Research Hospital on pediatric patients with subglottic stenosis, aged from 0 to 12 years and who underwent elective balloon dilatation under general anesthesia.

Characterisation of pregnancy-induced alterations in apolipoproteins and their associations with maternal metabolic risk factors and offspring birth outcomes: a preconception and longitudinal cohort study.

Background: Apolipoproteins as an integral part of lipoproteins are crucial for the transport and metabolism of lipids. However, there is a lack of longitudinal studies to quantify the concentrations of maternal apolipoproteins from preconception to postpartum and their associations with maternal metabolic health and offspring birth outcomes.

Methods: Quantification of apolipoproteins was performed on maternal plasma samples (N = 243 trios) collected at preconception, 26-28 weeks' pregnancy, and three months postpartum in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort study.

Improving Therapeutic Adherence and Reducing Therapeutic Inertia in the Management of People with Cardiometabolic Diseases: A Call-to-Action from the Middle East.

Hypertension, dyslipidemia, and type 2 diabetes are highly prevalent and poorly controlled cardiometabolic diseases in the Middle East. Therapeutic non-adherence and therapeutic inertia are major contributors to this suboptimal disease control. Regardless of the cardiometabolic disease, evidence-based solutions may be used to improve therapeutic non-adherence and overcome inertia, and thereby help to alleviate the heavy burden of cardiovascular disease in the Middle East.

Transient right bundle branch block (RBBB) and S1Q3T3 in a transit passenger due to acute pulmonary embolism- a case report.

Intermittent or transient right bundle branch block (RBBB) can occur in various clinical situations but is rarely described in acute pulmonary embolism. We present a unique case involving a 57-year-old male who experienced a syncopal episode during transit. He displayed signs of a transient right bundle branch block (RBBB) and S1Q3T3 on the initial EMS ECG, which reverted to normal ECG later.

A disturbed communication between hypothalamic-pituitary-ovary axis and gut microbiota in female infertility: is diet to blame?

Female infertility is a multifactorial condition influenced by various genetic, environmental, and lifestyle factors. Recent research has investigated the significant impact of gut microbiome dysbiosis on systemic inflammation, metabolic dysfunction, and hormonal imbalances, which can potentially impair fertility. The gut-brain axis, a bidirectional communication system between the gut and the brain, also plays a significant role in regulating reproductive functions.

A Multicenter ICET-A Survey on Adherence to Annual Oral Glucose Tolerance Test (OGTT) Screening in Transfusion-Dependent Thalassemia (TDT) Patients - The Expert Clinicians' Opinion on Factors Influencing the Adherence and on Alternative Strategies for Adherence Optimization.

Background: Current guidelines for screening glucose dysregulation (GD) in patients with transfusion-dependent thalassemia (TDT) recommend an annual 2-hour oral glucose tolerance test (OGTT) starting at the age of 10 years.

Objective: Assessment of adherence to OGTT screening in patients with TDT.

Methods: A questionnaire was distributed to 18 Thalassemia Centers in 10 different countries, targeting factors influencing adherence to annual OGTT screening in specialized multidisciplinary pediatric and adult TDT units and identifying strategies to improve adherence to OGTT in TDT patients.

The Impact of Idiopathic Intracranial Hypertension on Cardiovascular Disease Risk Among UK Women: An Obesity-Adjusted Analysis.

Introduction: Idiopathic intracranial hypertension (IIH) is known to elevate cardiovascular disease (CVD) risk, but the extent to which obesity and IIH-specific factors contribute to this risk is not well understood. WE aim to separate the effects of obesity from IIH-specific factors on the risk of stroke and CVD, building on previous findings that indicate a two-fold increase in cardiovascular events in women with IIH compared to BMI-matched controls.

Methods: An obesity-adjusted risk analysis was conducted using Indirect Standardization based on data from a cohort study by Adderley et al.

Optimizing the hyperbaric chamber pressurization profile during standard hyperbaric oxygen therapy.

Middle ear barotrauma (MEBT) is the most common complication in providing hyperbaric oxygen therapy (HBO). This study explored the impact of altering the shape of the time-pressure curve with the aim of reducing the occurrence of MEBT and optimizing the HBO experience during the pressurization process. Four distinct mathematically derived protocols-Constant Pressure Difference (CPD), Constant Volume Difference (CVD), Constant Ratio (CR), and Inverted Constant Ratio (ICR)-were investigated using computer simulations on a simple ear model.

Investigation of the Protective Effects of Dexmedetomidine, Midazolam, Propofol, and Intralipid on Oxidative Stress and Inflammation in Rats with Lidocaine-Induced Toxicity.

Aim: The aim of this study was to compare the effects of dexmedetomidine, midazolam, propofol, and intralipid on lidocaine-induced cardiotoxicity and neurotoxicity.

Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups (n = 8 per group): control (C), lidocaine (L), lidocaine + dexmedetomidine (LD), lidocaine + midazolam (LM), lidocaine + propofol (LP), and lidocaine + intralipid (LI). Dexmedetomidine (100 µg/kg), midazolam (4 mg/kg), propofol (40 mg/kg), and intralipid (10 mg/kg) were administered intraperitoneally as pretreatment.

Beyond Boundaries: Breast Cancer Metastasizing to Colon-An Insight into a Rare yet Significant Clinical Scenario: A Case Series.

Background: Colorectal metastasis from primary breast cancer is rare and presents a challenge for diagnosis and treatment.

Aim: To report two cases of colorectal metastasis from a primary invasive lobular breast carcinoma (ILBC) with different presentations while discussing the mode of diagnosis, immunohistochemistry (IHC), course of treatment, and response.

Case 1: A 47-year-old female, with a known case of bilateral invasive lobular breast cancer, was diagnosed in 2015 and staged as p Tx N3 M0.

Epidemiology of Rectal Cancer Patients in the Kingdom of Bahrain: A Retrospective Cohort Study.

Aim And Background: As rectal cancer diagnosis becomes more prevalent due to the increased awareness caused by campaigns, this study aims to focus on the demographics of patients diagnosed with rectal cancer in the Kingdom of Bahrain.

Methods: A retrospective cross-sectional study design was conducted on 184 patients diagnosed with primary or second primary rectal cancer. Stage and site of tumor at diagnosis, gender, BMI, family history, histology, and metastasis are discussed throughout the paper.

Burden of diabetes in correctional facilities: A global systematic review and meta-analysis.

Background: Diabetes mellitus presents significant public health challenges worldwide. While its prevalence and management in the general population have been extensively studied, comprehensive research on diabetes among incarcerated individuals is lacking. This study aims to conduct a systematic review and -analysis to determine the prevalence of diabetes within the prison population.

Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement.

Background: Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR.

Methods: Data were extracted from the Nationwide Readmissions Database from 2012 to 2017.

Association of corneal endothelial cell morphology with neurodegeneration in mild cognitive impairment and dementia.

Introduction: Corneal confocal microscopy (CCM) detects neurodegeneration in mild cognitive impairment (MCI) and dementia and identifies subjects with MCI who develop dementia. This study assessed whether abnormalities in corneal endothelial cell (CEC) morphology are related to corneal nerve morphology, brain volumetry, cerebral ischemia, and cognitive impairment in MCI and dementia.

Methods: Participants with no cognitive impairment (NCI), MCI, and dementia underwent CCM to quantify corneal endothelial cell density (CECD) and area (CECA), corneal nerve fiber morphology, magnetic resonance imaging (MRI) brain volumetry, and severity of brain ischemia.

Towards secure and trusted AI in healthcare: A systematic review of emerging innovations and ethical challenges.

Introduction: Artificial Intelligence is in the phase of health care, with transformative innovations in diagnostics, personalized treatment, and operational efficiency. While having potential, critical challenges are apparent in areas of safety, trust, security, and ethical governance. The development of these challenges is important for promoting the responsible adoption of AI technologies into healthcare systems.