The Effects of Intercalary Fragments at the Posterior Malleolus on Ankle Joint Pressure Distribution - A Biomechanical Cadaveric Study.

Introduction: With the increased use of CTs in cases with trimalleolar ankle fractures, bone fragments between the posterior malleolus and the rest of the articular surface tibial plafond surface - described as intercalary fragments (ICFs) - can be recognized. The aim of this study was to determine the ICF size threshold for a significant change in the pressure distribution at the ankle joint, having a considerable impact on the remaining cartilage of the joint.

Design And Methods: Eight human cadaveric lower legs were used, and a posterior malleolus Bartonicek II fracture was created with sequential 2mm, 4mm, 6mm and 8mm ICFs.

Recommendations on NMOSD treatment in Latin America: Utilizing consensus-based RAND/UCLA methodology.

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a serious condition affecting people worldwide, including Latin America (LATAM). Healthcare disparities and economic limitations make effective treatment access challenging. It is crucial to consider the best practice therapeutic decision-making, including emerging long-term preventive therapies, to ensure patients in LATAM and elsewhere can effectively manage their disease all over the world.

The Coexistence of Carotico-Clinoid Foramen and Interclinoidal Osseous Bridge: An Anatomo-Radiological Study With Surgical Implications.

Background And Objectives: The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies.

Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, a systematic scoping review was conducted up to June 5, 2023.

Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave.

Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill-defined. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement.

Middle ear ventilation tubes and water precautions: A survey of otolaryngologists and pediatricians on their recommendations.

Introduction. Middle-ear ventilation tubes are commonly placed in pediatric patients because of the high frequency of otitis media. Although avoidance of water activity has been recommended to prevent otorrhea, studies indicate that exposure to water does not increase these episodes.

Recurrent acute pancreatitis in pediatrics: characteristics and risk factors.

Recurrent acute pancreatitis (RAP) affects 15-36% of children with acute pancreatitis (AP) and may progress to chronicity. To determine the etiology and evolution of RAP, a descriptive retrospective cohort study was conducted in patients aged 1-18 years. Twelve patients with RAP were included out of 79 with AP, and demographic, etiological, clinical, analytical, and imaging data were collected.

Outcomes of liposuction techniques for management of lipedema: a case series and narrative review.

Background And Objective: Lipedema is a commonly underdiagnosed chronic condition. This study aimed to evaluate liposuction techniques for lipedema by conducting a systematic review and presenting our experience. A case series study and a comprehensive review were conducted.

A pilot study for continuous non-invasive intracranial pressure screening.

Intracranial hypertension (ICH) is a common and critical condition in neurocritical care, often requiring immediate intervention. Current methods for continuous intracranial pressure (ICP) monitoring are invasive and costly, limiting their use in resource-limited settings. This study investigates the potential of the electroencephalography (EEG) as a non-invasive alternative for ICP monitoring.

Population pharmacokinetics of cannabidiol and the impact of food and formulation on systemic exposure in children with drug-resistant developmental and epileptic encephalopathies.

Objective: Identifying factors influencing cannabidiol (CBD) exposure can optimize treatment efficacy and safety. We aimed to describe the population pharmacokinetics of CBD in children with drug-resistant developmental and epileptic encephalopathies (DEEs) and assess the influence of environmental, pharmacological, and clinical characteristics on CBD systemic exposure.

Methods: Data from two pharmacokinetic studies of patients aged 2-18 years with DEEs were included (N = 48 patients).

Experience with extracorporeal membrane oxygenation support in Latin America between 2016 and 2020.

Objective: To document the experience with ECMO therapy in healthcare institutions across Latin America between 2016 and 2020.

Design: Cross-sectional study.

Setting: Private and public health institutions from 7 countries.

The Bethesda System for Reporting Thyroid Cytopathology: Risk of Malignancy in Pediatric Thyroid Nodules.

Introduction: Thyroid nodules are infrequent findings in children, though malignancy rates are higher in this population. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) standardizes the reporting of thyroid fine needle aspiration (FNA) specimens and has become a global reference for assessing the risk of malignancy (ROM) of thyroid nodules. The 2023 update includes pediatric-specific risk predictions and management recommendations.

Variations and Opportunities in Postnatal Management of Hemolytic Disease of the Fetus and Newborn.

Importance: Preventive efforts in pregnancy-related alloimmunization have considerably decreased the prevalence of hemolytic disease of the fetus and newborn (HDFN). International studies are therefore essential to obtain a deeper understanding of the postnatal management and outcomes of HDFN. Taken together with numerous treatment options, large practice variations among centers may exist.

Improving Real-Time Feedback During Cochlear Implantation: The Auditory Nerve Neurophonic/Cochlear Microphonic Ratio.

Objectives: Real-time monitoring of cochlear function to predict the loss of residual hearing after cochlear implantation is now possible. Current approaches monitor the cochlear microphonic (CM) during implantation from the electrode at the tip of the implant. A drop in CM response of >30% is associated with poorer hearing outcomes.

Hereditary haemorrhagic telangiectasia.

Hereditary haemorrhagic telangiectasia (HHT) is a vascular dysplasia inherited as an autosomal dominant trait and caused by loss-of-function pathogenic variants in genes encoding proteins of the BMP signalling pathway. Up to 90% of disease-causal variants are observed in ENG and ACVRL1, with SMAD4 and GDF2 less frequently responsible for HHT. In adults, the most frequent HHT manifestations relate to iron deficiency and anaemia owing to recurrent epistaxis (nosebleeds) or bleeding from gastrointestinal telangiectases.

Risk factors for one-year mortality in 440 femoral peri-implant fractures: insights from the PIPPAS prospective, multicentre, observational study.

Aims: The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs).

Methods: This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses.

Biokinetic gait differences between Hallux valgus patients and asymptomatic subjects.

Background: Hallux valgus (HV) is the most prevalent foot condition, associated with a decline in quality of life and a high rate of complications. Pedobarography can be a diagnostic tool, although controversies exist due to differences in measurement scales, type of capture, software, and hardware used. Deformity level differences have not been thoroughly explored.

Validation of Härtel Surface Anatomical Landmarks for Locating the Foramen Ovale: A Computed Tomography Scan Analysis and Revised Technique Description.

Background And Objectives: Härtel triangle provides surface landmarks for locating the foramen ovale (FO) when performing trigeminal nerve percutaneous procedures. Although widely adopted in clinical practice, there is no report that these landmarks have ever been formally validated through modern imaging techniques. Here we aim to validate Härtel anatomical landmarks using computed tomography scans and propose technical considerations for percutaneous trigeminal procedures.

Mental Health Services for Serious Mental Illness: Scoping Review of Randomised Controlled Trials.

Aims: This review aims to classify the evidence from randomised controlled trials (RCTs) on mental health services (MHS) for people with serious mental illness (SMI) available in the Cochrane Schizophrenia Group's (CSzG) specialised register.

Design: Scoping review.

Methods: We retrieved and screened RCTs of service-level interventions considering non-pharmacological approaches for mental healthcare of the CSzG register.

Intraoperative Patellar Tendon Injuries during Total Knee Arthroplasty: A Comprehensive Review of Incidence, Risk Factors, and Management Strategies.

Patellar tendon rupture (PTR) is a rare and severe postoperative complication of total knee arthroplasty (TKA). Even rarer is the intraoperative occurrence of PTR during TKA. PTR is a major complication as it can lead to chronic disability, functional limitations, and postoperative morbidity.

Unveiling Inequities: Racial Disparities in Risk-Reducing Mastectomy for Breast Cancer Prevention.

Background: Risk-reducing mastectomy (RRM) significantly lowers breast cancer risk as a preventive surgery. While racial disparities in breast cancer treatment are well-documented, research on racial differences in the utilization and outcomes of RRM is limited.

Methods: We retrospectively analyzed the American College of Surgeons National Surgical Quality Improvement Program (2008-2022) to identify women who underwent RRM.

Pathway to care, treatment and disease burden of pulmonary arterial hypertension: a real-world survey of physicians and patients in Latin America.

Objectives: To investigate clinical characteristics, symptom profile, testing practices, treatment patterns and quality of life (QoL) among patients with pulmonary arterial hypertension (PAH) in Latin America.

Design: Data from the Adelphi Real World PAH Disease Specific Programme, a cross-sectional survey with retrospective data collection.

Setting: University/teaching hospital, regional centres, private practices and government institutions in Argentina, Brazil, Colombia and Mexico.

Development and validation of a multivariable predictive model for Emergency Department Overcrowding based on the National Emergency Department Overcrowding Study (NEDOCS) score.

Background Predicting potential overcrowding is a significant tool in efficient emergency department (ED) management. Our aim was to develop and validate overcrowding predictive models using accessible and high quality information. Methods Retrospective cohort study of consecutive days in the Hospital Italiano de Buenos Aires ED from june 2016 to may 2018.