Evaluation of the mesenteric arterial vasculature by computed tomography angiography and its implications for colorectal cancer surgery.

Objective: To determine the branching patterns of the inferior mesenteric artery (IMA) and to describe the clinical applicability of computed tomography (CT) angiography in the evaluation of these vessels to facilitate the planning of colorectal cancer surgery.

Materials And Methods: We included 100 patients who underwent CT angiography of the abdomen and pelvis. The branching patterns of the IMA were examined and classified as type 1 (bifurcated), including 1A (sigmoid and left colic arteries arising from a common trunk), 1B (sigmoid and superior rectal arteries arising from a common trunk) and 1C (sigmoid arteries arising from both trunks); type 2 (trifurcated); and type 3 (no left colic branch).

Intraoperative immediate strength recovery following lacertus fibrosus release in patients with proximal median nerve compression at the elbow.

Purpose: In the literature, we find that patients with lacertus syndrome (LS), proximal median nerve compression at the elbow, present subjective improvement of thumb, and index flexion strength after lacertus fibrosus (LF) release. The aim of this study is to objectively evaluate the immediate change in intraoperative flexion strength after LF release.

Method: We retrospectively reviewed prospectively collected data of a cohort of 24 patients with a double crush syndrome of the median nerve with no response to conservative treatment.

Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists.

Objective: To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program.

Design: Cross-sectional study.

Setting: A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements.

An assessment of esophageal balloon use for the titration of airway pressure release ventilation and controlled mechanical ventilation in a patient with extrapulmonary acute respiratory distress syndrome: a case report.

Background: Esophageal pressure measurement is a minimally invasive monitoring process that assesses respiratory mechanics in patients with acute respiratory distress syndrome. Airway pressure release ventilation is a relatively new positive pressure ventilation modality, characterized by a series of advantages in patients with acute respiratory distress syndrome.

Case Presentation: We report a case of a 55-year-old chilean female, with preexisting hypertension and recurrent renal colic who entered the cardiosurgical intensive care unit with signs and symptoms of urinary sepsis secondary to a right-sided obstructive urolithiasis.

A living WHO guideline on drugs to prevent covid-19.

Clinical Question: What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19.

A living WHO guideline on drugs for covid-19.

Updates: This is the fourteenth version (thirteenth update) of the living guideline, replacing earlier versions (available as data supplements). New recommendations will be published as updates to this guideline.

Clinical Question: What is the role of drugs in the treatment of patients with covid-19?

Context: The evidence base for therapeutics for covid-19 is evolving with numerous randomised controlled trials (RCTs) recently completed and underway.

Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy.

Purpose: After laparoscopic sleeve gastrectomy (LSG), several studies have reported an increase in the incidence of gastroesophageal reflux (GERD). The etiopathogenesis of GERD post-LSG is multifactorial, and hiatal hernia (HH) is one of them. The primary objective was to measure the incidence of de novo HH post-LSG.

Effect of the closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass: a prospective study.

Background: Internal hernias (IH) are a recognized problem in laparoscopic Roux-en-Y gastric bypass (LRYGB) that can cause intestinal obstruction. The routine closure of the mesenteric defects (MDs) to prevent IH in the LRYGB remains controversial.

Objectives: The main objective of our study was to evaluate the risk of reopening at the level of both MDs, the Petersen space, and the intermesenteric gap.

Variability in triage practices for critically ill cancer patients: A randomized controlled trial.

Purpose: Intensive care triage practices and end-user interpretation of triage guidelines have rarely been assessed. We evaluated agreement between providers on the prioritization of patients for ICU admission using different triage guidelines.

Materials And Methods: A multi-centered randomized study on providers from 18 different countries was conducted using clinical vignettes of oncological patients.

Results of subtalar arthroereisis for posterior tibial tendon dysfunction stage IIA1. Based on 35 patients.

Background: The aim of the study was to evaluate the clinical and radiological results obtained in the treatment of adult flexible flatfoot secondary to posterior tibial dysfunction with subtalar arthroereisis using a Kalix endorthesis.

Methods: 35 patients (37 feet) were studied, having been operated between January 2010 and January 2015 for reducible flatfoot secondary to posterior tibial tendon dysfunction stage IIA1 of Bluman.

Results: The average follow up was 47.

Vitamin D and Sjögren syndrome.

The immunomodulatory effects of vitamin D have been extensively studied in the context of autoimmunity. Multiple studies have demonstrated a high prevalence of vitamin D deficiency in autoimmune diseases. Recently, a possible protective role of vitamin D in autoimmunity has been described; however, this function remains controversial.

Nutritional Issues with Incremental Dialysis: The Role of Low-Protein Diets.

A gentle start of dialysis is a welcome possibility for both patients and physicians. Incident dialysis patients often maintain residual kidney function (RKF) for a considerable period of time; the start of dialysis is often driven mainly by uremic symptoms. Recently, the combination of a low-protein diet, along with a less-frequent dialysis schedule, has regained interest as an alternative option in selected and motivated patients.

P-glycoprotein in autoimmune rheumatic diseases.

P-glycoprotein (Pgp) is a transmembrane protein of 170 kD encoded by the multidrug resistance 1 (MDR-1) gene, localized on chromosome 7. More than 50 polymorphisms of the MDR-1 gene have been described; a subset of these has been shown to play a pathophysiological role in the development of inflammatory bowel disease, femoral head osteonecrosis induced by steroids, lung cancer and renal epithelial tumors. Polymorphisms that have a protective effect on the development of conditions such as Parkinson disease have also been identified.

Sepsis in vulnerable populations.

Despite the acquisition of a large body of evidence, there are many unanswered questions about sepsis. The definition of this disease is plagued by the lack of a simple pathophysiological description linking cause to effect and the activation of host immune responses that hinders disease progression at the same time producing multiorgan dysfunction. A plethora of inconsistent clinical features has served to obfuscate rather than illuminate.

Histological changes due to intravesical instillation of mitomycin C.

Objective: Transurethral resection (TUR) is highly effective in the local control of superficial bladder cancer. However, the recurrence rate can reach 80% of the cases. Adjuvant intravesical chemotherapy may decrease significantly tumor recurrence.