Outpatient Day-Care Management of Unruptured Intracranial Aneurysm: A Retrospective Cohort Study.

Objective: This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods.

Materials And Methods: This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.

Lunotriquetral Ligament Repair Using Augmented Internal Brace.

Lunotriquetral (LT) ligament tear, usually in combination with an adjacent carpal ligament injury, can result in complete LT dissociation and VISI (Volarflexed Intercalated Segment Instability). Operative techniques for the management of instability are highly variable with many described in literature, although there is little evidence to demonstrate the superiority of one definitive therapeutic technique of repair and reconstruction. In this paper, we discuss our proposed technique for performing LT ligament repair using an augmented internal brace, which addresses triquetral extension and lunate flexion.

Reversible Symptom Aggravation by Intake of Taurine-Rich Foods in Patients with Venous Congestive Myelopathy: Controlled Case Series Study.

Purpose: Reversible aggravation of myelopathy symptoms was observed after the intake of taurine-rich foods in patients with venous congestive myelopathy (VCM) caused by a spinal arteriovenous shunt (SAVS), and the taurine-challenge test was applied to demonstrate an association between taurine and VCM.

Materials And Methods: The current study reviewed any aggravation history of myelopathy symptoms, including walking difficulty, after consuming taurine-rich foods among 133 consecutive patients with a SAVS from a prospective institutional database from June 2013 to February 2021. The type of taurine-rich foods, demographic data, arteriovenous shunt level, and follow-up periods were obtained.

Clinical Manifestation and Radiologic Patterns of Spontaneous Cervicocephalic Dissection According to the Anatomic Location: A Single-Center Analysis in Korean Patients.

Purpose: Spontaneous cervicocephalic dissection (SCAD) is an important cause of stroke and shows various lesion locations and clinical features. The purpose of this study was to analyze the location of SCAD and its clinical and radiologic patterns in Korean patients.

Materials And Methods: Patients with SCAD who were evaluated between 2013 and 2018 at a tertiary center in Korea were reviewed.

Right Ventricular Dysfunction Predicts Outcome in Acute Heart Failure.

Aim: The severity of cardiac impairment in acute heart failure (AHF) predicts outcome, but challenges remain to identify prognostically important non-invasive parameters of cardiac function. Left ventricular ejection fraction (LVEF) is relevant, but only in those with reduced LV systolic function. We aimed to assess the standard and advanced parameters of left and right ventricular (RV) function from echocardiography in predicting long-term outcomes in AHF.

Synbiotic containing extensively hydrolyzed formula improves gastrointestinal and atopic symptom severity, growth, caregiver quality of life, and hospital-related healthcare use in infants with cow's milk allergy.

Background: Healthy gut microbiota is important for prognosis in cow's milk allergy (CMA). The application of synbiotics (specific pre- and probiotics) in extensively hydrolyzed formulae (eHFs) is a relatively new concept.

Aims: To evaluate a synbiotic-containing, whey-based eHF (SeHF) with galacto-oligosaccharides, fructo-oligosaccharides, and bifidobacterium breve M-16V in infants with CMA.

Anatomical variations in coronary venous drainage: Challenges and solutions in delivering cardiac resynchronization therapy.

Aims: To investigate the abnormalities of the coronary venous system in candidates for cardiac resynchronization therapy (CRT) and describe methods for circumventing the resulting difficulties.

Methods: From four implanting institutes, data of all CRT implants between October 2008 and October 2020 were screened for abnormal cardiac venous anatomy, defined as an anatomical variation not conforming to the accepted 'normal' anatomy. Patient demographics, procedural detail, and subsequent left ventricle (LV) lead pacing indices were collected.

Coronary Caverns: Spontaneous Recanalized Chronic Total Occlusion With Multiple Microchannels.

Spontaneous chronic total occlusion recanalization is rare. It has scarcely been described previously and with minimal visual detail. Optical coherence tomography permitted comprehensive visualization of the microchannels in this case, seldom seen previously.

Prospective multicentre mid-term clinical and radiological outcomes of 159 reverse total shoulder replacements and assessment of the influence of post-operative complications.

Background: The aim of our prospective multicentre study is to evaluate the five-year follow-up outcomes of primary reverse shoulder replacement utilizing two different designs of glenoid baseplates.

Methods: There were 159 reverse shoulder replacements (91 cemented and 68 uncemented stems, 67 Trabecular Metal baseplates and 92 Anatomical Shoulder baseplates in 152 patients (99 women) with a mean age of 74.5 (58-90) years.

Modified Barbero-Marcial repair for type I truncus arteriosus in a 2.7-kg neonate.

Truncus arteriosus is a rare cardiac anomaly, accounting for less than 4% of all congenital lesions. It is the result of failed aorticopulmonary septation during the fifth week of gestation leading to a single arterial trunk overriding the interventricular septum, a single semilunar valve, and typically a large conotruncal ventricular septal defect. Several classifications exist, and it typically requires surgical repair in the neonatal period.

Alterations in the Stool Microbiome in Newborns Undergoing Mild Therapeutic Hypothermia after Hypoxic-Ischemic Encephalopathy.

Background: Hypoxic-ischemic encephalopathy (HIE) is associated with brain injury in newborns and may lead to disability or death. Mild therapeutic hypothermia (TH) is an effective neuroprotective intervention and an established standard of care in western countries. The gut microbiome, the genomic and physicochemical contribution of the gut microbiota, serves important functions and is increasingly recognized as a major influencer on development.

When 'Being There' Is Disallowed: Disruptions to Knowing and Caring During COVID-19 Visitor Restrictions.

This qualitative study explored the accounts of five health professionals working in hospitals in Hamilton, Ontario, Canada who provided end-of-life care during the COVID-19 pandemic. The study goal was to understand how palliative care providers experienced and responded to the significant change in family presence when visitors were restricted to slow the spread of the virus. Identified was the loss and disruption of important forms of knowing including observational and embodied knowing.

A silent giant staghorn renal calculus managed successfully with open pyelolithotomy: a case report.

Staghorn calculi (SC) are associated with high morbidity and mortality; therefore, meticulous planning is required to minimize complications. In this case report, we will discuss the management of a giant right-sided SC (~ 8 cm in diameter), which was incidentally found in a 40-year-old male, who presented with left-sided renal colic symptoms with no associated renal impairment. This case was further complicated by multiple smaller calculi surrounding the giant SC.

Left heart bypass for repair of aortic coarctation in children: Technical tips and pitfalls.

Spinal cord injury secondary to coarctation repair in children is a serious, though relatively uncommon, complication. Several measures have been proposed to minimize this risk, which seems to affect more older children than neonates and those with inadequate collateral circulation. Left heart bypass has been proposed as a protective strategy.

Diaphragm Ultrasound is an Imaging Biomarker that Distinguishes Exacerbation Status from Stable Chronic Obstructive Pulmonary Disease.

Background: Evaluating the diaphragm muscle in chronic obstructive pulmonary disease (COPD) is important. However, the role of diaphragm ultrasound (DUS) in distinguishing the exacerbation status of COPD (AECOPD) is not fully understood. We set this study to evaluate the role of DUS as a biomarker for distinguishing the AECOPD.

Disproportionate Mitral Regurgitation Determines Survival in Acute Heart Failure.

To assess the prevalence and impact of mitral regurgitation (MR) on survival in patients presenting to hospital in acute heart failure (AHF) using traditional echocardiographic assessment alongside more novel indices of proportionality. It remains unclear if the severity of MR plays a significant role in determining outcomes in AHF. There is also uncertainty as to the clinical relevance of indexing MR to left ventricular volumes.

Online Educational Tools for Caregivers of People with Dementia: A Scoping Literature Review.

Background: Informal caregivers of people with dementia provide the majority of health-based care to people with dementia. Providing this care requires knowledge and access to resources, which caregivers often do not receive. We set out to evaluate the effect of online educational tools on informal caregiver self-efficacy, quality of life, burden/stress, depression, and anxiety, and to identify effective processes for online educational tool development.

Improving Clinical Handover on an Electronic Communication Platform: A Quality Improvement Project.

Background National guidance stipulates the essential components of a safe handover. Shift-based work and the COVID-19 pandemic has led to an increased turnover and re-deployment of staff into new clinical areas, creating challenges in delivering effective handovers. Aim The aim of this quality improvement project (QIP) was to improve adherence to a local standardised handover proforma to improve the quality and consistency of handovers.

The Managing Advanced Cancer Pain Together (MACPT) conversation tool: an evaluation of use in clinical practice.

To investigate use of the 'Managing Advanced Cancer Pain Together' conversation tool between individuals with advanced cancer and healthcare professionals (HCPs) during routine consultations. Twenty-one patients and six HCPs completed questionnaires before and after use of the tool (at their routine consultation 1 and consecutive consultation 2, respectively). Patients and HCPs were satisfied with communication during both consultations.

Assessing the quality of consent in elective hip and knee arthroplasty: Do modern orthopaedic surgeons make the cut?

Introduction: Improper consent is a failure of clinical care and also a major cause of litigation within health care authorities. 4% of surgical negligence claims are attributed to improper consenting in the NHS, with an average settlement fee of approximately £40,000 per claim. Improving quality of consenting therefore not only improves patient care but could also reduce healthcare cost.

The use of weighted blankets as a novel approach for treatment of persistent vocalizations in late stage dementia.

This study explored the use of weighted blankets as a non-pharmacological treatment for persistent vocalizations in late stage dementia. A weighted blanket was applied to three individuals with a diagnosis of dementia who had frequent and intense persistent vocalizations which were not responsive to other treatment modalities and necessitated in-patient hospitalization within a specialized behavioural unit. The evaluation found a non-statistically significant reduction in the duration of persistent vocalizations during the ten-minute application of the weighted blanket and a statistically significant reduction in the duration of persistent vocalizations during the ten minutes following the application of the weighted blanket.