Safe, effective and cost-effective oxygen saturation targets for children and adolescents with respiratory distress: protocol for a randomised controlled trial (OxyKids study).

Introduction: Little is known about the effectiveness and safety of oxygen saturation (SpO2) thresholds in children admitted with respiratory distress. The current 90%-94% threshold could lead to prolonged administration of supplemental oxygen, increased duration of hospital admissions, distress for children and families, and healthcare costs. To balance reducing unnecessary oxygen administration and preventing hypoxia, a lower SpO2 threshold of 88% for oxygen supplementation in children has been suggested.

Acute Pancreatitis: An Update of Evidence-Based Management and Recent Trends in Treatment Strategies.

Acute pancreatitis is a common gastrointestinal disease leading to hospitalisation. Recent advancements in its management have primarily focussed on the development of early phase medical interventions targeting inflammatory pathways, optimisation of supportive treatment (including fluid resuscitation, pain management and nutritional management), appropriate use of antibiotics, implementation of minimally invasive interventions for infected necrosis, and the necessity of follow-up for long-term complications. These advancements have significantly improved personalised management and overall outcomes of acute pancreatitis.

NAB2::STAT6 Rearranged Carcinoma of the Parotid Gland with Sebaceous Differentiation: A Case Report.

Purpose: The NAB2::STAT6 fusion is predominantly associated with solitary fibrous tumors (SFTs) and is utilized in diagnosing SFTs through nuclear STAT6 protein overexpression. Recent studies expanded the phenotypic spectrum of NAB2::STAT6 rearranged neoplasms, including adamantinoma-like and teratocarcinosarcoma-like phenotypes. We report a case of a NAB2::STAT6 rearranged epithelial tumor exhibiting sebaceous differentiation in the parotid gland.

Frailty index predicts adverse short- and long-term outcomes in older adults with rib fractures.

Background: Older adults with rib fractures pose an increasing clinical and financial burden on healthcare. Identifying and addressing the increased risk of adverse outcomes has been a key objective in geriatric co-management of surgical patients. The Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) is a useful predictor of complications and mortality in older adults, but its value in rib fracture management remains unclear.

Micronutrient Deficiencies in Heart Failure and Relationship with Exocrine Pancreatic Insufficiency.

Background: Micronutrient deficiencies are common and play a significant role in the prognosis of many chronic diseases, including heart failure (HF), but their prevalence in HF is not well known. As studies have traditionally focused on causes originating within the intestines, exocrine pancreatic insufficiency (EPI) has been overlooked as a potential contributor. The exocrine pancreas enables the absorption of various (fat-soluble) micronutrients and may be insufficient in HF.

Conservative Pulmonary Arteriovenous Malformation Screening in Children: Re-Evaluation of Safety.

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disease and screening to detect pulmonary arteriovenous malformations (PAVMs) is important to prevent complications. In adults, transthoracic contrast echocardiogram (TTCE) is used to screen PAVMs. In children, a conservative screening method seems to be sufficient to rule out major PAVMs and prevent them from PAVM-related complications.

Sensory alterations and immunological changes during the chronification of postsurgical pain: a study protocol for a prospective observational cohort study.

Introduction: Chronic postsurgical pain (CPSP) represents a widely underdiagnosed and often poorly treated medical problem, affecting 10-50% of all surgical patients, exhibiting neuropathic features in 35-60%. It is hypothesised that surgery-induced tissue damage and the subsequent immune response cause sensory alterations in the early postoperative period, ultimately leading to a chronic neuropathic or nociplastic pain state. The 'Sensory Changes and Immunological parameters in Postsurgical pain' study (SCIP-Pain study) was designed to test this hypothesis and identify sensory alterations and changes in the immunological response that are related to the development of CPSP with neuropathic features.

Epidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-Analysis.

Context: Functional abdominal pain disorders (FAPDs) are debilitating disorders with unknown current prevalence.

Objective: To estimate global prevalence rates of FAPDs, their entities, and variations by diagnostic criteria, geography, gender, and age.

Data Sources: Medline, Embase, CINAHL, PsycInfo, and Cochrane Library were searched through October 14, 2024.

Impact of Sheath Type on Vascular and Bleeding Complications After Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the MARVEL Registry Study.

Background: Vascular and bleeding complications remain a concern after transfemoral transcatheter aortic valve replacement (TAVR). The impact of the sheath type on these complications remains unclear.

Methods: The prospective MARVEL registry study analyzed enrolled 500 patients undergoing large-bore transfemoral procedures and arteriotomy closure with the MANTA vascular closure device from 10 hospitals in Europe and Canada.

Coronary CTA and CT-FFR in trans-catheter aortic valve implantation candidates: a systematic review and meta-analysis.

Objectives: Screening for obstructive coronary artery disease (CAD) with coronary computed tomography angiography (CCTA) could prevent unnecessary invasive coronary angiography (ICA) procedures during work-up for trans-catheter aortic valve implantation (TAVI). CT-derived fractional flow reserve (CT-FFR) improves CCTA accuracy in chest pain patients. However, its reliability in the TAVI population is unknown.

Impact of Bifurcation Lesions on Outcomes After FFR-Guided PCI or CABG.

Background: In the era of first-generation drug-eluting stents and angiography-guided percutaneous coronary intervention (PCI), the presence of a bifurcation lesion was associated with adverse outcomes after PCI. In contrast, the presence of a bifurcation lesion had no impact on outcomes following coronary artery bypass grafting (CABG). Therefore, the presence of a coronary bifurcation lesion requires special attention when choosing between CABG and PCI.

A systematic review of the accuracy of prognostic tests and scoring systems for use in the Global Vascular Guidelines' PLAN concept for the treatment of chronic limb threatening ischaemia.

Introduction: The 2019 Global Vascular Guidelines recommend risk assessment for evidence based revascularization based on the acronym PLAN; Patient risk, Limb severity and ANatomical complexity of disease. This meta-analysis compares a multitude of prognostic tests within these categories.

Methods: A systematic review and meta-analysis of tests that estimated 1 year major event (amputation free survival and major adverse limb events) probability.

The effect of early warning scoring systems on adverse outcome in surgical patients: A systematic review.

Background: An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.

Methods: This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799.

Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis.

Objective: To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).

Background: Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.

Cost-Effectiveness of rTMS as a Next Step in Antidepressant Non-Responders: A Randomized Comparison With Current Antidepressant Treatment Approaches.

Background: Although repetitive transcranial magnetic stimulation (rTMS) is an effective and commonly used treatment option for treatment-resistant depression, its cost-effectiveness remains much less studied. In particular, the comparative cost-effectiveness of rTMS and other treatment options, such as antidepressant medication, has not been investigated.

Methods: An economic evaluation with 12 months follow-up was conducted in the Dutch care setting as part of a pragmatic multicenter randomized controlled trial, in which patients with treatment-resistant depression were randomized to treatment with rTMS or treatment with the next pharmacological step according to the treatment algorithm.

Early Oncological Outcomes in Patients who Underwent Staging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Compared with Conventional Imaging Before Radical Prostatectomy and Extended Pelvic Lymph Node Dissection.

Background And Objective: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is increasingly used for primary staging in prostate cancer. Owing to accurate detection of small metastases on PSMA-PET/CT, patient selection for robot-assisted radical prostatectomy (RARP) has likely changed. This study analyzes oncological outcomes in patients undergoing RARP and extended pelvic lymph node dissection (ePLND) after PSMA-PET/CT staging, compared with those without PSMA-PET/CT.

Perspectives of the medical oncologist regarding adjuvant chemotherapy for pancreatic cancer: An international expert survey and case vignette study.

Introduction: Adjuvant chemotherapy improves survival in patients with resected pancreatic ductal adenocarcinoma (PDAC). The decision to initiate chemotherapy involves both patient and physician factors, decision-specific criteria, and contextual considerations. This study aimed to assess medical oncologists' views on adjuvant chemotherapy following pancreatic resection for PDAC.

Deferral of routine percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: Rationale and design of the PRO-TAVI trial.

Background: Concomitant coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The optimal treatment strategy for CAD is a topic of debate. An initial conservative strategy for CAD in patients undergoing TAVI may be favorable as multiple studies have failed to show an evident beneficial effect of percutaneous coronary intervention (PCI) on mortality after TAVI.