Overground robotic exoskeleton vs conventional therapy in inpatient stroke rehabilitation: results from a pragmatic, multicentre implementation programme.

Background: Despite the reported efficacy of overground robotic exoskeleton (ORE) for rehabilitation of mobility post-stroke, its effectiveness in real-world practice is still debated. We analysed prospectively collected data from Improving Mobility Via Exoskeleton (IMOVE), a multicentre clinical implementation programme of ORE enrolling participants with various neurological conditions and were given options to choose between 12 sessions of ORE or conventional therapy (control).

Methods: This is analysis of participants under IMOVE who fulfilled the following criteria (i) primary diagnosis was stroke (ischemic, hemorrhagic; first or recurrent), (ii) onset of stroke was within 9 months and (iii) the intervention was during inpatient stay.

Treatment of oropharyngeal cancer during the COVID-19 lockdown - outcomes for patients treated during the pandemic.

Background: The onset of the coronavirus disease 2019 (COVID-19) outbreak caused major interruptions to the entire healthcare network affecting referral, diagnosis and treatment pathways with the potential to affect cancer treatment outcomes. In Ireland a national lockdown was initiated in March 2020 involving a stay-at-home order with a limitation on travel, social interactions and closure of schools, universities and childcare facilities. We designed a retrospective study comparing treatment outcomes for patients with oropharyngeal cancer treated before and during the COVID pandemic.

Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.

Purpose: This study evaluated the impact of choosing the right versus left internal jugular vein (IJV) for initial central venous catheter (CVC) placement on hemodialysis catheter-related outcomes in critically ill patients.

Materials And Methods: Medical records from the University of Maryland Medical Center were reviewed for adult critical care patients who received an IJV CVC between January 1, 2019, and December 31, 2022, and later required an additional temporary hemodialysis catheter.

Results: The study included 214 patients, with 100 (46.

The relationship between symptoms and regurgitant severity in primary mitral regurgitation: a cardiovascular magnetic resonance study.

In the ACC/AHA guidelines, the presence of symptoms plays a central role in determining timing surgery in primary mitral regurgitation (MR). Studies have shown a disconnect between the severity of MR and symptoms. The purpose of this study is to assess risk factors for symptoms in patients with chronic primary MR.

Neuroblastoma Masquerading as Constipation: Reducing Diagnostic Error With the Pediatric Abdominal Point-of-Care Ultrasound Survey.

Abdominal pain is a common pediatric complaint in the emergency department and other clinical settings. While most causes are benign, dangerous and time-sensitive conditions may be present. Point-of-care ultrasound (POCUS) is a diagnostic modality that can help more thoroughly explore the differential diagnosis at a relatively low cost, without exposure to ionizing radiation, and in a timely manner.

On-Table Virtual Reality to Reduce Anxiety/Distress during Radiotherapy Treatments: A Pilot Randomized Trial.

We report the first randomized trial of a virtual reality (VR) headset used on-table during external beam radiotherapy treatments to reduce anxiety/distress during receipt of radiotherapy. A small pilot study was conducted among 10 patients, with VR randomized to start in the first week ('immediate VR') vs. second week ('delayed VR') of treatment.

Comparative Effects of Rosuvastatin and Atorvastatin Loading Doses on Immediate Post-percutaneous Coronary Intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) Flow in ST-Segment Elevation Myocardial Infarction (STEMI) Patients.

Background: Primary percutaneous coronary intervention (PCI) is crucial in managing acute ST-segment elevation myocardial infarction (STEMI), emphasizing the importance of optimal myocardial reperfusion.

Objective: The goal of this research was to determine how loading doses of rosuvastatin and atorvastatin affected the flow rate of thrombolysis in myocardial infarction (TIMI) immediately post-perfusion thrombolysis in patients undergoing primary PCI.

Methodology: This prospective, comparative study was carried out over a one-year period (January 2023 to December 2023) in Pakistan.

Combined Neoadjuvant-Adjuvant Immunotherapy and Abdominoperineal Resection for a Primary Anorectal Melanoma: A Case Report.

Anorectal melanoma (ARM) is a rare entity with aggressive biological behavior and poor prognosis. Clinically, ARM presents with atypical symptoms, such as anal pain and bleeding, thus often being misdiagnosed as a benign anorectal pathology and leading to delayed diagnosis. We present a case of a 73-year-old female patient with stage I ARM, treated successfully with a combination of neoadjuvant-adjuvant immunotherapy (nivolumab, an anti-PD-1 monoclonal antibody) and abdominoperineal resection.

Ultrahypofractionated Adjuvant Breast Radiation Therapy (± Boost) and Virtual Consultations: Patient Perspectives at 1 Year.

Purpose: In March 2020, a 1-week ultrahypofractionated adjuvant breast radiation therapy schedule, 26 Gy in 5 fractions, and telehealth were adopted to reduce the risk of COVID-19 for staff and patients. This study describes real-world 1-year late toxicity for ultrahypofractionation (including a sequential boost) and patient perspectives on this new schedule and telehealth workflows.

Methods And Materials: Consecutive patients were enrolled between March and August 2020.

Managing Epiglottitis in Adults: A Comprehensive Case Study.

Epiglottitis is an inflammatory condition involving the epiglottis and surrounding tissues. While it can develop at any age, it was traditionally more common in children, largely due to infections with type B (Hib). Since the introduction of the Hib vaccine, the incidence in children has significantly decreased, while cases in adults have become more prevalent.

A Case of Amyand's Hernia.

Inguinal hernias are the most prevalent type of abdominal wall hernia. While many cases are uncomplicated, some variant forms can pose a heightened risk of severe complications. We report the case of a 46-year-old male who arrived at the emergency department with a two-day history of diffuse abdominal pain, with an otherwise negative review of systems, an unremarkable medical and surgical history, and normal laboratory results.

An "Expanded Zone" Concept for Soft Tissue Coverage of the Upper Extremity: Upper Extremity "Expanded Zones".

Vascularized soft tissue coverage of open wounds of the lower extremity has long been predicated on the zone of injury and the available local flap donor site options found therein. A hypothesis was presented decades ago in this journal that attempted to extend a similar approach to simplify upper extremity coverage as well, but appears to have long been forgotten. However, with the emergence of the fasciocutaneous flap and its offspring the perforator flap, now a plethora of additional local flap options within the upper extremity may justify this idea being further considered.

Inflammatory Pseudotumor of the Spleen in a Patient With Psoriatic Arthritis: A Diagnostic Challenge in the COVID-19 Era.

The baseline inflammatory microenvironment in various organs of patients, which is shaped by pre-existing conditions and circulating drugs at the time before viral antigen exposure, may affect the severity of coronavirus disease-19 (COVID-19) infection and the nature of its complications. Inflammatory pseudotumor (IPT) of the spleen may represent one such complication that merits further investigation. We describe the case of a patient, who was under long-term treatment with a tumor necrosis factor inhibitor (TNFi), for psoriatic arthritis (PsA) and developed an inflammatory mass in the spleen, accompanied by systemic manifestations.

Preoperative gastric retention in endoscopic retrograde cholangiopancreatography.

We comment on the article by Jia , in the . We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a complex endoscopic therapeutic procedure, which demands great skill from the endoscopist but also has recognized complications.

The Presence of Type Va Double Common Bile Duct in a Male Patient: A Case Report.

Double common bile duct (DCBD) is a rare congenital anomaly of the biliary system, characterized by the presence of two common bile ducts. The condition can be classified into five distinct types. Type Va DCBD is one of the rare congenital variations where both bile ducts open separately into the duodenum: one opens normally at the major duodenal papilla, and the second opens independently into the duodenum at a different site, usually proximal to the major duodenal papilla.

Unilateral Concurrent Amyand's Hernia and Inguinal Bladder Hernia (IBH): A Case Report.

An inguinal hernia is a common surgical condition where abdominal contents protrude through a weakened area of the abdominal wall. While most are straightforward, rare variants can lead to significant complications. Named after the surgeon who successfully removed a vermiform appendix from a hernia sac, Amyand's hernia is a rare finding.

Duct of Luschka Bile Leak With Formation of Biloma Post-Cholecystectomy: A Case Study.

A rare complication of laparoscopic cholecystectomy is a biloma, which usually develops as a result of the dissection of non-visible, abnormal ducts of Luschka. This anatomical variation in the bile ducts was initially overlooked within the biliary tree. While it generally holds minimal clinical significance, it may occasionally lead to bile leakage following cholecystectomy.

Additive effects of cerebrovascular disease functional connectome phenotype and plasma p-tau181 on longitudinal neurodegeneration and cognitive outcomes.

Introduction: We investigated the effects of multiple cerebrovascular disease (CeVD) neuroimaging markers on brain functional connectivity (FC), and how such CeVD-related FC changes interact with plasma phosphorylated tau (p-tau)181 (an Alzheimer's disease [AD] marker) to influence downstream neurodegeneration and cognitive changes.

Methods: Multivariate associations among four CeVD markers and whole-brain FC in 529 participants across the dementia spectrum were examined using partial least squares correlation. Interactive effects of CeVD-related FC patterns and p-tau181 on longitudinal gray matter volume (GMV) and cognitive changes were investigated using linear mixed-effects models.

Associations of Circulating Platelet Endothelial Cell Adhesion Molecule-1 Levels With Progression of Cerebral Small-Vessel Disease, Cognitive Decline, and Incident Dementia.

Background: The association between platelet endothelial cell adhesion molecule-1 (PECAM-1) with cerebral small-vessel disease and cognition in dementia-free subjects remains uninvestigated.

Methods And Results: A prospective cohort of dementia-free subjects was recruited from memory clinics and followed up for 5 years. Annual neurocognitive assessments and twice-yearly brain magnetic resonance imaging scans were performed.