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Introducción: El cateterismo urinario es un procedimiento frecuente y en ocasiones es utilizado por fuera de las indicaciones aceptadas para el mismo. Esto aumenta el riesgo de complicaciones vinculadas a su uso, por lo que pueden ser prevenibles. El objetivo del estudio es conocer las características del uso de cateterismo urinario en pacientes ingresados en salas de cuidados moderados de un hospital universitario del tercer nivel de atención, determinar la frecuencia, duración e indicaciones más frecuentes, así como evaluar la presencia de complicaciones asociadas al mismo Metodología: Estudio de corte transversal, realizado en salas de cuidados moderados de un hospital terciario y universitario de Montevideo, Uruguay, el 21 de diciembre de 2022. Se incluyeron pacientes hospitalizados que presentaban o presentaron catéter vesical en la presente internación y se completó la recolección de variables mediante la revisión de la historia clínica. Resultados: De 155 pacientes ingresados en salas de cuidados moderados, a 26 (16,7%) les fue colocado un catéter urinario. La mediana de edad fue 61 años, 80% eran de sexo masculino. La mediana de internación fue de 22 días. En todos los pacientes se utilizó sonda vesical y el 54% fue colocado en el Departamento de Emergencia. En el 46% de los pacientes no se encontró indicación escrita de colocación en la historia clínica. En 50% de los casos no está especificado el motivo de indicación de sonda vesical, mientras que las indicaciones identificadas más frecuentes fueron el control de diuresis (27%) y la desobstrucción de vía urinaria baja (23%). La duración de cateterismo fue de una mediana de 13,5 días, mientras que el 27% de los pacientes la usaron más de 30 días. 35% de los pacientes presentaron complicaciones vinculadas a la sonda vesical, en su mayoría no infecciosas (27%) y 15% presentaron infección urinaria. Estos pacientes tuvieron una duración de cateterismo mayor a los que no presentaron complicaciones (23 vs 10 días, p=0,411). Conclusiones: El catéter vesical fue utilizado en un porcentaje no despreciable de pacientes ingresados en salas de cuidados moderados, de forma prolongada y frecuentemente sin indicación precisa, lo cual expone a un riesgo aumentado de complicaciones vinculadas.

Introduction: Urinary catheterization is a frequent procedure and is sometimes used outside of its accepted indications. This increases the risk of complications related to its use, so they may be preventable. The objective of this study is to know the characteristics of the use of urinary catheterization in patients admitted to moderate care wards of a tertiary care university hospital, to determine the frequency, duration and most frequent indications, as well as to evaluate the presence of associated complications. Methodology: Cross-sectional study, carried out in moderate care wards of a tertiary care and university hospital in Montevideo, Uruguay, on December 21, 2022. Hospitalized patients who present or presented a bladder catheter during the present hospitalization were included, and the collection of variables was completed by reviewing the medical history. Results: Of 155 patients admitted to moderate care wards, 26 (16.7%) had a urinary catheter placed. The median age was 61 years, 80% were male. The median hospitalization was 22 days. In all patients a bladder catheter was used and 54% were placed in the Emergency Department. In 46% of the patients, no written indication for placement was found in the clinical history. In 50% of cases, the reason for indicating the bladder catheter is not specified, while the most frequent indications identified were diuresis control (27%) and lower urinary tract obstruction (23%). The duration of catheterization was a median of 13.5 days, while 27% of the patients used it for more than 30 days. 35% of the patients presented complications related to the bladder catheter, mostly non-infectious (27%) and 15% presented urinary tract infection. These patients had a longer duration of catheterization than those without complications (23 vs 10 days, p=0,411). Conclusions: The bladder catheter was used in a non-negligible percentage of patients admitted to moderate care wards, for a long time and often without a precise indication, which exposes them to an increased risk of related complications.

Introdução: O cateterismo urinário é um procedimento frequente e às vezes é usado fora de suas indicações aceitas. Isso aumenta o risco de complicações relacionadas ao seu uso, portanto, podem ser evitáveis. O objetivo deste estudo é conhecer as características do uso do cateterismo urinário em pacientes internados em enfermarias de cuidados moderados de um hospital universitário terciário, determinar a frequência, duração e indicações mais frequentes, bem como avaliar a presença de complicações associadas ao mesmo. Metodologia: Estudo transversal, realizado em quartos de cuidados moderados de um hospital terciário e universitário em Montevidéu, Uruguai, em 21 de dezembro de 2022. Foram incluídos pacientes que apresentaram ou apresentaram sonda vesical durante a internação atual e a coleta de variáveis ​​foi concluída .revisando o histórico médico. Resultados: Dos 155 pacientes admitidos em enfermarias de cuidados moderados, 26 (16,7%) tiveram um cateter urinário colocado. A idade média foi de 61 anos, 80% eram do sexo masculino. A mediana de internação foi de 22 dias. Em todos os doentes foi utilizada sonda vesical e 54% foram internados no Serviço de Urgência. Em 46% dos pacientes, nenhuma indicação escrita para colocação foi encontrada na história clínica. Em 50% dos casos não é especificado o motivo da indicação da sonda vesical, enquanto as indicações mais frequentes identificadas foram controle da diurese (27%) e desobstrução do trato urinário inferior (23%). A duração do cateterismo foi em média de 13,5 dias, enquanto 27% dos pacientes o utilizaram por mais de 30 dias. 35% dos pacientes apresentaram complicações relacionadas ao cateter vesical, em sua maioria não infecciosas (27%) e 15% apresentaram infecção urinária. Esses pacientes tiveram uma duração mais longa de cateterismo do que aqueles sem complicações (23 vs 10 dias, p=0,411). Conclusões: A sonda vesical foi utilizada em percentual não desprezível de pacientes internados em quartos de cuidados moderados, por tempo prolongado e muitas vezes sem indicação precisa, o que os expõe a um risco aumentado de complicações associadas.

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Objetivo: analisar as características e os desfechos obstétricos adversos em gestantes/puérperas infectadas pelo SARS-CoV-2 em serviço de referência. Método: série de casos retrospectiva entre gestantes com Covid-19 em um hospital universitário em Minas Gerais, Brasil, atendidas no serviço de 2020 a 2021, coletados em abril de 2022, empregando-se estatística descritiva para análise dos dados através do Statistical Package for the Social Science. Resultados: incluídas 26 gestantes, em sua maioria brancas, que tiveram como principais desfechos obstétricos adversos a internação em UTI (43,5%), parto prematuro (34,6%), dado reestratificado de semanas para dias para investigar o encurtamento da gestação, onde constatou-se média de 38,6 dias potenciais de gravidez perdidos dos 280 dias ideais, e ainda 15,4% evoluíram para óbito materno. Conclusão: o estudo proporcionou evidenciar a necessidade de vigilância e atenção às gestantes com foco nos principais desfechos adversos, podendo-se intervir em tempo oportuno para diminuir adversidades.

Objective: to analyze the characteristics and adverse obstetric outcomes in pregnant/puerperal women infected by SARS-CoV-2 at a reference service. Method: a retrospective case series conducted among pregnant women with Covid-19 in a university hospital from Minas Gerais, Brazil, treated at the service from 2020 to 2021. The cases were collected in April 2022 employing descriptive statistics for data analysis in the Statistical Package for the Social Science. Results: a total of 26 pregnant women were included, mostly white-skinned, whose main adverse obstetric outcomes were admission to the ICU (43.5%), premature birth (34.6%) and data restratified from weeks to days to investigate shortening of pregnancy, where a mean of 38.6 potential days of pregnancy were lost out of the ideal 280 days, and 15.4% resulted in maternal death. Conclusion: the study provided evidence of the need for surveillance and care for pregnant women with a focus on the main adverse outcomes, enabling timely intervention to reduce adversities.

Objetivo: analizar las características y resultados obstétricos adversos en gestantes/puérperas infectadas por SARS-CoV-2 en un servicio de referencia. Método: serie de casos retrospectiva entre gestantes con Covid-19 en un hospital universitario de Minas Gerais, Brasil, atendidas en el servicio de 2020 a 2021. Los datos se recolectaron en abril de 2022, se utilizó estadística descriptiva para analizar los datos mediante el Statistical Package for the Social Science. Resultados: se incluyeron 26 gestantes, la mayoría de raza blanca, cuyos principales resultados obstétricos adversos fueron ingreso a UCI (43,5%), parto prematuro (34,6%), dato reestratificado de semanas a días para investigar el acortamiento de la gestación, que arrojó como resultado un promedio de 38,6. Se comprobó que se perdieron en promedio 38,6 días potenciales de embarazo de los 280 días ideales, y muerte materna (15,4%). Conclusión: la evidencia que proporcionó el estudio indica que es necesario vigilar y atender a las gestantes enfocándose en los principales resultados adversos, lo que permite intervenir de forma oportuna para reducir adversidades.

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BACKGROUND: Pregnancy-induced hypertension remains one of the important types of diseases that affect maternal and infant outcomes; prenatal and perinatal ultrasound examination is an important tool for evaluating fetal development. So, this study aimed to explore the clinical value of applying fetal heart quantification (fetal HQ) measuring left ventricular global longitudinal strain (LVGLS) and left ventricular ejection fraction (LVEF) in mid-to-late fetuses to predict neonatal complications in patients with gestational hypertension. METHODS: A retrospective summary of 146 pregnant women with gestational hypertension diagnosed from August 2020 to October 2023 into JinHua Maternal and Child Health Care Hospital was performed. Fetal HQ measured the fetal global spherical index (GSI), left and right ventricular spherical index (SI), left and right ventricular fractional shortening (FS), LVGLS and RVGLS, LVEF, and fractional area change (FAC) of the left and right ventricles. They were divided into complication group and non-complication group based on whether fetal complications occurred 28 days after birth. Multivariate logistic regression was used to screen risk factors to neonatal complications. RESULTS: The 146 neonates were divided into 39 of the complication group and 107 of the non-complication group. Compared with the latter group, pregnant women in the former group had a higher incidence of preeclampsia and eclampsia, increased mean systolic and diastolic blood pressure, significantly lower estimated fetal weight (EFW), left ventricular 24-segment SI, LVGLS, LVEF, and left ventricular FAC values (p < .05). Logistic regression showed higher of LVGLS (adjusted OR = 2.281, p < .001) was risk factors for neonatal complications, while higher LVEF (adjusted OR = 0.600, p < .001) and left ventricular FAC (adjusted OR = 0.784, p = .035) were protective factors. Spearman's correlation analysis showed a significant negative correlation between LVGLS and LVEF (r = -0.368, p < .001). Receiver operating curves (ROCs) showed the area under the curve (AUC) for predicting overall neonatal complications was 0.880 for LVGLS and 0.878 for LVEF (p < .001). CONCLUSIONS: Fetal HQ for fetal LVGLS and LVEF in mid-to-late pregnancy with gestational hypertension helps to assess the overall neonatal complications risk.

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Transcatheter aortic valve replacement (TAVR) is preferred therapy for elderly patients with severe aortic stenosis (AS) and increasingly used in younger patient populations with good safety and efficacy outcomes. However, cardiac conduction abnormalities remain a frequent complication after TAVR ranging from relative benign interventriculair conduction delays to prognostically relevant left bundle branch block and complete atrio-ventricular (AV) block requiring permanent pacemaker implantation (PPI). Although clinical, procedural and electrocardiographic factors have been identified as predictors of this complication, there is a need for advanced strategies to control the burden of conduction defects particularly as TAVR shifts towards younger populations. This state of the art review highlights the value of ECG-synchronized computed tomographic angiography (CTA) evaluation of the aortic root to better understand and manage conduction problems post-TAVR. An update on CTA derived anatomic features related to conduction issues is provided and complemented with computational framework modelling. This CTA-derived 3-dimensional anatomical reconstruction tool generates patient-specific TAVR simulations enabling operators to adapt procedural strategy and implantation technique to mitigate conduction abnormality risks.

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BACKGROUND: This research aims to assess the demographic characteristics, prevalence, outcomes, and complications in chronic kidney disease (CKD) patients following mandible fractures in the United States using a nationally representative database. METHODS: We analyzed data from the National Inpatient Sample from 2010 to 2019 in the United States. Patients with mandible fractures were categorized into three groups based on the International Classification of Diseases, Ninth and Tenth Revisions (ICD-9-CM and ICD-10-CM): end-stage renal disease (ESRD), non-ESRD CKD, and healthy kidney function. Chi-squared tests and analysis of variance (ANOVA) were used to compare these groups. Additionally, multivariate regression analysis was performed to determine whether CKD is an independent risk factor for complications in patients with mandible fractures. RESULTS: A total of 38,481 patients in the United States were estimated to have experienced mandible fractures between 2010 and 2019. The incidence rate of non-ESRD CKD in patients with mandible fractures significantly increased over time, while the prevalence of ESRD remained stable during the ten-year period. Compared to the healthy kidney function group, patients with chronic kidney disease exhibited higher hospital costs, longer hospitalization durations, and higher in-hospital mortality rates. Additionally, they had greater odds ratios for most of the investigated complications. CONCLUSIONS: This study revealed a steady annual increase in the morbidity rate of non-ESRD CKD among patients with mandible fractures, while ESRD prevalence remained stable over ten years. We observed a close association between chronic kidney disease and the prognosis of patients with mandible fractures. Clinicians should prioritize preventive measures and appropriate management of mandibular fractures in patients with CKD.

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OBJECTIVES: To investigate postoperative complications in patients who underwent alveolar bone graft surgery using mandibular cortical bone (MCB) with/without particulate artificial bone (PAB). DESIGN: Retrospective study. SETTING: Department of Oral and Cranio-Maxillofacial Surgery in the hospital from August 2020 to August 2023. PATIENTS: Patients who underwent alveolar bone graft using MCB were reviewed. They were diagnosed with unilateral or bilateral alveolar cleft, and some of them developed postoperative complications after MCB with/without PAB repair surgery. INTERVENTIONS: No interventions. MAIN OUTCOME MEASURE(S): Complications. RESULTS: Complications occurred in 12 of 149 patients who underwent surgery (8.05%). Among these evaluated patients, 10 had surgical site infection, 8 had mucosal dehiscence, 2 had discharge of resorbable plate debris, and 6 had grafted bone necrosis. Patients with bilateral alveolar clefts were more likely to experience complications (P = 0.033). CONCLUSION: MCB with/without PAB grafting is effective enough for patients to undergo reconstruction of the alveolar process.

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BACKGROUND: With the increasing demand for cosmetic procedures in recent years, the implementation of some of these procedures by unauthorized persons has led to undesirable results and subsequently to the creation of a large number of case files. AIMS: In this study, it is aimed to retrospectively evaluate the decision texts of the Turkish Supreme Court regarding minimally invasive cosmetic dermatology procedures and to evaluate the reasons and results of the applications reaching the high court in these procedures. METHODS: The Supreme Court's decisions in cases filed due to undesirable consequences caused by minimally invasive cosmetic interventions were scanned using the Supreme Court of Appeals' online database from 2013 to 2023. RESULTS: The majority of the procedures addressed by the lawsuits are carried out in beauty salons; laser epilation is the procedure that is conducted most frequently, and burns are the most prevalent complication (87.8%, 85.7%, and 77.6%, respectively). As an adverse event, 94.7% (n = 36) of burns occurred in beauty centers. Thirteen (26.5%) of the cases in our analysis were carried out by an unauthorized person. When laser epilation and other procedures are considered as two separate categories, in applications due to adverse events of laser epilation, 28 (66.7%) cases were concluded in favor of the defendant. CONCLUSIONS: Complications, especially burns, that occur after laser epilation performed by unauthorized persons in beauty salons constitute a serious caseload, and there seems to be a need for better control mechanisms to reduce this burden.

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Background: Castleman disease (CD) is a rare lymphoproliferative disorder that can occur anywhere along the lymphatic pathway. Retroperitoneal unicentric Castleman disease (UCD) is an extremely rare manifestation. This study aims to explore the clinical features and surgical treatment of retroperitoneal UCD. Methods: We retrospectively reviewed patients who underwent retroperitoneal tumor surgery and were diagnosed with CD based on postoperative pathology before December 31, 2022. Data from these patients were collected and analyzed. Results: A total of 15 patients were included in the final analysis. All patients underwent radical resection under general anesthesia. Two out of 15 patients (13.3%) experienced serious complications but recovered well. There were no perioperative deaths. The median follow-up time was 78.5 months (range: 18-107.5 months), and no deaths or recurrences occurred during this period. Conclusions: Surgical treatment for retroperitoneal UCD is safe. Patients with retroperitoneal UCD can achieve long-time survival through complete resection.

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The current treatment approach to patients with liver cirrhosis relies on the individual management of complications. Consequently, there is an unmet need for an overall therapeutic strategy for primary and secondary prevention of complications. The clinical potential of long-term albumin infusions supported by recent clinical trials has expanded its indications and holds promise to transform the management and secondary prevention of cirrhosis-related complications. This renewed interest in albumin comes with inherent controversies, compounding challenges and pressing need for rigorous evaluation of its clinical potential to capitalize on its therapeutic breakthroughs. Australia is among a few countries worldwide to adopt outpatient human albumin infusion. Here, we summarize currently available evidence of the potential benefits of human albumin for the management of multiple liver cirrhosis-related complications and discuss key challenges for wide application of long-term albumin administration strategy in Australian clinical practice. Australian Gastroenterological week (AGW), organised by the Gastroenterological Society of Australia (GESA), was held between 9-11 September 2022. A panel of hepatologists, advanced liver nurses and one haematologist, were invited to a roundtable meeting to discuss the use of long-term albumin infusions for liver cirrhosis. management in Australia. In this review, we summarise the proceedings of this meeting in context of the current literature.

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Tension pneumocephalus (TP) is an unusual and potentially life-threatening condition characterized by a large volume of intracranial air causing compression and displacement of the underlying cerebral cortex. The symptoms of TP are non-specific. Diagnosis is generally made by demonstration of the classic "Mount Fuji" sign on computed tomography imaging. TP is most commonly seen in the early postoperative period after craniotomy or trauma involving fractures through the pneumatized sinuses. We present a rare case of TP which resulted from an inadequately decompressed pneumothorax communicating with root avulsions of C8 and T1.

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Objective: To evaluate the efficacy of intraocular lens (IOL) cushion plate technology in reducing corneal endothelial cell loss during hard-core cataract surgery compared with conventional ultrasonic emulsification. Methods: Seventy-six patients with hard-core cataracts who underwent surgery at our institution from April 2019 to June 2022 were included. The patients were divided into an observation group (IOL cushion plate technology, 38 patients) and a control group (conventional ultrasonic emulsification, 38 patients). Surgical outcomes, including the corneal endothelial cell loss rate, best corrected visual acuity (BCVA), and central corneal thickness (CCTc), were compared between the two groups. Results: Preoperative patient characteristics were similar between the groups. Postoperatively, both groups demonstrated similar BCVA and CCTc values on days 7 and 30. However, compared with the observation group, the control group presented a significantly greater rate of corneal endothelial cell loss on postoperative days 7 and 30 (p < 0.05). Intraoperative complications and postoperative complications were notably greater in the control group (p < 0.05). The observation group had reduced ultramilk time and total energy consumption (p < 0.05). Conclusion: IOL cushion plate technology offers advantages in preserving corneal endothelial cells during hard-core cataract surgery, potentially improving surgical safety and efficacy.

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Lower abdominal pain is a common complaint for patients presenting for evaluation in the emergency department. Among other life-threatening complications, acute appendicitis needs to be ruled out in the case of right-lower quadrant pain (RLQ). Sigmoid perforation caused by an ingested foreign body is an uncommon cause of RLQ pain. This report presents the case of an otherwise healthy, 29-year-old male who presented to the emergency department with RLQ pain. His initial evaluation raised concern for acute appendicitis. However, during his exploratory laparoscopy, he was found to have a perforated sigmoid colon due to a skewer stick; the patient had no recollection of having ingested any foreign body. This paper highlights the importance of considering the possibility of sigmoid perforation by an ingested foreign body as a possible cause of RLQ pain. The article also reviews the most common causes of ingested foreign bodies, their potential complications and management.

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Background Pancreatitis, marked by sterile inflammation of the pancreas, can present as either acute or chronic. It involves the premature activation of proteolytic enzymes, leading to autodigestion, inflammation, and potential systemic effects. This study investigates the impact of obesity on the severity of acute pancreatitis, given its role in systemic inflammation and its association with severe morbidity and mortality. Methods A retrospective analysis was conducted on patients treated for acute pancreatitis over a five-month period at the Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh (WLL) NHS Foundation Trust, Wigan, United Kingdom. Patients were evaluated using diagnostic criteria such as abdominal pain, elevated serum enzyme levels, and imaging results. The study explored correlations between BMI and pancreatitis severity, hospital length of stay, and complications, applying the Atlanta severity classification. Results The analysis revealed a weak, statistically insignificant correlation between BMI and the severity of acute pancreatitis, hospital stay length, and complications. This was consistent across various statistical methods, including Pearson correlation coefficients and multiple linear regression. These findings suggest that, while obesity may influence the inflammatory response in acute pancreatitis, it does not have a significant impact on clinical outcomes within this cohort. Conclusions The study highlights the complex role of obesity in exacerbating pancreatic inflammation but also emphasizes the need for larger, more definitive studies to explore this relationship further. It underscores the importance of early recognition and intervention in managing acute pancreatitis, regardless of BMI status.

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Background: Over 25,000 men undergo inflatable penile prosthesis (IPP) placement yearly to treat erectile dysfunction (ED). Although various comorbidities are hypothesized risk factors for complications, this remains incompletely understood. Our objective was to utilize multi-institutional data to characterize risk for reintervention, complications, and infections in patients with common suspected risk factors undergoing IPP placement. Methods: We queried the TriNetX database for adult men who underwent IPP placement from 2003-2023 utilizing Current Procedural Terminology (CPT) codes. We examined the impact of diabetes mellitus (DM), hypertension (HTN), nicotine use, radiation therapy (RT), radical prostatectomy (RP), and urethral surgery [urethroplasty, artificial urinary sphincter (AUS), male urethral sling (MS)] on clinical outcomes defined by International Classification of Diseases 10th Revision (ICD-10) codes. Our primary outcome was need for reintervention based on CPT codes. Secondary outcomes included overall rates of complication and infection utilizing ICD-10 codes. Analytics were performed using TriNetX to calculate risk ratios (RRs) and Kaplan-Meier (KM) survival. We evaluated outcomes overall and for each individual comparison cohort using the remaining demographic variables to perform propensity score matching (PSM). Results: In a total of 11,026 patients there was an overall 13.5% risk of undergoing at least one reintervention, with some undergoing multiple based on CPT codes. KM analysis showed a median IPP survival of 18.2 years and a projected 10- and 20-year survival probability at 70.6% and 48.4% respectively. Overall complication rate was 19.3% with a 5.2% rate of infection based on ICD codes. Patients with history of urethral surgery were at higher risk of both IPP complication and re-intervention. When further analyzing type of re-intervention, patients with a history of smoking, prior RP, and prior AUS/MS placement had higher rates of device removal. Patients with a history of diabetes were less likely to undergo IPP replacement at the time of explant. There were no identified risk factors for IPP infection. Conclusions: This is the largest cohort of patients ever evaluated and can help guide patient selection and counseling. There was a higher rate of IPP complications than previously reported, but this may be due to different reporting parameters. History of prior urethral surgery conferred a higher risk of complications and re-intervention. These results can help guide patient selection and counseling.

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Background: Endoleaks are common complications after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA)/digital subtraction angiography (DSA) is considered the gold standard for evaluating contrast-enhanced ultrasound (CEUS) accuracy in the detection and classification of endoleaks. In recent years, CEUS has been widely used in this field. This study aimed to analyze the accuracy of CEUS in the detection and classification of endoleaks after EVAR. Methods: The data of 98 patients who underwent abdominal aorta CEUS from November 2017 to September 2023 in the ultrasound (US) department of Beijing Hospital were retrospectively analyzed. All the patients underwent EVAR of AAA before CEUS and CTA/DSA, and had complete clinical data. The CEUS and CTA/DSA results were compared to detect endoleaks and categorize the specific types of endoleaks. Results: Among the 98 patients, 74 were male and 24 were female. The patients had an average age of 74.8±9.8 years (range, 43-90 years). Among the 98 patients, 37 (37.8%) endoleaks were detected by CEUS, of which 8 were type Ia, 2 were type Ib, 15 were type II, 7 were type III, 2 were type IV, 2 were type Ia combined with type III, and 1 was type II combined with type III. In addition, among these 98 patients, 39 (39.8%) endoleaks were detected by CTA/DSA, of which 8 were type Ia, 3 were type Ib, 18 were type II, 6 were type III, 2 were type Ia combined with type III, 1 was type II combined with type III, and 1 was type Ib combined with type II. The sensitivity and specificity of CEUS in the detection of endoleaks were 92.3% and 98.3%, respectively. CEUS and CTA/DSA had similar diagnostic efficacy and good consistency in the detection and classification of endoleaks (Kappa value: 0.914, P<0.01). Conclusions: CEUS has high sensitivity and specificity in the detection and classification of endoleaks following EVAR, and its diagnostic efficacy is similar to that of CTA/DSA. In addition, US is safe, non-invasive and repeatable, and thus is worthy of extensive clinical application.

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Background: Carbohydrate drinking 2-3 hours before surgery has been widely adopted in colorectal operations. However, there is little direct evidence regarding its application in gastric cancer surgery. We aimed to evaluate the gastric residual volume, safety, and effectiveness of drinking 250 mL of 5% glucose solution 2-3 hours before elective gastric cancer surgery. Methods: We conducted an investigator-initiated, multicenter, randomized-controlled, parallel group, and equivalence trial. Eighty-eight patients with gastric adenocarcinoma were randomized into study or control group. Patients in the control group followed the traditional routine of 6-8 hours preoperative fasting, while those in the study group drank 250 mL of 5% glucose solution 2-3 hours before surgery. Immediately following tracheal intubation, gastric contents were aspirated through gastroscopy. The primary outcome was preoperative gastric residual volume. Results: Eighty-three patients were eventually analysed in the study (42 in the study group and 41 in the control group). Two groups were comparable at baseline characteristics. There were no statistical differences in residual gastric fluid volumes (35.86 ± 27.13 vs 27.70 ± 20.37 mL, P = 0.135) and pH values (2.81 ± 1.99 vs 2.66 ± 1.68, P = 0.708) between the two groups. Preoperative discomfort was significantly more decreased in the study group than in the control group (thirst score: 1.49 ± 1.23 vs 4.14 ± 2.07, P < 0.001; hunger score: 1.66 ± 1.18 vs 3.00 ± 2.32, P = 0.007). There was no statistical difference in the incidence of postoperative complications (19.05% vs 17.07%, P = 0.815). Conclusions: Drinking 250 mL of 5% glucose solution 2-3 hours before surgery in elective gastric cancer patients shows benefits in lowering thirst and hunger scores without increasing gastric residual volume and perioperative complications.

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Background: The more widespread use of peripheral venous catheters (PVC) has led to more frequent complications, not only in PVC-associated bacteremia, but also in phlebitis. This requires the catheter to be removed and increases healthcare costs. Our aim was to assess the PVC-associated complications in an endoscopy department. Methods: We performed a cross-sectional, descriptive study on patients admitted to our center and undergoing a procedure in the endoscopy department. We analyzed the appearance of the following PVC-associated complications: obstruction, phlebitis, redness, extravasation, pain, and infection on the day of the study. All catheter tips were sent to the microbiology laboratory for culture using the roll-plate semiquantitative technique. Clinical and microbiological data were collected. Results: We included a total of 46 patients with 50 PVCs. The median (IQR) age was 70.0 (55.0-81.5) years, and 58.7% were female. The median (IQR) hospital stay was 9.00 (6.00-14.25) days. Of the 50 PVCs, most were inserted in the emergency room (74.0%), and the median (IQR) indwelling time was 5.00 (3.00-7.00) days. The phlebitis rate was 78.0%, which occurred mainly in PVCs inserted in the emergency room (74.3%). The tip was colonized in 9 PVCs (18.0%). Conclusion: The endoscopy department can alert clinicians to PVC-associated complications. PVCs inserted in the emergency room were subject to a higher risk of phlebitis and/or colonization. Therefore, we recommend systematically replacing PVCs inserted in the emergency room within 48 h if preventive measures during insertion cannot be guaranteed.

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The COVID-19 outbreak has garnered significant global attention due to its impact on human health. Despite its relatively low fatality rate, the virus affects multiple organ systems, resulting in various symptoms such as palpitations, headaches, muscle pain, and hearing loss among COVID-19 patients and those recovering from the disease. These symptoms impose a substantial physical, psychological, and social burden on affected individuals. On February 15, 2020, the Chinese government advised incorporating antimalarial drugs into the guidelines issued by the National Health Commission of China for preventing, diagnosing, and treating COVID-19 pneumonia. We examine the adverse effects of Chloroquine (CQ) in treating COVID-19 complications to understand why it is no longer the primary treatment for the disease.

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Purpose: To explore the relationship between Red cell distribution width/albumin ratio (RAR) and vascular complications, including atherosclerosis of the lower limbs, diabetic nephropathy(DN), and diabetic retinopathy(DR), in patients with type 2 diabetes mellitus(T2DM). Patients and Methods: The study included 427 patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Jinan University (Guangzhou, China) between April 1, 2022 and May 31, 2023. Baseline characteristics were displayed according to the quartiles of the RAR. Logistic regression analysis and receiver operating characteristic curves (ROC) were used to analyze the data. Results: After adjusting for confounders, a higher RAR quartile(the fourth quartile) was associated with an increased risk of atherosclerosis of the lower limbs(OR: 2.973, 95% CI 1.281-6.906, p = 0.011), and diabetic nephropathy(OR: 2.876, 95% CI 1.315-6.287, p = 0.008) compared to the lowest RAR quartile. The patients were further divided into two groups according to urinary albumin to creatinine ratio (UACR≥30mg/g and UACR < 30mg/g) and Glomerular Filtration Rate (eGFR<60 mL·min⁻¹ (1.73 m²) ⁻¹ and eGFR≥60 mL·min⁻¹ (1.73 m²) ⁻¹). Similar results were observed. However, We found that RAR quartile did not significantly increase the likelihood of developing diabetic retinopathy(OR: 1.183, 95% CI 0.633-2.211, p = 0.598). Conclusion: The RAR ratio is associated with an increased risk of atherosclerosis of the lower limbs and diabetic nephropathy in patients with T2DM. The RAR ratio may be an important clinical marker of vascular complications in T2DM.

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The evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA) continue to be a complex and debated topic in revision TKA (rTKA). Despite the introduction of new evidence and innovative technologies aimed at addressing the approach and care of severe bone loss in rTKA, there is no single document that systematically incorporates these newer surgical approaches. Therefore, a comprehensive review of the treatment of severe bone loss in rTKA is necessary. The Stavros Niarchos Foundation Complex Joint Reconstruction Center Hospital for Special Surgery, dedicated to clinical care and research primarily in revision hip and knee replacement, convened a Management of Bone Loss in Revision TKA symposium on June 24, 2022. At this meeting, the 42 international invited experts were divided into groups; each group was assigned to discuss questions related to 1 of the 4 topics: (1) assessing preoperative workup and imaging, anticipated bone loss, classification system, and implant surveillance; (2) achieving durable fixation in the setting of significant bone loss in revision TKA; (3) managing patellar bone loss and the extensor mechanism in cases of severe bone loss; and (4) considering the use of complex modular replacement systems: hinges, distal femoral, and proximal tibial replacements. Each group came to consensus, when possible, based on an extensive literature review and interactive discussion on their group topic. This document reviews each these 4 areas, the consensus of each group, and directions for future research.