Notes

Inherent medical attributes involving non-immediate allergy or intolerance in order to iodinated distinction media.
Three meta-analyses were performed based on results of 6 observational studies and showed worse OHRQL (P < .00001) and HRQL (P < .0001) in patients with BMS compared to controls.

Patients with BMS reported poor HRQL and poor OHRQL compared to control groups, evidencing that this condition affects patients' well-being.
Patients with BMS reported poor HRQL and poor OHRQL compared to control groups, evidencing that this condition affects patients' well-being.
To evaluate the effectiveness of different diagnostic variables measured on panoramic radiographs (PAN) to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition.

Digital databases (MEDLINE, CENTRAL (Cochrane), Scopus, clinicaltrials.gov, ISRCTN registry) and hand searches were performed up to March 2020. Both randomized and non-randomized controlled trials were considered for the review. Study selection, data extraction, risk of bias assessment (RoB2.0 and ROBINS-I), and the certainty of evidence evaluation (GRADE) were performed according to Cochrane Handbook for Systematic Reviews of Interventions. The random-effects method for quantitative synthesis of dichotomous as well as continuous data was used.

Out of 767 retrieved records, 4 controlled trials fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk of bias except one. Overall certainty was strong to moderate. PDCs in distal sectors (RRreview can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well-designed clinical trials are recommended to strengthen the evidence.
Assessment of the future liver remnant (FLR) is routinely performed before major hepatectomy. In R1-vascular one-stage hepatectomy (R1vasc-OSH), given the multiplanar dissection paths, the FLR is not easily predictable. Preoperative 3D-virtual casts may help. We evaluated the predictability of the FLR using the 3D-virtual cast in the R1vasc-OSH for multiple bilobar colorectal liver metastases (CLM).

Thirty consecutive patients with multiple bilobar CLMs scheduled for R1vasc-OSH were included. Predicted and real-FLRs were compared. Propensity score-matched analysis was used to determine the impact of 3D-virtual cast on postoperative complications.

Median number of CLM and resection areas were 12 (4-33) and 3 (1-8). Median predicted-FLR was 899ml (558-1157) and 60% (42-85), while for the real-FLR 915ml (566-1777) and 63% (43-87). Median discrepancy between predicted and real-FLR was-0.6% (p=0.504), indicating a slight tendency to underestimate the FLR. The difference was more evident in more than 12 CLMs (p=0.013). A discrepancy was not evident according to the number of resection areas (p=0.316). No mortality occurred. Patients in virtual-group had lower major complications compared to nonvirtual-group (0% vs 18%, p-value 0.014).

FLR estimation based on 3D-analysis is feasible, provides a safe surgery and represents a promising method in planning R1vasc-OSH for patients with multiple bilobar CLMs.
FLR estimation based on 3D-analysis is feasible, provides a safe surgery and represents a promising method in planning R1vasc-OSH for patients with multiple bilobar CLMs.Polydactyly is a common congenital hand, foot, or both anomalies characterized by the presence of extra fingers. Postaxial polydactyly is the most common congenital malformation consisting of the lateral or fibular aspect of the foot. Extra finger excision in the treatment of foot polydactyly is considered the basic procedure in surgery. However, in some cases more complex surgeries should be preferred. In this study, the "on-top plasty" method with a minimally invasive approach is presented in a case of complex foot postaxial polydactyly.Some pri-miRNAs can code for short peptides called micropeptides (miPEPs) and it has been suggested that these peptides positively regulate the accumulation of their associated miRNAs. Recent data further support this model and point towards the potential for miPEPs to be used in the agricultural sector to improve crop agronomic traits.
The high prevalence of inadequately managed chronic pain indicates the need for alternative and multimodal treatment options. Use of cannabinoids in medicine is becoming a growing area of interest, specifically in the context of chronic pain. The efficacy of cannabinoids for the treatment of chronic pain is not well established.

The objectives of this rapid systematic literature review are to summarize the efficacy and secondary effects of cannabinoids for chronic pain management.

Rapid systematic review of randomized control trials.

Individuals with chronic pain (n = 1352).

Embase, Cochrane, PubMed, and CINAHL databases were searched. Inclusion criteria included cannabis of any formulation used to treat chronic pain of any origin.

Thirteen randomized controlled trials met the inclusion criteria. TPX0005 Five demonstrated moderate analgesic effects of cannabis for chronic pain, and eight concluded there were no significant impacts on pain in the cannabis-treated group versus the control group.

Evidence nnabinoids may have a potential role in chronic pain management. Inconsistent evidence on the efficacy of cannabis to treat chronic pain indicates the need for more studies on a larger scale. Clinicians should draw on available evidence and consider cannabinoids as a potential approach to chronic pain management.
A literature review was conducted to assess nurse-led nonpharmacologic pain management interventions intended for total knee/hip replacement patients.

This was a systematic review and meta-analysis.

The PubMed, Embase, CINAHL, and Cochrane Library databases were searched to identify relevant studies.

The systematic review was conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and all Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guidelines. Two reviewers independently selected the studies and appraised their quality. Thereafter, the effects of all described nurse-led nonpharmacologic pain management interventions were estimated regarding pain, anxiety, and satisfaction through a meta-analysis.

In total, 219 relevant studies were found through a search. Finally, 23 studies were selected for review, with 17 included in the meta-analysis. Nurse-led nonpharmacologic pain management was effective for pain relief (effect size,-0.22; 95% confidence interval [CI],-0.42 to-0.02), and educational interventions were especially effective (effect size,-0.36; 95% CI,-0.69 to-0.03). Although interventions reduced anxiety and improved satisfaction, these results were not statistically significant based on the analysis.

Our findings support that nurse-led nonpharmacologic pain management interventions could help reduce pain in patients with total knee/hip replacement by supplementing pharmacologic pain management.

Nurse-led nonpharmacologic pain interventions should be considered to reduce patient pain with total knee/hip replacement.
Nurse-led nonpharmacologic pain interventions should be considered to reduce patient pain with total knee/hip replacement.A 72-year-old man presented to the ED following witnessed cardiac arrest. After return of spontaneous circulation, an ECG was performed which demonstrated a wide complex rhythm with "shark fin" morphology. With careful examination it is possible to identify the J point and determine that the electrocardiogram (ECG) findings actually represent massive ST-elevation indicative of occlusion myocardial infarction (OMI). Initial troponin was undetectable. The patient underwent emergent cardiac catheterization and had a 100% proximal LAD occlusion that was successfully stented. The patient was discharged home neurologically intact several days later. This case highlights the importance of careful ECG interpretation and the limitations of troponin assays in the evaluation of acute coronary syndrome. Most importantly, we demonstrate how to evaluate for ST elevation in the context of a widened QRS complex.Headache is a frequent emergency department (ED) complaint. Secondary headache, due to infectious causes, must be carefully evaluated as a differential diagnosis. Red flag signs and classic physical examination findings are available to aid the diagnosis and evaluation of secondary headache. These findings, however, are limited by poor sensitivity and predictive value. We present a case of Herpes zoster (HZ) meningitis in a young healthy male adult with major presenting symptom of headache and new-onset rash to underscore the variation in atypical presentations of aseptic meningitis. HZ-associated aseptic meningitis often presents with characteristic, but at times atypical rash. link2 We recommend skin lesions be thoroughly evaluated, along with classic signs of fever and nuchal rigidity, to assist in the diagnosis of meningitis.
To describe interventional oncology therapies combined with immune checkpoint inhibitor (ICI) therapy targeting the programmed death 1 pathway in patients with different neoplasms.

This was a retrospective cohort study of patients who underwent tumor-directed thermal ablation, embolization, or selective internal radiation therapy (SIRT) between January 1, 2011, and May 1, 2019, and received anti-programmed death 1/PD-L1 agents ≤ 90 days before or ≤ 30 days after the interventional procedure. Immune-related adverse events (irAEs) and procedural complications ≤ 90 days after the procedure were graded according to the Common Terminology Criteria for Adverse Events version 5.0. The study included 65 eligible patients (49% female; age 63 years ± 11.1). The most common tumors were metastatic melanoma (n= 28) and non-small cell lung cancer (NSCLC) (n= 12). Patients underwent 78 procedures (12 patients underwent > 1 procedure), most frequently SIRT (35.9%) and cryoablation (28.2%). The most common target organs were liver (46.2%), bone (24.4%), and lung (9.0%). Most patients received ICI monotherapy with pembrolizumab (n= 30), nivolumab (n= 22), and atezolizumab (n= 6); 7 patients received ipilimumab and nivolumab.

Seven (10.8%) patients experienced an irAE (71.4% grade 1-2), mostly affecting the skin. Median time to irAE was 33 days (interquartile range, 19-38 days). Five irAEs occurred in patients with melanoma, and no irAEs occurred in patients with NSCLC. Management required corticosteroids (n= 3) and immunotherapy discontinuation (n= 1); all irAEs resolved to grade ≤ 1. There were 4 intraprocedural and 32 postprocedural complications (77.8% grade < 3). No grade 5 irAEs and/or procedural complications occurred.

No unmanageable or unanticipated toxicities occurred within 90 days after interventional oncology therapies combined with ICIs.
No unmanageable or unanticipated toxicities occurred within 90 days after interventional oncology therapies combined with ICIs.
Appendicitis is a common pediatric surgical emergency, and the diagnosis may be delayed or missed because of nonspecific findings in children. Not all patients with abdominal pain need to be imaged for appendicitis, and laboratory evaluation may improve diagnostic accuracy in this population.

To determine if C-reactive protein (CRP) and symptom duration could be used to improve diagnosis of appendicitis compared with white blood cell count (WBC) and absolute neutrophil count (ANC).

This was a retrospective chart review from June 2017 to 2019 at our tertiary academic children's hospital. A consecutive sample of all children <18years of age being evaluated for appendicitis who had magnetic resonance imaging ordered were included. link3 The diagnostic accuracy of WBC, ANC, and CRP were compared for patients with symptom duration ≤1day compared with symptom duration for >1day.

Five hundred thirty-nine patients were identified. The sensitivity and specificity of WBC (10,000cells/μL) was 87.1% and 65.2%, respectively; ANC (7,500cells/μL) was 86.
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