Notes

Your Oxo-Wall Continues to be In one piece: The Tetrahedrally Altered Corp(Intravenous)-Oxo Complex.
The mapping of the repetitive sequences, principally the microsatellite motifs, indicates a marked tendency for the accumulation of these sequences in the terminal portions of the chromosomes, which may have played a fundamental role in the differentiation of the three species.Background Case management (CM) is an intervention adapted to the needs of patients with chronic conditions or complex needs. Factors associated with effectiveness of CM, such as high intervention intensity, can represent challenges to its implementation. Telehealth has the potential to help overcome these challenges, but little work has been done to synthesize available evidence on telehealth CM. The purpose of this scoping review was thus to fill this gap and document which telehealth modalities have been used, summarize perspectives of key users, and discuss evidence on effectiveness of telehealth-delivered CM. Methods A search in MEDLINE, Scopus, and CINAHL for articles published between January 2005 and January 2021 was done. Studies in which telehealth was used for patient-case manager interaction and conducted in a population with complex health needs and/or chronic conditions were included. Articles selected for full-text review were independently screened by two reviewers. Data extraction was conducted once and validated by a second reviewer. Results Of 3,108 articles, 22 were retained for data extraction. A narrative synthesis was conducted. Most studies evaluated CM interventions delivered over telephone, yet, literature suggests that face-to-face contact is essential to CM success. Results also indicate that telehealth CM is acceptable and effective, associated with better utilization of health services and favorable clinical outcomes. Conclusions Lack of research evaluating telehealth CM delivered using modalities other than telephone. Further research should evaluate CM interventions that integrate platforms enabling visual information exchange.Importance The predictors of postoperative complications after paramedian forehead flaps (PMFF) are unknown. Objective To determine whether preoperative factors can predict post-PMFF complications. Debio1143 Design, Setting, Participants A retrospective review of 1438 adults from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database who underwent PMFF between 2010 and 2018. Main Outcomes and Measures Surgical complications, medical complications, and all-cause mortality. Results Of the 1438 patients, 75 experienced postoperative complications (5.2%). Of these, 36 developed isolated surgical complications (2.5%), 29 developed isolated medical complications (2.0%), and 8 developed concurrent surgical and medical complications (0.5%). Of the three mortalities (0.2%), one patient developed concurrent surgical and medical complications. A dirty or infected wound classification was the strongest predictor of postoperative complications (odds ratio [OR] 13.5; confidence interval [95% CI] 3.4-49.5). In contrast, the likelihood of postoperative complications decreased significantly with outpatient procedures (OR 0.4; 95% CI 0.2-0.8). Conclusions and Relevance A dirty or infected wound classification is the strongest predictor of postoperative complications after PMFF.Biobank participation of children is an ethically complicated process as the vulnerability of this population is a concern throughout the entire process of biobanking. Some ethical issues are more prominent in pediatric biobanking and may not need to be considered in biobanking of adult specimens and data. These include assent, reconsent at the age of majority, capacity to consent, and consequences of genetic results on the child and family members. This article describes current processes and best practices described in the literature as well as our experience at the BC Children's Hospital BioBank, a pediatric institutional biobank in Vancouver, Canada. The focus is on processes more specific to pediatric biobanking, such as assent, as well as topics that affect the pediatric population differently compared to adult biobanking.Pulmonary functional imaging may be defined as the regional quantification of lung function by using primarily CT, MRI, and nuclear medicine techniques. The distribution of pulmonary physiologic parameters, including ventilation, perfusion, gas exchange, and biomechanics, can be noninvasively mapped and measured throughout the lungs. This information is not accessible by using conventional pulmonary function tests, which measure total lung function without viewing the regional distribution. The latter is important because of the heterogeneous distribution of virtually all lung disorders. Moreover, techniques such as hyperpolarized xenon 129 and helium 3 MRI can probe lung physiologic structure and microstructure at the level of the alveolar-air and alveolar-red blood cell interface, which is well beyond the spatial resolution of other clinical methods. The opportunities, challenges, and current stage of clinical deployment of pulmonary functional imaging are reviewed, including applications to chronic obstructive pulmonary disease, asthma, interstitial lung disease, pulmonary embolism, and pulmonary hypertension. Among the challenges to the deployment of pulmonary functional imaging in routine clinical practice are the need for further validation, establishment of normal values, standardization of imaging acquisition and analysis, and evidence of patient outcomes benefit. When these challenges are addressed, it is anticipated that pulmonary functional imaging will have an expanding role in the evaluation and management of patients with lung disease.Background MRI, Tinel test, and rhomboid electromyography (EMG) can be used to predict whether C5 spinal nerve stumps are healthy and eligible for grafting in acute adult brachial plexus injuries, but their comparative diagnostic efficacies have not been evaluated. Purpose To compare diagnostic performances of MRI, Tinel test, and rhomboid EMG in predicting healthy C5 spinal nerve stumps that are eligible for grafting. Materials and Methods This retrospective study included consecutive adult patients with acute brachial plexus injury who underwent microreconstructions between January 2008 and December 2018. Healthy C5 spinal nerve stumps eligible for grafting with preceding normal intradural nerve rootlets were diagnosed by an experienced neuroradiologist using an avulsion severity score system based on fast imaging employing steady-state acquisition or FIESTA neurography, which separates intradural nerve rootlets into normal, partial mild, severe, and complete avulsions. Tinel test and rhomboid EMG results were assessed by an experienced nerve surgeon and neurologist, respectively.
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