Notes

cfDNApipe: A thorough qc as well as examination pipe for cell-free Genetic make-up high-throughput sequencing files.
Radiotherapy is one of the pillars in the multimodal therapy of sarcomas of the extremities or pelvis/retroperitoneum. It can be delivered prior to or following surgery. Novel radiation techniques, such as intensity-modulated radiotherapy using high-energy photons or protons, contribute to the reduction of acute and late toxicities. This review article summarizes these concepts.Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) not only have smoking as a common risk factor, they also share epidemiological relationships and important mutual effects. There is good evidence to suggest that COPD is highly prevalent but underdiagnosed among CAD patients and vice versa. The symptoms of the two diseases can overlap, making differential diagnosis challenging. This highlights the importance of pulmonary function tests (PFTs) in patients with CAD but also a cardiological assessment in patients with COPD. Chronic obstructive pulmonary disease is a risk factor for the development of CAD independent of other cardiovascular risk factors, and the presence of COPD worsens prognosis in patients with CAD. Mechanisms underlying the associations between COPD and CAD have been less well studied, but inflammation is increasingly being recognized as an important factor linking the two diseases. Other potential contributors include increased oxidative stress, platelet activation, and arterial stiffness. The influence of medications used to treat one condition on the other one needs to be understood and taken into account in patient management. Physicians need to be aware of the important links between COPD and CAD, both of which are commonly encountered in clinical practice. This should help to optimize the management of both conditions to improve patient outcomes.INTRODUCTION In high volume centres, audits are essential to ensure good surgical techniques and fracture fixations to avoid complications, revision surgeries and poor outcomes. A method to assess fixations for fractures of different regions employing different implants and surgical demands is a challenge. We present here a simple method of review and follow-up work flow of more than 6000 fixations every year that helped in improving outcomes and also provide training for residents and junior staff. MATERIALS AND METHODS The results of 6348 fracture fixations in 2014, led to a trauma review system in January 2015 to classify all fracture fixations by senior consultants into three categories category A (good fixations); category B (acceptable fixations; need further follow-up); category C (poor/unacceptable fixations needing revision) combined with a teaching program. this website A strategy was evolved that included the following practices (1) identifying 'red flag' fractures that led to frequent failures, (2) routine senes and can also serve as a teaching resource for junior staff. STUDY DESIGN Prospective study. LEVEL OF EVIDENCE Level II.BACKGROUND Like most medical disciplines, otorhinolaryngology is confronted with an increasing number of elderly and very old patients. In addition to the challenges of diagnostics and treatment, questions related to the influence of geriatric multimorbidity and functional limitations on treatment decisions and success also arise. MATERIALS AND METHODS A literature search was performed on the use of geriatric assessment instruments in otorhinolaryngology. RESULTS While there are already a great deal of data on the interaction of hearing disorders and cognition, the importance of other common functional deficits for otorhinolaryngology is poorly understood. CONCLUSION This article provides an overview of the most important instruments of geriatric assessment, including a discussion of their potential applicability in otorhinolaryngology.The Canadian FRAX® tool used without bone mineral density (BMD) is highly sensitive for identifying individuals qualifying for pharmacotherapy based upon an intervention threshold of 20% for major osteoporotic fracture risk (MOF) computed with BMD. INTRODUCTION This analysis was performed to inform initial BMD testing as part of Osteoporosis Canada's Guidelines Update for women and men at average risk, assuming a pharmacotherapy intervention threshold of 20% for FRAX® MOF computed with BMD. METHODS Women and men age 50 + without previous low-trauma fracture or high-risk medication use were identified in a BMD registry for the province of Manitoba, Canada. Fracture probability assessments with the Canadian FRAX® tool were computed without and with BMD (denoted MOF-clinical and MOF-BMD, respectively). RESULTS The study population consisted of 50,700 women (mean age 65.5 ± 9.4 years) and 4152 men (69.2 ± 10.0 years). FRAX MOF-clinical score was > 10% in 33.8% of women and 13.3% of men (P  99.9%). CONCLUSIONS FRAX without BMD offers an effective strategy to identify individuals meeting the current Canadian treatment threshold based upon FRAX® with BMD (≥ 20%). Moreover, this can be operationalized using simple age cutoffs of 70 years in the absence of additional clinical risk factors and 65 years in the presence of additional clinical risk factors.PURPOSE The aim of this study was to assess the neurologic outcome following extracorporeal cardiopulmonary resuscitation (ECPR) in five European centers. METHODS Retrospective database analysis of prospective observational cohorts of patients undergoing ECPR (January 2012-December 2016) was performed. The primary outcome was 3-month favorable neurologic outcome (FO), defined as the cerebral performance categories of 1-2. Survival to ICU discharge and the number of patients undergoing organ donation were secondary outcomes. A subgroup of patients with stringent selection criteria (i.e., age ≤ 65 years, witnessed bystander CPR, no major co-morbidity and ECMO implemented within 1 h from arrest) was also analyzed. RESULTS A total of 423 patients treated with ECPR were included (median age 57 [48-65] years; male gender 78%); ECPR was initiated for OHCA in 258 (61%) patients. Time from arrest to ECMO implementation was 65 [48-84] min. Eighty patients (19%) had favorable neurological outcome. ICU survival was 24% (n = 102); 23 (5%) non-survivors underwent organ donation procedures.
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