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However, while processing contextual signals, patients with schizophrenia failed to show decreased connectivity between caudal LPFC and areas located in ventral posterior regions. The absence of group difference in the functional specialization of posterior regions is difficult to interpret due to our small sample size. One interpretation for our connectivity results is that patients present an inefficient extinction of posterior regions involved in attention shifting by prefrontal areas involved in the top-down control of contextual signals. check details Further studies with larger sample sizes will be needed to ascertain those observations.Introduction and objectives Mortality remains high in cardiogenic shock (CS), especially in refractory CS involving the use of mechanical circulatory support (MCS) devices. The aim of this study was to analyze the results of a care program for patients in CS after the creation of a multidisciplinary team in our center and a regional network of hospitals in our area. Methods Observational and retrospective study of patients attended in this program from September 2014 to January 2019. We included patients in refractory CS who required MCS and those who, because of their age and absence of comorbidities, were candidates for advanced therapies. The primary endpoint was survival to discharge. Results A total of 130 patients were included (69 local and 61 transferred patients). The mean age was 52±15 years (72% men). The most frequent causes of CS were acute decompensated heart failure (29%), acute myocardial infarction (26%), and postcardiotomy CS (25%). MCS was used in 105 patients (81%), mostly extracorporeal membrane oxygenation (58%). Survival to discharge was 57% (74 of 130 patients). The most frequent destinations were myocardial recovery and heart transplant. Independent predictors of in-hospital mortality were SAPS II score, lactate level, acute myocardial infarction etiology, and vasoactive-inotropic score. Conclusions The creation of multidisciplinary teams for patients with mainly refractory CS and a regional network is feasible and allows survival to discharge in more than a half of attended patients with CS.Introduction and objectives Coronary heart disease is the leading cause of heart failure (HF). The aim of this study was to assess the risk of readmission for HF in patients with acute coronary syndrome without previous HF or left ventricular dysfunction. Methods Prospective study of consecutive patients admitted for acute coronary syndrome in 2 institutions. Risk factors for HF were analyzed by competing risk regression, taking all-cause mortality as a competing event. Results We included 5962 patients and 567 (9.5%) experienced at least 1 hospital readmission for acute HF. Median follow-up was 63 months and median time to HF readmission was 27.1 months. The cumulative incidence of HF was higher than mortality in the first 7 years after hospital discharge. A higher risk of HF readmission was associated with age, diabetes, previous coronary heart disease, GRACE score> 140, peripheral arterial disease, renal dysfunction, hypertension and atrial fibrillation; a lower risk was associated with optimal medical treatment. The incidence of HF in the first year of follow-up was 2.73% and no protective variables were found. A simple HF risk score predicted HF readmissions risk. Conclusions One out of 10 patients discharged after an acute coronary syndrome without previous HF or left ventricular dysfunction had new-onset HF and the risk was higher than the risk of mortality. A simple clinical score can estimate individual risk of HF readmission even in patients without previous HF or left ventricular dysfunction.Aims Real-world evidence of radium 223 (Ra-223) for the treatment of men with metastatic castration-resistant prostate cancer is emerging. In this prospective single-centre service evaluation, we report for the first time in the UK, real-world quality of life (QoL) and survival outcomes, including the sequencing impact, in 228 treated patients. We aim to share our 5-year experience on how to optimise Ra-223 treatment. Materials and methods Patients who received Ra-223 therapy between 2014 and 2018 at the Northern Centre for Cancer Care, Newcastle upon Tyne, UK were included in this evaluation. Demographics, clinical characteristics, blood parameters, treatment sequencing and QoL data using abbreviated Functional Assessment of Cancer Therapy-Prostate questionnaires were prospectively collected and analysed. Results In total, 228 patients were included; median age 72 years (51-87). The medium overall survival was 11.1 months. Overall survival in post-chemotherapy and chemotherapy-naïve patients was 8.1 and 12.3apy. No significant survival differences were observed between pre- and post-abiraterone and prednisolone or enzalutamide patients. The fracture rate in the post-abiraterone and prednisolone group seemed to be high. Bone health evaluation and protection should be incorporated as standard of care.The benefits of three-dimensional planning and guided surgery have been realised over the last few years in maxillofacial surgery. Reproducing the exact positioning of the cutting and drilling guides on the flat mandibular angles defined by the engineer is a challenge for the surgeon and for the reliability of guided bilateral sagittal split osteotomy. Reference screws positioned on the skeleton before the acquisition of medical computed tomographic data can provide a fixed landmark that can be used during surgery and by the engineer during the design phase. The objective of this proof of concept in vitro study is to calculate the accuracy obtained for guides positioned by inserting a reference screw. The precision obtained for 30 guides following the insertion of 30 reference screws on 15 mandibular models was analysed. The models were scanned using an optical scanner and compared to CAD-CAM projects. The mean (SD) absolute position (in)-inaccuracy is 0.1616 (0.1141) mm for the entire guide surface and 0.13143 (0.0835) mm for the rim surface. The results indicate that the use of reference screws is efficient, and so they can be used to position guides accurately during guided bilateral sagittal split osteotomy.
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