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Vocal cord palsy after cervical mediastinoscopy is usually reported at less than 1%. However, its incidence might be underestimated and no follow-up studies are available. Our study aimed to evaluate the incidence of voice changes after cervical mediastinoscopy and report on long-term outcomes, including quality of life, after at least one-year follow-up.

A retrospective cohort study was performed, considering all patients who underwent cervical mediastinoscopy in our center between January 2011 and April 2016. Patients with pre-existing voice changes, voice changes only after pulmonary resection and patients who underwent neoadjuvant chemo(radio)therapy were excluded. Voice changes with full recovery within 14days were attributed to intubation-related causes. Follow-up questionnaires, including the standardized Voice Handicap Index, were sent to patients with documented voice changes.

Of 270 patients who were included for final analysis, 17 (6.3%) experienced voice changes after cervical mediastinoscopmplication, with an incidence of at least 6.3% in our retrospective study, with persisting complaints in at least 1.5% of patients, leading to mild to moderate disabilities in daily living. These findings highlight the need for appropriate patient education for this underestimated complication, as well as the exploration of possible preventive measures.
Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC.

The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching "total knee arthroplasty", "antibiotic-loaded cement", "antibiotic prophylaxis", "antibiotic-impregnated cement" and "antibiotic-laden cement" in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included ttly single-center and retrospective studies, and further high-quality ones are needed for confirmation.
The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.
Isolated malignant pulmonary nodules were frequently seen in patients with breast cancer. These were metastasis from the breast cancer or new primary lung cancer. The role of surgery for such pulmonary nodules remains unclear.

A total of 90 patients who underwent surgery for solitary malignant pulmonary nodules between January 2010 and April 2018 after curative operation for breast cancer were reviewed.

The pathologic diagnoses revealed 63 patients with primary lung cancer (PLC) and 27 patients with pulmonary metastatic breast cancer (MBC), which were divided into two groups. All patients were female with a mean age of 55.08 ± 9.84years (range 31-75). Age differences between the two groups were insignificant. Of the 63 patients with PLC, 55(87%) had a lobectomy with lymphadenctomy and 8(13%) had a limited resection, while the majority of patients (78%) with MBC had a limited resection. All nodules were adenocarcinomas and their mean diameter was 1.63 ± 0.57cm. 7/55 of patients with PLC had N1 disease while 3/6 of those with MBC had involvement of N1 nodes. For all patients, the overall survival (OS) was 86.1% at 5years and the disease-free survival (DFS) was 86.0% at 5years. Patients with PLC had the better surgical outcomes including OS and DFS than those with MBC did (94.2% vs. 72.8%, p = 0.017; 93.6% vs. 63.9%, p = 0.002).

Surgical outcomes of isolated malignant pulmonary nodules in breast cancer patients were favorable. Surgery should be considered as an option for breast cancer patients with isolated pulmonary nodules.
Surgical outcomes of isolated malignant pulmonary nodules in breast cancer patients were favorable. Surgery should be considered as an option for breast cancer patients with isolated pulmonary nodules.
With opioid overdose rates doubling in the state of Kentucky over the last year, the opioid crisis is having a deadly impact on the state. Among Black individuals in particular, overdose rates have increased by nearly a third. As such, we must examine ways to effectively intervene to reduce deaths among this underrepresented population.

The current study utilized a thematic analysis to examine factors influencing treatment perceptions and experiences among a sample of 39 Black adults with a recent history of opioid use.

The primary themes highlighted in the study included "autonomous accessibility," "provider characteristics," and "relational support," which are aligned with Self-Determination Theory.

We discuss how these themes relate to treatment initiation, engagement, and completion and discuss implications of this research in treatment for Black adults. Specifically, we discuss treatment considerations among Black adults who use prescription opioids such as ensuring autonomy and a collaborative alized in treatment planning.
Intravenous iron is an effective treatment for anaemia in many populations but has not been evaluated in those with burn anaemia. This study aimed to evaluate the efficacy and safety of intravenous iron to manage burn anaemia.

This was a retrospective cohort study of patients admitted to the Royal Brisbane and Women's Hospital with burns to at least 15% total body surface area (TBSA). Data collected from patient records included demographics, treatment details, and outcomes including length of stay, blood transfusions, and serum haemoglobin concentrations. Linear mixed effects regression models were used to assess the effect of treatment with intravenous iron on haemoglobin over time.

Sixty patients met inclusion criteria, with 11 (18%) treated using intravenous iron. Those treated with intravenous iron had higher TBSA burns (median 39% vs 18%, P=0.0005), more operations (3 vs 1, P=0.0012), and more blood transfusions (median 8 units vs 0 units, P=0.0002). One patient (9%) experienced a minor adverse drug reaction from intravenous iron. When examining the change in modelled haemoglobin levels over the first 14 days following the last major operation, the change in the intravenous iron group (11.22g/L) was 14.56g/L greater than the change in the group not receiving intravenous iron (-3.34g/L, P=0.0282).

This exploratory study provides preliminary evidence of benefit and safety of intravenous iron treatment on burn anaemia recovery.
This exploratory study provides preliminary evidence of benefit and safety of intravenous iron treatment on burn anaemia recovery.
To determine the efficacy of Venastent - a novel iliac vein stent for non-thrombotic iliac vein lesions (NIVLs).

From October 2018 to January 2021, 256 NIVL patients were recruited at 19 Chinese hospitals. A randomised controlled trial was conducted to compare the efficacy of the new iliac vein stent-Venastent (Tianhong China) with Zilver stent (Cook USA). UMI-77 manufacturer All patients were allocated randomly to two groups the experimental group patients used Venastent, while the control group received the Zilver stent. The trial was registered in Chinese Clinical Trial Registry (ChiCTR2200057851).

A total of 123 patients in the experimental group and 122 patients in the control group had a full set of data collected (p= ns). The technical success rate was 100% (n= 245/245). The patency rate was 100% (n= 123/123) in the experimental group and 98.4% (n= 120/122) in control group one year after operation (p= ns). The lower extremity swelling remission rate was 79.1% (n= 87/110) in the experimental group and 78.4% (n= 91/116) in the control group (p= ns). The lower extremity pain relief rate was 68.8% (n= 50/80) in the experimental group and 77.2% (n= 71/92) in the control group (p= ns). The ulcer healing rate was 90% (n= 18/20) in the experimental group and 87% (n= 20/23) in the control group (p= ns). There was no difference in stent re-stenosis or clinical remission between the two groups.

The new iliac vein stent, Venastent, had a comparable high patency rate and safety profile as the Zilver stent (Cook) in NIVLs patients. Venastent significantly reduced symptoms of chronic venous disease.
The new iliac vein stent, Venastent, had a comparable high patency rate and safety profile as the Zilver stent (Cook) in NIVLs patients. Venastent significantly reduced symptoms of chronic venous disease.
To determine the degree patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations fear complications (death, dialysis, heart attack, stroke, blindness, diabetic foot infection, minor and major lower extremity amputation [LEA]) that can occur and to assess if there is a difference between fears of patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations and diabetic patients without these complications.

478 patients completed an eight question Likert scale survey. The study group was defined as non-infected foot ulcers, neuropathic fractures and Charcot neuroarthropathy.

Of the 478 patients, 121 (25.3%) had diabetic foot ulcers, Charcot neuroarthropathy or neuropathic fractures and dislocations and 357 (74.7%) did not. The study group had significantly higher odds of reporting extreme fear of foot infection (OR 2.8, 95% CI 1.8-4.5), major LEA (OR 2.8, 95% CI 1.8-4.4), minor LEA (OR 2.3, 95% CI 1.5-3.5), blindness (OR 2.0, 95% CI 1.3-3.2), dialysis (OR 2.0, 95% CI 1.1-3.3), and death (OR 2.4, 95% CI 1.4-4.2). In the study group highest rated fear measures were foot infection (3.71, SD 1.23), minor amputation (3.67, SD 1.45) and major amputation (3.63, SD 1.52). There were no significant differences in the mean fear of infection, minor amputation or major amputation.

Patients with diabetic foot ulcers, Charcot neuroarthropathy or neuropathic fractures and dislocations reported higher fear ratings of diabetes-related complications compared to those without these complications.
Patients with diabetic foot ulcers, Charcot neuroarthropathy or neuropathic fractures and dislocations reported higher fear ratings of diabetes-related complications compared to those without these complications.
This post hoc analysis evaluated efficacy and safety of dronedarone in atrial fibrillation (AF) and atrial flutter (AFL) patients with/without diabetes.

Patients were categorized according to baseline diabetes status. Time-to-event analyses were performed using Kaplan-Meier method. Hazard-ratios were assessed using Cox models.

945/4628 (dronedarone=482; placebo=463) patients in ATHENA and 215/1237 (dronedarone=148; placebo=67) patients in EURIDIS/ADONIS studies had diabetes. In ATHENA, there were higher rates of CV hospitalization/death in patients with diabetes (39.5%) than without diabetes (34.7%). Incidence of first CV hospitalization/death was lower in patients with diabetes treated with dronedarone (35.1%) than placebo (44.1%), and time to this event was longer in those treated with dronedarone than placebo (log-rank p=0.005). Median AF/AFL recurrence time was longer in patients treated with dronedarone than placebo in patients with diabetes (ATHENA 722 vs 527days, log-rank p=0.004; EURIDIS/ADONIS 100 vs 23days, log-rank p=0.
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