Notes

Economic analysis of the 'Take Charge' intervention for those following cerebrovascular event: Is caused by any randomised tryout.
MII-pH. Esophageal dysmotility may play a role in suspected LPR symptoms independent of reflux. HRM should be routinely considered in evaluating these patients.Ascariasis is a globally spread intestinal nematode infection of humans and a considerable concern in pig husbandry. Ascaris accomplishes a complex body migration from the intestine via the liver and lung before returning to the intestine. Tissue migration and the habitat shared with a complex microbial community pose the question of how the nematode interacts with microbes and host cells from various tissues. This review addresses the current knowledge of the trilateral relationship between Ascaris, its microbial environment, and host cells, and discusses novel approaches targeting these interactions to combat this widespread infection of livestock and man.The Society of Cardiovascular Anesthesiologists, in partnership with The Society of Thoracic Surgeons, has developed the Adult Cardiac Anesthesiology Section of the Adult Cardiac Surgery Database. The goal of this landmark collaboration is to advance clinical care, quality, and knowledge, and to demonstrate the value of cardiac anesthesiology in the perioperative care of cardiac surgical patients. Participation in the Adult Cardiac Anesthesiology Section has been optional since its inception in 2014 but has progressively increased. Opportunities for further growth and improvement remain. In this first update report on quality and outcomes of the Adult Cardiac Anesthesiology Section, we present an overview of the clinically significant anesthesia and surgical variables submitted between 2015 and 2018. Our review provides a summary of quality measures and outcomes related to the current practice of cardiothoracic anesthesiology. We also emphasize the potential for addressing high-impact research questions as data accumulate, with the overall goal of elucidating the influence of cardiac anesthesiology contributions to patient outcomes within the framework of the cardiac surgical team.Iatrogenic aortic dissection (iAD) is a relatively rare but a life-threatening complication associated with cardiac surgery. All members of the team caring for cardiac surgical patients (surgeons, perfusionists, and anesthesiologists) must be familiar with this complication to minimize its incidence and improve outcome. The present narrative review focuses on iAD occurring intraoperatively and during the early postoperative period (within 1 month) of cardiac surgery. The review also addresses iAD that occurs late (beyond 1 month) after cardiac surgery and iAD associated with other procedures. iAD occurs in about 0.06% of cases when the ascending aorta is the site of arterial cannulation, in about 0.6% when the femoral or iliac arteries are used, and in about 0.5% when the axillary or subclavian arteries are used. Mortality is estimated to be 30% but is more than double if not recognized until the postoperative period. Site of origin of dissection is most commonly the arterial inflow cannula (∼33%). Other common sites are the aortic cross-clamp or partial occlusion clamp (∼29%) and the proximal saphenous vein anastomosis site (14%). Sixty percent of cases occur during coronary artery bypass graft (CABG) surgery and 17% during aortic valve surgery with or without CABG. iAD may be somewhat less common in off-pump versus on-pump CABG but is still not very rare. Risk factors, presentation, diagnosis, and management are reviewed in detail as is the key role of the use of echocardiography in the early diagnosis of iAD and for guiding its management.
To prospectively evaluate the initial human experience with an absorbable vena cava filter designed for transient protection from pulmonary embolism (PE).

This was a prospective, single-arm, first-in-human study of 8 patients with elevated risk of venous thromboembolism (VTE). Seven absorbable IVC filters (made of polydioxanone that breaks down into H
O and CO
in 6 mo) were placed prophylactically before orthopedic (n= 5) and gynecologic (n= 2) surgeries, and 1 was placed in a case of deep vein thrombosis. Subjects underwent CT cavography and abdominal radiography before and 5, 11, and 36 weeks after filter placement to assess filter migration, embolization, perforation, and caval thrombosis and/or stenosis. Potential PE was assessed immediately before and 5 weeks after filter placement by pulmonary CT angiography.

No symptomatic PE was reported throughout the study or detected at the planned 5-week follow-up. No filter migration was detected based on the fixed location of the radiopaque markers (attached to the stent section of the filter) relative to the vertebral bodies. No filter embolization or caval perforation was detected, and no caval stenosis was observed. Throughout the study, no filter-related adverse events were reported.

Implantation of an absorbable vena cava filter in a limited number of human subjects resulted in 100% clinical success. One planned deployment was aborted as a result of stenotic pelvic veins, resulting in 89% technical success. No PE or filter-related adverse events were observed.
Implantation of an absorbable vena cava filter in a limited number of human subjects resulted in 100% clinical success. One planned deployment was aborted as a result of stenotic pelvic veins, resulting in 89% technical success. No PE or filter-related adverse events were observed.
Many guidelines now recommend multiparametric MRI (mpMRI) prior to an initial or repeat prostate biopsy. However, clinical decision making for men with a non-suspicious mpMRI (Likert or PIRADS score 1-2) varies.

To review the most recent literature to answer three questions. (1) Should we consider systematic biopsy if mpMRI is not suspicious? (2) Are there additional predictive factors that can help decide which patient should have a biopsy? (3) Can the low visibility of some cancers be explained and what are the implications?

A narrative review was performed in Medline databases using two searches with the terms "MRI" and "prostate cancer" and ("diagnosis" or "biopsy") and ("non-suspicious" or "negative" or "invisible"); "prostate cancer MRI visible". References of the selected articles were screened for additional articles.

Studies published in the last 5 years in English language were assessed for eligibility and selected if data was available to answer one of the three study questions.

Considerielop more accurate risk calculators and biomarkers.
mpMRI has high diagnostic accuracy and in cases of negative mpMRI, PSA density can be used to determine which patient should have a biopsy. Growing knowledge of the mechanisms and genetics underlying MRI visibility will help develop more accurate risk calculators and biomarkers.
The purpose of this article is to explain the role of urology nurse in prehabilitation and same-day discharge programs for robotic radical prostatectomy.

This article is based on the analysis of the literature and the experience of our center.

In order to prepare patients for outpatient surgery, urology nurse plays a key role during prehabilitation journeys. Two weeks before the operation, the healthcare teams (nurses, anesthetists, physiotherapists, etc.) organize workshops to explain to patients the operation course and post-operative care in order to allay any anxieties. Individual and group interviews, in specific workshops (compression stockings, urinary catheter, sexology) are organized in particular with urology nurse to answer all patients' questions. In association with enhanced recovery after surgery pathway, these programs improve the patient experience and satisfaction as well as peri-operative outcomes, and allows the development of an outpatient surgery program which currently represents approximately one third of surgeries.

The implementation of perioperative protocols including prehabilitation improves the early results of robotic total prostatectomy, but also the patient experience. The urology nurse has a key role to play during these patient education days and in the preparation, information, support and follow-up of the patient, since the prehabilitation journey until the patient leaves the outpatient clinic.
The implementation of perioperative protocols including prehabilitation improves the early results of robotic total prostatectomy, but also the patient experience. The urology nurse has a key role to play during these patient education days and in the preparation, information, support and follow-up of the patient, since the prehabilitation journey until the patient leaves the outpatient clinic.
Current recommendations for the management of stress urinary incontinence (SUI) include conservative interventions as first-line treatments. New approaches are emerging with the arrival of health applications on smartphones. The objective of this review is to evaluate the interest of mobile and Internet applications in the treatment of SUI in women.

Interventional studies evaluating the use of mobile applications or websites in the management of women with SUI were selected from PubMed, Cinalh and PEDro databases. An analysis of symptoms, quality of life and adherence was carried out, highlighting biases.

Eight of the 85 retrieved articles were selected. These studies report an improvement in SUI symptoms, quality of life and adherence after an intervention including new technologies (LE1). This type of intervention appears to be superior to the absence of intervention patients report an improvement in symptoms (ICIQ-SF P<0.001; decrease in the number of pads P=0.023, LE1) and a greater perception of improvement (P<0.001, LE1). This type of intervention seems to be more effective than those in paper format on the decrease in the number of pads (P=0.02, LE1) and the perception of improvement (P=0.03, LE1).

This innovative approach seems to reduce SUI symptoms, improve the quality of life and the functionality of pelvic floor muscles with long-term results. This type of intervention may improve adherence provided that it is associated with a treatment by a therapist.
This innovative approach seems to reduce SUI symptoms, improve the quality of life and the functionality of pelvic floor muscles with long-term results. This type of intervention may improve adherence provided that it is associated with a treatment by a therapist.The development of new video assisted surgical technologies has modified the interactions and the communication between the surgeon and the nurses. If the surgeon is cut off his surgical environment by his enhanced focus, the nurse, who has a central place in the OR, gets a new role enriched with an environmental survey and the realization of gestures out of operator's visual field. check details There is therefore a need for a safe system interaction and communication inspired by aeronautical and industrial sectors to reassure those professionals despite a lack of awareness among some of them. This safe communication is unnatural, especially during the learning phase. In this way, it must be taught as a priority even before acquiring the technical skills.Numerical simulations to evaluate thoracic aortic hemodynamics include a computational fluid dynamic (CFD) approach or fluid-structure interaction (FSI) approach. While CFD neglects the arterial deformation along the cardiac cycle by applying a rigid wall simplification, on the other side the FSI simulation requires a lot of assumptions for the material properties definition and high computational costs. The aim of this study is to investigate the feasibility of a new strategy, based on Radial Basis Functions (RBF) mesh morphing technique and transient simulations, able to introduce the patient-specific changes in aortic geometry during the cardiac cycle. Starting from medical images, aorta models at different phases of cardiac cycle were reconstructed and a transient shape deformation was obtained by proper activating incremental RBF solutions during the simulation process. The results, in terms of main hemodynamic parameters, were compared with two performed CFD simulations for the aortic model at minimum and maximum volume.
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