Notes

Airway administration inside the adult affected person with COVID-19: Large movement nasal air or otherwise not? A listing of data and native expert view.
 Increased rates of postoperative left bundle branch block (LBBB) and permanent pacemaker implantation (PPI) frequently occur after implantation of rapid deployment valves. The impact of LBBB on follow-up outcomes remains controversial. So far, no data regarding long-term outcomes exist.

 The aim of this study was to analyze the impact of LBBB on postoperative outcomes after rapid deployment aortic valve replacement (RDAVR).

 A total of 620 consecutive patients without preexisting LBBB or PPI who underwent rapid deployment AVR between March 2012 and September 2019 were included. New-onset LBBB was defined as any new LBBB that persisted at hospital discharge. The median follow-up time for clinical data was 1.7 years post-RDAVR.

 At discharge, new-onset LBBB was seen in 109 patients (17.5%). There were no differences between the LBBB groups and no-LBBB groups regarding baseline characteristics. At a median follow-up of 1.7 years, no difference was found between LBBB groups and no-LBBB groups concerning all-cause mortality (12.8 vs. 11.7%; hazard ratio [HR] 1.08; 95% confidence interval [CI] 0.74-1.53;
 = 0.54). Nevertheless, new-onset LBBB was associated with significant higher pacemaker implantation rates at follow-up (10.1 vs. 6.3%; HR 3.58; 95% CI 1.89-6.81
 < 0.001).

 After a median follow-up of 1.7 years, new-onset LBBB was not associated with increased mortality. Nevertheless, higher pacemaker implantation rates were observed in patients with new-onset LBBB after RDAVR.
 After a median follow-up of 1.7 years, new-onset LBBB was not associated with increased mortality. Nevertheless, higher pacemaker implantation rates were observed in patients with new-onset LBBB after RDAVR.
Arterial and venous thromboses associated with the coronavirus disease 2019 (COVID-19) have been well described. These events are caused by a hypercoagulable state due to endotheliopathy and infection-driven coagulopathy. There has been an ever-increasing number of documented cases of aortic thrombosis (AoT) in COVID-19 patients. We conducted a systematic review of current scientific literature to identify and consolidate evidence of AoT in COVID-19 patients.

A systematic review of literature was conducted between March 15, 2020, and May 1, 2021, on PubMed and Cochrane databases. Additionally, a case from our facility was included.

A total of 38 studies (12 case series and 26 case reports) and a case from our facility describing AoT in 56 COVID-19 patients were included. Patients were aged 64.8 ± 10.5 years, were predominantly male (75%), and had several comorbidities. AoT was symptomatic in 82,14% of patients; however, when D dimers were reported, they were significantly elevated even in otherwise asymptomatic patients. Most patients had no previous history of aortic disease. Thrombosis was described in all parts of the aorta, with several cases reporting multiple locations. The median reported time until development of AoT was 10 days. FPH1 ic50 Peripheral thrombosis occurred in 73.21% of cases, most commonly causing lower limb ischemia. Mortality rate was 30.4%.

AoT can occur with no clinical symptoms or as a primary symptom in otherwise asymptomatic COVID-19 patients. D dimers are a highly sensitive diagnostic tool. Diagnosis of this condition prior to development of complications could be instrumental in saving many lives.
AoT can occur with no clinical symptoms or as a primary symptom in otherwise asymptomatic COVID-19 patients. D dimers are a highly sensitive diagnostic tool. Diagnosis of this condition prior to development of complications could be instrumental in saving many lives.
Noise in operating theaters (OT) exceeds safety standards with detrimental effects on the health and performance of OT crews as well as patient safety. One of the reasons for these effects is the stress response to noise, which could be minimized by the Silent Operating Theater Optimisation System (SOTOS), a noise-reductive headset solution.

This study evaluates the effects of the SOTOS on the stress perceived by OT crew members, operationalized through
and
. Twenty-one heart surgeries and 32 robot-assisted prostatectomies at the University Medical Center Goettingen, Germany were examined. Twenty-six surgeries were conducted with and 27 without the SOTOS. The SOTOS-effect is defined as a more beneficial stress course from before to after surgery, when comparing the experimental group with and control group without SOTOS.

Eighty-one OT workers were investigated. The linear multilevel models revealed significant interactions between treatment and time of measurement on stress level (
[1, 406.66] = 3.62,
 = 0.029) and exhaustion (
[1, 397.62] = 13.12,
 = 0.00017). Nevertheless, there was no a significant main effect of surgery type on stress level (
[1, 82.69] = 1.00,
 = 0.32) or on exhaustion (
[1, 80.61] = 0.58,
 = 0.45). Additionally, no significant three-way interaction including surgery type, for stress level (
[1, 406.66] = 0.32,
 = 0.29) or exhaustion (
[1, 397.62] = 0.03,
 = 0.43), was found.

An SOTOS-effect was confirmed the development of stress over the course of an operation was beneficially modified by the SOTOS. Both surgery types are perceived as similarly stressful, and the staff benefits equally strongly from the intervention in both settings.
An SOTOS-effect was confirmed the development of stress over the course of an operation was beneficially modified by the SOTOS. Both surgery types are perceived as similarly stressful, and the staff benefits equally strongly from the intervention in both settings.
 Atrial fibrillation after cardiac surgery (AFACS) impacts 10 to 65% of patients. AFACS is associated with stroke and other systemic embolic manifestations.

 Patients at our hospital who underwent
valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study in the period from
.

 In total, 346 patients were included in the current analysis, with a mean age of 51.6 ± 16.1 years, and 51% were males.
. Univariate predictors of AFACS included age, gender, body mass index (BMI), operation type,
ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists
a month before surgery, use of diuretics
a month before surgery, length of ICU stay, total length of stay, cross-clamp time
90 minutes, pump time
120 minutes, postoperative acute kidney injury, left ventricular dimensions.By multivariate analysis, only age (
 = 0.028, AOR = 10.6), male gender (
 = 0.021,
), type of surgery (
 = 0.034, AOR = 7.12), history of AF (
 = 0.018, AOR = 
), BMI (
 < 0.001,
), EF before surgery (
≤ 0.001, AOR = 
), and LA diameter (
 = 0.0051, AOR = 18.23) were independent predictors of AFACS.

 This study identifies risk factors associated with the development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.
 This study identifies risk factors associated with the development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.
 To review data on the use of corticosteroids for the treatment of fetuses with high-risk congenital pulmonary adenomatoid malformation (CPAM).

 Integrative review based on the literature available on MEDLINE and LILACS, including articles published until November, 2020.

 The initial search resulted in 87 articles, 4 of which were selected for analysis, with all of them being retrospective descriptive observational studies. In the group of fetuses that received only a single corticosteroid cycle, the hydrops resolution rate was 70%, and the survival rate was 83.8%. In fetuses treated with 2 or more cycles of corticosteroids, there was an improvement in the condition of hydrops or edema in a single body compartment in 47%, and survival of 81.8% of the fetuses.

 The use of corticosteroids for the prenatal treatment of high-risk CPAM appears to be associated with an improvement in perinatal outcomes.
 The use of corticosteroids for the prenatal treatment of high-risk CPAM appears to be associated with an improvement in perinatal outcomes.
 To compare the oocyte maturation rate in the treatment of in vitro fertilization (IVF) in terms of the use of human chorionic gonadotropin (hCG), agonist gonadotropin-releasing hormone (GnRH) and dual trigger and to evaluate the associated risk factors for sub-optimal maturation rates.

 A retrospective cohort study with 856 women who underwent IVF. They performed oocyte retrieval and were classified into 3 groups (1 - hCG, 2 - GnRH agonist, 3 - dual trigger). The primary outcome was maturation rate per trigger, and the secondary outcomes were the pregnancy rate per oocyte retrieval and the correlations between low maturation rate as well as the clinical and treatment characteristics of women.

 The maturation rate was 77% in group 1; 76% in group 2, and 83% in group 3 (
 = 0.003). Group 2 showed women with better ovarian reserve, greater number of oocytes collected, and more mature oocytes and embryos compared with the other groups (
 < 0.001). The cumulative clinical pregnancy rate was no different between the groups (
 = 0.755). Low ovarian reserve and low doses of follicle-stimulating hormone (FSH) administered during the stimulus were associated with a higher chance of null maturation rate.

 The oocyte maturation rates and IVF results were similar in all groups. Low ovarian reserve is associated with the worst treatment results.
 The oocyte maturation rates and IVF results were similar in all groups. Low ovarian reserve is associated with the worst treatment results.
 Among the many factors involved in reconstructive microsurgery, identifying a good recipient vessel is one of the key elements leading to a successful result.

 Multiple modalities have been used to identify recipient vessels from simple palpation of axial arteries to hand-held Doppler, duplex ultrasound, computed tomography angiograms, and other advanced techniques. Although these various modalities bring their own unique advantages, using the duplex ultrasound can provide far superior and real-time information based on the anatomy and physiology of the recipient vessel.

 Duplex ultrasound is a valuable and powerful tool for reconstructive surgeons who are interested in performing microsurgery or supermicrosurgery.

 As we enter the era of individualized/customized reconstruction using superthin flaps, perforator-to-perforator anastomosis, and supermicrosurgery, understanding and becoming versatile with duplex ultrasound will be critical especially in choosing recipient vessels.
 As we enter the era of individualized/customized reconstruction using superthin flaps, perforator-to-perforator anastomosis, and supermicrosurgery, understanding and becoming versatile with duplex ultrasound will be critical especially in choosing recipient vessels.
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