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When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcomes and identify factors associated with survival and mortality in cases of multiple runs of extracorporeal membrane oxygenation.

Retrospective cohort analysis of the Extracorporeal Life Support Organization Registry.

The Extracorporeal Life Support Organization's registry was queried for neonates, children, and adults receiving 2 or more runs of ECMO during the same hospitalization, for any indication, from 1998 to 2015.

1,818 patients from the Extracorporeal Life Support Organization Registry.

Of the 1,818 patients, 1,648 underwent 2 runs and 170 underwent 3 or more runs of ECMO. The survival to discharge rate was 36.7% for 2 runs and 29.4% for 3 or more runs. No significant differences in survns of ECMO is growing, outcomes remain poor for most cohorts. Survival decreases with each additional run. Patients requiring additional runs for a pulmonary indication should be considered prime candidates. Renal complications on the first run significantly increases the risk of mortality on subsequent runs, and as such, careful consideration should be applied in these cases.

At our inpatient psychiatric hospital, which cares for children and adolescents, internal data of use of seclusions and holds as crisis interventions for immediate behavioral health issues demonstrated that we were using these too often.

Benchmarking indicated that we were at the 75% in use of these measures, and it became an organizational goal to reduce the use of these strategies in order to reduce the risk of retraumatization to an already traumatized child.

We used the Iowa Model for Evidence Based Practice-Revised to initiate an evidence-based practice project introducing and hardwiring Trauma Informed Care to the staff and institution. This involved implementing six core strategies specifically designed to reduce the use of crisis interventions.

Data obtained at 6 months revealed a 40% reduction in the use of holds and seclusions, and at 12 months, this change was sustained and even improved, reducing the use of these approaches by another 9%. Furthermore, the culture in the institution was changed, and Trauma Informed Care became the norm.

Evidence-based practice is a viable approach to change the culture and improve patient outcomes in inpatient psychiatric care of children and adolescents. Further investigation is warranted to determine the specific patient and staff experiences of being cared for, and caring within, the context of trauma-informed care.

Evidence-based practice is a viable approach to change the culture and improve patient outcomes in inpatient psychiatric care of children and adolescents. Further investigation is warranted to determine the specific patient and staff experiences of being cared for, and caring within, the context of trauma-informed care.

Few longitudinal studies have compared patient-reported long-term adverse effects after radical prostatectomy (RP) alone and RP followed by radiotherapy (RAD), also analyzing the effect of the development of post-treatment dysfunctions/problems (Symptom Burden) on Health-Related Quality of Life (HRQoL).

After median seven years since RP and six years since post-RP RAD, development of EPIC-26 Domain Summary Scores (DSS Changes) and HRQoL scores (SF-12) since the pre-RP situation were evaluated in respectively 317 prostatectomized men without and in 63 patients with additional post-RP RAD. Post-treatment inter-group differences of the prevalent Symptom Burden and of the DSS Changes were calculated. Multivariable logistic regressions evaluated the associations between DSS Changes and post-treatment impaired HRQoL.

Compared to RP alone, post-RP RAD increased the post-treatment Symptom Burden, with least inter-group differences within the urinary irritative/obstructive and bowel domain. No significant inter-group difference emerged for the proportions of men with impaired HRQoL. PAI-039 cost The odds of impaired HRQoL increased significantly with rising DSS Changes (worsening) within the vitality/hormonal domain. Worsening within urinary incontinence and bowel domains significantly increased the odds of impaired physical QoL. High HRQoL scores before RP reduced the odds of post-treatment impaired HRQoL. Living without a partner and use of androgen deprivation therapy increased this odds.

Post-RP radiotherapy increases post-treatment Symptom Burden with negative, though limited impact on the patient's HRQoL. Counceling before post-RP radiotherapy should cover this possible development, taking into account the patient's social situation.

Post-RP radiotherapy increases post-treatment Symptom Burden with negative, though limited impact on the patient's HRQoL. Counceling before post-RP radiotherapy should cover this possible development, taking into account the patient's social situation.

Adenomyosis is a common and refractory disease in gynecology. Preserving the uterus during treatment for adenomyosis remains a problem. High-intensity focused ultrasound (HIFU) is widely used in treatment of solid tumors. This study aimed to analyze patients with adenomyosis who were treated by HIFU and to preliminarily examine the characteristics of patients who are more suitable for HIFU to treat adenomyosis with reliable efficacy.

Over 2 years, 67 women who were diagnosed with adenomyosis and treated with HIFU at our gynecology department were included in this study. We investigated outcomes of their symptoms (dysmenorrhea and hypermenorrhea) and the volume of their uterine lesions. We also compared the patients' clinical profiles.

The women had a mean follow-up duration of 11.6 ± 0.46 months. In the numerical rating scale, used to assess the degree of dysmenorrhea, the score was significantly lower (mean difference -1.94, 95% confidence interval -2.704 to -1.176) 3 months after HIFU treatment compared with before treatment, then it remained stable for 3 to 12 months.