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rtical transfer of protective antibodies.The locus coeruleus (LC) is the major source of noradrenaline, which plays a key role in cognition. We aimed to detect the extent of the LC signal attenuation in Alzheimer's disease (AD) patients using a neuromelanin (NM)-sensitive MRI and how it may correlate with inflammatory and autonomic measures. An individually matched case-control study design was employed. 24 patients with AD and 24 age and gender matched controls with no cognitive impairment were recruited. The primary outcome measure was the LC signal intensity indicated by the LC contrast ratio (CR) and measured by the NM-sensitive MRI. Secondary outcome measures included neuropsychometric tests of cognitive state, peripheral inflammatory and autonomic measures. Conditional logistic regression analysis revealed a significant 22% LC-CR reduction in the AD group compared with the control group. However, there was no statistical significance from inflammatory or autonomic measures. This is the largest individually-matched case-control study to visualise the LC degeneration in AD patients. The study revealed significant LC degeneration which holds promise to stratify patients who may benefit from treatment targeting noradrenergic dysfunction.

Medical photography, ubiquitous in plastic surgery, provides essential information to the medical record. Smartphones have become the preferred tool for acquiring these photographs, but cause a data security issue. Furthermore, the management of photographs is frequently manual and time-consuming. The Pixacare software suite has been designed to meet this need in complete security. It includes a mobile application, a web application and a HADS server. The objective of the study was to calculate the time saved by the Pixacare application at the time of data acquisition.

This prospective and monocentric study was carried out in two steps in order to time the acquisition times with the usual method and with the Pixacare mobile application. Each phase included 89 patients recruited in plastic and maxillofacial surgery consultation with four surgeons. The number of patients and the average number of photographs per patient were comparable for each practitioner in both phases.

The acquisition time of the photographic data was divided by 3.77 (P<0.001). With the usual method, the average acquisition time was 259seconds, compared to 69seconds with the Pixacare application, saving 3minutes and 10seconds per patient.

The Pixacare software suite saves the surgeon significant time while ensuring appropriate data security. This study does not take into account the additional time saved by organising medical meetings, the benefits of sharing photographs between healthcare professionals and the efficiency of secure messaging.

The Pixacare software suite saves the surgeon significant time while ensuring appropriate data security. This study does not take into account the additional time saved by organising medical meetings, the benefits of sharing photographs between healthcare professionals and the efficiency of secure messaging.

Cerebral protection remains the cornerstone of successful aortic surgery; however, there is no consensus as to the optimal strategy.

To compare the safety and efficacy of innominate to axillary artery cannulation for delivering antegrade cerebral protection during proximal aortic arch surgery.

This randomized controlled trial (The Aortic Surgery Cerebral Protection Evaluation CardioLink-3 Trial, ClinicalTrials.gov Identifier NCT02554032), conducted across 6 Canadian centers between January 2015 and June 2018, allocated 111 individuals to innominate or axillary artery cannulation. The primary safety outcome was neuroprotection per the appearance of new severe ischemic lesions on the postoperative diffusion-weighted-magnetic resonance imaging. The primary efficacy outcome was the difference in total operative time. Secondary outcomes included 30-day all-cause mortality and postoperative stroke.

One hundred two individuals (mean age, 63±11years) were in the primary safety per-protocol analysis. Baseline erebral protection with innominate cannulation is safe and affords similar neuroprotection to axillary cannulation during aortic surgery, although the burden of new neurological lesions is high in both groups.

The durability of mitral valve repair (MVr) is usually defined by the absence of recurrent significant mitral regurgitation. Postrepair mitral stenosis (MS) is a less frequent and less studied mode of failure of MVr. We analyzed our experience in patients who underwent reoperation for postrepair MS to characterize mechanisms resulting in MS and to summarize reoperative surgical strategies and mid-term outcomes.

Using a prospective database, we retrospectively analyzed data on 35 consecutive patients who underwent reoperation for symptomatic moderate to severe MS between January 1, 2011, and February 1, 2020.

The mean patient age was 61.4±11.4years, and 69% were female. The median annuloplasty ring size used at the initial repair was 28mm (interquartile range, 26-30mm). Additional repair techniques at the initial operation included leaflet resection in 12 patients (34%) and commissuroplasty or edge-to-edge repair in 6 patients (18%). At reoperation, the most common mechanism of MS was pannus ingrowth in 20 patients (57%), leaflet calcification in 12 (34%), commissural fusion in 5 (14%), and tunnel effect (functional MS) in 3 (9%). Twenty-two patients (63%) underwent valve replacement, and 13 (37%) underwent valve re-repair. In patients who underwent re-repair, annuloplasty revision was performed in all patients, with 6 patients (46%) converted from complete ring to band, 4 (11%) converted from ring to pericardial annuloplasty, 2 (6%) converted to no annuloplasty, and 1 (8%) with annuloplasty ring upsizing. There were no in-hospital or 1-year mortalities. Romidepsin cost Survival at the 5-year follow-up was 93.9%.

MS causing late failure of MVr is frequently associated with smaller ring sizes and inflammatory or calcific changes in the valve. Highly selected patients may be good candidates for mitral valve re-repair.

MS causing late failure of MVr is frequently associated with smaller ring sizes and inflammatory or calcific changes in the valve. Highly selected patients may be good candidates for mitral valve re-repair.