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98; 95%CI, 0.95-1.01; P=.719). Neither obesity nor overweight were predictors of mortality, embolism, and bleeding events. In contrast, nutritional status-assessed by the CONUT score-was associated with mortality, embolism and bleeding after multivariate analysis (HR for composite endpoint, 1.15; 95%CI, 1.14-1.17; P<.001).

BMI was not an independent predictor of events in patients with AF in contrast to nutritional status, which showed a strong association with mortality, embolism, and bleeding. The study was registered at ClinicalTrials.gov (Identifier NCT04364516).

BMI was not an independent predictor of events in patients with AF in contrast to nutritional status, which showed a strong association with mortality, embolism, and bleeding. The study was registered at ClinicalTrials.gov (Identifier NCT04364516).

Cardiogenic shock (CS) mortality remains very high and mechanical circulatory support (MCS) may provide an effective alternative of treatment in selected patients. The aim of this study is to analyse the results of a multidisciplinary team care program (including anaesthesiologists, cardiologists, cardiothoracic surgeons, and intensivists) in CS patients who required MCS, in a tertiary centre without a heart transplant (HT) program.

Prospective observational study that sought to analyse the characteristics and survival to discharge predictors in a consecutive CS patients cohort treated with MCS.

A total of 48 patients were included. Mean age was 61 ± 14 years. Before MCS, 45.8% of the patients presented with cardiac arrest. A 54.2% 30-day survival and 45.8% overall survival to discharge, was found. Age and vasoactive-inotropic score were independent predictors of mortality.

A multidisciplinary team-care based MCS program in CS patients is feasible and may achieve favourable results in a centre without HT program.

A multidisciplinary team-care based MCS program in CS patients is feasible and may achieve favourable results in a centre without HT program.The nationwide COVID-19 epidemic ended in 2020, a few months after its outbreak in Wuhan, China at the end of 2019. Most COVID-19 cases occurred in Hubei Province, with a few local outbreaks in other provinces of China. A few studies have reported the early SARS-CoV-2 epidemics in several large cities or provinces of China. However, information regarding the early epidemics in small and medium-sized cities, where there are still traditionally large families and community culture is more strongly maintained and thus, transmission profiles may differ, is limited. In this study, we characterized 60 newly sequenced SARS-CoV-2 genomes from Anyang as a representative of small and medium-sized Chinese cities, compared them with more than 400 reference genomes from the early outbreak, and studied the SARS-CoV-2 transmission profiles. Genomic epidemiology revealed multiple SARS-CoV-2 introductions in Anyang and a large-scale expansion of the epidemic because of the large family size. Moreover, our study revealed two transmission patterns in a single outbreak, which were attributed to different social activities. We observed the complete dynamic process of single-nucleotide polymorphism development during community transmission and found that intrahost variant analysis was an effective approach to studying cluster infections. In summary, our study provided new SARS-CoV-2 transmission profiles representative of small and medium-sized Chinese cities as well as information on the evolution of SARS-CoV-2 strains during the early COVID-19 epidemic in China.

Various techniques have been described in the literature for prominent ear correction. DL-AP5 in vivo These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures.

Patients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients' demographic data, pre- and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperichondrial flap was planned into two proximal- and distal-based. They were then elevated from tith low recurrence rates and high patient satisfaction.

III.

III.

Evidence is scarce on morbidity after urinary diversion ± cystectomy as treatment for benign bladder indications.

To conduct a morbidity assessment and to evaluate the impact of concomitant subtrigonal cystectomy (SC) versus urinary diversion (UD) alone.

This was a retrospective study of 97 patients with benign bladder conditions between 2009 and 2017.

Open UD and/or concomitant SC.

Data for 30-d complications were extracted using a procedure-specific catalog and were graded according to the Clavien-Dindo classification (CDC), and Comprehensive Complication Index (CCI) values were calculated. Traditional morbidity endpoints focused on the comparative morbidity of UD + SC versus UD alone. Multivariable regressions were computed to evaluate the impact of SC versus UD alone on cumulative morbidity. Subgroup analyses were repeated for patients with previous irradiation.

Of 97 patients, 46 (47%) underwent UD + SC and 51 (53%) underwent UD alone. Forty-nine patients (51%) had a history of abdominopelvicersion (UD) is a surgical procedure to create a new way for urine to exit the body. We found that among patients undergoing UD for benign bladder conditions, those who also have their bladder removed and patients who have received previous radiotherapy do not experience more complications.

Urinary diversion (UD) is a surgical procedure to create a new way for urine to exit the body. We found that among patients undergoing UD for benign bladder conditions, those who also have their bladder removed and patients who have received previous radiotherapy do not experience more complications.

Platinum-based combination chemotherapy is the standard treatment for advanced or metastatic urothelial carcinoma (AMUC). However, data comparing the efficacy of different platinum agents are limited.

This review aimed to assess the efficacy of carboplatin as a first-line treatment for AMUC using phase 3 randomized trial data.

Multiple databases were searched for articles published until August 2021. Studies that compared overall survival (OS), complete response (CR), and objective response rates (ORRs) in chemotherapy-eligible patients with AMUC were deemed eligible.

Four studies were included. Compared with immune checkpoint inhibitor (ICI) monotherapy, neither cisplatin- nor carboplatin-based chemotherapy was associated with significant OS (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.85-1.11, p = 0.64 and HR 0.90, 95% CI 0.78-1.04, p = 0.16, respectively) and CR (odds ratio [OR] 1.16, 95% CI 0.70-1.92, p = 0.57 and OR 0.89, 95% CI 0.52-1.53, p = 0.67, respectively benefits, while both weponse. It is currently believed that cisplatin provides greater benefits than carboplatin; this requires re-evaluation.

Cisplatin- as well as carboplatin-based chemotherapy is as effective as immune checkpoint inhibitors in terms of survival and eliciting a positive response. It is currently believed that cisplatin provides greater benefits than carboplatin; this requires re-evaluation.

Sentinel Lymph Node Biopsy (SLNB) is used to stage the axilla, but there is limited data in patients with prior ipsilateral breast cancer. This study compares redo-SLNB (reSLNB) and Axillary node sample (ANS) in this sub-cohort of patients.

This is a retrospective study looking at patients with a new ipsilateral primary or recurrence with history of breast-conserving surgery. Planned and performed surgery, patient demographics and previous treatments were recorded. Node positivity and success rate of reSLNB was analyzed.

A total of 86 patients were identified that had mastectomy for ipsilateral recurrent disease with radiologically negative axilla. Out of the 48 that had reSLNB, 35(72.9%) were successful. Nineteen percent of the reSLNB had positive axillae and 20% of the ANS patients. reSLNB success rate was significantly lower amongst patients with previous axillary surgery (P=.014) and previous positive nodes(P=.001).

reSLNB should be considered to restage the axilla in patients with previous history of ipsilateral cancer especially that there is growing evidence showing good identification rate.

reSLNB should be considered to restage the axilla in patients with previous history of ipsilateral cancer especially that there is growing evidence showing good identification rate.

Breast cancer (BC) is the most frequently diagnosed cancer in women, and over 90% of BC-related deaths are associated with metastasis. The effects of BC stem cells-derived extracellular vesicles (BCSCs-EVs) have been implicated in cancer control. This work aims to probe to the relevance of BCSCs-EVs to liver metastases of BC cells and the molecules involved.

First, EVs were extracted from BCSCs for MDA-MB-231 and SUM149PT cell co-culture. The effects of BCSCs-EVs on the proliferation of BC cells in vitro and in vivo as well as liver metastasis were evaluated. Subsequently, we analyzed differentially expressed microRNAs (miRNAs) after BCSCs-EVs by microRNA microarray and had them verified by RT-qPCR. Bioinformatics analysis was conducted to analyze target mRNAs of miR-197. The binding relationship of miR-197 to PPARG mRNA was examined. Finally, MDA-MB-231 and SUM149PT cells co-cultured with BCSCs-EVs were treated with miR-197 inhibitor or a PPARG-specific agonist.

BCSCs-EVs promoted the growth of MDA-MB-231 and SUM149PT cells in vitro and in vivo as well as liver metastasis. BCSCs-EVs increased the expression of miR-197 in MDA-MB-231 and SUM149PT cells, and miR-197 could target PPARG mRNA. BCSCs-EVs treatment inhibited the mRNA and protein expression of PPARG in cells, thereby activating epithelial-mesenchymal transition (EMT). Knockdown of miR-197 or activation of PPARG in BCSCs-EVs-treated cells significantly counteracted the promoting effect of BCSCs-EVs on BC cell growth and metastasis.

BCSCs-EVs facilitated EMT of BC cells by delivering miR-197 to BC cells and inhibiting PPARG expression, thereby promoting growth and metastasis of BC cells.

BCSCs-EVs facilitated EMT of BC cells by delivering miR-197 to BC cells and inhibiting PPARG expression, thereby promoting growth and metastasis of BC cells.

Patients with heart failure (HF) and preserved ejection fraction (HFpEF), in contrast to those with reduced ejection fraction, are older, have more comorbidities, and are not candidates for effective therapeutic measures. Therefore, they are at high risk for hospital admission and mortality. This study evaluated the benefit of a comprehensive continuous care program (UMIPIC program) in patients with HFpEF.

We prospectively analyzed data on 2401 patients with HFpEF attended to in internal medicine departments who form part of the RICA registry. They were divided into 2 groups one was followed-up on in the UMIPIC program (UMIPIC group, n 1011) and another received conventional care (RICA group, n 1390). A total of 753 patients in each group were selected by propensity score matching and admissions and mortality were assessed during 12 months of follow-up after an episode of hospitalization due to HF.

Compared to the RICA group, the UMIPIC group had a lower rate of HF admissions (19.2% versus 36.5%, respectively; hazard ratio [HR] = 0.