Mcintoshnyholm2648

Twelve patients in the operative group underwent a second operation for hardware removal (12/27, 44%). In the non-operative group, six patients (6/30, 20%) subsequently underwent eight operative procedures.

Although this study failed to demonstrate a difference in functional outcomes between operative and non-operative treatment of Neer type II distal clavicle fractures, non-operative management led to more complications including a moderate rate of non-union, which often required secondary surgery to correct, a higher rate of early dissatisfaction with shoulder appearance and a delayed return to activities in the first 6 months. Operative management provided a safe and reliable treatment option with few complications, but often required secondary hardware removal, especially with hook plate fixation.

Level I, Therapeutic.

Level I, Therapeutic.

To determine if changes in pelvic trauma care and treatment protocols has affected overall mortality rates after pelvic ring injury.

Retrospective chart review.

Level I trauma center.Patients/Participants A total of 3314 patients with pelvic ring injuries who presented to a single referral center from 1999 through 2018.

Cohort comparison (years 1999 through 2006) and (years 2007 through 2018).

Change in patient demographic data, fracture characteristics, date of injury, associated injuries, length of hospital stay, Abbreviated Injury Severity Score (AIS), and in-hospital mortality.

The composite mortality rate was 6.5% (214/3314). The earliest cohort presented a mortality rate of 9.1% (111/1224; 95% confidence interval [CI], 7.6-10.8%) compared to the more recent cohort mortality rate of 4.9% (103/2090; 95% CI, 4.1-5.9%). HRS-4642 in vitro Overall mortality was significantly lower in the more recent time period, a risk difference of 4.1% (95% CI, 2.3-6.1%; P < 0.01). After adjusting for age and AIS of the brain, chest, and abdomen, the mortality reduction was more pronounced with an adjusted risk difference of 6.4% (95% CI, 4.7-8.1%; P < 0.01).

Significant improvement in the mortality rate of pelvic ring injuries has been demonstrated in recent years (4.9% versus 9.1%). Improvement coincides chronologically with changes in trauma resuscitation and implementation of adjuvant treatments for managing patients with severe hemorrhagic shock. Although the exact benefit of each treatment awaits further research, this data might indicate improved care for these difficult patients.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

The increase of the depth of focus (DOF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons that have seen how new surgical possibilities to achieve DOF enlargement have emerged. Nowadays, several technologies to extend the DOF are available, from corneal laser refractive surgery (LRS) procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspherical profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and therefore extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DOF, especially considering that SA depends on pupil diameter and this decreases with age.

The increase of the depth of focus (DOF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons that have seen how new surgical possibilities to achieve DOF enlargement have emerged. Nowadays, several technologies to extend the DOF are available, from corneal laser refractive surgery (LRS) procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspherical profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and therefore extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DOF, especially considering that SA depends on pupil diameter and this decreases with age.

Evidence on systolic dysfunction, as assessed by left ventricular (LV) mechanics, in hypertensive heart disease phenotyped by abnormal LV geometric patterns is still limited. Thus, we performed a systematic meta-analysis of 2D/3D speckle-tracking studies in order to provide an updated comprehensive information on this topic.

The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search for articles published from the inception up to 31 January 2021. Studies were identified by using MeSH terms and crossing the following search items 'myocardial strain', 'left ventricular mechanics', 'speckle tracking echocardiography', 'systolic dysfunction', 'hypertensive heart disease', 'left ventricular hypertrophy', left ventricular remodeling", 'concentric hypertrophy', 'eccentric hypertrophy'.

Overall, data of 267 normotensive controls and 712 hypertensive patients (234 normal geometry, 97 LV concentric remodeling, 176 eccentric LVH, and 205 concentric LVH) from eight studies were considered. Pooeccentric LVH group but not the concentric remodeling was compared with the normal geometry one.

The present meta-analysis confirms that GLS performs better than ejection fraction in identifying systolic dysfunction in the hypertension setting. More importantly, it suggests that this occurs in patients with altered LV structure and geometry, such as LVH.

The present meta-analysis confirms that GLS performs better than ejection fraction in identifying systolic dysfunction in the hypertension setting. More importantly, it suggests that this occurs in patients with altered LV structure and geometry, such as LVH.

Resistant hypertension carries a poor prognosis and current guidelines recommend the exclusion of the white-coat phenomenon for proper diagnosis. However, guidelines do not focus on patients treated with at least three drugs whose blood pressure (BP) is controlled at the office but elevated out of it. We aimed at determining whether this masked uncontrolled apparent resistant hypertension (MUCRH) detected through home blood pressure monitoring (HBPM) has prognostic value for fatal and nonfatal events in these hypertensive patients.

Hypertensive patients treated with at least three drugs who performed a baseline HBPM between 2008 and 2015 were followed to register the occurrence of total mortality, cardiovascular mortality, and fatal and nonfatal cardiac and cerebrovascular events. MUCRH was defined as office blood pressure less than 140/90 mmHg and home BP at least 135 and/or 85 mmHg. Multivariable Cox proportional hazard models were adjusted to determine the independent prognostic value of MUCRH for the events of interest.