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Patients with cancer may have an increased risk of persistent opioid use following hysterectomy.

Risks and benefits of opioid analgesia for surgical pain among patients with cancer undergoing hysterectomy should be carefully considered.

Risks and benefits of opioid analgesia for surgical pain among patients with cancer undergoing hysterectomy should be carefully considered.Tuberculosis is a chronic infection by Mycobacterium tuberculosis that results in over 1.5 million deaths worldwide each year. Currently, there is only one vaccine against tuberculosis, the Bacillus Calmette-Guérin (BCG) vaccine. Despite widespread vaccination programmes, over 10 million new M. tuberculosis infections are diagnosed yearly, with almost half a million cases caused by antibiotic-resistant strains. Novel vaccination strategies concentrate mainly on replacing BCG or boosting its efficacy and depend on animal models that accurately recapitulate the human disease. However, efforts to produce new vaccines against an M. Selleck Panobinostat tuberculosis infection have encountered several challenges, including the complexity of M. tuberculosis pathogenesis and limited knowledge of the protective immune responses. The preclinical evaluation of novel tuberculosis vaccine candidates is also hampered by the lack of an appropriate animal model that could accurately predict the protective effect of vaccines in humans. Here, we review the role of zebrafish (Danio rerio) and other fish models in the development of novel vaccines against tuberculosis and discuss how these models complement the more traditional mammalian models of tuberculosis.The most widely used patient-reported outcome (PRO) measure for soft tissue sarcoma (STS) patients is the Toronto Extremity Salvage Score (TESS). The aim of the study was to validate and test the reliability of the TESS for patients with lower extremity STS based on Finnish population data. Patients were assessed using the TESS, the QLQ-C30 Function and Quality of life (QoL) modules, the 15D and the Musculoskeletal tumour Society (MSTS) score. The TESS was completed twice with a 2- to 4-week interval. The intraclass correlation coefficient (ICC) was used for test-retest reliability. Construct validity was tested for structural validity and convergent validity. Altogether 136 patients completed the TESS. A ceiling effect was noted as 21% of the patients scored maximum points. The ICC between first and second administration of the TESS was 0.96. The results of exploratory factor analysis together with high Cronbach's alpha (0.98) supported a unidimensional structure. The TESS correlated moderately with the MSTS score (rho = 0.59, p less then 0.001) and strongly with the mobility dimension in the 15D HRQL instrument (rho = 0.76, p less then 0.001) and the physical function in QLQ-C30 (rho = 0.83, p less then 0.001). The TESS instrument is a comprehensive and reliable PRO measure. The TESS may be used as a validated single index score, for lower extremity STS patients for the measurement of a functional outcome. The TESS seems to reflect patients' HRQoL well after the treatment of lower extremity soft tissue sarcomas.

Obesity in fertile age women has increased worldwide leading to increased bariatric procedures. Lower body contouring surgery (LBCS) is one of the most commonly performed esthetic operations, mainly owing to massive weight loss. However, there is a paucity of data regarding pregnancy and delivery after LBCS. In this study, we examined whether LBCS influences pregnancy or delivery and mother and baby outcome.

In this national registry-based study, we used data from the Finnish Institute of Health and Welfare and the Causes of Death registry. We included fertile age women, from 18 to 54 years who had LBCS with or without a bariatric procedure and who experienced pregnancy and delivery were compared to all deliveries in Finland during 1999- 2016.

We identified 92 women who had LBCS before delivery. These 92 women had planned cesarean sections more often (P < .001) and preterm delivery was more common (P < .001). None of the mothers or babies died. Of the 92 women, 26 had a preceding bariatric procedure. The preceding bariatric procedures did not increase the risk for preterm delivery or low birth weight. The need for urgent or emergency sections was not increased. The heightened number of planned cesareans is caused by the different demographics of the study group, indicating that previous LBCS is not a contraindication for vaginal delivery.

Pregnancy and delivery are safe for the mother and the baby after LBCS. The possible deviations from normal pregnancy and delivery should be discussed with fertile age women seeking LBCS.

Pregnancy and delivery are safe for the mother and the baby after LBCS. The possible deviations from normal pregnancy and delivery should be discussed with fertile age women seeking LBCS.This editorial explores value in relation to plastic surgery and strategies that have been suggested to deliver value-based healthcare. We consider how value is measured, accounting for patient outcomes and experiences, costs and equity, and describe strategies that might improve value, such as outcome-based reimbursement, reporting transparency and high volume specialist centres.

Cochlear ischemia is hypothesized as one of the major etiologies of idiopathic sudden sensorineural hearing loss. Therefore, anticoagulant therapies are designed to be beneficial in certain patients with this condition.

This study aimed to determine which patients with idiopathic sudden sensorineural hearing loss would benefit from heparin treatment as adjuvant therapy.

In total, 134 patients who underwent magnetic resonance imaging for unilateral idiopathic sudden sensorineural hearing loss at a tertiary referral hospital between January 2014 and December 2018 were included in this retrospective study. All patients received Intratympanic steroid injections or heparin therapy plus oral corticosteroids. Radiological parameters of the vertebrobasilar system and clinical data from pre- and post-treatment assessments were analyzed.

Most patients (71.6%) had a tortuous basilar artery The 65 patients with severe-to-profound idiopathic sudden sensorineural hearing loss showed a significant relationship between idiopathic sudden sensorineural hearing loss laterality and basilar artery displacement to the opposite side (p = 0.