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A multivariate analysis revealed odds ratios for tumor volumes (0.64; 95% confidence interval (CI), 0.46-0.89; P=.008), solid volume percentages (0.96; 95% CI, 0.93-0.99; P=.024), skewness (3.45; 95% CI, 1.38-8.65; P=.008), and entropy levels (0.21; 95% CI, 0.07-0.58; P=.003). The area under the receiver operating characteristic curve was 0.90 (95% CI, 0.85-0.94) for the optimal model containing these 4 variables, with 85% sensitivity and 79% specificity.

Voxel-based histogram analysis of 3-dimensional computed tomography images accurately detected early-stage lung adenocarcinomas suitable for sublobar resection.

Voxel-based histogram analysis of 3-dimensional computed tomography images accurately detected early-stage lung adenocarcinomas suitable for sublobar resection.

The last decade has witnessed an increased number of stand-alone interventional cardiology units due to the consolidation of cardiac surgery services. We aimed to explore the impact of a heart team on the midterm outcomes of patients with multivessel coronary artery disease.

This prospective registry included 1063 consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and percutaneous coronary intervention, with or without on-site cardiac surgery services.

Of the 1063 patients, 576 (54%) and 487 (46%) were admitted to centers with or without on-site cardiac surgery services, respectively. Centers with cardiac surgery services compared with those without had more male patients (82% vs 77%, P=.026) and more patients who were taking aspirin (75% vs 67%, P=.008) before admission. Other characteristics were similar between the groups, including mean SYNTAX score (22.5±9.6 vs 22.2±10, P=.680). Late outcomes revealbased intervention with coronary artery bypass grafting, which is associated with less favorable outcomes. These findings suggest that a heart-team approach should be mandatory even in centers with stand-alone interventional cardiology units.

We aimed to investigate tricuspid valve function and adverse events after conventional repair and valve replacement for Ebstein's anomaly and compare them with cone repair.

The medical records of 151 patients (mean age, 25years; 62% were female) who underwent operation in a single center from 1985 to 2018 were retrospectively analyzed. To determine tricuspid valve regurgitation during follow-up, serial echocardiographic examination was used (n=2397, tricuspid regurgitation grades were graphed for every patient).

Thirty-nine patients underwent cone repair, 107 patients underwent other repair techniques, and 5 patients underwent valve replacement. The operative mortality was 1.3% (n=2). Failed valve repair (defined as in-hospital death, conversion to replacement, or in-hospital reoperation) was less frequent after cone repair than after other repair techniques (5%, n=2 vs 20%, n=21, P=.039). Mean follow-up was 12.3years (cone repair 3.7years). The 5-year cumulative incidence of moderate or greater recurrelower incidence of moderate or greater recurrent tricuspid regurgitation at the midterm follow-up.

Primary pulmonary sarcomas (PPS) and pulmonary carcinosarcomas (PCS) are rare aggressive lung malignancies. We reviewed our 21-year experience with the surgical and nonsurgical treatment of both tumors, comparing their clinical, histopathologic, and treatment results.

All patients with PPS or PCS who underwent surgical and nonsurgical treatment between 1998 and 2019 at our cancer center were retrospectively reviewed. Multivariable Cox proportional hazards model was constructed.

In total, 100 patients were analyzed 45 with PPS and 55 with PCS. Among patients with PPS, 31 of 45 (69%) underwent surgery with 1 (3%) operative mortality. For patients with PCS, 29 of 55 (53%) underwent surgery with no operative mortality. Patients with PPS were younger than PCS (P<.01). Fewer patients were smokers among PPS (58%) versus PCS (93%) (P<.01). For resected PPS, mean tumor size was 8.2±4.1cm (range 2.2-18.0) compared with 10.1±5.0cm (range 3.9-17.0) for unresected PPS. Tumor size for resected PCS was 6.2±2.6cm among patients with PPS. Whenever feasible, surgical resection, even in locally advanced disease, may yield long-term survival in these aggressive lung tumors, although the level of evidence is low.

Healthcare-associated infections are serious and significant complications present across healthcare services, including residential aged care facilities. Although ensuring high quality personal and clinical care delivered to older people residing in these facilities is a high national priority, there is a paucity of evidence published about outbreaks, governance and education programs held for healthcare workers within Australian residential aged care facilities. The aim of this study is to examine the scope of practice of Infection Prevention and Control professionals within Australian residential aged care facilities and the types of infection prevention and control education and training delivered.

A cross-sectional study was conducted inviting all Australian residential aged care facilities to participate in an online survey.

A total of 134 residential aged care facilities completed the survey. The majority (88.1%) reported having a designated Infection Prevention and Control professional responsib. Wnt peptide Yet, more support and resources are needed to assist these efforts.The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic.