Mcmahonalexandersen3917

ICU admissions and deaths were 15% and 8% higher than reported, respectively.

Accounting for SARS-CoV-2 RT-PCR-based diagnostic tests’ precision is a simple way to improve estimations for the true number of COVID-19 cases among tested persons.

Accounting for SARS-CoV-2 RT-PCR-based diagnostic tests’ precision is a simple way to improve estimations for the true number of COVID-19 cases among tested persons.

In en bloc vertebrectomy, the posterior approach is associated with limited access to anterior structures (vertebral body, esophagus, aorta, azygos vein). Video-assisted thoracoscopic surgery (VATS) might prove to be advantageous during thoracic en bloc vertebrectomy by allowing a combined anterior-posterior access in the prone position. We describe the technique and review the outcomes of 33 cases of video-assisted thoracoscopic en bloc vertebrectomy.

A retrospective, single-center cohort study included all cases of VATS with a minimum follow-up of 1 year. A team of thoracic and orthopaedic surgeons performed the surgical procedure with the patient in a single, prone position. Anterior release was carried out thoracoscopically, followed by posterior en bloc tumor removal.

From 2003 to 2019, 33 patients were included. Nine patients underwent total vertebrectomy (8 had single-level and 1 had 3-level), and 24 patients underwent partial vertebrectomy (1 had single-level, 8 had 2-level, 13 had 3-level, and bstantial chest wall and/or mediastinal invasion, and lung cancer exceeding 7 cm. The technique yielded satisfactory surgical and oncologic outcomes.

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

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.The presence of lower pole stones poses a unique challenge due to the anatomical considerations involved in their management and treatment. Considerable research has been performed to determine the optimal strategy when faced with this highly relevant clinical scenario. Standard options for management include observation, shock wave lithotripsy, retrograde intrarenal surgery, or percutaneous nephrolithotomy. Indeed, each approach confers a distinct set of risks and benefits, which must be placed into the context of patient preference and expected outcomes. The current state of practice reflects a combination of lessons learned from managing calculi not only in the lower pole, but also from other locations within the kidney as well.

Periumbilical hernias are a common finding in morbidly obese patients undergoing bariatric surgery; however, the timing of repair is still debated. The aim of this paper is to compare the outcomes of simultaneous versus delayed mesh repair of umbilical hernia in patients undergoing laparoscopic sleeve gastrectomy (LSG).

We retrospectively compared 2 groups of morbidly obese patients with small/medium periumbilical hernia (up to 4 cm) in a case-matched study the first group underwent LSG with simultaneous periumbilical hernia repair; in the second, hernioplasty was performed after weight loss induced by LSG. Patients were matched at a 11 ratio according to age, comorbidities, defect size (<2 or ≥2 cm), and obesity grade (<40 or ≥40 kg/m). Demographic, clinical information, hernia size, data from the surgery, and its complications were retrieved and analyzed.

In total, 40 patients were retrieved from our prospectively maintained database and divided into 2 matched groups of 20 subjects each. Baseline characteristics were comparable. After a median time of 19.8±5.6 months, the recurrence rate was not significantly different in the 2 groups. There was no difference in the rate of single complications, but overall morbidity was significantly higher in patients undergoing a 2-step approach. LSG operation time and hospital stay resulted in comparable, but total hospital stay was longer for those readmitted for delayed hernioplasty.

In the case of morbidly obese patients with small/medium periumbilical hernia undergoing LSG, a simultaneous approach should be offered. Our proposed technique did not prolong operative time and showed a lower rate of overall morbidity.

In the case of morbidly obese patients with small/medium periumbilical hernia undergoing LSG, a simultaneous approach should be offered. Our proposed technique did not prolong operative time and showed a lower rate of overall morbidity.

The therapeutic role of pelvic lymph node dissection (PLND) in prostate cancer (PCa) is unknown due to absence of randomized trials.

to present a critical review on the therapeutic benefits of PLND in high risk localized PCa patients.

A search of the literature on PLND was performed using PubMed, Cochrane, and Medline database. Articles obtained regarding diagnostic imaging and sentinel lymph node dissection, PLND extension, impact of PLND on survival, PLND in node positive "only" disease and PLND surgical risks were critically reviewed.

High-risk PCa commonly develops metastases. In these patients, the possibility of presenting lymph node disease is high. selleckchem Thus, extended PLND during radical prostatectomy may be recommended in selected patients with localized high-risk PCa for both accurate staging and therapeutic intent. Although recent advances in detecting patients with lymph node involvement (LNI) with novel imaging and sentinel node dissection, extended PLND continues to be the most accurate method to stage lymph node disease, which may be related to the number of nodes removed. However, extended PLND increases surgical time, with potential impact on perioperative complications, hospital length of stay, rehospitalization and healthcare costs. Controversy persists on its therapeutic benefit, particularly in patients with high node burden.

The impact of PLND on biochemical recurrence and PCa survival is unclear yet. Selection of patients may benefit from extended PLND but the challenge remains to identify them accurately. Only prospective randomized study would answer the precise role of PLND in high-risk pelvis confined PCa patients.

The impact of PLND on biochemical recurrence and PCa survival is unclear yet. Selection of patients may benefit from extended PLND but the challenge remains to identify them accurately. Only prospective randomized study would answer the precise role of PLND in high-risk pelvis confined PCa patients.