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To investigate the relationship between upper-thigh intermuscular fat, subcutaneous fat measured by CT and major complications after primary total hip arthroplasty (THA).

Between 2015 and 2021, consecutive patients who had primary THA and preoperative hip CT were retrospectively included. Upper-thigh muscle cross-sectional intermuscular fat, subcutaneous fat, and muscle area were measured on hip CT images. The major complications included dislocation, aseptic loosening, infection, and periprosthetic fracture. The effect of upper-thigh intermuscular fat, subcutaneous fat and muscle area on the outcome was analyzed using multivariable cox proportional hazards analysis. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

A total of 3028 patients were included and 71 (2.34%) of them had major complications. During a median of 25 months of follow-up, patients showed increased incidence of total major complications with increased intermuscular fat area (log-rank p=0.012). The multivariable cox regression revealed that per SD increment in intermuscular fat area was associated with higher risk of total major complications (HR=2.04, 95% CI=1.71-2.43, p < 0.001), dislocation (HR=1.96, 95% CI=1.44-2.66, p < 0.001), aseptic loosening (HR=2.02, 95% CI=1.30-3.16, p=0.002), infection (HR=1.94, 95% CI=1.24-3.05, p=0.004), and periprosthetic fracture (HR=2.26, 95% CI=1.67-3.07, p < 0.001).

Upper-thigh intermuscular fat, but not subcutaneous fat measured on CT associated with the risk of major complications after primary THA.

Upper-thigh intermuscular fat, but not subcutaneous fat measured on CT associated with the risk of major complications after primary THA.

Historically, repair of bladder exstrophy (BE) is associated with compromise to the upper tracts; the single stage repair of BE was considered to exacerbate risks of kidney impairment.

We aim to evaluate the risk of upper urinary tract deterioration or chronic kidney disease after the complete primary repair of exstrophy (CPRE).

As part of the U.S.-India Multi-institutional Bladder Exstrophy Collaboration, we prospectively performed data collection on all patients managed at the Civil Hospital, Ahmedabad from 2010 to 2020. All patients who underwent primary or redo BE or primary penopubic epispadias (PE) repair using CPRE were included. Data on annual VCUG and DMSA, serum creatinine and cystatin-C, urinary albumin, and creatinine were aggregated.

72/104 patients who underwent CPRE at a median age of 1.7 years (IQR 1.1-4.6) were included 43(60%) patients with primary BE, 17(24%) with redo BE, and 12(17%) with primary PE. At a median follow-up of 4 years (IQR 3-6), the overall median eGFR was 105 for BE

Modern CPRE technique for the repair of BE may increase the risk of kidney scarring in the intermediate-term follow-up, however, this finding does not correlate with low eGFR and presence of albuminuria inpatients. Therefore, close follow-up with serial kidney function measurements is warranted and necessary after CPRE.

Modern CPRE technique for the repair of BE may increase the risk of kidney scarring in the intermediate-term follow-up, however, this finding does not correlate with low eGFR and presence of albuminuria inpatients. Therefore, close follow-up with serial kidney function measurements is warranted and necessary after CPRE.

Febrile urinary tract infection (UTI) is a common childhood infection related to renal scarring and potentially long-term complications like chronic kidney disease. It would be of great benefit to find a correlation between easy-accessible factors in the acute phase of a febrile UTI and the development of renal scar formation and/or decreased renal function in order to identify children at risk of future complications.

The aim of this study was to identify factors associated with the development of decreased split renal function (DSRF) and/or permanent renal scar formation in children with febrile UTI.

The medical records of 212 Children aged 0 months to 15 years with febrile UTI admitted to The Pediatric Department of Lillebaelt Hospital, Kolding from January 2011 to September 2014 were systematically reviewed. We analyzed clinical, laboratory, and radiologic findings. Statistical analysis was performed to identify factors associated with renal scar formation and DSRF on nuclear imaging at 6 months folge to the ongoing debate regarding renal scarring but also reveals the possibility of associated factors for the development of DSRF following a febrile UTI in children. However, due to the retrospective design as well as the small number of events in our study definite conclusions on whether the above-mentioned factors are indeed prognostic for the development of renal scarring or DSRF following a febrile UTI can not be drawn.

This study contributes with further knowledge to the ongoing debate regarding renal scarring but also reveals the possibility of associated factors for the development of DSRF following a febrile UTI in children. However, due to the retrospective design as well as the small number of events in our study definite conclusions on whether the above-mentioned factors are indeed prognostic for the development of renal scarring or DSRF following a febrile UTI can not be drawn.Charcot-Marie-Tooth disease type 1A (CMT1A) is related to PMP22 gene duplication. It is characterized at electrodiagnostic testing (EDX) by diffuse homogeneous signs of demyelination, such as velocity slowing and prolonged distal latencies. These abnormalities are less pronounced in infants under two years old, and the possibility of normal nerve conduction studies (NCS) in infants with CMT1A under one year of age has been questioned. We report three infants who displayed normal or almost normal NCS. EDX abnormalities in CMT1A patients may therefore appear late during development. This may affect early EDX diagnosis in infants and should be considered for upcoming clinical trials.There is an increased desire for miniature ultrasound probes with small apertures to provide volumetric images at high frame rates for in-body applications. Satisfying these increased requirements makes simultaneous achievement of a good lateral resolution a challenge. As micro-beamforming is often employed to reduce data rate and cable count to acceptable levels, receive processing methods that try to improve spatial resolution will have to compensate the introduced reduction in focusing. Existing beamformers do not realize sufficient improvement and/or have a computational cost that prohibits their use. PI3K inhibitor Here we propose the use of adaptive beamforming by deep learning (ABLE) in combination with training targets generated by a large aperture array, which inherently has better lateral resolution. In addition, we modify ABLE to extend its receptive field across multiple voxels. We illustrate that this method improves lateral resolution both quantitatively and qualitatively, such that image quality is improved compared with that achieved by existing delay-and-sum, coherence factor, filtered-delay-multiplication-and-sum and Eigen-based minimum variance beamformers. We found that only in silica data are required to train the network, making the method easily implementable in practice.In recent years, long- and short-pulse ultrasound (US)-targeted microbubble cavitation (UTMC) has been found to increase perfusion in healthy and ischemic skeletal muscle, in pre-clinical animal models of microvascular obstruction and in the myocardium of patients presenting with acute myocardial infarction. There is evidence that the observed microvascular vasodilation is driven by the nitric oxide pathway and purinergic signaling, but the time course of the response and the dependency on US pulse length are not well elucidated. Because our prior data supported that sonoreperfusion efficacy is enhanced by long-pulse US versus short-pulse US, in this study, we sought to compare long-pulse (5000 cycles) and short-pulse (500 × 10 cycles) US at a pressure of 1.5 MPa with an equivalent total number of acoustical cycles, hence constant acoustic energy, and at the same frequency (1 MHz), in a rodent hind limb model with and without microvascular obstruction (MVO). In quantifying perfusion using burst replenishment icrobubble oscillation induces vasodilation, and therapeutic efficacy for the treatment of MVO can be tuned by varying pulse length; relative to short-pulse US, longer pulses drive greater microbubble cavitation and more rapid microvascular flow rate restoration after MVO, warranting further optimization of the pulse length for sonoreperfusion therapy.

We examined patient attitudes and beliefs and provider perspectives on patients' attitudes and beliefs towards testosterone therapy in Veterans Affairs (VA).

We used a thematic analysis approach to understand variation in patient attitudes and beliefs towards testosterone at six VA sites with high and low levels of testosterone prescribing in VA. Semi-structured phone interviews with 18 patients and 22 providers at these sites were transcribed and coded using a priori theoretical constructs and emergent themes. A cross-case matrix of coded data was used to evaluate themes related to patient-level factors.

Patients' beliefs toward testosterone did not differ across sites. Patients, not providers, generally initiated conversations about testosterone. We identified five key domains related to patient beliefs and provider perceived patient beliefs towards testosterone reasons for initiating testosterone, patient information sources and expectations about testosterone, receptivity towards discontinuation of testosterone, patient/provider engagement in information sharing, and self-advocacy by the patients in decision-making.

Patient factors play an important role in testosterone prescribing decisions.

By considering these patient factors, providers can potentially help create a partnership with patients and foster shared decision-making for testosterone and other, similar medications.

By considering these patient factors, providers can potentially help create a partnership with patients and foster shared decision-making for testosterone and other, similar medications.To evaluate the role of magnetic resonance imaging (MRI) chest as an alternative modality to CT chest for follow-up of patients recovered from severe COVID-19 acute respiratory distress syndrome (ARDS). A total of 25 subjects (16 [64%] men; mean age 54.84 years ± 12.35) who survived COVID-19 ARDS and fulfilled the inclusion criteria were enrolled prospectively. All the patients underwent CT and MRI chest (on the same day) at 6-weeks after discharge. MRI chest was acquired on 1.5T MRI using HASTE, BLADE, VIBE, STIR, and TRUFI sequences and evaluated for recognition of GGOs, consolidation, reticulations/septal thickening, parenchymal bands, and bronchial dilatation with CT chest as the gold standard. The differences were assessed by independent-sample t-test and Mann-Whitney U test. P-value of less than 0.05 was taken significant. There was a strong agreement (k = 0.8-1, P less then 0.01) between CT and MRI chest. On CT, the common manifestations were GGOs (n=24, 96%), septal thickening/reticulations (n=24, 96%), bronchial dilatation (n=16, 64%), parenchymal bands (n=14, 56%), pleural thickening (n=8, 32%), consolidation (n=4, 16%) and crazy-paving (n=4, 16%).

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