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However, potential confounders such as age, gender, and BMI and the diversity of CAC scores may affect the association.

In participants without symptomatic coronary disease, the presence of OSA was associated with the presence and extent of CAC. However, potential confounders such as age, gender, and BMI and the diversity of CAC scores may affect the association.

Sternal and rib fractures are common concomitant injuries. However, the impact of concurrent sternal fractures on clinical outcomes of patients with rib fractures is unclear. Fluorescein-5-isothiocyanate concentration We aimed to unveil the pulmonary morbidity and mortality impact of concomitant sternal fractures among patients with rib fractures.

We identified adult patients admitted with traumatic rib fractures with vs. without concomitant sternal fractures using the 2012-2014 National Inpatient Sample (NIS). After 21 propensity score matching and adjustment for residual imbalances, we compared risk of pulmonary morbidity and mortality between patients with vs. without concomitant sternal fractures. Subgroup analysis in patients with flail chest assessed whether sternal fractures modify the association between undergoing surgical stabilization of rib fractures (SSRF) and pulmonary morbidity or mortality.

Of 475710 encounters of adults admitted with rib fractures, 24594 (5%) had concomitant sternal fractures. After 21 propensity score matching,, which encompasses heterogeneous injury patterns with likely variable clinical relevance.

Recurrent laryngeal nerve (RLN) injury and postoperative hypocalcemia are potential complications of thyroidectomy, particularly in malignancy. Intraoperative nerve monitoring (IONM) remains controversial. We sought to evaluate the impact of IONM on these complications using a national data set.

The American College of Surgeons National Surgical Quality Improvement Program thyroidectomy-targeted data set was queried for patients who underwent thyroidectomies from 2016 to 2017. Patients were grouped according to IONM use. Logistic regression models were constructed to evaluate associations of variables with 30-day hypocalcemic events (HCEs) and RLN injury. Associations were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). A subgroup analysis was performed of patients with malignancy.

A total of 9527 patients were identified; 5969 (62.7%) underwent thyroidectomy with IONM and 3558 (37.3%) without. By multivariable analysis, IONM had protective associations with HCE (OR = .81, 95% CIective association with HCE and RLN injury, both overall, and in the malignant subgroup. Intraoperative nerve monitoring was correlated with improved thyroidectomy outcomes, especially if the indication was malignancy. This warrants further study to clarify cause and effect.Cognitive tasks borrowed from experimental psychology are often used to assess individual differences. A cardinal issue of this transition from experimental to correlational designs is reduced retest reliability of some well-established cognitive effects as well as speed-accuracy trade-off. The present study aimed to address these issues by examining the retest reliability of various methods for speed-accuracy integration and by comparing between two types of task modeling difference scores and residual scores. Results from three studies on executive functions show that (a) integrated speed-accuracy scoring is generally more reliable as compared with nonintegrated methods mean response time and accuracy; and (b) task modeling, especially residual scores, reduced reliability. We thus recommend integrating speed and accuracy, at least for measuring executive functions.

Postoperative ambulation is an important tenet in enhanced recovery programs. We quantitatively assessed the correlation of decreased postoperative ambulation with postoperative complications and delays in gastrointestinal function.

Patients undergoing major abdominal surgery were fitted with digital ankle pedometers yielding continuous measurements of their ambulation. Primary endpoints were the overall and system-specific complication rates, with secondary endpoints being the time to first passage of flatus and stool, the length of hospital stay, and the rate of readmission.

100 patients were enrolled. We found a significant, independent inverse correlation between the number of steps on the first and second postoperative days (POD1/2) and the incidence of complications as well as the recovery of GI function and the likelihood of readmission (

< .05). POD2 step count was an independent risk factor for severe complications (

= .026).

Digitally quantified ambulation data may be a prognostic biomarker for the likelihood of severe postoperative complications.

Digitally quantified ambulation data may be a prognostic biomarker for the likelihood of severe postoperative complications.The peroxide value of edible oils is a measure of the degree of oxidation, which directly relates to the freshness of the oil sample. Several studies previously reported in the literature have paired various spectroscopic techniques with multivariate analyses to rapidly determine peroxide values using field portable and process instrumentation; those efforts presented "best-case scenarios" with oils from narrowly defined training and test sets. The purpose of this paper is to evaluate the use of near- and mid-infrared absorption and Raman scattering spectroscopies on oil samples from different oil classes, including seasonal and vendor variations, to determine which measurement technique or combination thereof is best for predicting peroxide values. Following peroxide value assays of each oil class using an established titration-based method, global and global-subset calibration models were constructed from spectroscopic data collected on the 19 oil classes used in this study. Spectra from each optical technifor determining peroxide value of oils.

Portal vein thrombosis can be a life-threatening complication associated with a splenectomy. Laparoscopic splenectomy has been suggested to cause an increased rate of portal vein thrombosis. Our study evaluated the rate of portal vein thrombosis in pediatric patients who underwent a splenectomy via single-site laparoscopy.

A retrospective chart review was performed for all patients undergoing laparoscopic splenectomy from November 2012 to July 2019. link2 Demographic data, operative details, postoperative imaging, and patient outcomes were obtained for analysis. Patients were contacted to determine if they had any complications for which they sought medical care elsewhere.

There were 78 pediatric patients who underwent laparoscopic splenectomy over the 7-year period. The most common indication was sickle cell disease (70.5%). Single-incision laparoscopy was performed in 61.5% of the cases. Eight were converted to open. Eleven patients (14.1%) had a laparoscopic cholecystectomy performed during the same operaton laparoscopic splenectomy do not have a higher rate for portal vein thrombosis.

Wide variation of opioid prescribing persists despite attempts to quantify number of opioids utilized postoperatively. We aim to prospectively determine number of opioids used after common surgery procedures to guide future prescribing.

A prospective observational trial was performed of opioids prescribed and used postoperatively. Patients filled out pre- and postoperative surveys, and number of opioids utilized was captured at postoperative visit.

One-hundred-and-thirteen patients met inclusion. Median opioids prescribed exceeded number of opioids taken for all procedures. Median number of opioids taken postoperatively was fewer than 10 for all categories of procedures simple skin/soft tissue 2 (IQR 1-4), complex skin/soft tissue 1.5 (IQR 0-14), simple laparoscopy 1 (IQR 0-20) and complex laparoscopy 4 (IQR 0-20), laparotomy 0 (IQR 0-26), and open inguinal hernia 2 (IQR 0-2). Nearly 80% of patients had leftover opioids, and 31% planned to keep them. There was little difference between preoperative and postoperative level of satisfaction with a pain control regimen.

Postoperatively, patients utilize opioids less frequently than prescribed and often keep leftover pills. Patient pain control satisfaction is unrelated to number of opioids prescribed and taken postoperatively.

Postoperatively, patients utilize opioids less frequently than prescribed and often keep leftover pills. Patient pain control satisfaction is unrelated to number of opioids prescribed and taken postoperatively.

Decreased pancreatic volume (PV) is a predictive factor for diabetes mellitus (DM) after surgery. There are few reports on PV and endocrine function pre- and post-surgery. We investigated the correlation between PV and insulin secretion.

Seventeen patients underwent pancreaticoduodenectomy (PD) Pre- and post-surgery PV and C-peptide index (CPI) measurements were performed. Additionally, the correlation between PV and CPI was analyzed.

The mean preoperative PV (PPV) was 55.1 ± 31.6mL, postoperative remnant PV (RPV) was 25.3±17.3mL, and PV reduction was 53%. The mean preoperative C-peptide immunoreactivity (CPR) was 1.39 ± .51 and postoperative CPR was .85±.51. The mean preoperative CPI was 1.29±.72 and postoperative CPI was .73 ± .48. Significant correlations were observed between RPV and post CPR (ρ = .507, P = .03) and post CPI (ρ = .619, P = .008).

There was a significant correlation between RPV and CPI after PD. link3 A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.

There was a significant correlation between RPV and CPI after PD. A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.

Neoadjuvant treatment (NT) has become standard in the management of borderline resectable pancreatic cancer (BR-PDAC), improving prognosis. The primary mechanism for this improvement remains unclear.

Clinicopathological data of patients with BR-PDAC who underwent resection between January 2008 and December 2018 at a single institution were retrospectively reviewed. Univariable and multivariate analyses were used to compare survival between patients who received NT vs. those who underwent upfront resection (UR).

A total of 138 patients were included, 64 underwent UR and 74 NT. Neoadjuvant treatment resulted in higher margin-negative (R0) resection rate (68.9%) than UR (43.8%,

= .005). Neoadjuvant treatment was associated with improved overall survival (OS,

= .009) and progression-free survival (PFS,

= .027). R0 resection was also associated with improved OS (

< .001) and PFS (

< .001). On multivariable analysis, when adjusting for clinically relevant variables without considering R staould be accurately predicted.

Mediastinal masses are commonly encountered by the thoracic surgeon. Few studies have reported on the frequency and characteristics of symptoms at presentation. The primary objective of this study is to determine how often patients present with symptoms from a mediastinal mass. The secondary objective is to determine if the presence of symptoms has an effect on outcomes after surgery.

A retrospective review of an institutional database was performed. All patients who underwent surgical resection of a mediastinal mass from 2013 to 2019 were included in the analysis. Medical records were reviewed for the presence or absence of symptoms preoperatively, and these cohorts were compared. Multivariable analysis was performed, adjusting for clinical variables to assess for differences between these cohorts.

70 patients underwent surgery for a mediastinal mass. The average age was 49.2years, and 46 patients (65.7%) presented with symptoms. There were no significant differences in demographics between the symptomatic and asymptomatic groups.