Simonweeks3838

A conditional recommendation is made for the implementation of community-based gun buyback programs and a conditional recommendation for community-based violence prevention programs, with special emphasis on cultural appropriateness and community input.

Gun violence may be mitigated by community-based efforts, such as gun buybacks or violence prevention programs. These programs come with caveats, notably community cultural relevance and proper support and funding from local leadership.Level of Evidence Review, Decision, level III.

Gun violence may be mitigated by community-based efforts, such as gun buybacks or violence prevention programs. These programs come with caveats, notably community cultural relevance and proper support and funding from local leadership.Level of Evidence Review, Decision, level III.

To determine whether autotransfusion of salvaged blood with single leukoreduction is associated with post-transplant tumor recurrence in patients with advanced hepatocellular carcinoma (HCC).

Previous studies have consistently demonstrated the safety of autotransfusion of salvaged and leukoreduced blood during liver transplantation for HCC. However, the effects of this technique remained unknown for advanced HCC.

Of 349 patients who underwent living donor liver transplantation for advanced HCC 74/129 without autotransfusion were matched with 74/220 with autotransfusion using propensity score based on tumor biology, allogeneic transfusion, and others. Survival analysis was performed with death as a competing risk event. The primary outcome was HCC recurrence.

Recipients in autotransfusion group received 811 (497-1247) mL of salvaged blood with single leukoreduction. In the matched cohort, cumulative overall recurrence probability at 1/2/5 years after transplantation was 24.6%/38.3%/39.7% for non-autotrorable probabilities for autotransfusion, in patients with advanced HCC. Thus, blood salvage and autotransfusion could be safely used with single leukoreduction, without double-filtered leukoreduction, during liver transplantation for HCC with potential benefits from avoiding allogeneic red blood cell transfusion.

We developed, tested, and validated machine learning algorithms to predict individual patient-reported outcomes at 1-year follow-up to facilitate individualized, patient-centered decision-making for women with breast cancer.

Satisfaction with breasts is a key outcome for women undergoing cancer-related mastectomy and reconstruction. Current decision-making relies on group-level evidence which may lead to sub-optimal treatment recommendations for individuals.

We trained, tested, and validated three machine learning algorithms using data from 1921 women undergoing cancer-related mastectomy and reconstruction conducted at eleven study sites in North America from 2011 to 2016. 3,4-Dichlorophenyl isothiocyanate cost Data from 1921 women undergoing cancer-related mastectomy and reconstruction were collected prior to surgery and at 1-year follow-up. Data from 10 of the 11 sites was randomly split into training and test samples (21 ratio) to develop and test three algorithms (logistic regression with elastic net penalty, Extreme Gradient Boosting tratient-centered decision-making for women undergoing breast cancer treatment.

To evaluate healthcare dependency following hepatopancreatobiliary (HPB) cancer surgery in older adults (OA).

Functional outcomes are central to decision-making by OA, but long-term risks of dependency have not been described beyond 1 year in this population.

All patients over age 70 undergoing hepatectomy or pancreatectomy for cancer between 2007-2017 in Ontario were analyzed. Outcomes were 1) receipt of homecare and 2) time at home. Homecare was analyzed with cumulative incidence functions, and time at home with Kaplan-Meier and Cox multivariate models.

A total of 902 and 1283 patients underwent hepatectomy and pancreatectomy, respectively. Homecare use was highest (72.3%) in post-operative month-1, decreasing to stabilize between year-1 (25.5%) and year-5 (18.3%). Repeated receipt of homecare was associated with female sex (HR 1.18, 95%CI 1.05-1.32), receipt of adjuvant therapy (HR 1.56, 1.37-1.78), and more recent year of surgery (HR 3.80, 3.05-4.72). The ratio of home nursing care vs. personal suansitional care planning.

Following HPB cancer surgery, there is a high rate of long-term healthcare dependency for OA. There is an immediate high need for homecare that reaches a new baseline after 6 months, and the majority of OA will have at least one year with low time at home, most commonly the first year. These findings can aid in pre-operative preparation and transitional care planning.COVID-19 has strained hospital capacity, detracted from patient care, and reduced hospital income. This article lays out a tested strategy that surgical and hospital leaders can use to overcome clinical and financial strain, emphasizing the experience at 2 leading North American medical centers. By classifying the time and resource needs of surgical patients and smoothing the flow of surgical admissions over all days of the week, hospitals can dramatically improve hospital efficiency, the quality of care and timely access to care for emergent and urgent surgeries. Through and beyond the time of COVID, smoothing the flow of surgical patients is a key means to restore hospital vitality and improve the care of all patients.

The aim of present study is to evaluate efficacy and safety of proximal splenic vein embolization (PSVE) for liver transplant recipients having complicated large splenorenal shunts (SRS).

In adult living donor liver transplantation (ALDLT) for a patient who has large splenorenal shunts (SRS), their interruption is utmost important to maintain adequate portal flow by avoidance of portal flow steal through the preexisting SRS. We effectively managed most of the recipients with surgical ligation and/or additional radiologic embolization using by intraoperative cine-portogram (IOP). However, when complete interruption is not achieved in a few recipients having complicated large SRS, it may leave a chance of lethal portal flow steal in the recipient afterwards.

PSVE was performed in 13 patients between April 2014 and November 2017. We performed a retrospective analysis of preoperative images, postoperative graft and recipient outcomes, and presence of isolated portal hypertension.

Ten patients underwent PSVE as an additional secondary method because of for portal steal syndrome through the remaining SRS after surgical interruption and/or embolization, and 3 patients underwent PSVE only as a primary method of SRS interruption.