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Objective: The increasing significance of medicolegal evaluation following maxillofacial traumatic events constitutes a complex issue. This clinical research aimed to assess the current etiology of oral and maxillofacial injuries in Portuguese population. Material and methods: An epidemiological clinical observational study was conducted in Centro Hospitalar Lisboa Norte on a sample of 384 subjects diagnosed with oral and maxillofacial trauma, between 2018 and 2020. Data were collected through clinical reports and analyzed using SPSS version 27. Results: Women and men were nearly identical in the number and distribution, with 49.5% females and 50.5% males. In 2020, there was a decrease in the number of traumatic incidents compared to other years. Falls or accidental descents were found to be the most common cause of injury, accounting for 44.3%, followed by assaults accounting for 24.7%. A total of 84 subjects exhibited soft tissue injuries related to periodontal region. The upper central incisors (174) were the most frequently affected teeth with uncomplicated fractures, and the predominant form of treatment was the administration of pain medication. Conclusion: A correlation between falls or accidental descents, female subjects, and advancing age, as well as between assaults, male subjects, and adults, has been established. Falls or accidental descents and assault were the predominant etiologies, and the year 2020 exhibited a decrease in the incidents of traumatic events., Cilj: Sve veće značenje sudsko-medicinske evaluacije nakon maksilofacijalnih traumatskih događaja složeno je pitanje. Autorima ovoga kliničkoga istraživanja cilj je bio procijeniti trenutačnu etiologiju oralnih i maksilofacijalnih ozljeda u portugalskoj populaciji. Materijal i metode: Epidemiološ-ka klinička opservacijska studija provedena je između 2018. i 2020. godine u Kliničkome bolničkom centru Lisabon-sjever na uzorku od 384 ispitanika s dijagnosticiranom oralnom i maksilofacijalnom traumom. Podatci su prikupljeni iz kliničkih izvješća i analizirani u SPSS verziji 27. Rezultati: Muški i ženski ispitanici bili su gotovo izjednačeni u broju i distribuciji – sudjelovalo je 49,5 % žena i 50,5 % muškaraca. U 2020. godini zabilježen je pad broja traumatskih incidenata u odnosu prema ostalim godinama. Ustanovljeno je da su padovi ili slučajna spuštanja najčešći uzrok ozljeda – čine 44,3 %, a slijede napadi koji čine 24,7 %. Ukupno 84 ispitanika imalo je ozljede mekog tkiva u parodontnoj regiji. Gornji središnji sjekutići (174) bili su najčešće zahvaćeni kad je riječ o nekompliciranim prijelomima, a prevladavajući oblik liječenja bili su lijekovi protiv bolova. Zaključak: Utvrđena je korelacija između padova ili slučajnih silazaka, ženskih subjekata i starije dobi, te između napada muških subjekata i odraslih. Padovi ili slučajni padovi i napadi bili su dominantni uzroci, a u 2020. godini smanjio se broj traumatskih događaja.

Allogeneic hematopoietic cell transplant (allo-HCT) provides the only potential route to long-term remission in patients diagnosed with blast phase transformation of mye-loproliferative neoplasm (BP-MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry-based study of BP-MPN patients undergoing allo-HCT. BP-MPN patients undergoing first allo-HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow-up of 62 months, the estimated 3-year overall survival (OS) was 36% (95% confidence interval [CI], 32-36). Factors associated with lower OS were Karnofsky Performance Score (KPS) < 90 (hazard ratio [HR] 1.65, p < .001) and active disease at allo-HCT (HR 1.45, p < .001), whereas patients undergoing allo-HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3-year OS of patients undergoing allo-HCT in complete response (CR) and with a KPS >= 90 was 60%. KPS < 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression-free survival (PFS). Conversely, most recent allo-HCT associated with a higher PFS (HR 0.96, p = .008). Active dis-ease at allo-HCT (HR 1.34, p = .03) was associated with a higher cumulative inci-dence of relapse (RI) and allo-HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS < 90 (HR 1.91, p < .001), active disease (HR 1.74, p = .003) and allo-HCT from mismatched related donors were associated with a higher non-relapse mortality (HR 2.66, p = .003). In this large series of BPMPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo-HCT in the more recent era, with a KPS >= 90 and in CR at transplant had a better prognosis.

Amaç: Bu retrospektif çalışmanın amacı, 2008-2019 yılları arasında Dicle Üniversitesi, Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Cerrahisi Anabilim Dalı’na başvurmuş travmaya bağlı maksillofasiyal kırık izlenen hastaların demografik dağılımını ve tedavi yöntemlerini geriye dönük analiz edip elde edilen bulguları değerlendirmek ve tartışmaktır. Gereç ve Yöntemler: Kliniğimize başvuran 374 maksillofasiyal travma vakasına ait dosya dokümanları toplanarak incelendi. Elde edilen veriler cinsiyet, yaş, etiyoloji, mevsim, anatomik lokalizasyon ve tedavi seçeneklerine göre analiz edildi. Bulgular: Yapılan istatiksel analiz sonucunda; 257’si erkek (%68,7), 117’si kadın (%31,3) olan 374 hastada 400 maksillofasiyal kırık tespit edildi. Ortalama yaş 25 (7-68) olarak tespit edildi. Etiyolojik nedenler sıralandığında 129 hasta (%34,5) ile düşme ilk sırada yer aldı. Daha sonra sırasıyla 124 hasta (%33) ile darp, 69 hasta (%18,4) ile trafik kazası, 21 hasta (%5,6) ile spor kazası, 12 hasta (%3,2) ile iş kazası, 12 hasta (%3,2) ile at tepmesi, 4 hasta (%1) ile ateşli silah yaralanması ve 3 hasta (%0,8) ile diş çekim sonrası oluşan çene kırığı etiyolojik sebepler arasında yer almaktadır. Tedavisi gerçekleştirilmiş 400 kırığın 334’ü (%83) mandibulada, 46 (%11) tanesi maksillada, 3 (%1) tanesi zigomatik kemikte, 3 tanesi (%1) orbitada ve son olarak 14 tanesi (%4) çoklu kırık şeklinde görüldü. Sonuç: Maksillofasiyal kırıkların insidansı, etiyolojisi ve hastaların demografik özellikleri bölgelere göre çeşitlilik göstermektedir. Coğrafik, sosyal ve ekonomik değişkenlere sahip sahaların katılacağı çok merkezli çalışmaların bölgeler arasındaki farklılığın daha detaylı anlaşılabilmesini sağlayarak hem hastaların tedavisine hem de literatüre büyük katkı sağlayacağını düşünmekteyiz., Background: The purpose of this retrospective study was to evaluate and discuss the demographic distribution and treatment methods of patients with maxillofacial fracture who admitted to the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery due to trauma between 2008-2019. Methods: The file documents of 374 maxillofacial trauma cases admitted to our clinic were collected and examined. The data obtained were analyzed according to gender, age, etiology, season, anatomical localization and treatment options. Results: As a result of statistical analysis, 400 maxillofacial fractures were detected in 374 patients, of whom 257 (68.7%) were male and 117 (31.3%) were female. The mean age was 25 (7-68) years. When etiological causes were listed, fall was in the first place with 129 patients (34.5%). Then, respectively, interpersonal violence with 124 patients (33%), traffic accident with 69 patients (18.4%), sports accident with 21 patients (5.6%), occupational accident with 12 patients (3.2%), horse kick with 12 patients (3.2%), gunshot wounds with 4 patients (1%) and jaw fractures that occured after tooth extraction with 3 patients (0.8%) were among the etiological causes. Of the 400 fractures treated, 334 (83%) were seen in the mandible, 46 (11%) were in the maxilla, 3 (1%) were in the zygomatic bone, 3 (1%) were in the orbit and finally 14 (4%) were multiple fractures. Conclusion: The incidence, etiology and demographic characteristics of maxillofacial fractures vary according to regions. We think that multicentre studies involving fields with geographic, social and economic variables will contribute to both the treatment of patients and the literatüre by providing a more detailed understanding of the differences between regions.

Height loss starting in middle age is reported to be an independent risk factor for cardiovascular mortality. Recent studies have revealed an inverse association between height and hypertension, but the influence of hypertension on height loss is unknown. Since hypertension is an established cardiovascular risk factor, clarifying the association between baseline hypertension and height loss could lead to an efficient tool to estimate the risk of mortality. A retrospective study of 11,154 Japanese aged 40–74 years was conducted. Height loss was defined as being in the highest quintile of annual height decrease (≥2.015 mm/year for men and ≥1.756 mm/year). Baseline height was significantly inversely associated with incident hypertension for men only. The adjusted odds ratio (OR) and 95% confidence interval (CI) for incident hypertension for each 1 standard deviation increment of height (5.9 cm for men and 5.6 cm for women) was 0.90 (0.84, 0.97) for men and 1.07 (0.91, 1.26) for women, respectively. We also found that baseline hypertension is independently positively associated with height loss for men only. The adjusted OR was 1.25 (1.11, 1.42) for men and 0.93 (0.71, 1.21) for women. These results might lead to an efficient tool for estimating the risk of height loss, which has been reported to be associated with a higher risk of mortality in adults.

Myxopapillary ependymomas (MPEs) possess leptomeningeal, neural axis dissemination, seeding metastases, and extra-neural spread which are malignant characteristics, even they classified low-grade lesions as WHO grade II. Managing such lesions remains an arguable neurosurgical challenge. The study aimed to discuss the management of MPEs by evaluating the long-term surgical outcomes of consecutively treated MPEs in different 3 neurosurgical centers.Medical records of all diagnosed patients with spinal tumors at our institutions were reviewed retrospectively. This study included all consecutive MPE who underwent surgical intervention in our institutions in different periods between February 2004 and December 2020.A total of 44 patients with MPE were treated surgically in three institutions. 28 (63.6%) patients were males. Six patients were pediatric patients (≤18 years). The mean age was 36.2 years. The preoperative course was 19.2 months. The most common symptom was leg pain, observed in 35 (79.5%) patients. Gross-total resection was performed in 35 (79.5%) patients. 39 (88.7%) patients had good functional outcomes with an average follow-up period of 106.2 months. The progression was observed in 5 (11.4%) patients. Extending2 segments, unclear boundaries, bone-erosions were associated with poor prognosis and progression. Laminectomy and surgical complications were associated with poor functional outcomes. En bloc resection without violation of lesions' integrities reduced the progression.Radiological, intraoperative, and surgical factors can affect the functional outcomes and the progression of MPEs. Some precautions in the surgical interventions particularly in MPEs with defined radiological features can improve functional outcomes and reduce the progression risk.

Objective: Oral pathological lesions in the mouth vary greatly. However, few studies have evaluated these lesions with long-term data. This study aimed to analyze the demographic parameters (i.e., age, gender, anatomical location, and incidence) of oral pathologies in the Aegean Region. Materials and Methods: In this retrospective study, histopathological reports of 30 years in the Department of Oral Pathology, Faculty of Dentistry, Ege University, were analyzed. Data on sex, age, lesion location, and histopathologic diagnosis were analyzed. Results: The histopathological data of 6,330 patients were evaluated. Most of the pathological oral lesions were osseous lesions (n=3,858), and 2,472 soft tissue pathologies were identified. The posterior mandible was the most common location of these lesions (n=2,011). Conclusion: Determining the variety and frequency of oral pathological lesions at a societal level is important for the management of these lesions.

The safety and efficacy of elective drug-coated balloon (DCB) angioplasty for unrestrictive de novo coronary stenosis in daily practice is not fully understood, especially in comparison to those of drug-eluting stents (DESs).A total of 588 consecutive de novo coronary stenotic lesions electively and successfully treated with either DCB (n=275) or DESs (n=313) between January 2016 and December 2019 at our medical center were included. The primary safety endpoint was the incidence of target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization. The secondary angiographic efficacy endpoint was angiographic restenosis frequency, defined as a follow-up percent diameter stenosis of50. The endpoints were compared after baseline adjustment using propensity score matching. In addition, the frequency and predictors of late lumen enlargement (LLE), defined as minus late luminal loss, were examined in 201 crude angiographic follow-up lesions after DCB angioplasty.A total of 31 baseline parameters were adjusted to analyze 177 lesions in each group. The TLF frequencies (DCB group: 9.6% during a mean observational interval of 789±488 days vs. DES group: 10.2%, 846±484 days, p=0.202) and cumulative TLF-free ratios of both groups were not significantly different (p=0.892, log-rank test). The angiographic restenosis frequency in the DCB group (6.3%, n=128) was not significantly different from that of the DES group (10.1%, n=100, p=0.593). LLE was observed in 45.3% of entire lesions, and a type-A dissection was a significant predictor of LLE among 23 variables (odds ratio: 3.02, 95% CI: 1.31-6.95, p=0.010).The present single-center retrospective study revealed statistically equivalent midterm clinical safety and angiographic efficacy among both elective DCB angioplasty and DESs placements in the treatment of unrestrictive de novo coronary lesions. In our daily practice environment, LLE was achieved in approximately half after DCB angioplasty.

Radiation-induced mucositis in head and neck cancer patients generates difficulties in eating and swallowing, and may influence treatment tolerance, compliance, and quality of life. However, predictive factors have not been studied in detail. Thus, the aim of this study was to describe the association between pre-radiotherapy clinical factors and the incidence of severe radiation-induced mucositis in nasopharyngeal or oropharyngeal cancer patients. This retrospective study included all patients with definitive radiotherapy or chemoradiotherapy for nasopharyngeal or oropharyngeal cancer between July 2011 and June 2021 in a single center. The eligibility criteria included patients who received oral management during radiotherapy. Exclusion criteria was patients who received postoperative radiotherapy. The data were acquired from the medical records of patients. One hundred patients were included in this retrospective study. Grade 3 radiation-induced mucositis occurred in 47 patients (47%). Lymphocyte count was significantly associated with grade 3 mucositis (OR = 0.40; 95% CI = 0.19–0.86; p = 0.018). It is suggested that pre-radiation lower lymphocyte counts are a predictive risk factor for severe mucositis in patients who undergo definitive radiotherapy or chemoradiotherapy for nasopharyngeal or oropharyngeal cancer

The prognosis of the Chiari malformation type 1 (CM1) demonstrates a variant spectrum that varies from full recovery to complicated worse neurological disability.To investigate the factors affecting the outcomes of conservative and surgical treatment for CM1 by evaluating adult patients consecutively managed at our institutions.We retrospectively reviewed the medical records of patients diagnosed with CM1 at two reference neurosurgical centers for eight years (2010-2017). We selected all CM1 adult patients who managed conservatively or surgically as the core sample for this study. For clinical evaluation, we used a Chicago Chiari Outcome Scale (CCOS). For radiological assessment, we adopted both craniocervical and contrast-phase MRIs. We investigate factors such as age, sex, pretreatment symptoms, symptoms duration, and radiological findings in both groups.Ninety patients were treated conservatively. After a progression, five of them were treated surgically later and included in a total of 72 patients who underwent decompressive surgery. We successfully managed 85 patients (94.4%) of the conservative group and 64 patients (88.9%) of the surgical group. We found that patients with aqueductal stroke volume (ASV) of 12 µl are surgical candidates. We observed a strong positive correlation between clinical improvement and the increase in ASV values.ASV≤12 µl is a significant predictor for surgical intervention. The presence of heavy sleep apnea or/and functional symptoms, tonsillar herniation13.4 mm on coronal images, low ASV, long symptom durations, and a syrinx are the independent prognostic factors that affected outcomes negatively.

Background There have been several reports about the prognosis of teeth adjacent to edentulous spaces for implant-supported fixed prostheses (ISFPs) and removable partial dentures (RPDs). However, there are few reports about the prognosis of the other remaining teeth comparing ISFPs with RPDs. Purpose The aim of this study was to evaluate and compare the prognosis of the remaining teeth for ISFPs and RPDs in terms of survival and complication-free rates. Methods Subjects were partially edentulous patients with ISFPs or RPDs inserted in 2003-2016. Teeth adjacent to edentulous spaces (A-teeth), teeth not adjacent to edentulous spaces (R-teeth), and teeth opposing edentulous spaces (O-teeth) were investigated. The endpoints were tooth extraction and complications. A multivariate cox regression model was used to estimate the risk factors for survival of the investigated teeth. Results A total of 233 (ISFP: 89, RPD: 144) patients were included in the statistical analyses. An IFSP prosthesis, when compared to an RPD prosthesis did not significantly decrease the tooth loss rate for A-teeth (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.30-1.92), for R-teeth (HR: 0.54; 95% CI: 0.28-1.05), or for O-teeth (HR: 0.45; 95% CI: 0.10-2.09). Conclusions In partially edentulous spaces, the difference between ISFPs and RPDs does not affect the prognosis of teeth adjacent to edentulous spaces, teeth not adjacent to edentulous spaces, and teeth opposing edentulous spaces. Namely, our findings suggest that it depends largely on the tooth type, jaw, endodontic therapy performed, not on the type of prostheses.

PURPOSE: The aim of this study was to investigate the prevalence of long bone fractures among cats, presented at the Small Animal Clinic, Faculty of Veterinary Medicine, Trakia University, a center that attracts cases from all over Bulgaria, and to analyze their seasonal, breed-, sex- and age-related distribution. METHODS: The study cohort comprised 267 cats with long bone fractures. All patients were analyzed retrospectively for a period of five years (2016 to 2020). Data about cat signalment (breed, sex, age, body weight) and fractured bone were evaluated. RESULTS: The cases with fractured femur were statistically significantly (p=0.0001) more prevalent (n=139; 52.06%) than those of all other affected long bones. Long bone fracture tended to occur most commonly in male (54.68%), than female (45.32%) cats. Statistically significantly (p

Background Point-of-care (POC) MRI is a bedside imaging technology with fewer than five units in clinical use in the United States and a paucity of scientific studies on clinical applications. Purpose To evaluate the clinical and operational impacts of deploying POC MRI in emergency department (ED) and intensive care unit (ICU) patient settings for bedside neuroimaging, including the turnaround time. Materials and Methods In this preliminary retrospective study, all patients in the ED and ICU at a single academic medical center who underwent noncontrast brain MRI from January 2021 to June 2021 were investigated to determine the number of patients who underwent bedside POC MRI. Turnaround time, examination limitations, relevant findings, and potential CT and fixed MRI findings were recorded for patients who underwent POC MRI. Descriptive statistics were used to describe clinical variables. The Mann-Whitney

BACKGROUND The resistance rate to antibacterial drugs is the key inhibitor of Helicobacter pylori (H. pylori) eradication treatment. AIM To evaluate the prevalence and drug resistance of H. pylori based on big data. METHODS Gastric mucosal specimens were collected from naive patients undergoing upper gastrointestinal endoscopy for H. pylori culture and antimicrobial susceptibility testing (AST), including clarithromycin, levofloxacin, metronidazole and amoxicillin. Every 10 years of age was grouped as an age group. The H. pylori infection and resistance were explored based on the age group and gender. RESULTS The number of H. pylori-positive specimen was 94509 in 283823 gastric mucosal specimens, with an infection rate of 33.30%. The infection rate increased with age, and males had a higher infection rate than females. The average resistance rate of H. pylori to amoxicillin and metronidazole was 0.21% and 93.72%, which remained stable. The average resistance rate to clarithromycin was 23.99% with an increasing trend from 14.43% to 38.24%. The average resistance rate to levofloxacin was 30.29%, which increased from 17.07% to 39.42% and mostly stabilized after 2017. The resistance rate of H. pylori increased with age, except amoxicillin. H. pylori in females are at higher risk of resistance to metronidazole, but not to amoxicillin, regardless of the age group. Meanwhile, H. pylori in females are at higher risk of resistance to levofloxacin and clarithromycin in the 21-50 age group. The single, dual, triple and quadruple-drug resistance rate was 54.59%, 29.03%, 11.71% and 0.11%, respectively. CONCLUSION The resistance of H. pylori in Taizhou city is serious. Guided by the consensus report, individualized treatment based on AST is recommended.

Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. The World Health Organization (WHO) estimated that approximately 2.5 billion people living in dengue-endemic countries. Objective: To assess the various factors in pediatric to severe dengue infection-A Retrospective study. Methods: A hospital-based Retrospective study was conducted at Emergency, Observation and Referral Unit, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from January to June 2021. Number of patients included in the study was 52. In children with high degree clinical suspicion of Dengue infection NS 1 antigen (who came within first 48 hours of fever) and/or Dengue Antibody IgM, IgG (who came after five days of fever) were performed. Results: The study was enrolled 102 patients of suspected dengue fever of whom 52 (50.98%) were serologically confirmed to have dengue infection. 29 (55.8%) patients were males and 23 (44.2%) were females. 38 (37.25%) patients had classic dengue fever while 12 (11.76%) fulfilled the criteria of dengue hemorrhagic fever. Of those patients with dengue hemorrhagic fever, 6 patients had developed dengue shock syndrome. Most of dengue cases occurred during the month of June to September depicts the role of rainy season on clustering of cases. Maximum number of cases 52 cases (68.49%) was in the children age groups. All cases and is the most common symptom followed by headache, myalgia, vomiting etc. Hemorrhagic manifestations were seen that included petechiae, ecchymosis, gum bleeding, hematuria, malena, hematemesis and epistaxis. Most common complications were hepatic dysfunction, renal failure, multi organ failure, encephalopathy and ARDS. Conclusion: Dengue is one amongst the key causes of dedifferentiated fever. It presents as an extremely broad wellness and is hardly recognized as a clinical entity by primary health care physicians. This study support additional studies on applying intervention measures to boost the diagnostic accuracy and exactness at the first tending level in dandy fever endemic regions.

BACKGROUND: Neonatal hypoglycemia is one of the most common causes of admission to neonatal intensive care unit requiring intravenous dextrose therapy. Administration of IV dextrose and transfer to the NICU may interfere with parent-infant bonding, breastfeeding, and has financial implications. OBJECTIVE: Retrospective study to evaluate the effect of dextrose gel supplementation for asymptomatic hypoglycemia in reducing NICU admissions and intravenous dextrose therapy. METHOD: A retrospective study conducted for eight months each before and after introduction of dextrose gel in the management of asymptomatic neonatal hypoglycemia. Asymptomatic hypoglycemic infants were given only feeds in pre dextrose gel period and dextrose gel along with feeds in the dextrose gel period. Rates of admission to NICU and the need of IV dextrose therapy were evaluated. RESULTS: High risk characteristics (Prematurity, Large for Gestational Age, small for Gestational Age, Infants of diabetic mother etc.) were equally distributed among both the cohorts. Primary outcome results showed significant reduction in NICU admissions from 396/1801(22%) to 329/1783 (18.5%) (odds ratio, 95% CI 1.24(1.05-1.46, p 0.008). There was significant reduction in IV dextrose therapy requirement from 277/1405 (15.4%) to 182/1454 (10.2%) (odds ratio, 95% CI 1.59(1.31- 1.95, p

Background: Some special consensus recommended the duration of perioperative antibiotic prophylaxis was within 24 hours postoperatively in breast cancer undergoing postmastectomy implant breast reconstruction. However, surgeons in practice favored to prolong the duration. The aim of this study was to estimate the effects of duration of antibiotics on major adverse outcomes in real clinical practice setting with diverse population using overlap weighting model. Methods: In this retrospective study, patients with breast cancer undergoing breast implant reconstructions were collected in Fudan University Shanghai Cancer Center from 1 January 2008 to 31 December 2021. Cases were divided into two groups according to the duration of perioperative antibiotic prophylaxis: short-term group (≤ 24 hours) and long-term group (>24 and≤48 hours). The primary outcomes were unplanned reoperations and complication-related unplanned reoperations. Unplanned reoperation was defined as debridement, expander removal without prosthesis implantation, expander removal and expander implantation, prosthesis removal and prosthesis implantation, prosthesis removal, prosthesis removal and expander implantation. By reviewing the patients’ detailed medical history, all unplanned reoperations were divided into non-complication-related unplanned reoperations and complication-related unplanned reoperations. Non-complication-related unplanned reoperations included: patients voluntarily gave up continuing reconstruction, suspected recurrence of cancer, changed reconstruction methods, unsatisfactory appearance, and unknown reasons. Complication-related unplanned reoperations included: infection, exposure of prosthesis or expander, poor wound healing, rupture of expander, necrosis of skin flap, bleeding. The secondary outcomes were infections that required intervention. It was defined as both met with white blood cells elevation and physician antibiotic prescription during outpatient follow-up. To adjust confounders, propensity score overlap weighting was used, and subgroup analysis and sensitive test were conducted to demonstrate the robustness of results. A P value less than 0.05 was considered statistically significant. Results: In 4367 cases of unilateral implant reconstructions, 4128 (95%) were included in this study. Among them, 1689 were expander implantation, 1124 were prosthesis implantation and 1315 were expander removal and prosthetic implantation. At inclusion, only 283 cases (6.9%) received antibiotics prophylaxis ≤24 hours, 3090 cases (74.9%) with duration >24 and≤48 hours, and 755 cases (18.3%) with duration >48 hours. Of them, 230 cases (5.6%) underwent unplanned reoperation, including 131 (3.2%) complication-related unplanned reoperations, and 99 (2.4%) non-complication-related unplanned reoperations. And there were 110 cases (2.7%) with infections that required intervention. In unweighted or weighted data set, short-term antibiotic use did not significantly increase the risk of adverse outcomes, including unplanned reoperation, complication-related unplanned reoperation, and infection required intervention, compared with long-term antibiotic use with or without patients with duration more than 48 hours. Most subgroup analysis showed no evidence of heterogeneity of the effects of duration of antibiotic use on adverse outcomes. Conclusion: In clinical setting with diverse population, prolong antibiotic prophylaxis with more than 24 hours is not necessary to reduce major adverse outcomes, even in some critical conditions. Appropriating and accessible prophylactic initiatives should be developed and implemented with shorten the duration of antibiotic prophylaxis and minimized adverse outcomes. Key words: perioperative antibiotic prophylaxis, breast cancer, postmastectomy implant reconstruction, unplanned reoperation Citation Format: Zeqing Li, Jiajian Chen, Shuang Hao, A-Yong Cao, Xiaoyan Huang, Zhiming Shao, Jiong Wu. Effects of different duration of prophylactic antibiotic use on unplanned reoperation in breast cancer patients undergoing implant-based breast reconstruction: A retrospective study with overlap weighting analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-07-02.

Background: Asian women have relatively small breast sizes compared to European American women, so the latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction in Chinese patients with breast tumor. To explore the current status of LDF with or without implants (IMP) breast reconstruction in China, we conducted this study. Methods: This study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction in Fudan University Shanghai Cancer Center (FUSCC) from 2000 to 2019. The basic clinicopathological information, the timing and type of reconstruction, postoperative hospitalization time and serious complications requiring surgical intervention were analyzed. Continuous variables were expressed as mean values or median values, while categorical variables were expressed as frequencies. Data were analyzed by using Chi-square and Kruskal-Wallis tests. All P values reported were two-sided and were calculated at a significance level of 0.05. Results: A total of 2868 patients who underwent breast reconstruction for breast tumor were analyzed in this study, 785 (27.4%) patients used LDF for breast reconstruction, and 397 (13.8%) patients underwent autologous breast reconstruction utilizing abdominal flap. The number of breast reconstruction patients and the diversity of reconstruction procedures were increasing year by year. Breast reconstructions utilizing LDF have decreased as a percentage of breast reconstructions, but have increased in number in the past few years. Among patients with LDF breast reconstruction, the majority (97.3%) underwent immediate reconstruction, 11 patients underwent delay reconstruction, and 10 patients underwent immediate-delay reconstruction. 448 patients underwent expanded LDF breast reconstruction, and 337 (42.9%) patients underwent LDF combined with IMP breast reconstruction. 13 patients underwent restoration of reconstructed breast with LDF, 12 of which were changed to LDF±IMP reconstruction due to unsatisfactory outcome of expander reconstruction or failed implant reconstruction, and one patient was changed to LDF reconstruction from failed abdominal flap reconstruction. In terms of pathological type, 629 (80.1%) patients had invasive carcinoma, 129 (16.4%) had carcinoma in situ, 18 (2.3%) patients had phyllodes tumor and 9 (1.1%) patients had other malignancies. The median reconstruction age of the patients was 37 years old, the mean BMI was 21.76kg/cm2, and the mean postoperative length of stay was 11.13 days. There were no significant differences in postoperative hospitalization time, reconstruction age, BMI, pT, ER, PR, HER2, Ki67, and radiotherapy between patients with expanded LDF and LDF combined with IMP breast reconstruction. Patients with neoadjuvant therapy (P=0.045), phyllodes tumors or other malignant tumors (P=0.023), and those with more metastatic lymph nodes (P=0.031) were tent to expanded latissimus dorsi flap reconstruction. Serious complications requiring surgical intervention occurred in 13 patients (1.65%), including 7 patients who underwent surgical debridement or scar repair due to wound infection and poor healing, and 3 patients who removed the implant due to implant infection. The reconstructed latissimus dorsi flaps necrosis occurred in 3 patients, and the reconstructed breasts were removed in these patients. There was no significant difference in the incidence of serious complications requiring surgical intervention between patients with expanded LDF and those with LDF combined with implant reconstruction, P=0.79. Conclusions: LDF±IMP breast reconstruction is a mature breast reconstruction procedure in our center with high safety. Whether combined with implant reconstruction did not affect the postoperative hospitalization time and the incidence of serious complications. Citation Format: Shuyue Zheng, Jiajian Chen, Shuang Hao, Benlong Yang, Xiaoyan Huang, Guangyu Liu, Jiong Wu. Current status of latissimus dorsi flaps with or without implants for breast reconstruction in patients with breast tumor: A single-center retrospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-15-07.

Background: About 60% of breast cancers (BCs) traditionally categorized as HER2 negative (HER2-neg; immunohistochemistry [IHC] 0, IHC 1+ or IHC 2+/in situ hybridization [ISH]–) express low levels of HER2 (HER2-low; IHC 1+ or IHC 2+/ISH–; Schettini, NPJ Breast Cancer 2021). In the phase 3 DESTINY-Breast04 trial (NCT03734029), trastuzumab deruxtecan (T-DXd) showed significantly longer progression-free survival and overall survival (OS) vs physician’s choice of chemotherapy in patients (pts) with HER2-low metastatic BC (mBC) who previously received chemotherapy (Modi, NEJM 2022). As HER2-low becomes a clinically relevant HER2 status among pts with BC, greater understanding of pts with HER2-low disease is needed, including identification of these pts using conventional IHC assays. Our objectives were to assess the prevalence of HER2-low among HER2-neg mBC based on rescored HER2 IHC slides, to describe characteristics of pts with HER2-low mBC, and to characterize concordance between historical HER2 scores and rescores. Methods: This global, multicenter, retrospective study (NCT04807595) included pts with confirmed HER2-neg (HER2 IHC 0, 1+, or 2+/ISH−) unresectable/mBC diagnosed from 2014 through 2017. HER2 IHC-stained slides were rescored after training on low-end expression scoring using Ventana 4B5 and other assays by local laboratories at 13 sites in 10 countries blinded to historical HER2 scores. BCs were categorized as HER2-low (IHC 1+ or IHC 2+/ISH−) or HER2 IHC 0 (IHC 0 or >0< 1+). Prevalence of HER2-low and concordance between historical HER2 scores and rescores were assessed. Demographics, clinicopathological characteristics, treatment patterns, and outcomes were examined via data from medical charts/health records. Results: HER2 rescores were obtained for 781 pts with HER2-neg mBC. HER2-low prevalence was 67.1% overall; 71.1% in hormone receptor (HR)–positive (HR+) and 52.5% in HR–negative (HR−) subgroups. There were no notable differences in characteristics (Table) or treatment patterns between pts with HER2-low and HER2 IHC 0. The most frequent therapies used in the first treatment in the metastatic setting were endocrine therapy (64.1%) for pts with HR+ mBC and chemotherapy (94.4%) for pts with HR− mBC. Among pts with HR+ mBC, 10.2% received cyclin-dependent kinase 4/6 inhibitors as part of their first treatment. There were no statistically significant differences in clinical outcomes between the HER2-low and HER2 IHC 0 groups within each HR subgroup. For pts with HR+ mBC, median time to first subsequent treatment was 10 and 8 months for the HER2-low and HER2 IHC 0 groups, respectively. Overall, concordance was 81.2% (kappa=0.582). Concordance between historical HER2 scores and rescores was 87.3% for HER2-low and 70.1% for HER2 IHC 0 samples. Conclusions: The prevalence of HER2-low (67.1%) among pts previously categorized as HER2-neg mBC in this study was similar to that of an earlier study (≈60%). No obvious differences in patient characteristics or clinical presentation were seen between pts with HER2-low and HER2 IHC 0 mBC. Overall percentage agreement between rescored and historical HER2 scores was 81.2%; agreement was numerically greater for HER2-low than HER2 IHC 0. As HER2-targeted therapies such as T-DXd for the treatment of pts with HER2-low BC are emerging, a greater understanding of pts with HER2-low expression who may benefit from these therapies is important. Citation Format: Giuseppe Viale, Mark Basik, Naoki Niikura, Eriko Tokunaga, Sara Brucker, Frédérique Penault-Llorca, Naoki Hayashi, Joo Hyuk Sohn, Rita Teixeira de Sousa, Adam M. Brufsky, Ciara S. O’Brien, Fernando Schmitt, Gavin Higgins, Della Varghese, Gareth D. James, Akira Moh, Andrew Livingston, Victoria de Giorgio-Miller. HER2-15 Retrospective Study to Estimate the Prevalence and Describe the Clinicopathological Characteristics, Treatment Patterns, and Outcomes of HER2-Low Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr HER2-15.

BACKGROUND Acute kidney injury (AKI) is one of the most common acute pancreatitis (AP)-associated complications that has a significant effect on AP, but the factors affecting the AP patients’ survival rate remains unclear. AIM To assess the influences of AKI on the survival rate in AP patients. METHODS A total of 139 AP patients were included in this retrospective study. Patients were divided into AKI group (n = 72) and non-AKI group (n = 67) according to the occurrence of AKI. Data were collected from medical records of hospitalized patients. Then, these data were compared between the two groups and further analysis was performed. RESULTS AKI is more likely to occur in male AP patients (P = 0.009). AP patients in AKI group exhibited a significantly higher acute physiologic assessment and chronic health evaluation II score, higher Sequential Organ Failure Assessment score, lower Glasgow Coma Scale score, and higher demand for mechanical ventilation, infusion of vasopressors, and renal replacement therapy than AP patients in non-AKI group (P < 0.01, P < 0.01, P = 0.01, P = 0.001, P < 0.01, P < 0.01, respectively). Significant differences were noted in dose of norepinephrine and adrenaline, duration of mechanical ventilation, maximum and mean values of intra-peritoneal pressure (IPP), maximum and mean values of procalcitonin, maximum and mean serum levels of creatinine, minimum platelet count, and length of hospitalization. Among AP patients with AKI, the survival rate of surgical intensive care unit and in-hospital were only 23% and 21% of the corresponding rates in AP patients without AKI, respectively. The factors that influenced the AP patients’ survival rate included body mass index (BMI), mean values of IPP, minimum platelet count, and hospital day, of which mean values of IPP showed the greatest impact. CONCLUSION AP patients with AKI had a lower survival rate and worse relevant clinical outcomes than AP patients without AKI, which necessitates further attention to AP patients with AKI in surgical intensive care unit.

Purpose This study aims to evaluate clinical efficiency and side effects of combined therapy of traditional Chinese medicine in female treating chronic pelvic pain. Methods A retrospective study was conducted by analyzing 179 patients with chronic pelvic pain. They were divided into the 3-course group and the 1-course group. Patients in the 3-course group received combined therapy of traditional Chinese medicine 10 days per menstrual cycle for three months, while the 1-course group received the same combined therapy for only one menstrual cycle. VAS scores of five kinds of pain were compared between the two groups. Meanwhile, SF-36 scores, menstruation, leucorrhea and major accompanying symptoms were analyzed. To assess side effects of the combined therapy, safety indices were recorded before and after treatment as well. Results VAS scores of patients in the 3-course group after treatment were significantly lower than that before the treatment. Total scores of SF-36 were significantly improved after the treatment, and persistently improved even after the discontinuation of the treatment. The menstrual and leucorrhea condition improved as well after the treatment. In addition, among the concomitant symptoms, insomnia, loss of appetite, mental fatigue symptoms were significantly improved after the treatment. More importantly, significances were observed in the improvement of most VAS scores between patients who underwent a 1-course treatment and patients with a 3-course treatment. Meanwhile, no significant change was observed in safety indices before and after treatment. Possible adverse events related to the treatment plan for all enrolled patients included mild skin rash in 16 patients, stomachache in 3 patients after taking medicine on an empty stomach, and oral ulcer in 1 patient. Conclusion Combined therapy of traditional Chinese medicine alleviated symptoms of chronic pelvic pain, soothed the accompanying symptoms, and hence helped to improve the life quality of women.

Background: COVID-19 is newly emerging infectious disease that spread globally at unpredictable and unique pattern to the extent that the World Health Organization announced COVID-19 as a pandemic in the first couple months of 2020. This study aims to describe clinical and demographic features of COVID-19 patients and the influence of various risk factors on the severity of disease. Methods: This research is a retrospective study based on Saudi Arabia's ministry of health's Covid-19 data. The analysis relies on data of all COVID-19 patients recorded in Riyadh between 1st, March 2020 and 30th, July 2020. Statistical analyses were performed to investigate the effect of demographic characteristic, clinical presentation, and comorbidities on infection severity. Results: A total number of 1026 COVID-19 patients were identified based on the demographic data as follows: 709 cases (69% of cases) were males and 559 cases (54% of cases) were Saudi. Most of patients were diagnosed with mild signs and symptoms 697 (68% of cases), while 164 patient (16% of cases) demonstrated moderate signs and symptoms, and 103 cases (10%) were severe and 62 (6%) had critical febrile illness. Fever, cough, sore throat, and shortness of breath were the most common symptoms among patients with COVID-19. Among studied comorbidities in COVID-19 patients, diabetes mellitus and hypertension were the most prevalent. The results from the bivariate logistic regression analysis revealed that older age, diabetes mellitus, asthma, smoking, and fever are associated with severe or critically ill cases. Conclusion: The findings of this study show that old age, fever, and comorbidities involving diabetes mellitus, asthma, and smoking were significantly associated with infection severity. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

To retrospectively analyze local and systemic factors that resulted in the short-term tooth loss of teeth that were previously assigned a favorable prognosis in patients who were seen and treated over an observational five-year period. This retrospective study included the records of patients who had a minimum of two dental exams at least twelve months apart over a 5-year period. This study investigated extracted teeth with an initially favorable periodontal prognosis that were then divided into one of four categories based on the reason for extraction: caries, periodontal disease, endodontic reasons, or fracture. Patient- and tooth-related factors associated with the extracted teeth were recorded: crown-to-root ratio, initial pocket depth, initial periodontal diagnosis, maintenance interval, presence of existing restoration, furcation involvement, and systemic conditions. Data analysis was performed using a linear mixed model. A total of 50 patients with 111 teeth met the inclusion criteria for this study. A higher odds ratio (OR) for tooth loss due to caries, endodontic reasons, and fracture were found in teeth with a history of root canal treatment with an OR of 3.61, 3.86, and 2.52, respectively. For tooth loss due to periodontal disease, higher ORs were found in patients who were on anti-depressants (OR = 4.28) and patients who had an initial diagnosis of Stage III/IV periodontitis (OR = 2.66). In addition, teeth with initial probing depths ≥5 mm (OR = 4.32) and with furcation involvement (OR = 1.93) showed a higher OR for tooth loss due to periodontal disease. Within the limitations of this study, previously root-canal-treated teeth present a higher OR for early loss due to caries, recurrent endodontic lesions, or fracture. In addition, patients with anti-depressant medication use, sporadic maintenance, initial probing depths ≥5 mm, and furcation involvement represent a significantly higher OR of tooth loss due to periodontal disease even for initially favorable teeth.

The aims of this study were (1) to evaluate the transparotid facial nerve dissection approach (TFND), in which the intraparotid cervicofacial or temporofacial division is identified first through a superficial lobe incision; and (2) to compare extracapsular dissection with a TFND (ECD-TFND) with partial superficial parotidectomy with a retrograde approach (PSP) for benign tumours in the tail of the parotid gland with respect to surgical outcomes. Eighty-nine patients underwent PSP or ECD-TFND for benign tumours in the tail of the parotid gland: 49 were treated surgically with PSP and 40 with ECD-TFND. The mean ( ± standard deviation) surgical time did not differ significantly between the groups: 64 ± 22.4 min for PSP and 59 ± 19.8 min for ECD-TFND (P = 0.302). There was a significant difference in sialocele: 18 (36.7%) patients in the PSP group and four (10%) in the ECD-TFND group (P = 0.002). There was also a significant difference in facial nerve injuries: temporary paralysis was observed in 13 (26.5%) patients in the PSP group and two (5%) in the ECD-TFND group (P = 0.007). It appears that TFND is a viable and safe approach when performing ECD for benign tumours in the tail of the parotid gland. ECD-TFND should be preferred over PSP for benign tumours in the tail of the parotid gland.

Single-shot spinal diamorphine is becoming common practice in urological surgery to aid post-operative pain; however, its safety and efficacy require investigation. This study is a retrospective analysis of 113 laparoscopic or robotic-assisted nephrectomies over 4 years under one consultant urologist. Data were collected on demographic, pre-operative scores, anaesthesia, surgical information, post-operative outcomes and opioid consumption. Two main groups were established: no spinal diamorphine (NSD) and spinal diamorphine (SD). Four subgroups were then created, separating those who received patient-controlled anaesthesia (PCA) or not: Group 1 [general anaesthetic (GA)]; Group 2 [GA and PCA]; Group 3 [GA and spinal diamorphine] and Group 4 [GA, spinal diamorphine and PCA]. Ninety-eight eligible patients were identified. At 6 hours, pain scores were significantly higher for all non-spinal groups ( p < 0.05); at 9 h, pain scores were significantly higher in NSD patients compared to SD ( p = 0.026); at 12 h, pain scores were significantly higher for NSD patients compared to SD ( p = 0.024), and Group 1 compared to Group 3 ( p = 0.023). Total opioid consumption in the first 24 h post-surgery was higher in Group 1 compared to Group 3 ( p = 0.024). There was no higher incidence of urinary retention, or any neurological complications reported within the SD patients. The study found a reduction in post-operative pain scores with the use of spinal diamorphine prior to laparoscopic and robotic-assisted nephrectomies. The findings may also suggest that pre-operative spinal diamorphine use can reduce the total volume of opioids administered via other routes in the first 24 h post-operatively. It recommends its routine administration but encourages prospective investigation.