Global Microsurgery Team Web conferencing SeriesBridging the Knowledge Space during the COVID19 Widespread

Aims The aim of this study was to investigate clinical outcomes of patients at high risk of restenosis after implantation of bioresorbable vascular scaffold (BVS). check details Methods and results The COMPARE-ABSORB trial was an investigator-initiated, prospective randomized study. Patients at high risk of restenosis were randomly assigned to receive either BVS or everolimus-eluting stent (EES). A dedicated implantation technique was recommended for BVS. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) or clinically-indicated target lesion revascularization at 1 year. The enrolment was discontinued prematurely because of a high thrombosis and TVMI rate in the BVS arm. A total of 1,670 patients were recruited (BVS 848 patients and EES 822 patients). TLF occurred in 43 patients (5.1 %) of the BVS group and 34 patients (4.2%) of the EES group (absolute difference 0.9%, 95% confidence interval (CI) -1.2%-3.0%, P non-inferiority less then 0.001). Definite or probable device thrombosis (2.0% vs. 0.6%, hazard ratio 3.32, 95% CI 1.22 to 8.99, P=0.012) and TVMI (4.0% vs. 2.1%, hazard ratio 1.96, 95% CI 1.10 to 3.51, P=0.02) were significantly higher in the BVS group than the EES group. Conclusions In patients at high risk of restenosis, non-inferiority of BVS compared with EES in terms of TLF was met at 1 year. BVS carried a higher risk of device thrombosis and TVMI than EES.Aims Several left atrial appendage (LAA) closure systems are available and due to differences in device design results of specific occluders derived from trials cannot be simply generalized to all devices. The present analysis sought to assess two contemporary LAA closure devices in clinical practice. Methods and results The work represents a non-randomized sub-analysis of the prospective, multicenter, Left-Atrium-Appendage Occluder Register - GErmany (LAARGE) registry. The WATCHMAN (group 1) and the Amplatzer Cardiac Plug (ACP) or Amulet occluder (group 2) were assessed. A total of 641 patients at 38 centers were enrolled. Of them, 278 (43%) and 340 (53%) patients received the WATCHMAN and ACP/Amulet occluder, respectively. High technical success was achieved with a slight difference between the groups (96% in group 1 vs. 99% in group 2; p=0.007). Procedural safety did not differ (98% in group 1 vs. 97% in group 2; p=0.55). The Kaplan Meier estimated 1-year composite of death or stroke was 12.0% and 12.9%, respectively (p=0.79). Conclusions Both the WATCHMAN and the ACP/Amulet occluder provide excellent procedural results with comparable implantation success and no differences with respect to procedural safety and long-term effectiveness.The aim of this descriptive and correlational study was to determine the relationship between nursing students' moral sensitivity and attitudes towards medical errors. The study sample consisted of 309 fourth graders of the school of nursing of a university. Data were collected using a Descriptive characteristics form, the Moral Sensitivity Questionnaire (MSQ) and the Medical Errors Attitude Scale (MEAS). Participants had a mean MSQ and MEAS score of 91.31 ± 21.29 and 3.77 ± 0.44, respectively. There was a negative correlation between MEAS and MSQ scores, indicating that the higher the moral sensitivity, the higher the participants' awareness of medical errors and error reporting. It is, therefore, recommended that students be offered moral education based on different teaching methods to help them develop positive attitudes towards medical errors.Increasing evidence points to endothelial cell dysfunction as a key pathophysiological factor in severe coronavirus disease-19 (COVID-19), manifested by platelet aggregation, microthrombi and altered vasomotor tone. This may be driven by direct endothelial cell entry by the virus, or indirectly by activated inflammatory cascade. Major risk groups identified for adverse outcomes in COVID-19 are diabetes, and those from the Black, Asian and ethnic minority (BAME) populations. Hyperglycaemia (expressed as glycated haemoglobin or mean hospital glucose) correlates with worse outcomes in COVID-19. It is not known whether hyperglycaemia is causative or is a surrogate marker - persistent hyperglycaemia is well known as an aetiological agent in microangiopathy. In this article, we propose that pre-existing endothelial dysfunction of microangiopathy, more commonly evident in diabetes and BAME groups, makes an individual vulnerable to the subsequent 'endothelitis' of COVID-19 infection.The role of neoadjuvant chemotherapy in variant histology bladder cancers has yet to be validated in randomized control trials. Several case series have reported experience with NAC in the setting of variant histology. PATIENT SUMMARY We reviewed outcomes for patients with variant histology muscle-invasive bladder cancer who received chemotherapy before cystectomy. Outcomes varied significantly in the current literature. The best outcomes are associated with neoadjuvant chemotherapy (NAC) for small cell variants, while there is potential benefit with the use of NAC for squamous cell and adenocarcinoma variants.Background A new generation of risk calculators (RCs) for prostate cancer (PCa) incorporating magnetic resonance imaging (MRI) data have been introduced. However, these have not been validated externally, and their clinical benefit compared with alternative approaches remains unclear. Objective To assess previously published PCa RCs incorporating MRI data, and compare their performance with traditional RCs (European Randomized Study of Screening for Prostate Cancer [ERSPC] 3/4 and Prostate Biopsy Collaborative Group [PBCG]) and the blood-based Stockholm3 test. Design, setting, and participants RCs were tested in a prospective multicenter cohort including 532 men aged 45-74 yr participating in the Stockholm3-MRI study between 2016 and 2017. Outcome measurements and statistical analysis The probabilities of detection of clinically significant PCa (csPCa) defined as Gleason score ≥3 + 4 were calculated for each patient. For each RC and the Stockholm3 test, discrimination was assessed by area under the curve (AUC), calibration by numerical and graphical summaries, and clinical usefulness by decision curve analysis (DCA).