Articles: outcome.
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Multicenter Study
Intestinal Autotransplantation for Locally Advanced or Locally Recurrent Colon Cancer Invading SMA.
To examine the outcomes of intestinal autotransplantation (IATx) in patients with locally advanced (LACC) or locally recurrent (LRCC) colon cancer invading the superior mesenteric artery (SMA). ⋯ Extended resection for LACC or LRCC invading SMA can be performed safely and is associated with prolonged survival.
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Cerebral ventriculitis remains a challenging neurosurgical condition because of poor outcomes including mortality rates of nearly 80% and a prolonged course of treatment in survivors. Despite current conventional management, outcomes in some cases remain unsatisfactory, with no definitive therapeutic guidelines. This feasibility study aims to explore the use of a novel active, continuous irrigation and drainage system (IRRA flow [IRRAS AB]) combined with intraventricular drug delivery for patients with cerebral ventriculitis. ⋯ The use of active irrigation with drainage for continuous delivery of intraventricular irrigation fluid with antibiotics led to dramatically low mortality. In our case series, it led to a marked improvement in neurological status, imaging findings, and cerebrospinal fluid profiles, making it a technically feasible and safe treatment for ventriculitis.
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Randomized Controlled Trial Multicenter Study
Colchicine in Acute Myocardial Infarction.
Inflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of cardiovascular events. ⋯ Among patients who had myocardial infarction, treatment with colchicine, when started soon after myocardial infarction and continued for a median of 3 years, did not reduce the incidence of the composite primary outcome (death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization). (Funded by the Canadian Institutes of Health Research and others; CLEAR ClinicalTrials.gov number, NCT03048825.).
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Multicenter Study
Graduated Autonomy of Laparoscopic Liver Resection Based on Liver Resection Complexity: A Western and Eastern Bi-Institution Study for Learning Curve.
Laparoscopic liver resection (LLR) requires a high degree of expertise in both hepatobiliary and minimally invasive surgery. Our group previously reportwed a 3-level LLR complexity classification based on intrapostoperative outcomes: grade I (low), grade II (intermediate), and grade III (high). We evaluated the learning curve effect in each complexity grade to assess the experience needed for a surgeon to safely progress through the grades. ⋯ A gradual progression in LLR per complexity grade as follow: 40 cases of low grade I procedures before starting intermediate complexity grade II procedures, and 30 cases of intermediate complexity grade II procedures before starting high complexity grade III procedures may ensure a safe implementation of high complexity LLR procedures.
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Multicenter Study Observational Study
Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.
To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs. ⋯ A prospective, multicenter, and multidisciplinary TEE registry was successfully implemented, and demonstrated that focused TEE is safe and clinically impactful across multiple critical care applications. Further studies from this research network will accelerate the development of outcome-oriented research and knowledge translation on the use of TEE in emergency and critical care settings.