Articles: cations.
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: Three-dimensional (3D) bioprinting is a revolutionary technology in building living tissues and organs with precise anatomic control and cellular composition. Despite the great progress in bioprinting research, there has yet to be any clinical translation due to current limitations in building human-scale constructs, which are vascularized and readily implantable. ⋯ A detailed discussion is made on the technical barriers in the fabrication of scalable constructs that are vascularized, autologous, functional, implantable, cost-effective, and ethically feasible. Clinical considerations for implantable bioprinted tissues are further expounded toward the correction of end-stage organ dysfunction and composite tissue deficits.
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To explore the role of pancreatic ductal adenocarcinoma (PDAC) size on surgical and survival outcomes. ⋯ Among the tumors measured, 21.5% were <20 mm and 78.5% >20 mm. Larger tumors were associated with higher Ca19.9, T3-T4 and N1, higher grade, perineural invasion, R1 resections, more positive lymph nodes, and higher lymph node ratios (P < 0.05). Tumours <20 mm showed a better prognosis (33 vs 23 months; P < 0.01), but worse surgical results with higher pancreatic fistula (21.1% vs 14.6%; P < 0.01) and mortality rates (1.5% vs 0.3%; P = 0.04). PDAC size was associated with worse prognosis (hazard ratio 1.26, P = 0.02), together with Ca19.9, grading, and N1. When measured at imaging, tumor size was underestimated (median 23 vs 30 mm; P < 0.01) and did not influence prognosis CONCLUSIONS:: PDAC size >20 mm, measured at gross pathology, correlates with surgical outcomes and is an independent predictor of poor prognosis. Given that imaging underestimates size by about 20%, perhaps tumors that measure >20 mm at imaging should be considered for neoadjuvant treatment regardless of resectability.
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To evaluate the use of the new absorbable polymer scaffold poly-4-hydroxybutyrate (P4HB) in complex abdominal wall reconstruction. ⋯ In our early clinical experience with the absorbable polymer matrix scaffold P4HB, it seemed to provide superior clinical performance and value-based benefit compared with porcine cadaveric biologic mesh.
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To examine the relationship between hospital outcomes and expenditures in patients undergoing bariatric surgery in the United States. ⋯ Medicare payments for bariatric surgery are significantly lower at hospitals with low complication rates. These findings suggest that efforts to improve bariatric surgical quality may ultimately help reduce costs. Additionally, these cost savings may be most prominent amongst the patients at the highest risk for complications.
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Melanoma is the most common malignancy encountered during pregnancy. Conflicting data have led to ongoing confusion regarding pregnancy-associated melanoma (PAM) in the media and among the public. The objective of this study was to better characterize both the clinical presentation of PAM and its prognostic implications. ⋯ We observed no difference in DFS, OS, or MSS between the 2 groups. Pregnant patients should be screened for melanoma in a similar manner to nonpregnant patients and should be counseled that their survival is not adversely affected by their pregnancy.