Articles: cations.
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Randomized Controlled Trial Multicenter Study Comparative Study
Early Closure of a Temporary Ileostomy in Patients With Rectal Cancer: A Multicenter Randomized Controlled Trial.
The objective was to study morbidity and mortality associated with early closure (8-13 days) of a temporary stoma compared with standard procedure (closure after > 12 weeks) after rectal resection for cancer. ⋯ It is safe to close a temporary ileostomy 8 to 13 days after rectal resection and anastomosis for rectal cancer in selected patients without clinical or radiological signs of anastomotic leakage.
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Randomized Controlled Trial
Safety and immunogenicity of the tau vaccine AADvac1 in patients with Alzheimer's disease: a randomised, double-blind, placebo-controlled, phase 1 trial.
Neurofibrillary pathology composed of tau protein is a main correlate of cognitive impairment in patients with Alzheimer's disease. Immunotherapy targeting pathological tau proteins is therefore a promising strategy for disease-modifying treatment of Alzheimer's disease. We have developed an active vaccine, AADvac1, against pathological tau proteins and assessed it in a phase 1 trial. ⋯ AXON Neuroscience SE.
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Flexion-distraction injuries (FDI) represent 5% to 15% of traumatic thoracolumbar fractures. Treatment depends on the extent of ligamentous involvement: osseous/Magerl type B2 injuries can be managed conservatively, while ligamentous/Magerl type B1 injuries undergo stabilization with arthrodesis. Minimally invasive surgery without arthrodesis can achieve similar outcomes to open procedures. This has been studied for burst fractures; however, its role in FDI is unclear. ⋯ Percutaneous instrumentation without arthrodesis represents a low-risk intermediate between conservative management and open instrumented fusion. This “internal bracing” can be used in osseous and ligamentous FDIs. Neurologically intact patients who do not require decompression and those that may not tolerate or fail conservative management may be candidates. The current level of evidence cannot provide official recommendations and future studies are required to investigate long-term safety and efficacy.
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Randomized Controlled Trial
Gender-Based Differences in Surgical Residents' Perceptions of Patient Safety, Continuity of Care and Well-Being: An Analysis from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.
Little is known about gender differences in residency training experiences and whether duty hour policies affect these differences. Using data from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial, we examined gender differences in surgical resident perceptions of patient safety, education, health and well-being, and job satisfaction, and assessed whether duty hour policies affected gender differences. ⋯ Gender differences exist in perceptions of surgical residency. These differences vary across cohorts and can be influenced by duty hour policies.
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The accuracy of intraoperative diffusion tensor imaging (DTI)–based tractography of the corticospinal tract (CST) is crucial for its use in neurosurgical planning and its implementation in image-guided surgery. To the best of our knowledge, this is the largest prospective correlative study of the intraoperative DTI tractography of the CST and intraoperative direct electrical subcortical stimulation (DESS) of the CST, with application of intraoperative magnetic resonance imaging (iMR). ⋯ CST visualization in the iMRI setting appears to have a high sensitivity in accurately localizing the area of the CST adjacent to the resection cavity in glioma surgery. More prospective studies with a large sample size are needed to further support the results.