Differences In Terms Of Outcomes Research Articles

Pityriasis Rubra Pilaris: A Multicentric Case Series of 65 Spanish Patients

IntroductionPRP is a rare entity of unknown etiopathogenesis. Lack of management guidelines makes it a challenge for clinicians. ObjectiveTo add our experience to increase evidence about PRP. MethodsWe performed a retrospective, descriptive and multicentric study of 65 patients with PRP, being the largest European case series of patients with PRP. ResultsPRP was more frequent in male patients with an average age of 51 years, but erythrodermic forms presented in older patients (average age 61 years).Six (75%) paediatric patients and ten (60%) non-erythrodermic adults controlled their disease with topical corticosteroids. On the contrary, 26 (68%) erythrodermic patients required biologic therapy as last and effective therapy line requiring an average of 6.5 months to achieve complete response. ConclusionOur study showed a statistical difference in terms of outcome and response to treatment between children or patients with limited disease and patients who develop erythroderma.

Temporal trends of blood eosinophilia in severe uncontrolled CRSwNP treated with dupilumab: a real-life study.

Induced eosinophilia is commonly related to dupilumab treatment. We analysed the temporal trends of blood eosinophilia in patients with severe uncontrolled CRSwNP during the first year of treatment with dupilumab in real-life setting to evaluate its correlation with outcomes of response and adverse events (AEs). Seventy-four patients with severe uncontrolled CRSwNP treated with dupilumab at our institution were enrolled. At each visit, we evaluated AEC, outcomes of response to treatment and AEs. A significant increase in AEC was observed since the first month with a peak at 3 months; at 12 months, the values returned comparable to those at baseline. A ≥ 50% increase of the baseline AEC with a value greater than 500 cells/mm3 was documented in 38/74 patients (Group A) regardless of the time of observation, whereas in 36/74 patients (Group B), no changes were observed. Analysing the blood eosinophilia trend over time in group A, we observed a temporary eosinophilia with early onset (within 6 months), persistent eosinophilia with early onset, and eosinophilia with late onset. No differences in terms of outcomes of response to treatment or AEs were found between Group A and Group B, or between patients who developed an AEC ≥ 1500 cells/mm3 or not. In our series, we observed that an increase in AEC with different temporal trends may be observed in CRSwNP patients during the first year of treatment with dupilumab. In our series, eosinophilia is not correlated with a negative outcome of response to treatment or a risk of AEs.

Clinical Characteristics, Risk Factor and Outcome of Brain Abscess: A Retrospective Analysis During a 10-year Period

Background: This study aimed to collect and analyze the information of patients diagnosed with primary brain abscess at our hospital over the last 10 years to determine the predisposing risk factors, clinical characteristics, and predictors of outcome.Methods: The retrospective study evaluated hospital records and radiology data of patients diagnosed with and treated for brain abscess in our hospital from 2013 to 2022. A total of 25 patients were included in this study. Clinical characteristics of patients diagnosed with brain abscess were identified, and the surgical group and the non-surgical group were compared and the risk factors for poor prognosis were investigated. In addition, the excision and aspiration groups were compared among patients who underwent surgical treatment.Results: Seventeen patients (68%) underwent surgery, and the remaining eight patients (32%) underwent conservative treatment. Of the 17 patients who underwent surgery, nine patients (52.94%) underwent stereotactic drainage, and eight (47.05%) underwent craniotomy, and excision. At discharge, nine patients (36%) had poor outcomes (modified Rankin Scale score 3-6), including one (5.88%) who died, and the remaining 16 (68%) had good outcomes (mRS score 0-2).Conclusions: The most common comorbidity in the patients with brain abscess was diabetes mellitus, and Gram-positive Staphylococcus was the most common pathogen. Headache and confusion are also associated with poor outcomes. In addition, aspiration and excision had no significant differences in terms of outcomes

Impact of COVID-19 on incidence, clinical presentation, and prognosis of acute chest syndrome in patients with sickle cell disease.

Acute chest syndrome (ACS) is a frequent complication of sickle cell disease (SCD). Because coronavirus disease 2019 (COVID-19) increases mortality and morbidity in many diseases, we retrospectively analyzed the impact of SARS-CoV-2 infection on the incidence, the clinical presentation, and the prognosis of ACS in patients with SCD by comparing ACS episode before and during COVID-19 pandemic. Ninety-nine episodes of ACS were registered over 24 months before pandemic versus 81 episodes over 24 months during the pandemic period. The number of ACS episodes varies among children regarding the two period of time: 26 episodes (26%) for the pre-pandemic period versus 11 episodes (13%) for the pandemic period (p=0.03). Comparisons between adults and children showed a higher incidence of initial VOC (45%vs. 24%; p=0.04) in adults, and a higher incidence of initial pneumonia (35%vs. 15%; p=0.01) and documented infection (35%vs. 7%; p<0.001) in children. One patient died during the pandemic period but without any relationship with ACS or COVID-19. During this pandemic period, 13 episodes of ACS (16%) were found related to coronavirus infection. These ACS episodes did not show any significant differences in terms of outcome when compared to the other ACS episodes observed during this period. Overall, coronavirus infection did not demonstrate a negative impact on incidence, clinical presentation, and outcome of ACS in patients with SCD. Early management, chronic treatment with HU, and exchange transfusions could likely explain the low morbidity and mortality rates.

CLinicopathological characteristics of extranodal marginal zone B‐cell lymphoma of the intestine: a single center analysis

Extranodal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT-lymphoma) is mot commonly diagnosed in the stomach (30%–35%), but is exceedingly rare in the intestinal tract (2%). Consequently, data on this special subgroup are scarce. Out of 484 patients with MALt-lymphoma diagnosed and treated at our institution from 1999 to 2020, 42 (11%) had intestinal involvement (24 primary and 18 secondary) and were restrospectively analyzed. Out of 18 patients rated as secondary intestinal invlevement, 14 patients had gastric MALT-lymphoma as the primary origin. Median age at diagnosis was 67 years (interquartile range (IQR) 53–72) and the median follow-up time was 47 months (IQR 32–102). Patients presenting with lymphoma-associated symptoms were significantly more common in the group of primary versus secondary intestinal MALT lymphomas (52% vs. 20%, p = .047). Nine patients each, i.e. 9/18 secondary and 9/24 primary intestinal MALT lymphomas were found positive for Helicobacter pylori. Intestinal organs involved included the colon (n = 19), duodenum (n = 11), small intestine (n = 8) and rectum (n = 5). MALT-IPI could be calculated for 39 patients, with low MALT-IPI documented in 37/39 cases. Seven patients were found to be positive for translocation t(11;18)(q21;q21), 6 of whom had primary gastric MALT lymphoma, suggesting the presence of the translocation as highly suggestive for secondary involvement. Treatment data were available in 41 our of those 42 patients. Eleven patients (27%) received local therapy (ten surgery, and one radiotherapy, complete response rate 90%), 16 (38%) systemic therapy (overall response rate 87%) and 9 (22%) had only antibiotic therapy (complete response rate 38%). in 4/41 patients, only watchfuil waiting was applied. Eighteen patients progressed during follow-up; the median progression free survival following first line therapy was 50 mos (CI: 38.4–53.7 mos), with anumerical trend towards longer PFS in primary (134 mos) versus secondary MALT lmyphoma (35.5 mos). The estimated overall survival was 301 months, with 6 patients having died during follow up (two from lymphoma progression, the other 4 from unrelated conditions). A comparison in terms of PFS and Os with the cohort of 144 patients with gastric MALT-lmyphoma showed no significant difference in terms of outcome. Overall, patients with intestinal MALT-lymphoma appear to have a good prognosis irrespcetive of primary or secondary involvement, whichbappears to be comparable to our data obtined in gastric MALT-lymphoma. Keyword: Extranodal non-Hodgkin lymphoma No conflicts of interests pertinent to the abstract.

Management and Outcomes of Hip Fractures in Lower Limb Amputees: A Case Series.

Hip fractures in amputees pose a significant challenge for the orthopedic surgeon due to technical difficulties and there is no standardisation in their management. Their treatment is consequently left to the surgeon's ingenuity. The aim of this study is to describe the clinical characteristics and outcome of a series of hip fractures in lower limb amputees. A total of 12 patients and 15 hip fractures in lower limb amputees were included. Amputations below the malleoli and prosthetic surgery due to osteoarthritis constitute the exclusion criteria. Demographic, amputation-related and fracture data as well as radiological, functional, and clinical outcomes were collected through the patients' medical records. Age at fracture and at amputation were different depending on the cause of amputation. Most patients (10/12) were male. Seven patients had an infracondylar amputation and five patients had a supracondylar amputation. Ten hip fractures were on the same side of the amputation, three were contralateral and one was bilateral. Pertrochanteric (6/15) and subcapital (5/15) were the main types observed. Different traction methods and surgical procedures were used. We observed no significant differences in terms of outcome regardless of the fracture, traction method, and surgical management. No complications related to surgery or during follow-up were found. Mortality at one year postoperatively was absent. Provided an experienced orthopaedic surgeon, a pre-operative assessment, a comprehensive surgical planning, and a multidisciplinary rehabilitation strategy are present; a satisfactory outcome is to be expected.

Characteristics of COVID-19 vaccinated and unvaccinated patients admitted to Careggi University Hospital, Florence, Italy

More than 11.5 billion COVID-19 vaccine doses have been administered around the world. Although vaccine effectiveness for severe infections is reported to be 89.0%, breakthrough infections are common and may lead to severe outcome in fragile population. We conducted a real-world observational study on 420 COVID-19 admitted patients from July 2021 to January 2022 in a tertiary level Italian hospital. We collected patient’s vaccination and SARS-CoV-2 serological status, SARS-CoV-2 treatments, oxygen supports, intensive (ICU) and subintensive (sub-ICU) care unit admissions, length of staying (LoS) and in-hospital mortality. One-hundred-seventy-two vaccinated and 248 unvaccinated patients were admitted during the study period. Vaccinated group (Vg) had a significantly more elevated Charlson Comorbidity Index than Unvaccinated group (UVg), and no statistical differences were found in terms of in-hospital mortality, LoS or ICU and sub-ICU admissions. Among Vg, anti-S antibodies were detected in 86.18% of patients (seropositives). Vaccinated seronegative patients’ in-hospital mortality was significantly higher than vaccinated seropositive patients (33.33% vs 10.69%, p = 0.0055): in particular, mortality rate in 45–69 years old population was higher in vaccinated seronegative group, and comparable in patients ≥ 70 years old. No differences in terms of outcome were registered between Vg and UVg, taking into account that Vg was considerably older and with more comorbidities. In line with other recent observations, higher mortality rate was evidenced for seronegative vaccinated patients. Primary prophylaxis and early treatments result to be necessary, especially for older and immunosuppressed populations.

Comparison of Preprint Postings of Randomized Clinical Trials on COVID-19 and Corresponding Published Journal Articles

Randomized clinical trials (RCTs) on COVID-19 are increasingly being posted as preprints before publication in a scientific, peer-reviewed journal. To assess time to journal publication for COVID-19 RCT preprints and to compare differences between pairs of preprints and corresponding journal articles. This systematic review used a meta-epidemiologic approach to conduct a literature search using the World Health Organization COVID-19 database and Embase to identify preprints published between January 1 and December 31, 2021. This review included RCTs with human participants and research questions regarding the treatment or prevention of COVID-19. For each preprint, a literature search was done to locate the corresponding journal article. Two independent reviewers read the full text, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 tool. Time to publication was analyzed using a Cox proportional hazards regression model. Differences between preprint and journal article pairs in terms of outcomes, analyses, results, or conclusions were described. Statistical analysis was performed on October 17, 2022. This study included 152 preprints. As of October 1, 2022, 119 of 152 preprints (78.3%) had been published in journals. The median time to publication was 186 days (range, 17-407 days). In a multivariable model, larger sample size and low risk of bias were associated with journal publication. With a sample size of less than 200 as the reference, sample sizes of 201 to 1000 and greater than 1000 had hazard ratios (HRs) of 1.23 (95% CI, 0.80-1.91) and 2.19 (95% CI, 1.36-3.53) for publication, respectively. With high risk of bias as the reference, medium-risk articles with some concerns for bias had an HR of 1.77 (95% CI, 1.02-3.09); those with a low risk of bias had an HR of 3.01 (95% CI, 1.71-5.30). Of the 119 published preprints, there were differences in terms of outcomes, analyses, results, or conclusions in 65 studies (54.6%). The main conclusion in the preprint contradicted the conclusion in the journal article for 2 studies (1.7%). These findings suggest that there is a substantial time lag from preprint posting to journal publication. Preprints with smaller sample sizes and high risk of bias were less likely to be published. Finally, although differences in terms of outcomes, analyses, results, or conclusions were observed for preprint and journal article pairs in most studies, the main conclusion remained consistent for the majority of studies.

The impact of transcatheter edge-to-edge repair on right ventricle-pulmonary artery coupling in patients with functional mitral regurgitation.

The impact of transcatheter edge-to-edge repair on right ventricle-pulmonary artery coupling in patients with functional mitral regurgitation.

Interaction of sex and diabetes in Asian patients with heart failure with mildly reduced left ventricular ejection fraction

The impact of sex and diabetes mellitus (DM) on patients with heart failure with mildly reduced ejection fraction (HFmrEF) is not well elucidated. This study aims to evaluate sex differences in the clinical profile and outcomes in Asian HFmrEF patients with and without DM. Patients admitted nationally for HFmrEF (ejection fraction 40-49%) between 2008 and 2014 were included and followed up until December 2016. The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular (CV) death and/or heart failure (HF) rehospitalisations. A total of 2,272 HFmrEF patients (56% male) were included. More women had DM than men (60% versus 55%, P=0.013). Regardless of DM status, HFmrEF females were older, less likely to smoke, had less coronary artery disease, narrower QRS and lower haemoglobin compared to men. The odds of having DM decreases in smokers who are women as opposed to men (Pinteraction =0.017). In multivariate analysis, DM reached statistical analysis for all-cause mortality and combined CV mortality or HF rehospitalisation in both men and women. However, the results suggest that there may be sex differences in terms of outcomes. DM (vs non-DM) was less strongly associated with increased all-cause mortality (adjusted hazards ratio [adj HR] 1.234 vs adj HR 1.290, Pinteraction <0.001] but more strongly associated with the combined CV death/HF rehospitalisation (adj HR 1.429 vs adj HR 1.317, Pinteraction =0.027) in women (vs men). Asian women with HFmrEF had a higher prevalence of DM, with differences in clinical characteristics, compared to men. While diabetes conferred poor outcomes regardless of sex, there were distinct sex differences. These highlight the need for sex-specific management strategies.

Association of pre-ESRD care education with patient outcomes in a 10-year longitudinal study of patients with CKD stages 3\u20135 in Taiwan

There is little comprehensive education for people with end-stage renal disease (ESRD) progress. We investigated the differences in terms of outcomes between patients with CKD stages 3–5 who enrolled and did not enroll in the pre-ESRD care education in Taiwan. This retrospective cohort study was conducted using data from the National Health Insurance Research Database (NHIRD). All patients diagnosed with CKD stages 3–5 who received the pre-ESRD care education through the pay for performance (P4P) program were enrolled. Based on whether or not they participated in the program, they were categorized into P4P or non-P4P groups. All analyses were performed from January 2006 through December 2015. Study outcomes were risk of hemodialysis dependency, hospitalization, and all-cause mortality. In this study of 29,337 patients, those with CKD stages 3–5 in the P4P group had lower events of hemodialysis, hospitalization, and all-cause mortality compared to patients in the non-P4P group. This study suggested that pre-ESRD care education is associated with increased patient outcomes, resulting in lower hemodialysis and hospitalization events and a higher overall survival rate in patients with CKD stages 3–5. Patient education could raise opportunities to improve pre-ESRD care by reaching patients outside the traditional health care setting.

CD34 and CD105 Microvessels in Resected Bone Specimen May Implicate Wound Healing in MRONJ.

Clinical treatment outcome of MRONJ (medication-related osteonecrosis of the jaw) surgery despite radical osseous removal and primary closure healing still shows differences in terms of outcome and disease recurrence. The study aims to assess the rate of angiogenesis of MRONJ lesions in order to understand the impact of angiogenesis and neoangiogenesis status on MRONJ surgical treatment outcome. This is the first study correlating microvessel density with prognosis in MRONJ surgically-treated patients. The immunohistochemical expression of CD34 and CD105 in MRONJ specimens obtained from surgically-treated patients was evaluated. The most vascularized areas detected by CD34 and CD105 were selected and the microvessel density value of the samples was registered. Samples were retrospectively divided according to the clinical outcome of MRONJ surgical treatment, dividing patients into two groups, “healed” and “not healed”. Statistical analysis was performed to assess if neovessels could influence treatment outcome in patients undergoing radical surgery. In the examined cohort, this value was highly predictive of better treatment outcome after radical surgery of MRONJ. Understanding of angiogenesis-dependent factors deserves further attention as a future target for MRONJ prevention and therapies.

No Racial Disparity in Outcome Measures After Endovascular Treatment for Stroke in the Elderly.

Despite the lower rates of good outcomes and higher mortality in elderly patients, age does not modify the treatment effect of mechanical thrombectomy for large vessel occlusion strokes. We aimed to study whether racial background influences the outcome after mechanical thrombectomy in the elderly population. We reviewed a prospectively maintained database of patients with acute ischemic stroke treated with mechanical thrombectomy from October 2010 through June 2020 to identify all consecutive patients with age ≥80 years and anterior circulation large vessel occlusion strokes. The patients were categorized according to their race as Black and White. Univariable and multivariable analyses were performed to define the predictors of 90-day modified Rankin Scale and mortality in the overall population and in each race separately. Among 2241 mechanical thrombectomy, a total of 344 patients (median [interquartile range]; age 85 [82-88] years, baseline National Institutes of Health Stroke Scale score of 19 [15-23], Alberta Stroke Program Early CT Score 9 [7-9], 69.5% females) were eligible for the analysis. White patients (n=251; 73%) had significantly lower median body mass index (25.37 versus 26.89, P=0.04) and less frequent hypertension (78.9% versus 90.3%, P=0.01) but more atrial fibrillation (64.5% versus 44.1%, P=0.001) compared with African Americans (n=93; 27%). Other clinical, imaging, and procedural characteristics were comparable between groups. The rates of symptomatic intracerebral hemorrhage, 90-day modified Rankin Scale score of 0 to 2, and mortality were comparable among both groups. On multivariable analysis, race was neither a predictor of 90-day modified Rankin Scale score of 0 to 2 (White race: odds ratio, 0.899 [95% CI, 0.409-1.974], P=0.79) nor 90-day mortality (White race: odds ratio, 1.368; [95% CI, 0.715-2.618], P=0.34). In elderly patients undergoing mechanical thrombectomy for acute ischemic stroke, there was no racial difference in terms of outcome.

Long-term outcome of left atrial appendage occlusion with multiple devices

BackgroundTo evaluate long-term efficacy of left atrial appendage occlusion with multiple devices. MethodsAll consecutive patients who underwent left atrial appendage occlusion (LAAO) with a follow-up of at least 4 years, were included in this single center, retrospective registry. No specific exclusion criteria were applied. LAA occlusion was performed with the Watchman, Watchman FLX, Amplatzer Cardiac plug or Amplatzer Amulet occluder devices. ResultsA total of 224 consecutive patients underwent LAAO occlusion. Mean age was 72.5 ± 9.0 years. A history of stroke was present in 29%, TIA in 8.5% and a previous episode of bleeding in 64.7% of patients. In 63% there was a contraindication to oral anticoagulants. The average CHADS-VASc was 4.0 ± 1.6 and the average HAS-BLED was 3.4 ± 1.3. There was a reduction of strokes of 72.9%, thromboembolic events of 59.7% and major bleeding events of 70.9% compared to historic data. During follow-up, 48.3% of the ischemic and major bleeding events occurred within the first year. The annual mortality rate of 7.5 deaths/ 100 patients years. There were no significant differences in terms of outcome between the devices used and there were no late events associated with any device. The main antithrombotic regimen in the long term was with single antiplatelet therapy and the second one was no therapy. ConclusionLAAO is a safe and effective procedure, that reduces ischemic and bleeding events in the long-term, regardless of the type of device used, in AF patients at high risk of ischemic stroke and major bleeding, without the need of anticoagulation.

Comparison of Standard Percutaneous Nephrolithotomy with Mini-Percutaneous Nephrolithotomy for Removal of Renal Stones in Adults

Renal stones are the third most common problem affecting about 10% of global population. The management of nephrolithiasis has undergone a complete transformation since the 1980s. Percutaneous nephrolithotomy (PCNL) has established itself an effective and safe technique that delivers high stone-free rate as well as overall shorter treatment time. We aim to compare the outcome of mini-PCNL with standard-PCNL in patients presenting with renal stones. In all, 90 patients fulfilled the selection criteria and randomized into two groups. Group A underwent mini-PCNL whereas Group B underwent standard-PCNL. Pre-operative hemoglobin level was recorded. Duration of procedure as well as drop in hemoglobin level was also recorded. A kidney, ureter, and bladder (KUB) X-ray was performed to confirm the presence of of stone and stone-free status. The mean age of patients in mini-PCNL group was 43.11 years and in standard-PCNL group, it was 36.91 years. The mean stone size in patients of mini-PCNL group was 29.53 mm and 31.58 mm in standard-PCNL group. The mean duration of renal stone in mini-PCNL group was 1.91 years and that in standard-PCNL group 1.80 years. The mean operative time in mini-PCNL group was 59.56 min and 61.22 min in standard-PCNL group. The mean fall in hemoglobin in mini-PCNL group was 0.38 g/dL and that in standard-PCNL group 0.51 g/dL. In mini-PCNL group, stone clearance was observed in 42 (93.3%) patients, while in standard-PCNL group, it was observed in 45 (100%) patients. This difference was insignificant (P &gt; 0.05). Mini-PCNL and standard-PCNL have no significant differences in terms of outcome, operative time, and stone clearance, although fall in hemoglobin level was less in mini-PCNL group, which showed less blood loss in this group, thereby making it a more appropriate method for renal stone removal.

Clinical evaluation after matrix-associated autologous chondrocyte transplantation : a comparison of four different graft types.

AimsThe aim of this retrospective study was to determine if there are differences in short-term clinical outcomes among four different types of matrix-associated autologous chondrocyte transplantation (MACT).MethodsA total of 88 patients (mean age 34 years (SD 10.03), mean BMI 25 kg/m2 (SD 3.51)) with full-thickness chondral lesions of the tibiofemoral joint who underwent MACT were included in this study. Clinical examinations were performed preoperatively and 24 months after transplantation. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) Subjective Knee Form, the Brittberg score, the Tegner Activity Scale, and the visual analogue scale (VAS) for pain. The Kruskal-Wallis test by ranks was used to compare the clinical scores of the different transplant types.ResultsThe mean defect size of the tibiofemoral joint compartment was 4.28 cm2 (SD 1.70). In total, 11 patients (12.6%) underwent transplantation with Chondro-Gide (matrix-associated autologous chondrocyte implantation (MACI)), 40 patients (46.0%) with Hyalograft C (HYAFF), 21 patients (24.1%) with Cartilage Regeneration System (CaReS), and 15 patients (17.2%) with NOVOCART 3D. The mean IKDC Subjective Knee Form score improved from 35.71 (SD 6.44) preoperatively to 75.26 (SD 18.36) after 24 months postoperatively in the Hyalograft group, from 35.94 (SD 10.29) to 71.57 (SD 16.31) in the Chondro-Gide (MACI) group, from 37.06 (SD 5.42) to 71.49 (SD 6.76) in the NOVOCART 3D group, and from 45.05 (SD 15.83) to 70.33 (SD 19.65) in the CaReS group. Similar improvements were observed in the VAS and Brittberg scores.ConclusionTwo years postoperatively, there were no significant differences in terms of outcomes. Our data demonstrated that MACT, regardless of the implants used, resulted in good clinical improvement two years after transplantation for localized tibiofemoral defects.Cite this article: Bone Joint Res 2021;10(7):370–379.

Transconjunctival and Subciliary Approach in the Treatment of Orbital Fractures: A Study on Oculoplastic Complication.

(1) Background: The aim of the present study was to compare lower eyelid post-operative complications, such as ectropion, entropion, and scleral show of orbital floor fractures, associated to the subciliary vs transconjunctival approaches. (2) Materials and Methods: A retrospective comparative study of patients who underwent surgery for orbital fractures by means of a transconjunctival or a subciliary approach at the Clinic of Dentistry and Maxillofacial Surgery of the University of Verona from January 2013 through September 2018 was designed. Data related to the trauma and to surgical procedures were retrieved, as well as a series of anthropometric parameters extrapolated from standardized photographs. Statistical analysis was performed on the outcomes. (3) Results: 33 patients underwent surgery by means of a transconjunctival approach and 36 patients by means of a subciliary approach. Ectropion was observed to a greater extent in the subciliary group, however the difference resulted to be not statistically significant. Patients in which osteosynthesis devices were used presented with a greater incidence of scleral show with respect to the remaining patients. No statistically significant difference was observed for any of the parameters taken into account. (4) Conclusions: Since the two approaches does not seem to be associated with remarkable differences in terms of outcomes, the choice of technique should be tailored to the patient’s features and the surgeon’s experience.

Comparison of functional outcome and complications in Gartland’s Type III fracture Supracondylar Humerus in paediatric population by different pinning technique

Background: Fracture Supracondylar humerus is one among common fracture in children betweenage 5-7 years. Boys are frequently affected than girls. Extension variety is more common. Theconventional approach to treat fracture supracondylar humerus (Type III) is a close reduction withpercutaneous fixation. There have been controversies as to which surgical technique should be used,cross pinning or two-wire lateral pinning. This study aims to find which method of pinning is mostappropriate to fix fracture supracondylar humerus. Method and material: A Retrospectivecomparative study was designed to analyze the outcome of the cross pinning and lateral pinningmethod. A total of 60 patients were included in the study. They were divided into two groups of 30each. Group A comprised of fixation by cross pinning method. Group B comprised of fixation by two-wire lateral pinning method. Results of both groups were analysed about Flynn’s criteria andcomplications. Result: The mean age in Group A was 5.1 years and in Group B was 4.8 years. Onepatient was lost to follow up in Group A. On the final follow up, there was statistically no differencein terms of outcome according to Flynn’s criteria in both groups. According to Flynn’s criteria&gt;95%of patients had a satisfactory outcome in both groups. Among Group A, there were 2 cases ofiatrogenic ulnar nerve praxis whereas in group B there was one case of pin loosening. Conclusion:On comparing both techniques there was no significant difference in the outcome. However, there isa slight increase in the chances of iatrogenic ulnar nerve injury in the cross pinning method.

CD5-Positive Marginal Zone Lymphoma: Clinical Characteristics of the MSKCC Cohort, and Comparison with the CD5-Negative Population

CD5-Positive Marginal Zone Lymphoma: Clinical Characteristics of the MSKCC Cohort, and Comparison with the CD5-Negative Population

Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center.

Background/AimsBile leak is a common complication of cholecystectomy, and it is also observed in other conditions such as ruptured liver abscess, hydatid cyst, and trauma. Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line management for such conditions. However, studies on the outcomes of endoscopic management for bile leaks with etiologies other than post-cholecystectomy injury are extremely limited. MethodsWe conducted a retrospective review of patients with symptomatic bile leak who were referred to a tertiary care center and who underwent ERCP between April 2016 and April 2019. The primary outcome was complete symptomatic resolution without extravasation of the contrast medium during the second ERCP conducted after 6 weeks. ResultsIn total, 71 patients presented with symptomatic bile leak. The etiologies of bile leak were post-cholecystectomy injury in 34 (47.8%), liver abscess in 20 (28.1%), and post-hydatid cyst surgery in 11 (15.4%) patients. All patients were managed with ERCP, sphincterotomy, and stent placement for 6 weeks, except for one who underwent surgery. The primary outcome was achieved in 65 (91.5%) of 71 patients. There was no significant difference in terms of outcome in relation to the interval between the diagnosis of bile leak and ERCP. ConclusionsMost patients with bile leak can be successfully managed with ERCP even when performed on an elective basis.